When Patients Customize Nursing Home Ratings, Choices And Rankings Differ From The Government’s Version

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VOL. 35| NO. 4April 2016Patients’ & Consumers’ Use Of Evidence

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• From The Editor-In-Chief
• DataGraphic: Using Evidence
• Understanding Public Views
• Need For Engagement
• Shared Decision-Making
• Neglected Discussions About Cost
• Aids To Select High-Quality Plans
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When Patients Customize Nursing Home Ratings, Choices And Rankings Differ From The Government’s Version

1. Dana B. Mukamel1,*, 
2. Alpesh Amin2, 
3. David L. Weimer3, 
4. Joseph Sharit4,
5. Heather Ladd5 and 
6. Dara H. Sorkin6

+Author Affiliations

1. ¹Dana B. Mukamel (dmukamel@uci.edu) is a professor in the Department of Medicine at the University of California, Irvine.
2. ²Alpesh Amin is a chair and professor in the Department of Medicine as well as executive director of the Hospitalist Program at the University of California, Irvine.
3. ³David L. Weimer is a professor at the La Follette School of Public Affairs, University of Wisconsin–Madison.
4. ⁴Joseph Sharit is a research professor in the Department of Industrial Engineering at the University of Miami, in Coral Gables, Florida.
5. ⁵Heather Ladd is a senior statistician in the Department of Medicine at the University of California, Irvine.
6. ⁶Dara H. Sorkin is an associate professor in the Department of Medicine at the University of California, Irvine.

1. ↵*Corresponding author

Abstract

Report cards currently published by the Centers for Medicare and Medicaid Services (CMS) offer composite (summary) quality measures based on a five-star ratings system, such as the one featured on the Nursing Home Compare website. These ratings are “one size fits all patients” measures. Nursing Home Compare Plus is an alternative that allows patients and their families to create their own composite scores based on their own preferences and medical needs. We present data from 146 patients who were discharged from the hospital to nursing homes who used Nursing Home Compare Plus. We found that the individual patient-constructed composites differed from CMS’s five-star ratings composite. Patients differed from each other and from CMS in the number of performance measures they chose to include in their composite and in their weighting of each performance measure. When comparing Nursing Home Compare Plus to Medicare’s five-star ratings, we found only minimal agreement on ranking of nursing homes. We conclude that patients might benefit if current report cards are modified to include an option for personalized ranking.

• Precision Medicine
 
• Quality Report Cards
 
• Patient Centered Care
• Decision Making
 
• Personalized Patient Referrals