Overview of the 2007 Survey

The Maryland Health Care Commission conducted a survey in 2007 to measure the experience and satisfaction of family members and other designated responsible parties of residents in Maryland’s nursing homes.

The purposes of the survey are to provide: 1) measures of experience and satisfaction with various aspects of life and care; 2) comparisons on experience and satisfaction measures between nursing homes in Maryland; and 3) comparisons between nursing home peer groups, defined as nursing homes in the same geographic region, nursing homes of similar size, and for-profit or non-profit.

Note: there were four size categories: eighty or fewer residents, 81-120 residents, 121-160 residents, and more than 160 residents.

A total of 224 nursing homes throughout Maryland participated in the 2007 survey. Responsible parties of residents who resided in the nursing home for at least 90 days were eligible to participate. A responsible party is most often a family member, a spouse or a child, but also can be non-relative such as a friend. It is important to remember responsible parties of residents with a stay less than 90 days were not asked to participate in the survey, therefore, the experience and satisfaction of the responsible parties of people who need short-term skilled nursing care or rehabilitation following an acute hospital stay are not captured by the results of this survey. There were several nursing facilities that had only short stay residents; therefore, no results are reported for those facilities.

Nursing homes with a sufficient response rate received a report that presents results specific to that facility with comparisons to statewide and peer averages. The results can serve as a management tool for use by nursing home staff by identifying areas where an individual nursing home excels or areas where improvement is needed.

How the Survey was Conducted

All nursing homes in Maryland that had one or more residents with stays of 90 days or longer were included in the initial sample. The nursing homes provided a list of designated responsible parties for each resident. A survey packet was mailed on September 17, 2007 to each designated responsible party whose resident met the eligibility criteria. One week later a follow up reminder postcard was sent and a second survey packet was mailed to those who did not respond initially. Phone calls to responsible parties who did not return the second mailed survey were made to get a maximum response from as many facilities as possible. Surveys with responses that were returned from September 17, 2007 to November 19, 2007 were included in the results.

The survey instrument used in this project was specifically designed for responsible parties and not for the residents themselves. Designated responsible parties completed the survey about their experience and satisfaction with the facility and the care provided to residents. The survey contained 58 items in all: 46 items which assessed seven domains or aspects of residents' life and care, three (3) items which assessed overall satisfaction and nine items which asked information about the resident, responsible party relationship to the resident, and visitation patterns:

The seven domains rated by respondents are:

• Staff and Administration of the Nursing Home
• Care Provided to Residents
• Assistance During Mealtime
• Quality and Variety of Food
• Activities Available to Residents
• Autonomy & Resident Rights
• Physical Aspects of the Nursing Home

The overall satisfaction items measured overall satisfaction with the facility, an overall rating of care, and whether the respondent would recommend the nursing home.

How to Read the Results

The domain scores in this report are averages on a scale of 1 to 4. The domain scores are calculated by averaging the scores on the four-point scale (where 1=Never, 2=Sometimes, 3=Usually, and 4=Always) across all valid items, or questions, within that domain. This resulted in an average domain score that ranged from 1 to 4. Higher scores are better.

The overall satisfaction questions were rated in a different way. Two of the overall scores are averages on a scale of 1 to 10 where the number 10 represented the best or highest rating and the number 1 represented the least or lowest rating. The question "If someone needed nursing home care, would you recommend this nursing home to them?" had the options of Definitely Yes, Probably Yes, Probably No, and Definitely No. The results table shows the percentage of respondents that answered Definitely Yes and Probably Yes.

Determination of an actual average would require surveying the entire population of responsible parties, which is not practical. For this reason, the results show an average score.

It was expected that among those answering the survey, there would be specific areas where a respondent did not have enough experience to evaluate the nursing facility in one or more areas. It was also anticipated that certain items contained on the survey might not be relevant to the experience of the respondent or the condition of the resident. Each item included an option ("does not apply") that could be used in these instances. Any measure or domain containing less than 10 total responses for a facility is shown as "NR" for "not reported" in the table.

Ten nursing homes had a very small number of surveys returned by responsible parties. The results for these 10 homes cannot be reported and all their results are designated as "NR" in this table. Data for these homes have been included the totals for the state and peer group results.