title: When Patients Customize Nursing Home Ratings, Choices And Rankings Differ From The Government's Version.
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.
authors.affiliation: Dana B. Mukamel (dmukamel@uci.edu) is a professor in the Department of Medicine at the University of California, Irvine.
authors.forename: Dana B
authors.initials: DB
authors.lastname: Mukamel
authors.affiliation: Alpesh 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.
authors.forename: Alpesh
authors.initials: A
authors.lastname: Amin
authors.affiliation: David L. Weimer is a professor at the La Follette School of Public Affairs, University of Wisconsin-Madison.
authors.forename: David L
authors.initials: DL
authors.lastname: Weimer
authors.affiliation: Joseph Sharit is a research professor in the Department of Industrial Engineering at the University of Miami, in Coral Gables, Florida.
authors.forename: Joseph
authors.initials: J
authors.lastname: Sharit
authors.affiliation: Heather Ladd is a senior statistician in the Department of Medicine at the University of California, Irvine.
authors.forename: Heather
authors.initials: H
authors.lastname: Ladd
authors.affiliation: Dara H. Sorkin is an associate professor in the Department of Medicine at the University of California, Irvine.
authors.forename: Dara H
authors.initials: DH
authors.lastname: Sorkin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014487:Centers for Medicare and Medicaid Services, U.S. / Q000592:standards; D005260:Female; D006076:Government; D006707:Homes for the Aged / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000592:standards* / Q000706:statistics & numerical data; D057240:Patient Preference / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000592:standards*; D011787:Quality of Health Care; D014481:United States
keywords: Decision Making; Patient Centered Care; Personalized Patient Referrals; Precision Medicine; Quality Report Cards