1. Ten States Have Online Search Tools With Facility Quality Ratings

In line with the federal Find & Compare tool for nursing homes, Vital found 10 states offer interactive, online tools where the public can look up individual nursing homes or assisted living facilities. The facility profiles offer basic information on each facility along with some form of quality information based on state inspections data, facility complaints and investigation data, federal quality data, or resident and family survey data.

Maryland, Minnesota, and Ohio’s online tools provide the most comprehensive information about facility quality, including ratings based on resident and/or family surveys. Other states also offer robust tools with a good mix of basic facility information and quality data, but they do not include quality information based on resident or family experiences.

2. Ten States Survey Residents and Family Members

The experiences, satisfaction, quality of life, and outcomes of people receiving LTSS are gaining more attention at federal and state levels. For example, the Centers for Medicare & Medicaid Services (CMS) has promoted patient and service recipient surveys through Consumer Assessment of Healthcare Providers and Systems (CAHPS®) suite of surveys and through the Home and Community-based Services (HCBS) Quality Measure Set.

Vital identified 10 states currently conducting standardized statewide surveys in nursing homes or assisted living facilities, or in both settings, to assess resident perspectives on their quality of life or family members’ satisfaction in those settings.

Maryland, Minnesota, Ohio, and Oregon currently share facility-level resident and family member survey results through public-facing publications or online tools. Colorado, Delaware, Tennessee, and Wisconsin conduct resident and family satisfaction surveys, but results are not shared publicly, and the survey instruments used vary by provider in all but Wisconsin. Connecticut and Maine are starting to conduct surveys in 2024.

3. Ten States Use State Inspections and Federal Data for Facility-Level Quality Measures

Vital found 10 states use state inspection results and/or investigation data to publicly report on facility quality. Among these ten states, six states also report on nursing home quality using federal data related to Find & Compare. The Florida Health Finder is an example of facility-level quality measures based on inspections, complaints, and federal data, that are published in an online search tool.

4. Four States Use Value-Based Payments and Grants to Reward and Reinforce Quality

Another national trend unfolding in LTSS is linking payment for services to quality, sometimes called pay for performance or value-based payment. Under these programs, facilities receive higher payments for services delivered under public programs when they meet certain state-set quality standards. Value-based payment programs was one focus of the recent CMS Medicaid Innovation Accelerator Program for states. Vital found value-based payment programs in Colorado, Michigan, Minnesota, and Tennessee for nursing homes that achieve specific quality standards.

Another strategy to reinforce quality is grants focused on quality improvement. Minnesota offers grant programs for nursing homes and assisted living facilities as a part of their statewide quality initiatives.