The decision to place a loved one in a nursing home is a hard one. Careful selection of a nursing home can be a long process, because many factors should be taken into account to assure good quality of care and the resident’s well-being. Data on the quality of nursing home care is increasingly available from a number of public sources. One recent study showed just how difficult it can be to measure nursing home quality of care.

Researchers studied 10 Veterans Affairs (VA) and 650 community nursing homes in New York caring for 4,763 veterans and 195,438 nonveteran residents. The purpose of the study was to measure the quality of care in the VA nursing homes and community nursing homes that also provided care for veterans. It was hoped that this information could assist the VA in making decisions about how and where to care for nursing home residents. They looked at the rates of pressure ulcer (bed sore) development, functional decline, behavioral decline, and death.

Unfortunately, the study found that this information about quality of care might not be helpful in identifying nursing homes that are the “best” (or “worst”). They found that most of the nursing homes performed well on some quality measures but not well on other measures, making it difficult for family members to choose. For example, would it be better to choose a nursing home where residents are more likely to decline in function but less likely to develop bed sores?

People with a computer and internet access can find many websites that provide data that can help them choose a nursing home. People without a computer and internet access can use a computer at their local public library. In addition, Medicare publishes many brochures about nursing homes, and people can also call 1-800-MEDICARE (1-800-633-4227) to receive information by mail.

Medicare offers a “Nursing Home Compare Website” http://www.medicare.gov/NHCompare that consumers can use to search for and compare nursing homes by state, county, city, zip code, or the name of the nursing home. For example, this site tells whether the nursing home is Medicare and Medicaid approved, its number of beds, whether it is for-profit, nonprofit, church affiliated, located in a hospital, or is part of a chain of nursing homes. Information on this website includes data about staff and the numbers of residents whose health has declined while residing at the nursing home. All of this information together can be useful in determining which nursing home is right for your loved one.

Each state inspects nursing homes at least every 9 to 15 months. The reports are available to the public and contain information about any problems found. Contacting your state department of aging is a good place to start. Another good resource is the National Citizens’ Coalition for Nursing Home Reform ( HYPERLINK "http://www.nccnhr.org" www.nccnhr.org).

Despite the many resources available about nursing homes nationwide, visiting the nursing home on more than one occasion is absolutely necessary. Medicare provides a helpful checklist that family members can print out and take with them as they visit nursing homes ( www.medicare.gov/Publications/Pubs/pdf/02174.pdf ). When visiting a nursing home, it may be very useful to speak to nursing home residents and their relatives whenever possible.

The summary above is from the full report entitled “Purchasing or Providing Nursing Home Care: Can Quality of Care Data Provide Guidance.” It is in the April 2005 issue of the Journal of the American Geriatrics Society (Volume 53, Issue 3, pages 603-608). The report is authored by Dan R. Berlowitz, MD, MPH, Amy K. Rosen, PhD, Fei Wang, PhD, Dionyssios Tsilimingras, MD, Pierre N. Tariot, MD, Joe Engelhardt, PD, Boris Kader, PhD, and Dana B. Mukamel PhD.