Patients Skeptical of Nursing Home Care Quality, Patient Experience

September 13, 2023 - When it comes to care quality and patient experience, American nursing homes barely pass. In a new poll from West Health and Gallup, patient respondents gave nursing homes just a D+ for the quality of care they think they’d receive.

Patient respondents also said they wouldn’t be comfortable living in a nursing home if they could no longer live independently, according to the survey.

Nursing homes have been under the microscope, especially since the COVID-19 outbreak. The virus spread quickly throughout the facilities with catastrophic consequences. Since then, regulators have zeroed in on nursing homes, most recently with the Biden Administration proposing mandatory minimum staffing levels that some facilities fear they won’t be able to hit.

This latest poll showed that industry questions about nursing home quality are now swaying public perception. For one thing, nursing homes barely squeak by with a passing grade from the public.

Around a third (36 percent) of adults gave nursing homes a D grade for the quality of care they provide, while 6 percent actually fail the institutions. Another third gave nursing homes a C grade. Meanwhile, a scant number of respondents viewed nursing homes favorably; 8 percent gave them a B, and a mere 1 percent gave nursing homes an A.

To that end, most respondents don’t want to end up in a nursing home. While it is true that aging in place is ideal for most, patients are displaying heightened wariness about the prospects of living in a nursing home should they no longer be able to care for themselves.

Overall, 41 percent of poll respondents said they’d be very uncomfortable living in a nursing home, and another 29 percent said they’d be somewhat uncomfortable.

People are similarly apprehensive about sending a family member or loved one to live in a nursing home. A quarter (26 percent) said they are very uncomfortable with having a family member live in a nursing home, while 35 percent are somewhat uncomfortable with that prospect.

It was much more uncommon to be okay with the idea of living in a nursing home. Just about one-fifth said they’d be at least somewhat comfortable living in a nursing home facility, and only a few more respondents said they’d be somewhat comfortable with nursing home care for a loved one.

And the driving force behind all of that hesitancy? For the most part, it’s the perception of care quality in nursing homes, the survey showed.

Seven in 10 respondents said the quality of care provided in nursing homes was the top factor causing discomfort.

Another quarter (27 percent) said they have patient safety concerns. In fact, 41 percent of respondents said they do not believe nursing homes are safe places for older adults; only a quarter of respondents expressed confidence in patient safety in nursing homes. Still, respondents are divided on how well nursing homes work to mitigate avoidable patient harms, the data showed.

Just under half (45 percent) of respondents worried about the mental health and emotional impacts of being admitted into a nursing home.

Meanwhile, 34 percent of respondents expressed some personal worries, like not wanting to lose their independence. For 28 percent of respondents, worries about nursing home care are related to a fear of dying in a nursing home.

And like other sites of care, cost is also a serious factor. About half of the poll’s respondents said they would be uncomfortable accessing nursing home care because of the potential associated costs.

This survey should be a wake-up call for nursing homes nationwide as they stare down a public perception problem, the poll administrators said.

“The new poll makes it clear that nursing homes have much work to do to instill more public confidence in their facilities,” West Health and Gallup wrote in an article describing survey results. “While it’s natural that people entering nursing homes would have reservations about the lifestyle changes inherent in moving into such a care facility, they should not have to worry about their safety or the quality of care they will receive.”

There is potential for the minimum staffing level proposals to improve the quality of care delivered in nursing homes—and public perceptions—but that remains to be seen. Moving forward, it may be fruitful for healthcare policymakers to boost funding for home healthcare and community-based services that could keep older adults out of the nursing home setting.