Study Shows ‘Quality of Life’ Issues Matter Most to Nursing Home Residents in Evaluating Care

October 20, 2010

Press Release

Press Room – 2010 NIC Press Releases


Wins GE Award for Best Research Paper

Contact: Renee Tilton, (410) 626-0805 or

Annapolis, Md. – The white paper “Where Allies Part Ways and Strangers Converge: Nursing Home Performance in the Eyes of the Residents, Families, and State Surveyors” was announced by the National Investment Center for the Seniors Housing & Care Industry (NIC) as the winner of the GE Award for Best Research Paper from its annual call for applied research papers. The article was printed in the 2010 Seniors Housing & Care Journal and analyzes nursing home performance ratings based on data from 89 nursing homes in 30 states.The research and writing was conducted by three individuals: Vivian Tellis-Nayak, Ph.D., vice president – research, My InnerView; Bradley N. Shiverick, CPHQ, senior vice president, Healthcare Analytics; and Mauro Hernandez, Ph.D., Concepts in Community Living, Inc.

The results of the winning research revealed that nursing home residents tend to place great weight on quality of life issues, but families and state surveyors tend to focus more on quality of care issues. Residents and families both give their top ratings to the way staff show respect and ensure resident safety, and to the quality of care from nurses.

Satisfaction surveys were mailed to both residents and families from 89 nursing home facilities, resulting in 2,430 responses from residents and 3,779 responses from families. Twenty-two core items along the dimensions of quality of life, quality of care, and quality of service were identified and measured, and included aspects of nursing home life such as resident safety, privacy needs, friendship opportunities, meal quality, and religious/spiritual needs.

Key findings from the study showed:

  • Both residents and families rate their nursing homes highly.
  • Although their concerns overlap, residents and families disagree significantly in the way they rate the 22 areas of nursing home life.
  • The 22 areas of nursing home life bear different meaning for residents and families; each area affects the two groups unequally when recommending their nursing home.
  • The assessment of a nursing home by families is in step with the judgment state surveyors pass on it. While quality of life assumptions underlie the ratings by residents, quality of care principles guide the ratings of families and state surveyors.

“What residents in long term communities ask for is not high-tech cures, but a caring touch that silently assures them you really care,” said winning author Tellis-Nayak. “They are less concerned about staff ratios, high credentials, and clinical protocols. They yearn for caregivers who recognize their worth, affirm their individuality, and relate to them in a healing bond of friendship.” The authors suggest that to promote person-centered care, nursing homes need to understand the sociocultural factors behind the quality of life and quality of care paradigms that shape their clients’ expectations.

This is the 13th year the peer-reviewed Journal, published annually by NIC, continues its tradition of disseminating empirically based research and commentaries about quality and progressive practices in the seniors housing and care industry. The author(s) of the Best Research Award paper received a $2,500 total cash prize sponsored by GE Healthcare Financial Services.

Linda Hollinger-Smith, RN, Ph.D., FAAN, Mather LifeWays Institute on Aging, served as managing editor of the Journal. The three other editors were Joan Hyde, Ph.D., Gerontology Institute, University of Massachusetts/Boston; David A. Lindeman, Ph.D., Center for Technology and Aging, Center for Innovation and Technology in Public Health; and Margaret Ann Wylde, Ph.D., ProMatura Group LLC.

In addition to the winning paper, a special commendation was given to the paper “Occupancy and Revenue Gains from Culture Change in Nursing Homes: A Win-Win Innovation for a New Age of Long-Term Care” by Amy Elliot. The paper analyzed results from 185 mid-stage adopter homes and a comparison group of control homes and found evidence that culture change implementation results in return on investment for adopter homes through both increased occupancy and per bed per day revenue.

“This was also the first year NIC offered a New Investigator Award for researchers in graduate school or who have recently graduated,” said Robert G. Kramer, president of NIC. “We’re pleased to have an opportunity to recognize up-and-coming leaders in the industry.” The New Investigator Award was given to Katherine Marx for her paper “Group Activity Participation and Community/Medical Service Use Before and After Moving into a Continuing Care Retirement Community: A Five-Year Examination,” which was co-authored by Jean Gaines, Kasey Burke, Barbara Resnick, and John Parrish. This study of 157 older adults living in one of four large-scale CCRCs described their reported participation in group activities and medical services retrospectively one year immediately prior to and prospectively five years post-move into a CCRC and discovered five distinct patterns of changes in activity and/or service utilization over time.

The other papers included in this year’s Journal are: “Whole-Person Wellness in Senior Living: Perspectives of 23 Pioneering Communities,” “Successful Practices for Developing Cognitive Stimulation Programs,” and “Senior House Operations in Finland.”

Copies of the 2010 Seniors Housing & Care Journal are available through NIC for $95. Limited quantities of the Journal from previous years are also available. To order, visit or call NIC at (410) 267-0504.

About NIC

Founded in 1991, the National Investment Center for the Seniors Housing & Care Industry (NIC) is a nonprofit education and research organization providing information about business strategy and capital formation for the senior living industry. NIC is the leading provider of historical and trend data on the industry through its NIC Market Area Profiles (NIC MAP®) Data and Analysis Service that tracks quarterly more than 12,000 properties in the 100 largest metropolitan markets. Proceeds from its annual conference are used to fund research on issues of importance to the industry. For more information, visit or call (410) 267-0504.