The Association Between Quality of Care and Quality of Life in Long-Stay Nursing Home Residents With Preserved Cognition

Abstract

Objectives: To assess the overall quality of life of long-stay nursing home residents with preserved cognition, to examine whether the Centers for Medicare and Medicaid Service's Nursing Home Compare 5-star quality rating system reflects the overall quality of life of such residents, and to examine whether residents' demographics and clinical characteristics affect their quality of life.

Design/measurements: Quality of life was measured using the Participant Outcomes and Status Measures-Nursing Facility survey, which has 10 sections and 63 items. Total scores range from 20 (lowest possible quality of life) to 100 (highest).

Setting/participants: Long-stay nursing home residents with preserved cognition (n = 316) were interviewed.

Results: The average quality-of-life score was 71.4 (SD: 7.6; range: 45.1-93.0). Multilevel regression models revealed that quality of life was associated with physical impairment (parameter estimate = 0.728; P=.04) and depression (parameter estimate = -3.015; P=.01) but not Nursing Home Compare's overall star rating (parameter estimate = 0.683; P=.12) and not pain (parameter estimate = -0.705; P=.47).

Conclusion: The 5-star quality rating system did not reflect the quality of life of long-stay nursing home residents with preserved cognition. Notably, pain was not associated with quality of life, but physical impairment and depression were.