Abstract
In December 2008 the Centers for Medicare and Medicaid Services (CMS) launched a five-star rating system of nursing homes as part of Nursing Home Compare, a web-based report card detailing quality of care at all CMS-certified nursing homes. Questions remain, however, as to how well consumers use this rating system as well as other sources of information in choosing nursing home placement. We used a qualitative assessment of how consumers select nursing homes and of the role of information about quality, using semistructured interviews of people who recently placed a family member or friend in a nursing home. We found that consumers were receptive to using Internet-based information about quality as one source of information but that choice was limited by the need for specialized services, proximity to family or health care providers, and availability of Medicaid beds. Consumers had a positive reaction when shown Nursing Home Compare; however, its use appeared to be limited by lack of awareness and, to some extent, initial lack of trust of the data. Our findings suggest that efforts to expand the use of Nursing Home Compare should focus on awareness and trust. Useful additions to Nursing Home Compare might include measures of the availability of activities, information about cost, and consumer satisfaction.