An Appraisal of Nursing Home Care

A recent study of nursing home care in Massachusetts documented changes in institutional costs and facility compliance with state and federal regulations between 1965 and 1969. This article is based upon the latter. For comparative purposes, 129 facilities of a universe of approximately 690 nursing homes were retained from the 1965 and 1969 samplings. Data for the following conditions were obtained by inspectors of the Massachusetts Department of Public Health: administration, nursing personnel and nursing service, dietary, recreation, physical therapy, physical plant, and clinical records. In addition, nursing homes were examined for the 18 conditions of Medicare. Cost data were obtained from the Rate-Setting Commission of Massachusetts. The data were examined through the use of rank-correlation and multiple regression to reveal changes in costs and quality between 1965 and 1969. A gross increase in compliance with state standards occurred and a significant cost-quality relationship was found in both survey years. ^JTUDENTS of long-term care have been recently ^ preoccupied with several public policy-re-lated issues including: What is acceptable pa-tient care in the nursing home context and how can it be measured? What factors explain variations in the quality and quantity of care between different institutions? Are variations in quality and quantity of care associated with type of ownership? Although a number of re-searchers have addressed these questions at the conceptual level, the only empirical at-tempts to confront them were made by Ander-son et al. in their 1966 study of nursing home