Finding a high-quality nursing home, whether for short-term rehab or long-term care, has got to be one of the most frustrating experiences on the planet. You’ve heard the horror stories of high staff turnover and patient neglect. It’s a common dilemma: More than a million older adults enter nursing homes in the US each year.
How can you find a good one? One resource is the federal government’s Nursing Home Compare website. It offers certain statistics that are useful—as we’ll explain—but it doesn’t tell you some other crucial things you really want to know, such as…
- Is the staff really caring?
- Is the staff responsive to concerns and complaints, whether from patients or family members?
- Is the facility in good shape and attractive…run-down and shabby…or somewhere in between?
- Would people who really know this nursing home give it high marks—or would they warn you away from it?
Now a new study suggests a useful complement to dry federal statistics. It’s a website that you probably already use, perhaps to find a plumber at home or a restaurant while traveling: Yelp. Using the site, which relies on online consumer-generated reviews, has its drawbacks, of course—and it certainly shouldn’t be your only resource. But if you know how to use it, doing so can fill in the gaps so that you have a more complete picture when you make this critical decision, whether it’s for a parent, spouse, sibling or yourself. Here’s what the study found…
Putting Yelp to the Test
Researchers with the Leonard Davis School of Gerontology at University of California, Los Angeles, collected and evaluated 264 Yelp consumer ratings and reviews of 51 nursing homes—30 large and 21 small, with an average of 116 and 58 occupied beds, respectively—across California. They chose Yelp to study because it’s become popular for evaluating health-care options. The site had more than seven million consumer reviews related to health care in 2016, up from just 160,000 in 2008.
Yelp also includes “Nursing Home Inspect,” a kind of “red flag” service that warns of serious deficiencies, fines and other negative aspects based on statistics culled from the federal Centers for Medicare and Medicaid Services. It’s the result of a partnership between Yelp and the investigative journalism organization ProPublica. The information becomes part of any Yelp search for a nursing home. (While the information is publicly available elsewhere, it’s delivered in a user-friendly format on Yelp.)
The purpose of the study was to understand how consumers are using Yelp in evaluating nursing homes, what kinds of information they are finding and whether it is information that isn’t readily available from other sources.
The conclusion: Yelp probably belongs in your nursing home evaluation toolkit. The biggest reason is that through Yelp reviews, you can learn how other families feel about the quality of care and the nature of the staff at reviewed nursing homes—something you otherwise might be hard-pressed to find.
What’s in Yelp Nursing Home Reviews
Most nursing homes in the study garnered either one star (worst; 37%) or five stars (best; 45%)—a total of 82%. The most frequently posted comments were related to staff attitudes and caring (53%) and staff responsiveness (29%). They typically expressed strong, emotional opinions (which could help explain the polarized star ratings), such as…
- “I would give five stars to the rehab therapists. They are an amazing group of caring individuals…I was so lucky to have found them…”
- “This place is the worst place for anyone to recover or be at. My father was treated like crap here…very, very unprofessional staff when transport[ing] him to his dialysis his socks had holes in them from being dragged on the ground…”
The next most frequently mentioned topics addressed a nursing home’s physical environment—cleanliness (25%), aesthetics and meals (each at 14%). The quality of clinical care, such as dementia treatment, as well as the safety and security of residents and financial issues were all infrequently commented on.
Taken together, these reviews create a picture of daily life in each nursing home—which is unique among the various rating systems of facilities. No other source of information captures the voices of residents and family members and provides such rich detail, the researchers note.
Yelp has its drawbacks, of course. Many nursing homes are not reviewed at all, and any given one that is may have such polarized ratings—almost all ones and fives—that you can’t be confident of any conclusion. Most concerning, reviews may be fake, posted by people who have a business connection to a nursing home, for example. While businesses can’t pay to have reviews included—or removed—it’s still possible to game the system. Yelp is working to weed out false reviews. But it’s important to understand both the value of Yelp reviews and their limitations.
Finding the Right Nursing Home
Given that Yelp’s online reviews offer information that’s complementary to what you’ll find on Nursing Home Compare and other sites but not 100% trustworthy, the scientists recommend consulting both types of ratings…
- Start with Yelp, and pay attention to data from Nursing Home Inspect that automatically pops up when you search. Because of the limitations of Yelp reviews, however, don’t use them as the primary way that you choose a nursing home. Rather, use Yelp to point yourself toward nursing homes that you should look into more extensively.
- Once you have found some worth exploring, check them out at Nursing Home Compare. It offers information based, in part, on roughly annual on-site inspections. It includes information about every Medicare- and Medicaid-certified nursing home in the country. It focuses on data such as staffing levels (the amount of staff time per resident per day) and clinical issues (prevalence of urinary tract infections, for example).
- Now, if possible, talk to friends and relatives who’ve had recent stays in local facilities.
- Finally, visit any nursing homes you are considering, and ask lots of questions of the residents, their families and staff. If you can, have a meal there. Sniff around—literally. Go back and visit again.
Do this with all the homes you’re considering until you have decided which is right for your loved one or yourself. Once you do find one and have some experience there, you can always post a review on Yelp.