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In an industry that lacks public quality reporting data, prospective residents are turning to online reviews, which may or may not be valid and reliable measures of quality and satisfaction, according to the results of a new study.

“As assisted living communities continue to expand, concerns about the viability of the model involving real estate, hospitality and increasingly the healthcare sectors have raised concerns about care quality in this setting,” the authors wrote. “In absence of concerted state or federal efforts to assess and report assisted living quality, online reviews constitute a possible, yet underexplored, source of data.”

Researchers from the University of Rochester explored online reviews as a potential source of information about assisted living communities, comparing the association between the reviews and aspects of state regulations. Their results were published recently in JAMDA, the journal of AMDA–The Society of Post-Acute and Long-Term Care Medicine.

They looked at 149,265 reviews for 8,828 communities. 

Researchers found lower odds of positive reviews in communities that were larger, had a higher proportion of residents who were Medicare/Medicaid beneficiaries, and were located in urban areas. Communities located in micropolitan areas — an urban geographic area with 10,000 to 50,000 people —  and those in states with more direct care worker hours, had greater odds of high ratings.

Online reviews, the authors said, increasingly are common in long-term care and can be a promising source of information about satisfaction for both prospective residents and their families as well as policymakers. 

Unlike with nursing homes, there are no federal reporting mandates for assisted living, and only a handful of states require some reporting from assisted living communities, the authors noted. In the absence of data, prospective residents base their choices almost entirely on location, price, amenities, word-of-mouth recommendations and, increasingly, online reviews, they said. 

The most positive reviews emphasized care and attention to residents, as well as quality, the study found. The most negative reviews referenced cleanliness and the general environment. Staffing, meals and general environment most commonly were mentioned in the online reviews.

According to the authors, this is the first study of its kind to examine the association between assisted living online reviews and community-, county- and state-level factors. They said that future work is necessary to establish the validity and reliability of those measures of care quality and consumer satisfaction.