Personalizing Nursing Home Compare and the Discharge from Hospitals to Nursing Homes

Objective. To test whether use of a personalized report card, Nursing Home Compare Plus (NHCPlus), embedded in a reengineered discharge process, can lead to better outcomes than the usual discharge process from hospitals to nursing homes. Data Sources/Setting. Primary data collected in the Departments of Medicine and Surgery at a University Medical Center between March 2014 and August 2015. Study Design. A randomized controlled trial in which patients in the intervention group were given NHCPlus. Participants included 225 patients or their family members/surrogates. Data Collection. Key strokes of NHCPlus users were recorded to obtain information about usage. Users were surveyed about usability and satisfaction with NHCPlus. All participants were surveyed at discharge from the hospital. Survey data were merged with medical records. Principal Findings. About 85 percent of users indicated satisfaction with NHCPlus. Compared to controls, intervention patients were more satisfied with the choice process (by 40 percent of the standard deviation p < .01), more likely to go to higher ranked five-star nursing homes (OR = 1.8, p < .05), traveled to further nursing homes (IRR = 1.27, p < .10), and had shorter hospital stays (IRR = 0.84, p < .05). Conclusions. Personalizing report cards and reengineering the discharge process may improve quality and may lower costs compared to the usual discharge process.