Nursing Home Care Compare Limits Effective Patient Navigation

A new Government Accountability Office (GAO) report is calling into question the utility of the Nursing Home Care Compare website, indicating that it obscures information about nursing home ownership and makes it harder for patients to make patient navigation decisions.

The report, published at the end of January, also found that certain terms are left undefined on the Care Compare website, with can pose a challenge for individuals with limited health literacy in particular.

Care Compare, which also has iterations for other sites of care like hospitals, is a patient-facing online tool intended to help individuals and their families select where to get treatment. Care Compare displays information about healthcare quality and patient experience to help folks make informed healthcare decisions.

The website has evolved over the years as the Centers for Medicare and Medicaid Services (CMS) has worked to make it more usable for patients and their caregivers. The Care Compare websites are at their best when they are readable and understandable for those with all levels of health literacy.

This latest GAO report calls that usability into question.

Looking at the Care Compare website for nursing homes specifically, GAO found that not all of the essential information is displayed in a usable manner. For example, CMS is responsible for displaying information about nursing home ownership, like whether a certain nursing home is a part of a national chain.

By presenting that information, CMS is letting users look up information about that particular nursing home chain’s quality scores.

But GAO found that the way in which CMS presents this information on the Nursing Home Care Compare website “does not align with the characteristics of effective transparency tools,” GAO reported.

Foremost, the website does not make it easy for users to identify relationships between nursing homes and their ownership. GAO said the website obscures common ownership—whether the nursing home is a part of a chain—and therefore the patterns in quality scores within that chain.

“Therefore, it is difficult for consumers to know whether a given owner is associated with nursing homes of high or low quality,” GAO pointed out.

Additionally, Care Compare uses terminology that could be difficult for patients with even high health literacy to understand. For example, the website offers up a certain percentage of indirect ownership interest, phrasing which many users may not be able to decipher.

GAO suggested that CMS reexamine its Nursing Home Care Compare websites and assess how they align with transparency best practices. The agency emphasized that CMS should look at how clearly it defines chain ownership and facilitates consumer navigation and access to quality scores.

“CMS has demonstrated a commitment to improving the transparency of nursing home ownership information and has an opportunity to present ownership information in a way that helps consumers make more informed care choices,” GAO said.