More than 20 percent of all hospitalized Medicare patients are discharged to skilled nursing facilities. Public reporting tools like Medicare Nursing Home Compare provide data on the quality of such facilities, but it is unclear whether patients and their families use this information when choosing an establishment. For a Commonwealth Fund–supported study, researchers interviewed 98 patients about their experiences with selecting a nursing home.

What the Study Found

  • Hospital staff provided little guidance in the selection process, with most patients receiving only a list of names and addresses of local nursing facilities.
  • Patients typically chose a facility based on its distance from their home, their own previous experience with the facility, and the experiences of family members and friends. The few patients who considered quality metrics focused on the number of staff, cleanliness, and amenities.
  • Most patients were satisfied with their choice. However, many would have been willing to travel further to attend a higher-quality facility or one recommended by their doctor.
  • Patients generally felt rushed, unprepared, and unassisted during the nursing facility selection process and valued having help from family and friends.


Patients and family caregivers would benefit from better access to data on nursing facility quality as well as assistance from hospital staff in understanding that information.