TY - JOUR
T1 - Unpacking Quality in Assisted Living
T2 - Assessing the Validity and Reliability of Quality of Life and Family Satisfaction Surveys in Minnesota's Assisted Living Report Card
AU - Bucy, Taylor I.
AU - Moeller, Kelly
AU - Kohli, Nidhi
AU - Skarphol, Tricia
AU - Shippee, Tetyana P.
N1 - Publisher Copyright:
© 2025 The Author(s).
PY - 2026/2
Y1 - 2026/2
N2 - Objective More than 800,000 people in the United States live and receive services in assisted living (AL) communities. Despite considerable heterogeneity in both design and regulation, a cornerstone of AL is an emphasis on quality of life. In 2019, the State of Minnesota approved funding for the development of an AL Report Card, intended to measure quality from the perspective of both residents and their family care partners. The purpose of this study was to describe preliminary efforts to establish reliability and validity of statewide resident and family surveys. Design Cross-sectional, secondary analysis of novel AL resident and family survey data (wave 1, 2021–2022; wave 2, 2022–2023). Setting and Participants Residents of AL communities (wave 1 = 1392; wave 2 = 15,910) and their care partners (wave 1 = 2323; wave 2 = 11,935) in Minnesota. Methods Descriptive statistics, confirmatory factor analysis. Results Both the resident quality of life (R-QOL) and family satisfaction (FS) surveys largely exhibit acceptable scale reliability and construct validity with improvement between waves. For individual constructs in the R-QOL (environment, autonomy, culture) and FS (experience, choice, staff) surveys that do not perform well, we find some evidence that these individual constructs are likely measuring the same or similar underlying construct. The addition of a new survey question in wave 2 of the FS, however, means findings should be interpreted cautiously. Conclusions and Implications The Minnesota AL Report Card is the product of collaborative partnerships between residents/consumers, care partners, and public and private entities. Although analyses conducted for research purposes may suggest modifications to the consumer-facing surveys, it is important that modifications are accepted through an iterative, consensus-building process to ensure continued stakeholder buy-in.
AB - Objective More than 800,000 people in the United States live and receive services in assisted living (AL) communities. Despite considerable heterogeneity in both design and regulation, a cornerstone of AL is an emphasis on quality of life. In 2019, the State of Minnesota approved funding for the development of an AL Report Card, intended to measure quality from the perspective of both residents and their family care partners. The purpose of this study was to describe preliminary efforts to establish reliability and validity of statewide resident and family surveys. Design Cross-sectional, secondary analysis of novel AL resident and family survey data (wave 1, 2021–2022; wave 2, 2022–2023). Setting and Participants Residents of AL communities (wave 1 = 1392; wave 2 = 15,910) and their care partners (wave 1 = 2323; wave 2 = 11,935) in Minnesota. Methods Descriptive statistics, confirmatory factor analysis. Results Both the resident quality of life (R-QOL) and family satisfaction (FS) surveys largely exhibit acceptable scale reliability and construct validity with improvement between waves. For individual constructs in the R-QOL (environment, autonomy, culture) and FS (experience, choice, staff) surveys that do not perform well, we find some evidence that these individual constructs are likely measuring the same or similar underlying construct. The addition of a new survey question in wave 2 of the FS, however, means findings should be interpreted cautiously. Conclusions and Implications The Minnesota AL Report Card is the product of collaborative partnerships between residents/consumers, care partners, and public and private entities. Although analyses conducted for research purposes may suggest modifications to the consumer-facing surveys, it is important that modifications are accepted through an iterative, consensus-building process to ensure continued stakeholder buy-in.
KW - Long-term services and supports
KW - assisted living
KW - long-term care
KW - quality of life
UR - https://www.scopus.com/pages/publications/105025022724
UR - https://www.scopus.com/pages/publications/105025022724#tab=citedBy
U2 - 10.1016/j.jamda.2025.106023
DO - 10.1016/j.jamda.2025.106023
M3 - Article
C2 - 41354092
AN - SCOPUS:105025022724
SN - 1525-8610
VL - 27
JO - Journal of the American Medical Directors Association
JF - Journal of the American Medical Directors Association
IS - 2
M1 - 106023
ER -