A Health Outcomes Approach to Evaluating Long-Term Care Facilities: Lessons from the United States

ABSTRACT

With the number of long-term care facilities in Korea increasing substantially, their quality and evaluation system has been an issue of concern. Policy makers need to consider critical aspects relating to health outcomes and client satisfaction when evaluating quality in long-term care. This requires a substantial amount of information gathered from a system of inspection, survey, data, and feedback. This study reviews the characteristics of Online Survey Certification and Reporting system (OSCAR) and the survey instrument used by the Centers for Medicare and Medicaid Services (CMS) in the U.S. and introduces the history of the U.S. nursing home (NH) inspection/survey system. OSCAR is administered by state agencies that contract with CMS and collect data through onsite inspections of facilities approximately once per year. The major components of OSCAR data are facility characteristics, resident characteristics, and survey deficiencies including scope and severity. We discuss the strengths and weaknesses of OSCAR, the primary source of information on the performance of all Medicare/Medicaid certified facilities, including a comparison of resident health outcome evaluation measurement between Korea's assessment tool and OSCAR. Introduction of a data collection system that includes a periodic survey process similar to OSCAR may help policy makers gain a better understanding of the NH industry in Korea and address shortcomings of the system.