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Journal of Applied Gerontology
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0733464809332365v1
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Inspection Visits in Residential Care Facilities for the Elderly

The Effects of a Policy Change in California

Cristina Flores

University of California, San Francisco

Alan Bostrom

University of California, San Francisco

Robert Newcomer

University of California, San Francisco

This study investigated the effects of a policy change in California that decreased annual state inspections of residential care facilities for the elderly to once every 5 years. Data collection involved a 5-year retrospective review of public facility files. Files were obtained from a probability sample of 340 licensed facilities, stratified by facility size and district office. Generalized estimating equations were used for multivariate analyses of size, office, and period effects of types of visits made and citations relative to quality of care. Routine survey visits were replaced with increases in the number of complaint- or problem-driven visits. Rates of quality of care citations arising from complaints or problems increased. Practice patterns among offices and variations by facility size were identified. Data from the resulting process affect comparisons of the industry and facility trends regarding quality of care. The problem-driven system may affect the rate of proactive consultation and quality-improvement visits.

Key Words: quality of care • quality assurance • residential care • long-term care • assisted living

This version was published on October 1, 2009

Journal of Applied Gerontology, Vol. 28, No. 5, 539-559 (2009)
DOI: 10.1177/0733464809332365
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