Nursing Home Characteristics and Resident Quality of Care Outcomes: A Scoping Review

Abstract

Context: Nursing facilities are an essential part of the long-term care continuum, providing a setting where older adults and persons with disabilities receive critical services and supports. Despite extensive research linking facility characteristics to resident outcomes, the facility and resident factors under investigation vary in the context of a diverse industry landscape and poor understanding of key quality of care outcomes. Objectives: This scoping review focused on identifying key concepts, summarising existing findings, and identifying gaps in research linking nursing facility characteristics and resident outcomes. Methods: Guided by PRISMA-ScR guidelines, this scoping review focused on empirical, English-language research published in five databases between 2005 and 2022. The research studies meeting specified inclusion criteria were subjected to thematic analysis for the extraction of key concepts and synthesis of findings. Findings: The 91 research studies in the final analytic sample conceptualised facility-level characteristics and resident outcomes using six and nine broad domains, respectively. The subcategories making up these discrete domains varied widely across studies. While evidence of linkages between facility environments and resident outcomes varied, there was general support that higher staffing capacity and home-like environments with support for autonomy and social integration were linked to better functional outcomes and higher overall subjective well-being of residents. Implications: It is imperative to understand how facility-level characteristics influence resident outcomes, and this scoping review provides insight into these complex relationships. A better understanding of this area is key to improving policies and regulatory oversight, as well as more broadly inform data driven decision-making.