The identification of residents capable of accurately describing daily care: Implications for evaluating nursing home care quality

Purpose: The goal of this study was to develop a method of identifying incontinent nursing home (NH) residents capable of providing accurate interview information about daily NH care. Design and Methods: In 177 incontinent NH residents from four facilities, selected Minimum Data Set (MDS) ratings were compared with two standardized, performance-based, cognitive screening instruments to predict which residents could accurately answer questions concerning receipt of daily incontinence and mobility care practices. Results: MDS ratings of activity of daily living performance and cognition significantly predicted residents' ability to accurately describe daily care practices. Performance-based measures of cognitive functioning did not outperform the MDS ratings. Selecting residents who scored two or more on four orientation items composing the MDS Recall subscale identified residents capable of accurately describing daily care practices with a sensitivity of 64% and a specificity of 75%. Implications: The MDS-based criteria identified are a promising, objective method for selecting incontinent NH residents for interview to verify the occurrence of specific daily care practices.