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. Author manuscript; available in PMC: 2020 Sep 10.
Published in final edited form as: Health Aff (Millwood). 2016 Apr;35(4):706–713. doi: 10.1377/hlthaff.2015.1377

EXHIBIT 2.

Representative quotations from interview respondents, June–September 2014

Theme/subtheme Quotation
THEME 1: CHOOSING A NURSING HOME
Recommendations from health care providers “The hospital suggested it. ‘Cause the doctor is affiliated with that nursing home.”
“The doctor pretty much, uh, recommended that that would be one that would be…suitable for him, one they’ve used in the past.”
Use of Internet “I did a little research, just on Google. I even did reviews on Yelp, to see what other people think, and then reviews all over.”
Visiting the nursing home “[Consumers should] go more than one time, because if they know you [are] making an appointment to come in, they gonna be on their best behavior. You want to do a surprise visit.”
“Without seeing the place—and I mean, like I had told you before, really seeing the place—you’re not gonna know.”
THEME 2: DEFINING QUALITY
Cleanliness “The first thing I looked for, does it smell like urine?”
“Cleanliness I would tie into the, uh, competency of the staff.‘Cause, you know, if they’re not taking care of the place, what else aren’t they doing?”
Staffing “They don’t have enough CNAs [certified nursing assistants]. They need one or two more, because they putting all this work on one girl.”
”Very attentive and, and they seem to develop like a friendship with the patients as opposed to just ‘Hey, I gotta do this to this patient.’”
“Basically whether or not the staff is at the very least content to be there. Because in some nursing homes, the staff is just not motivated by their management or not motivated by their surroundings.”
Activities “[Important that they] have a level of interaction that is self-fulfilling and enriching. And respect.”
“You might not think that’s important, but to let a person lay there and die, it’s not humane. You gotta make sure they have activities.”
THEME 3: COMPETING CONSIDERATIONS
Specialized services “Due to the situation and the equipment that he needed, the social worker picked [the nursing home].”
Proximity “[Distance was a factor because] obviously I wasn’t going to put him 50 miles away.
“It’s a pretty badly run place. But it was at least in the neighborhood so that we could get there and keep an eye on him.”
Bed availability “There were some places that had a waiting list, but they were nicer.”
“Most of the times…you can’t get a room by yourself as a new patient, if they even have a bed at all for you at some of these places. You sometimes have to wait a while.”
THEME 4: ROLE OF MEDICAID
Different treatment “Some nursing homes right out and told me, ‘No, you know, we don’take Medicaid. Sorry to waste your time.’”
“Once they hear Medicaid, you know, they give you a cold shoulder.”
Delays “We ran into a brick wall, because right now his, his status with Medicaid is pending. And until it becomes official, we had a lot of places say, until it’s locked in, you know, we can’t accept it.”
THEME 5: AWARENESS AND TRUST OF NURSING HOME COMPARE
Usefulness “I think this is fantastic. This saves a lot of time. You know, I could just look right on here, ‘cause I know if it has a certain rating I’m not gonna want it.”
“The hospital should tell you, “Here, there’s a website you should go on, and there’s the choice.”
Vehicle for communication “It definitely would have been something I could have brought with me and said, ‘Oh, can you explain to me about this?’”
“I would go to the administrator and ‘I need you to see this’. …You know? ‘Because if you’re below average, you need to come up a little bit. You need to step up your game.’”
Trust “Anybody can say anything on the Internet.”
“I’m sure it’s very tempting for the people to change things that don’t quite put in the best light.”
“I would be suspect on these, because, first of all, I would like to know if they accept advertising.”
“But if it’s a company from Medicare, it’s different. I would trust them more.”
Improvements “You know what else this should show? What activities they offer. You know, in a day, do they take the residents, you know, or different games? What kinda arts and crafts?”
“[I would like to know] the efficiency of it. Like even though…it might be a facility that costs more, or, you know, some kinda rating where they would show what I was getting, they actually giving me what I’m paying for.”

SOURCE Authors’ analysis.