A lot of us look to Yelp for the best of local shopping, food, and services. But how many of us would trust it to root out facilities worthy of caring for our elderly loved ones?
Not many, according to Yelp data. Only 7 percent of the platform’s 155 million reviews concern healthcare.
Yet according to a New York Times report on a study by the University of Southern California, Yelp reviews may be useful for nursing home research. In fact, they’re among very few resources that offer a glimpse of how dangerous some of these facilities can be.
But do the reviewers themselves know the whole story?
The Ratings You Can’t Trust
Each year for the last 20, millions of Americans have relied on the federal tool Nursing Home Compare (NHC) for the inside scoop on nursing homes. Its database stores information in 3 categories – staffing, quality of care, and annual inspection results from the Centers for Medicare and Medicaid Services – the latter of which forms the basis of NHC’s Five-Star Quality Rating System.
The other 2 categories, however, are reported by the homes themselves. The website includes no consumer feedback at all. This, said Dr. Anna Rahman, a USC researcher, makes Nursing Home Compare nothing more than “a marketing tool.”
“Most people don’t realize how little it measures,” Rahman said. “It’s garbage in and garbage out.”
Critics have agreed for years that NHC’s quality measures are distorted. They have little correlation with residents’ and families’ opinions, according to research, including a 2014 New York Times investigation that found the rating system contains “seriously” misleading information. So misleading, in fact, that while the rating system sparked a rise in 4- and 5-star homes, the rate of nursing home complaints spiked 37 percent.
How Could Yelp Help?
For their study, Rahman’s team looked at 264 Yelp reviews of 51 nursing homes across California.
Unlike Nursing Home Compare, few of these reviews addressed health care quality, staffing levels, or safety. Instead, Yelp reviewers were prone to comment on intangibles. More than half (53 percent) referred to staff attitude and caring, and 29 percent to staff responsiveness.
In conclusion, USC researchers “recommend that NH consumers consult both types of rating systems because they provide complementary information.”
And they’re careful not to say “supplementary.” Researchers warn that online platforms, whether they be Yelp, Facebook, or Google, aren’t the most reliable indicators of nursing home quality. We simply don’t have enough to go by. The 51 nursing homes in the study garnered only 5 reviews on average, and a relatively large proportion of facilities have zero.
On the other hand, Yelp is more likely than NHC to be unbiased. Having teamed up with Nursing Home Inspect’s creator ProPublica to provide information on serious nursing home deficiencies, Yelp also uses software to filter out fake reviews. In time, as people post more and more genuine ones, we may have an accurate sense of how much nursing homes have hidden – which is thus far out of our grasp.
The Lowballed Prevalence of Nursing Home Abuse
We’ve seen the discrepancies between nursing home ratings and complaints. Worse, what Nursing Home Compare won’t tell you is that 1 in 3 nursing homes have been cited for abusing and mistreating their residents – and because inspections don’t catch everything, the rate could even be higher.
Nursing home abuse takes many unspeakable forms, from sexual assault to financial exploitation. But far too many perpetrators, both aides or owners, are able to get away with their crimes. Elders fear what will happen to them if they come forward. Nursing homes care much less about their residents than their reputations. As a result, 1 in 4 serious incidences isn’t reported to police.
Nursing homes, especially for-profit ones, will also do anything to protect their bottom line. Instead of providing adequate staff, nourishment, and medical care, they use precious Medicare dollars to pay executives, investors, and as New York Times highlights, placement services they bribe for referrals.
The bottom line is this: Both Nursing Home Compare and Yelp have their limitations. But consumer reviews are definitely a start.
When weighing up who to trust with your loved one’s future, try to use multiple sources, talk to anyone you know with experiences at local facilities, and visit facilities yourself (multiple times) to get a true impression. And do review if you already have these experiences, good or bad. The more reviews at our disposal, the more useful they’ll become.