Skip Navigation U.S. Department of Health and Human Services
Agency for Healthcare Research Quality
Archive print banner
Future Directions for Community-Based Long-Term Care Health Services Research

This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: Let us know the nature of the problem, the Web address of what you want, and your contact information.

Please go to for current information.

Table 2. Priority Long-Term Care Quality Concerns

Quality Concerns Process and structure Outcome


Caregiver training

Caregiver health: Burden, Stress, Physical decline.

Economic impact: Impact on employment

Quality of care

Clinical care: Skin care, Periodic turning, Range of motion exercises, Medications, Toilet training, Use of restraints.

Care planning: Adequacy of care plan.

Staffing: Turnover, Staff ratios and composition, Training, Compensation.

Responsiveness: Elapsed time to receive services.

Mental health: Cognition, Mood.

Disability: ADLs and IADLs, Unmet functional needs, Mobility, Strength—balance—and endurance, Social integration, Ability to engage in productive activity, Social development (children).

Infections: Tooth and gum decay and loss, Pneumonia, Septicemia, Urinary tract infections.

Geriatric syndromes: Pressure ulcers, Incontinence, Contractures, Sleep disturbances, Bruises.


Discomfort: Pain.

Preventable outcomes: Falls, Transportation accidents, Unnecessarily restrictive environment, Inappropriate hospitalizations—emergency department use.

Nutrition: Weight loss, Dehydration.

Quality of life

Home environment: Noisiness in common areas, Furnishings, Safety features.

Organized activities

Personal/internal: Autonomy, Dignity, Privacy.

Personal/social: Social interaction, Locus of control.

External/societal: Safety, Abuse and neglect, Financial harm.

Return to Document


The information on this page is archived and provided for reference purposes only.


AHRQ Advancing Excellence in Health Care