A Novel Tool for Integrating Resident Preferences for Improving Service Delivery and Satisfaction in Long-term Care Settings Abstract At any given time approximately 5% of older adults with an average age of 84 years are living in nursing homes and assisted living communities. Federal regulations mandate a focus on person-centered care based on knowing and honoring resident preferences. Yet despite good intentions, preferences are often overlooked in the day-to-day press of managing residents in long-term care. When preferences are honored, residents report greater satisfaction with care. Staff may report higher job satisfaction when they know and honor resident preferences. Preliminary research has established there is a significant industry need for a streamlined tool to capture and act upon resident preferences to improve the quality of care in long-term care settings. The digital tool we envision will be called Care Preference Assessment of Satisfaction or ComPASS™. Members of the research team have developed the Preferences for Everyday Living Inventory (PELI), a scientifically validated questionnaire that helps long-term care staff learn about a person’s most important preferences. The PELI’s 72 questions focus on five key domains of an individual’s day-to-day life: 1) social contact, 2) personal development, 3) leisure, 4) living environment, and 5) daily routine. Phrased in clear, conversational language and tested with a diverse sample of older adults, the PELI gathers practical information about how each person likes to live daily life – including preferred wake-up times, whether to take a shower or bath and the recreational activities that bring the most pleasure. Information from the PELI helps care teams customize services and activities, as well as build trusting relationships with residents that result in better and more personalized care. Sixteen PELI questions are consistent with Section F of the Centers for Medicare and Medicaid Services (CMS) Minimum Data Set (MDS) 3.0. The MDS is a report that is required to be gathered on every resident residing in over 15,800 long-term care facilities annually. There is an opportunity to increase the value of data gathering if resident care preferences can be shared digitally in a way that is utilized for care execution, operations assessment, management, and required MDS reporting. This project will focus on establishing the feasibility of overcoming institutional barriers and achieving these outcomes through a demonstration of the impact of the ComPASS technology. This Phase I project will accomplish the following specific aims: AIM 1: Complete 3 focus groups (administrators and IT, nursing staff, activities and certified nursing assistants) to define the organizational needs, use of information, and barriers to implementation. AIM 2: Expand the pilot digital tool (ComPASS-16) to a) enable additional PELI items flexibly for targeted data gathering, b) provide summary data for caregivers to deliver resident preferences, and c) provide summaries on delivered care for internal assessment and improvement and for MDS reporting. AIM 3: Conduct a field test of ComPASS in 4 long-term care facilities and assess short-term impact. With a successful implementation and demonstration of the impact on residents, staff, and administrators, we will pursue full commercialization of ComPASS in Phase II. In doing so we will significantly improve the ability of care staff to deliver preference-based care to older adults living in long-term care.

Narrative At any given time approximately 5% of older adults with an average age of 84 years are living in long-term care facilities. Approximately 23% of older adults over the age of 85 live in nursing homes. The 85 and older population is the fastest-growing portion of the US population and is expected to triple by 2030 to 19 million and the number of people living in long-term care facilities is expected to continue to grow as quickly. In 2022, it was estimated that 1.4 million Americans lived in nursing homes. We can project that between 4.2 and 4.4 million older adults will be living in nursing homes. Federal regulations mandate a focus on person-centered care based on knowing and honoring resident preferences. Preliminary research has established there is a significant industry need for a streamlined tool to capture and act upon resident preferences to improve the quality of care in long-term care settings. The digital tool we envision will be called the Care Preference Assessment of Satisfaction or ComPASS™.