Over the past 12 years, members of the Minimum Data Set (MDS) and Quality Research Team at the University of Missouri-Columbia have been working with the Missouri Department of Health and Senior Services to improve care in Missouri nursing homes. The team conducted initial qualitative studies that explored the multidimensional aspects of quality of nursing home care. Using grounded theory methods, dimensions important to consumers and overlapping dimensions important to providers, healthcare professionals, and regulators were identified. The quality dimensions were operationalized in a theoretical model of quality of nursing home care. We learned from the studies that quality of care in nursing homes is a concept that encompasses broad dimensions of not only technical care provided but also the context or environment in which the care is delivered.

Rantz, M.J., Zwygart-Stauffacher, M., & Flesner, M. (2005). Advances in measuring quality of care in nursing homes: a new tool for providers, consumers, regulators, and researchersJournal of Nursing Care Quality, 20(4), 293-296.