Whether the quality recognition programs have any effect on promoting quality resident care remains unanswered. Both the programs are relatively new and neither state has performed any formal analysis of their impact on quality. Interestingly, however, most stakeholders express the opinion that the programs are unlikely to affect quality. "Window dressing " and "a warm fuzzy for providers" were typical of the comments received. Many with whom we spoke were concerned that the programs focused on high-performing facilities instead of the facilities most in need of assistance concerned. One stakeholder noted, "Only 5 percent of facilities are eligible--we worry about the other 95 percent."
Some stakeholders voiced the opinion that the awards, like a good rating on the facility report card, are a marketing tool which becomes increasingly relevant when bed occupancy is lower. When occupancy rates are lower, consumers may have more choice about where to go, and, thus, providers may compete by improving quality.