Exploring the Cost and Value of Private Versus Shared Bedrooms in Nursing Homes

Abstract

Purpose: There is debate about the relative merits and costs of private versus shared bedrooms in nursing homes, particularly in light of the current efforts at creating both cost-efficient and person-centered care facilities. The purpose of this project was to explore the extent to which there is evidence-based information that supports the merits of three different bedroom configurations: traditional shared, enhanced shared, and private. Design and Methods: We developed a framework of four broad domains that were related to the different bedroom configurations: psychosocial, clinical, operational, and construction or building factors. Within each dimension, we identified individual factors through the literature, interviews, and focus groups, with the goal of determining the breadth, depth, and quality of evidence supporting the benefits of one configuration over another. Results: The vast majority of factors identified in this study, regardless of whether there was solid empirical data, information from the focus groups, or other anecdotal evidence, indicated better outcomes associated with private rooms over shared rooms in nursing homes. Cost estimates suggest that construction cost (plus debt service) differences range from roughly $20,506 per bed for a traditional shared room to $36,515 for a private one, and that such differences are recouped in less than 2 years if beds are occupied, and in less than 3 months if a shared bed remains unoccupied at average private-pay room costs. Implications: Despite limited empirical evidence in some areas, this project provides the foundation for an evidence-based life-cycle costing perspective regarding the relative merits of different bedroom configurations.

Sexuality and intimacy in assisted living: Residents’ perspectives and experiences

“…Privacy is also a major barrier to sexual expression in long-term care settings. An unlocked-door policy, the presence of roommates, regular room checks by staff, and staff access to medical and health-related information have been shown to hinder residents’ perceptions of privacy (Calkins & Cassella, 2007; Eckert, Carder, Morgan, Frankowski, & Roth, 2009; Morgan, 2009) and are suspected to significantly deter or prevent sexual activity or expression, as well (Bauer, 1999; Rheume & Mitty, 2008). …”

Mental and behavioral health environments: critical considerations for facility design

“…Additionally, the consensus was that private rooms increase construction costs due to the area requirements and increase staffing costs due to the need to supervise larger areas, a conclusion supported by other researchers (e.g., Calkins & Cassella, 2007).…”

Acuity-adaptable patient room from the patient’s perspective

“…[11,14,25] Older adults overwhelmingly prefer the private rooms and provided them sense of control over their environment according to Calkins and Cassela. [1] Physician-owned specialty hospital, MedCath with acuityadaptable patient room designs won a national award for its design in recognition of high rating on patient satisfaction. [17,27] that resulted in broadening their hospital's market base.…”

“…Such transfers contribute to errors in communication, patient disorientation, dissatisfaction, and falls. [1] In the acuity-adaptable patient room model, the delineated level of care is brought to the patient to eliminate or minimize these adverse outcomes.…”

“…Evidence indicates that patients cared for in this room have positive clinical consequences with regard to infection prevention, client preference as well as satisfaction, [1] nurse and physician satisfaction, [2] patient safety, [3] and reduced length of stay [4] compared to care delivered in the standard patient room. The evidence also suggests that acuity-adaptable rooms contribute to a decrease in noise levels.…”