The landmark Nursing Home Care Reform Act of 1987 mandated basic standards of care to ensure the physical, mental, and psychosocial wellbeing of residents. Yet little has changed since it was enacted. Highquality facilities continue to provide good care, while poorly operated ones remain substandard. This volume provides an original, evidencebased framework for improving care in nursing homes.Taking a broad perspective, the authors review the history, development, and current state of care in nursing homes. After defining the concept of ''quality'' inside the home, they assess an array of qualitative and quantitative statistical data to identify inconsistencies found among U.S. facilities. Individual chapters focus on varied aspects of care and the ways in which it is measured, including a thorough review of such key mechanisms as the Online Survey, Certification, and Reporting (OSCAR) data network and the StructureProcessOutcome (SPO) model. The book also examines specific factors related to measuring and improving care, including government encouragements and sanctions, staffing policies, and the integration of technology into practice. Throughout, the authors provide proven recommendations grounded in sound methodology and realworld experience. This serviceoriented guide provides vital tools, informed tips, and provocative ideas for professionals, students, and policy makers involved in gerontology and geriatrics.