The last decade has seen a substantial growth in the development of residential care facilities (assisted-living facilities). Evaluation of the quality of care in this service delivery sector has been hampered by the lack of a consensus definition of quality and the lack of reliable instruments to measure quality. Founded on extensive research on nursing home care quality, a field test of the Residential Care Facility Version of the Observable Indicators of the Nursing Home Care Quality Instrument was conducted in 35 residential care facilities in Missouri. Content validity of the 34 items was rated by 4 expert raters as 3.4 on a 4-point scale of relevance. Test-retest was 0.94, interrater reliability was 0.73, and internal consistency was 0.90 for the total scale, indicating excellent results for initial field-testing. A focus group confirmed the 5 dimensions of quality of care measured by the instrument as important in residential care settings.

Aud, M.A., Rantz, M.J., Zwygart-Stauffacher, M., & Manion, P. (2004). Developing a residential care facility version of the observable indicators of nursing home care quality instrument. Journal of Nursing Care Quality, 19(1): 48-57.

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