Windsor, LC closures expose pressures on smaller nursing homes, but experts say lapses go beyond money

However, Assoc Prof Tan believes greater transparency could strengthen governance and encourage improvements across the sector.

“There is no reason for us to be too conservative,” he said, adding that publishing inspection findings could encourage more professionals to contribute to the sector while helping donors identify homes that need support.

In the United States, nursing homes participating in Medicare or Medicaid receive public five-star ratings based on health inspections, staffing and quality measures. Australia similarly publishes star ratings based on residents’ experience, compliance with quality standards, staffing and care indicators.

Assoc Prof Wee agreed that greater transparency could help families make more informed choices, but cautioned that poorly designed rating systems could encourage operators to chase inspection scores rather than improve residents’ well-being.

“A single audit is a snapshot, and homes differ enormously in the acuity and frailty of the residents they take on. Without case-mix adjustment, raw audit results can mislead, and could even penalise homes that do the harder work of caring for sicker residents,” he said.

Publishing routine audit results also risks pushing operators towards caring for the audit rather than the resident, with “defensive, risk-averse practice” and compliance for show rather than genuine improvement, he added.  

Instead, he said, any future reporting framework should measure residents’ quality of life and lived experience alongside compliance with regulatory standards.