Quality of care in German nursing homes

BackgroundSince the introduction of long-term care insurance in 1995, external quality assessments have been developed in the German healthcare system. In this long-term healthcare insurance all Germans are insured and have to pay contributions (Bundesministerium für Gesundheit, Ministry of Health [4]). Quality characterizes the degree of fulfilment of a predefined standard for the appraisal of a service (Scharnbacher et al. [28]). These quality assessments did not establish transparency between nursing homes because neither competitors nor prospective clients had access to the results. This barrier was lifted t…