Examining family and facility characteristics associated with family satisfaction in assisted living: the Minnesota Assisted Living Report Card project.

Background and Objectives: Family members play an essential role in monitoring and advocating for quality of care in assisted living (AL) communities. Despite their importance, few population-based studies have examined how family and facility characteristics influence family satisfaction in AL. We evaluated family and facility characteristics associated with family satisfaction in AL. Methods: Using cross-sectional survey data from the Minnesota Assisted Living Report Card project (2024), we identified resident- and facility-level predictors of AL resident-reported quality of life in 8 domains, including experience, choice, needs, housekeeping, food, environment, staff, and overall satisfaction, using multivariable linear mixed regression with facility-level random intercept to account for facility-level clustering. Results: Among 15 320 family member respondents in licensed AL facilities with more than 5 beds (51.1% of age <65 years, 65.4% female, 92.3% White), mean domain scores ranged from 67.2 (Food) to 82.1 (Overall), indicating generally positive perceptions. Across all domains, lower satisfaction was observed among respondents who are younger, people of color, and female, and among spouses or siblings of residents. Families visiting or communicating less frequently tended to report lower satisfaction with choice and overall satisfaction. Smaller and non-profit facilities received higher ratings across most domains, while facilities in the Twin Cities metropolitan area scored higher than those in the rest of the state. Discussion and Implications: Family satisfaction in AL reflects both family composition and facility context. Policymakers and providers can leverage family satisfaction metrics to inform targeted quality improvement and promote equitable, family-centered care across the AL sector.