What 1000 Senior Care Organizations Teach Us All About Online Reviews

From the most challenging tasks come the most important learnings.

When it comes to getting online reviews, few industries are as challenged as the Senior Care businesses.  One of our clients is in this field and we’ve created an online review management system for them.  We’ve learned a lot about the day to day challenges in getting a high volume of good reviews (we’ve left their data out of this article).

Even if you have nothing to do with senior care, understand that other industries and niches can benefit from learning about this sample’s struggles to get good reviews.

Let’s start with why getting senior care reviews is so challenging.

  1. Many of the elderly don’t have email addresses, computers, tablets, and smartphones.  Add to that a relatively low interest and skill level in using the internet and generating a healthy flow of reviews becomes difficult.
  2. Secondly, the industry already operates under federal requirements to interview patients and report metrics like customer satisfaction.  Reporting on these rating standards requires staff time and effort.  Understandably getting Google reviews is less important to the staff than the mandatory ones.  But people searching online for these services are likely going to look at Google reviews, rather than the Centers for Medicare and Medicaid Services reviews.
  3. Finally, many in the industry don’t value the idea of online review marketing.  It sometimes seems a little gimmicky to those whose main mission is the care of older adults, and many can’t seem to bring themselves to ask patients for reviews.

So, given these factors, I always laugh when I hear people in other industries complain about their online reputation challenges.  Their task seems a lot easier compared to Senior Care.

We wanted to find out a little more about senior care organizations’ online reviews, their results, and how were they approached the task of getting online reviews.  We wanted to find out some of the most and least successful ones were doing.

The answers could be beneficial in solving online review challenges for other sectors and industries.

We then sampled over 100 assisted living, nursing home, and home health care organizations in Columbus, Dayton, Chicago, Cincinnati, Sarasota, and San Diego for number of Google reviews, and average star ratings, and we read through over 650 of their reviews to determine as much as possible, their sources (friends and family, patients, and employees).  Reading through hundreds of online reviews was even more instructive than we imagined.  It gave us insights into who was actually leaving reviews and what motivated them.


Having a high volume of 5-Star reviews is important.  An organization with just 1, 5-Star review is one bad review away from a 3- Star online reputation. 


We called the most successful of these locations and asked for them to share their approach to getting reviews.

All of this, plus a scan of the top 100 local senior care organizations for 10 relevant keywords to determine the % of them with no reviews, have led to the learnings in this article.

What we learned from analyzing senior care online review results

Our sample size is far from a rigorous statistical analysis of the industry.  But it does define a few useful lessons.

The first chart below is from the sample of home care organizations (an average of the top 10 home care organizations that showed up in Google’s local search results for each keyword indicated).  The average number of reviews for all 60 home care organizations in the sample was 7.8, with an average rating of 3.5 stars.  This sample included those who actually had reviews.  Industrywide numbers could be much lower if those organizations with no reviews were taken into account.  An astounding 46% of another 600 organization sample had 0 reviews. 

This is not a good result.  Particularly in an industry where trust is all important to acquiring more patients, and when this data is so visible online.  And in case you’re wondering, having 0 reviews is almost as bad as having poor reviews.  Neither creates trust in prospective patients and their families.

Insights from the analysis

    • There are two categories of senior care organizations relative to online reviews the adaptors figuring out how to solve the problem of online reviews for the benefit of their businesses, and the victims who are at the mercy of random negative reviews. Senior care organizations with dozens of reviews, approaching 5 stars, are building a competitive advantage. Overall the senior care services sector has a major challenge in creating a culture of consistent 5-Star reviews.  This is evidenced by the frequent situation of both 1 and 5-Star ratings coming from the same facility.
    • Company ownership and leadership in this process are critical.  The organizations that got the highest reputation score seem to have management or owners committed to their online reputation.  They understood the importance to the business of having a sparkling reputation online and set expectations for their staff.
    • There are review rock stars out there, even in this review challenged industry.  Organizations that respond to each and every review, positive or negative stand out with a wow! factor.  Responding to both positive and negative reviews in a warm, professional manner shows the world that they cared for their patients.  It demonstrated an understanding that their public response to reviews was an opportunity to verbalize their branding message for all the world to see.  It was to them free advertising.  Contrast this to many in this industry who ignore their online reviews, and who don’t have a clue what people are saying about them, or what to do about it.  Both positive and negative reviews are treasure chests of learnings and ideas for service improvements.
    • TARGET 10.4.8. To become demonstrably better than local Dayton and Columbus competitors, a senior care organization needs to target for at least 10 reviews per location and an average Google Star Rating of 4.8 in 2018, and then build on that in future years.  This has proven to be achievable based on the work done by some of the benchmark companies in this sample.   A high volume of 5-Star reviews is important.  An organization with just 1- 5-Star review is one bad review away from a 3- Star online reputation.

The chart below shows a sample of senior care organizations (includes nursing homes and assisted living facilities).  They averaged 6 reviews per location with an average rating of 3.2 stars.  Their “no reviews” metric of another 400 senior care organizations was 23%

    • Emotions motivate people to write online reviews. Angry people write reviews without prompting.  People that like the way they’ve been treated are generally happy to help and will go through a few inconveniences to do so – like signing up for a Gmail account.  But even happy patients had to be persuaded and reminded to write reviews.
    • A laptop for Mom 7% to 9% of the reviews in this sample were left by people who were clearly patients. Likely there were more patients in this sample that could not be identified as such.  The barrier to getting online reviews from elderly clientele because of low computer skills and experience is real but shrinking.  Senior care services organizations should not assume that the elderly can’t leave reviews.  Ask them for reviews. (2017 Pew research shows that 42% of adults over 80 use the internet, jumping to 60% in ages 75-79).
    • It’s a family and friends affair. The senior care organizations that are best at collecting large numbers of high reviews tend to put a priority on collecting reviews from the patient’s family and friends, friends of the company, and employees.
    • To the victor belongs the spoils. There’s a huge opportunity for senior care service organizations who learn how to deliver quality services and capture these experiences in the form of 5-Star online reviews. There are wide variations within this sector’s review results. The senior care services organization that figures out how to do this well will have a real competitive advantage over local and regional competition for years to come.

Universal lessons from senior care online review struggles

It goes without saying that quality products and services are the basis for getting good reviews.  These are good lessons for people in the senior care industry.

What are the more universal lessons from this small sample of one very challenging niche?  The good news is that you can answer this question for yourself.  Ask yourself these questions about your organization’s approach to getting reviews:

  1. Are your products and services customer pleasers?  Do you continuously improve the quality of your products and services?
  2. Are you allowing yourself to be at the mercy of online reviews, or do you see it as an opportunity to engage with customers and spread positive brand messages?
  3. Is there an understanding of how strategically important online reviews are to the business, today and in the future?
  4. Do you know what your competition is doing to get more reviews?  How much are you ahead or behind them?
  5. How engaged and committed is leadership to using online reviews as a marketing advantage??
  6. Do you have a system that everyone understands (and really uses) to monitor, build, and market your online reputation?
  7. Are you assuming that some people won’t or can’t leave a review?  Are you asking everyone, and their families and friends to leave a review?
  8. Are you monitoring and tracking online reviews and responding in a professional way to both positive and negative reviews?
  9. Do you know how many reviews you have per location and what your ratings are?  Do you have goals for the number of reviews, star ratings, and % public responses to online reviews?
  10. Do you have underperforming or poorly performing products and services that is a source of a large number of negative reviews?
  11. Does everyone understand that even if you have a few 5-star reviews, it only takes one negative review to give the organization a 1 star or 2-star rating?
  12. Does everyone understand that advertising and other marketing efforts are undermined and less effective when the organization has a poor online reputation?
  13. If some organizations in senior care can be successful at getting and managing reviews, why can’t you be even more successful?

Just a few years ago, there wasn’t nearly the kind of importance attached to online reputations as there is today.  Today over 90% of people read reviews before a purchase – and believe them.  In addition, almost as many have not purchased as a result of reading negative reviews.

It may not be fair, but judging from this small sample and talking with people in the industry, The senior care industry is going to have to step up its online review game.  So must we all.

No matter what business you’re in, customers, patients, and clients armed with smartphones and tablets demand high-quality products and services and will tell everyone if they aren’t satisfied.  That’s not exactly new.

What is new is the growing importance of online reviews to a business and the ability of social media to amplify each and every review.  That’s just the way the world works today, and businesses that don’t go about taking control of their review process will lose out to those that do.

Hopefully, the learnings from this sample of senior care review challenges will help other businesses to create better online reputations.

If you have additional data or learnings regarding online reviews from this or other industries, please let me know, or leave a comment.

Contact us if we can help with your reputation challenges.

Photo By USF SLE


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