I

Data from the

NATIONAL HEALTH SURVEY

Utilization of Nursing Homes

United States:

National Nursing Home Survey

August 1973-April 1974

Presents statistics on various measures of utilization according to

selected facility, resident, staffing, and financiaI characteristics.

These statistics include distribution of beds, occup~cy rate, demographic characteristics of residents, length of stay since current

admission, primary reason for admission, living arrangements prior

to admission, admissions, discharges, rate of turnover, full-time

equivalent staff, skill of charge person, charges for care, and sources

of payment. Based on data collected in the National Nursing Home

Survey.

DHEW Publication No. (H RA) 77-1779

Series 13

Number 28

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

Public Health Service

Health Resources Administration

National Center for Health Statistics

Hyattsvil Ie, Md. ‘July 1977
.

Library of Congress Cataloging in Publication Data

United States. National Center for Health Statistics.

Utilization of nursing homes, United States.

(Vkd and health statistics: Series 13, Data from the National Health Survey; no. 28)

(DHEW publication; no. (HRA) 77-1779)

Includes bibliographical references.

1. Nursing homes–LJnited States–Utilization-Statistics. I. Sutton, Jearmine FOX.

II. Title. III. Series United States. National Center for Health Statistics. Vital and health

statistics: Series 13, Data on health resources utilization; no. 28. IV. Series: United States.

Dept. of Health, Education, and Welfare. DHEW publication; no. (HRA) 77-1779.

RA407.3.A349 no. 28 [RA997] 362.1’1’0973 [362.6’15’09731

ISBN 0-8406-0090-9 77-608185

For SJle by the Superintendent of Documents, U.S. Government Printfng Office

Wash@ton, D.C. YX02

Stock No. 017-w2-00567-1
NATIONAL CENTER FOR HEALTH STATISTICS

DOROTHY P. RICE, Director

ROBERT A. ISRAEL, Deputy Director

JACOB J. FELDMAN, Ph.D., Associate Director for Analysis

GAIL F. FISHER, Associate Director for the Cooperative Health S tatistics System

ELIJAH L. WHITE, Associate Director for Data Systems

JAMES T. BAIRD, JR., Ph.D., Associate Director for International Statistics

ROBERT C. HUBER, Associate Director for Management

MONROE G. SIRKEN, Ph.D., Associate Director for Mathematical S tatistics

PETER L. HURLEY, Associate Director for Operations

JAMES M. ROBEY, Ph.D., Associate Director for Program Development

PAUL E. LEAVERTON, Ph. D., Associate Director for Research

ALICE HAYWOOD, Information Officer

DIVISION OF HEALTH RESOURCES UTILIZATION STATISTICS

SIEGFRIED A. HOERMANN, Director

JOAN F. VAN NOSTRAND, Chief Long-Term Care Statistics Branch

W. EDWARD BACON, Ph.D., Chiej Hospital Care Statistics Branch

STEWART C. RICE, Acting Chiej Family Pkmning Statistics Branch

JAMES E. D.LOZIER, Chie~ Ambulatory Care Statistics Branch

MANOOCHEHR K. NOZARY, Chief Technical Services Branch

Vital and Health Statistics-Series 13-No, 28

DHEW Publication No. (HRA) 77-1779

Library of Congress Catalog Card Number 77-608185
CONTENTS

Introduction ............................................................................................................................................. 1

Scope of Report ................................................................................................................................... 1

Background .......................................................................................................................................... 1

Facility Data ............................................................................................................................................ 2

General Characteristics of Homes ......................................................................................................... 2

Dktribution of Beds ............................................................................................................................. 3

Occupancy Rate .................................................................................................................................. . 4

Resident Data ........................................................................................ ....................................................

Demographic Characteristics .................................................................................................................

Ixngth of Stay Since Current Admission ..............................................................................................

Pnmaxy Reason for Admission .............................................................................................................

Living Arrangements Prior to Admksion ..............................................................................................

Adrnissipns ...........................................................................................................................................

Rate of Patient Turnover ......................................................................................................................

Waiting fists ................................................o...o....................................................................................

Dk.charges.............................................................................................................................................

5

5

6

7

8

9

10

11

12

Staffing and Financial Characteristics ........................................................................................................ 15

FuB-Time Equivalent Employees .......................................................................................................... 15

Level of Skill of Person in ~age .....................................................$...................................................

16

Average Total Monthly Charge for Care................................................................................................ 17

Primary Source of Payment .................................................................................................................. 19

References .................................................................................................................................................

21

List of Detailed Tables ............................................................................................................................... 23

Appendixes

I. Technical Notes on Methods ...................................................................................................... 39

II. Definitions of Certain Terms Used in This Report ..................................................................... 51

111. Selected Questionnaires Used in the 1973-74 NationaI Nursing Home Survey ........................... 53

IV. Criteria for Classifying Nursing Homes According to Level of Nursing Care............................... 77

LIST OF FIGURES

1. Percent change in the number of nursing homes and the average annuzd change for 1963,1969, and

August 1973-April 1974: United States ............................................................................................ 3

2. Percent change in the number of nursing home beds and the average annual change for 1963,1969,

and August 1973-April 1974: United States ...................................................................................... 4

3, Percent distribution of residents by sex and age: United States, August 1973-April 1974 ................... 5

4. Percent distribution of residents by length of stay since current admission: United States, August

1973-ApIil 1974 ............................................................................................................................... 6

5. Percent distribution of residents by the primary reason for admission to the nursing home: United

States, August 1973 -ApriJ 1974 ........................................................................................................ 8

ili
6. Percent distribution of full-time equivalent employees in nursing homes by occupation category:

United States, August 1973-April ~ 974 ...........-.....“............................................................................

7. Percent distribution of nursing homes by number of shifts per day: United States, August 1973-April

1974 .................................................................................................................................................

LIST OF TEXT TABLES

A. Number and percent distribution of nursing homes by certification status, according to size, ownership, and geographic region: United States, August 1973-April 1974 ................................................

B. Number and percent distribution of nursing home beds by ownership and geographic region of the

home, according to certification status of the bed: United States, August 1973-April 1974 .............

C. Occupancy rate of beds in nursing homes, by certification status, ownership, size, and geographic

region: United States, 1972 ..............................................................................................................

D. Number and percent distribution of residents by length of stay since current admission, according to

age and sex: United States, August 1973-April 1974 ........................................................................

E. Number and pert.nt distribution of residents by length of stay since current admission, according to

certification status, ownership, size, and geographic region: United States, August 1973-April

1974 ....................................................................................................................................... ..........

F. Median length of stay of residents since current admission, by certification status, ownership, size,

and geographic region: United States, August 1973-April 1974 ........................................................

G. Percent distribution of residents by primary reason for admission, according to sex, age, and length

of stay since current admission: United States, August 1973-April 1974 ..........................................

H. Percent distribution of residents by primary reason for admission, according to certification status,

ownership, size, and geographic region: United States, August 1973-April 1974 ..............................

J. Number and percent distribution of residents by living arrangements prior to admission, according to

certification status, ownership, size, and geographic region: United States, August 1973-April

1974 ........................................................................................................................................ .........

K. Number and percent distribution of admissions to nursing homes, by certification status, ownership,

size, and geographic region: United States, 1972 ..............................................................................

L. Number of admissions to nursing homes and admissions per bed: United States, 1962, 1968, and

1972 ............................................................................................................................................. ....

M. Rate of resident turnover (admissions per bed), by certification status, ownership, size, and geographic region: United States, 1972 ..................................................................................................

N. Number and percent dk.ribution of nursing homes by whether or not a wziting list was maintained,

accordhg to certification status, ownership, size, and geographic region: United States, August

1973-April 1974 ...............................................................................................................................

O. Number and percent distribution of discharges by discharge status, according to certification status,

ownership, size, and geographic region: United States, 1972 ............................................................

P. Number and percent distribution of discharges by discharge status: United States, 1962, 1968, and

1972 .................................................................................................................................................

Q. Percent distribution of full-time equivalent employees by occupation category, according to certification status of the home: United States, August 1973-April 1974 ..................................................

R. Number of full-time equivalent employees per 100 residents, by occupation category and certification status of the home: United States, August 1973-April 1974 ......................................................

S, Number of full-time equivalent employees per 100 nursing home residents for 1964, 1968, and

August 1973-April 1974: United States ............................................................................................

15

17

2

4

5

6

7

8

9

10

11

12

12

12

13

14

14

15

16

16

iv
T. Percent distribution of numing homes with person in charge on duty for three shifts by level of skifl

of the person in charge, according to certification status, ownership, and size of home: United

States, August 1973 -Aptif 1974 ........................................................................................................ 18

U. Number and percent of nursing homes with three shifts and percent with RN’s in charge for thee

shifts: United States, 1968 and August 1973-Aprif 1974 .................................................................. 18

W. Average totaf monthly charge and number of residents, by age, sex, length of stay since current admission, and primary reason for admission: United States, August 1973-Apxil 1974 ........................ 19

Y. Average total monthly charge: United States, 1964, 1969, and August 1973-ApIif 1974 .................... 19

Z. Percent distribution of residents by primary source of payment, according to age, sex, length of stay

since current admission, and primary resson for admission: United States, August 1973-April

1974 .................................................................................................................................... ............. 20

v
SYMBOLS

Data not available---------------------------—----- ---

Category not applicable------------------------– . . .

Quantity zero--–-—-–-----–-—-----—- -

Quantity more than Obut less than 0.05-— 0.0

Figure does not meet standards of

reliability or precision--—------—--—--- *

vi
UTILIZATION OF NURSING HOMES

Jeannine Fox Sutton, Division of Health Resources Utilization Statistics

I

INTRODUCTION

Scope of Report

In the last 10 years, the increased utilization

of nursing homes has made them one of the

most rapidly expanding sectors of the Nation’s

health care delivery system. This report will present a three-dimensional view of the Nation’s

utilization of nursing homes by reviewing (1)

facility data, (2) resident data, and (3) staffing

and charge data collected in the National

Nursing Home Survey from August 1973 to

April 1974. Examination of these three areas

~$,illinclude a review of such measures as admissions to and discharges from nursing homes,

primary reason for admission, prior living

arrangement, occupancy rates of nursing home

beds, the average length of stay since current

admission, the level of skill of the person in I

charge of work shifts in the home, and the average monthly charge for resident care.

Reports pertaining to data collected in the

1973-74 National Nursing Home Survey have

been published. One report presents data on

operating and financial characteristics of the

facilit y,l and a second report presents data on

demographic and social characteristics of the

residents.2 Future publications will present data

on the health profile of the residents, their

chm.ges for care, and medical services received as

~trcll-’us data on” facility and staff characteristics

and cm the cost of providing care.

Background

The 1973-74 National Nursing Home Survey

was designed and developed by the Division of

Hwdth Resources Utilization Statistics in conjunction with a group of experts in various fields

encompassing the broad area of long-term care.

It was specifically designed as the first in a continuing series of surveys to satisfy the diverse

data needs of those who establish standards for,

plan, and provide long-term care. Facilities

within the scope of this survey were those nursing homes that provided some level of nursing

care. Criteria for classifying nursing homes and

definitions of the two classes discussed here are

presented in appendix IV.

From August 1973 to April 1974, data from

a national sample of nursing homes concerning

their services, costs, residents, and staff were

collected via a combination of mail and personal

interview survey techniques. Data on characteristics of the facilities and on all staff members

were collected by interviewing the administrator. Data for a sample of residents were

collected by personal interview with the nurse

who usually provided care for the resident.

When answering the questions, the nurse generally referred to the resident’s medical record.

A detailed description of the data collection

procedures is presented in appendix I; definitions of terms are given in appendix II; the data

collection instruments are presented in appendix

III. Because the estimates from the survey are

based on a sample of nursing homes rather than

on a complete enumeration, they are subject to

sampling variability. Detailed information on the

sampling variability of these estimates is given in

appendix I.

Data from five previous surveys of nursing

homes conducted by the National Center for

Health Statistics may be used to study changes

in nursing home care. Published data are available from the three sample surveys of “resident

1
Table A. Numbar and percent distribution of nursing homes by certification s

United States, August 1973-A

Size, ownership, and geographic region

All homes .......................................................................................

—Size

Less than 50 beds ................... ........................................................................

50-99 beds ......................................................................................................

100-199 beds ..... .................................................................... ............ .............

200 beds or more ........................................................................................ ....

Ownershio

Proprietary ................................................................... .......... ........................

Nonprofit and government .............................................................................

Geographic region

Northeast ................................................................. .......................................

North Central ............................... ..................................................................

South ................ ...... .. .... ........................................ ..........................................

West ... .......................................... .......................................... ........ .................

10f these homes, s percent were certified by Medicare only.

2of these homes, 35 percent were certified as both SNH’S and ICF’SNOTE: Figures may not add to totals due to rounding.

places” conducted in 1963,3’6 1964,7-14 and

1969,1 5‘2 1 as well as from a national census of

nursing homes conducted in 1968. The 1963,

1964, and 1969 surveys included those facilities

that provided either nursing or personal care,

and the 1973-74 survey included only those

providing some level of nursing care. (The 1963

survey also covered homes providing hospital

care.) To allow for valid comparisons of data

over time, homes providing personal care or

hospital care were excluded from the 1963,

1964, and 1969 estimates.

FACILITY DATA

General Characteristics of Homes

Approximately 15,700 homes provided nursing care in the United States during the period

]tus, accordi ng to size, ownership, and geographic region:

ril 1974

Number

of

homes

15,700

6,400

5,500

3,200

600

11,900

3,900

3,100

5,600

4,100

2,900

II Certification status

Both Medicaid only

Total

Medicare

Not

certi-

;::i. SNH’S2 ICF’S fied

caidl

Percent distribution

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

26.5

9.5

31.8

46.7

4B.2

27.2

24.4

31.3

16.3

20.1

50.3

22.4

15.9

24.8

29.1

32.9

21.2

25.9

27.1

19.9

22.4

22.0

28.1

35,9

28.5

16.0

*

29.3

24.4

17.7

35.6

36.5

12.B

23.1

38.B

14.9

B.2

●

22.3

25.3

24.0

28.2

21.0

15.0

under study., Of these homes, about 75 percent

were operated under a proprietary t~pe of

ownership (table A) and about 25 percent under

nonprofit or government auspices. These homes

provided care for about 1,075,800 residents, or

approximately 5 percent of the U.S. population

65 years of age and over. The following nursing

care homes were included in the 1973-74 survey:

Those certified as extended care facilities

(ECF’S) by Medicare (Title XVIII of the

Social Security Act).’

aThe extended care facility and skilled nursing

home designations are used in this report because most

of the survey was conducted prior to the legislation that

created the skilled nursing facility.

2
by

Those certified as skilled nursing homes

(SNH’S) by Medicaid (Title XIX of the

Social Security Act).’

Those certified as intermediate care facilities (ICF’S) by Medicaid.

Those not certified by either program but

providing some level of nursing care.

Of the homes certified, some were certified

both the Medicare and the Medicaid programs, and others were certified only by the

Medicaid program to participate as both a skilled

nursing home and as an intermediate care facility. In order to provide detailed data on the

homes by certification status, some small certification subgroups were combined with larger

ones when both provided similar levels of care.

Thus, the 4,200 homes classified as having been

certified by both Medicare and Medicaid include

8 percent that were certified by Medicare only.

Similarly, the 3,500 homes classified as having

been certified by Medicaid as skilled nursing

homes (SNH’S) include 35 percent that were

also certified as intermediate care facilities

(ICF’S).

When the number of homes in these four

certification groups are examined (table A),

percents range from 22 percent for SNH’S to 28

percent for ICF’S. Even though the distribution

of homes appears nearly equal over the four

certification groups, there were, in fact, significantly more homes in the ICF group than in the

SNH group.

Examination of the geographic location of

the homes shows that, of the four geographic

regions, the North Central Region had the highest proportion of the total homes (over onethird) and the South had the second highest

(over one-fourth) (table A). Additional information on the distribution of nursing homes is

presented in table 7.

When the number of homes from the 1963

and 1969 surveys were adjusted to reflect the

same population as that used for the 1973-74

survey, the percent increase in the number of

homes providing nursing care since 1969 was

small, about 3 percent for the entire period or

an average yearly increase of less than 1 percent.

For the 10- or n-year span from 1963 to 1973-

74, however, the increase was 23 percent (or an

P

2,6

1969 to

1973.74

0,7

I

228

1963 m

1973.74

2.3

—

I I I I I I

o 5 10 15 20 25

PERCENT

KOTE F,gurt, from 1963 and 1969 were ad,u,tcd m cxcludc Per,ond art homes and hmPNal <are fw!l,.

,,,$. For ,0.,.,, “f datz, SC, refmnce, 6 and 20.

Figure 1. Percent change in the number of nursing homes and

the average annual change for 1963, 1969, and August

1973-April 1974: United States

average yearly increase of over 2 percent) (figure

1). “

Distribution of Beds

Nursing care homes in the 1973-74 survey

have been categorized for this report into four

bed-size groups-less than 50 beds, 50-99 beds,

100-199 beds, and 200 beds or more. Homes

with more than 200 beds accounted for only 4

percent of the total number of homes and represented a significantly smaller percent of homes

than those in the other three groups. At the

other end of the spectrum, homes with less than

100 beds represented about 75 percent of all

homes.

During the survey period, nursing home beds

totaled about 1,177,300. Of these, 24 percent

were certified as ECF beds by Medicare; 49

percent were certified as SNH beds by Medicaid;

and 32 percent were certified as ICF beds by

Medicaid (table B). It should be noted that these

percents do not add to 100 percent because

some beds have dual certification. For example,

a bed certified by Medicare may also be certified

by Medicaid. Since one bed may be counted

twice, the sum of all certified beds exceeds the

actual number of beds by more than 5 percent.

Homes under a proprietary ownership accounted

for over 70 percent of the total number of beds.

Since over three-fourths of all homes are in this

3
Table B. Numbar and percent distribution of nursing home beds by ownership and geographic region of the home, according to

certification status of the bed: United States, August 1973-April 1974

I

Certification of bed

Ownership and geographic region

All bedsl

Medicare

beds SNH beds ICF beds

I

Number

All beds

~

.................................... ................................................................. , ,

Total .........................................................................................................

Ownership

Proprietary .............................. ........................................ .. ...... .... ..............................

Nonprofit and government .......................................... ..............................................

Geographic region

Northeast ...................... ............................................................................................

North Central ......................................... .................................................. .................

South ........................................................................................................................

West ..........................................................................................................................

100.0

I

100.0

70.7 78.2

29.3 21.8

21.3 28.3

34.7 17.3

25.8 17.9

18.2 36.5

100.01 100.0

76.0 73.1

24.0 26.9

24.2 14.2

25.9 39.4

21.7 34.6

28.1 11.8

l’r’h~ sum of certified beds ~xceed~ the total ~umb~r of bed5 beca”~e some beds may have dua] ce~tifi~ation.

NOTE: Estimates for beds differ by an average of 0.3 percent from those presented in reference 2 due to inclusion of a bed-ratio

adjustment factor in the weighting as described in appendix I.

ownership category, this significantly higher percent of beds is not unexpected.

The numbers of beds were distributed similarly to the number of homes when examined by

region. As with homes, the percent of beds in

the North Central Region was significantly

greater than the percents in the other three regions. The South also accounted for a significantly larger percent of beds than the Northeast

or the West did.

Figure 2 shows the percent change in the

number of beds in homes providing nursing care.

When the numbers of beds from the 1963 and

1969 surveys are adjusted to reflect a similar

population to that of the 1973-74 survey, the

percent increase in beds between 1963 and

1973-74 is 131 percent or an average yearly

increase of about 13 percent. Growth since 1969

was much slower; the increase was 38 percent

for the 4-year span, or over 9 percent per year.

Occupancy Rate

Another measure of the utilization of nursing homes is the occupancy rate of the beds in

the home. This rate was computed for this

I

I I I I I I I I I I I I I I I

o 10 20 30 40 50 60 70 80 90 100 110 120 130 140

PERCENT

NOTE, F,w,, from 1963 and1969 w,,, adjusted to .xcludc Pmm.1 CU. homes and hmpttd ,am 1.,111

t,,,, For mu,,,, of data, seer, ferenms 6 md 20,

Figure 2. Percent change in the number of nursinghomebeds

and the average annual change for 1963, 1969, and August

1973-April 1974: United States

report by using the formula

z

Aggregate number of days of care provided

to residents in 1972 X 100

L ‘ Estimated number of beds in 1972 X 366

4
The number of beds in 1972 was estimated by

adjusting the number of beds in 1973-74 for any

change in beds during the preceding year of

1972. An occupancy rate based on days of care

provided gives a more stable estimate of utilization for a calendar year than a rate based on

number of beds occupied last night does.

Generally, 87 percent of all beds were occupied in homes during 1972 (table C). While the

occupancy rate by type of certification varied

from 85 percent for both Medicare and Medicaid homes to 89 for ICF ‘s, no significant differences were found. No significant differences

were found in the occupancy rates by ownership, size, or geographic region of the home.

Table C. Occupancy rate of beds in nursing homes, by certification status, ownership, size, and geographic region: United

States. 1972

Certification, ownership, siza, and

geographic region

All homes ...........................................

Certification status

Both Medicare and Medicaid2 ............................

Medits~~s~nly:

..........................................................

ICF’S .............................................................

Not cartified .......................................................

Ownership

Proprietary .........................................................

Nonprofit and government .................................

—6ize

Lessthan 50 beds ...............................................

50-99 beds ..........................................................

100-199 beds ......................................................

200 beds ormore ...............................................

Geographic ragion

Northeast ...........................................................

North Central .....................................................

South ,,,.,, ,.,,.,.... .................................................

West ...................................................................

Occwe?yy

86.5

84.9

85.7

89.2

88.4

86.4

86.7

89.2

88.6

86.3

80.1

89.0

86.2

86.5

84.2

‘z Aggregate number of days of care provided

to residents in 1972 X 100

~Estimatednumberof bedsin 1972 X 366

See a pendix II for additional information concerning ratios.

!&f these homes, s percent were certified by Medicare

only.

30 f these homes, 3S percent were certified as both SNH’S

and ICF’S.

For Medicare, SNH, and ICF beds, table 6 -

presents the percent of beds filled “last night.”

When sampling variability is considered, the percent of beds filled “last night” is significantly

smaller for Medicare beds than for those certified as SNH or ICF beds. Almost 60 percent of

the SNH and ICF beds were filled compared

with about 12 percent of Medicare beds. Further

examination shows that, regardless of the ownership, size, or geographic region of the homes, a

smaller percent of Medicare beds was filled on

the night prior to the survey.

RESIDENT DATA

Demographic Characteristics

An overall picture of the types of persons

using nursing homes during the 1973-74 survey

can be obtained by examining the age and sex of

the residents, their length of stay since current

admission, primary reason for admission, and

living arrangements prior to admission. Since,

as of July 1973, almost 60 percent of the civilian population over 65 years of age were

women, it is not surprising that 7 out of 10 nursing home residents that year were women.

Generally, there were 238 females per 100

males. Of the female nursing home residents,

almost 80 percent (figure 3) were 75 years and

over—a reflection of the longer lifespan of

‘GEURiE~ H65”74Y’”S lE!E~::e

All residents

Male 16.5

Female 8.2

1 I I I I I I I I I 1

0 10 20 30 40 50 60 70 80 90 lW

PERCENT OF RESIDENTS

Figure 3. Percent distribution of residents by sax and age:

United States, August 1973-April 1974

5
women. In comparison, about 63 percent of the

male nursing home residents were 75 years and

over. (The Division of Vital Statistics of the

National Center for Health Statistics estimates

the lifespan in 1973 to have been 75 years for

females and 68 years formales.22 )

Length of Stay Since Current Admission

The length of stay as defined in this report is

the time interval between the patient’s current

admission to the home and the day the survey

was conducted. (See question 5 of the Resident

Questionnaire in appendix III). Nearly 72 percent of all residents in nursing homes during the

1973-74 survey had been there for less than 3

years and nearly 15 percent had been in nursing

homes for less than 3 months (figure 4).

The length of stay of residents according to

their age and sex is shown in table D and table 1.

Between 70 and 75 percent of the residents had

a length of stay of less than 3 years regardless of

the sex or age category examined.

Table E and table 2 examine length of stay

according to various faciIit y characteristics.

Homes certified by both Medicare and Medicaid

had a significantly larger percentage of the shortterm residents (less than 3 years) than homes in

E“ Less than 3.5,9 6.11.9 1.2,9 3 years

3 months months months years or mora

LENGTH OF STAY SINCE CURRENT AOMISSION

Figure 4. Percent distribution of residents by length of stay

since current admission: United States, August 1973-April

1974

the other certification groups had. Thk was

probably due to the generally shorter stay of

residents receiving Medicare benefits (Medicare

will finance a maximum of 100 days of cake).

Homes that were not certified had a significantly

higher percent of longer term residents (3 years

or more) in comparison with homes certified as

SNH’S, or for both Medicare and Medicaid.

When ownership of the home is considered,

government and nonprofit homes had a significantly higher percent of long-term residents

(38 percent). Proprietary homes had 24 perTable D. Number and percent distribution of residents by length of stay since current admission, according to age and sex: United

States, August 1973-April 1974

Age and sex

All residents ................................................

Less than 65 years .......................................................

65-74 years .................................................................

75 years or more .........................................................

Males ................................................................

Less than 65 years .......................................................

65-74 years .................................................................

75 years or more .........................................................

Females ............................................................

Less than 65 years .......................................................

65-74 years ................................................ .................

75 years or more .......................................... ...............

Number

of

residents

1,075,800

114,300

163,100

798,400

318,100

52,400

65,100

200,600

757,700

61,900

98,000

597,800

II Length of stay since current admission

Total

Less than

3 to less 6 to less 1 to less I

3 yeers

3 months

than 6 than 12 than 3 or

months months years more

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

14.4

14.4

16.5

14.0

17.1

15.5

17.3

17.5

13.3

13.5

16.0

12.9

Percent distribution

9.7

9.3

11.0

9.4

10.5

9.6

11.0

10.5

9.3

9.1

10.9

9.1

14.5

14.1

15.8

14.3

14.7

14.1

15.2

14.7

14,4

14.0

16.1

14.1

33.2

31.7

31,3

33.9

32.2

31.9

30.8

32.7

33.7

31.6

31.7

34.2

28,2

30.4

25.3

28.4

25.6

28.9

26.6

24.7

29.3

31.8

25.3

29.7

NOTE: Figures may not add to totals due to rounding,

6
Table E. Number and percent distribution of residents by length of stay since current admission, according to certification status,

ownership, size, and geographic regi&r: United’ States, August 1973-April 1974 -

Age and sex

All residents ................................................

Certification status

Both Madicaid and Medicarel .....................................

Medicaid only:

SNH’S2 ..................................................................

ICF’S ......................................................................

Not certifiad ...............................................................

Ownership

Proprietary ............o.....................................................

No~profit and government ..........................................

Size —

Les than 50 beds ........................................................

50- i 9 beds ..................................................................

100-199 bads ..............................................................

200 beds or mora ........... .............................................

Geographic region

Northeast ....................................................................

North Central ..............................................................

South ..........................................................................

West ............................................................................

Number

of

residents

1,075,800

406,900

292,500

236,700

139,800

756,200

319,700

162,600

367,700

386,100

159,300

236,100

368,700

278,200

192,800

Total

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

II Length of stay since current admission

1 I 1 i

Less than

3 months

3 to less

than 6

months

6 to Iess 1 to less

than 12 than 3

months years

Percent distribution

14.4

20.1

12.1

10.3

10.1

16.0

10.7

12.1

14.9

16.4

11.0

14.6

11.7

14.6

19.3

9.7

11.3

8.5

9.3

7.8

10.4

7.9

10.3

9.2

10.3

8.5

9.6

9.4

9.2

11.0

14.5

16.3

14.0

13.1

12.5

15.1

13.0

11.7

14.6

15.5

14.4

14.1

14.1

14.8

15.3

33.2

33.1

35.3

32.9

30.0

34.5

30.2

32.1

34.3

33.2

32.1

31.7

33.1

35.2

32.4

3 years

or

more

28.2

19.2

30.2

34.4

39.5

24.0

38.1

33.8

27.0

24.5

34.0

30.1

31.7

26.2

22.0

@f these residents, 23,500 were in facilities certified by Medicare only.

20 f these residents, 129,600 were in facilities certified as both .CJNH$sand 1CF>5.

NOTE: Figures may not add to totals due to rounding.

cent of their residents in this “3-years-or-more” shorter stays and half have longer stays. As such,

group.

Homes in the smallest and largest size groups

(those with less than 50 beds and those with 200

or more) had significantly higher. percents of

long-term residents than homes in the middlesize categories had. Specifically, homes in each

of these two bed-size groups accounted for

about 34 percent of long-term residents.

Homes in the Northeast and North Central

Regions had significantly larger percents (30-31

percent) of long-term residents than homes in

the West Region (22 percent) had. Southern

homes had 26 percent of residents with this

longer length of stay.

The median length of stay is the point in the

distribution where half of the residents have

it is a good measure of central tendency since it

is not affected by the extremes in the distribution. The median length of stay for all residents

in the survey was 547 days, or 1.5 years. Table

F shows how this median vanes according to

certification, ownership, size, and geographic

region of the home. Residents with a median

length of stay greater than 2 years were those in

noncertified facilities and those in homes

operated under nonprofit and government

auspices.

Primaty Reasonfor Admission

The nurse respondent was asked to select

the primary reason the resident was admitted

7
Table F. Median length of stay of residents sinca current admission by certification status, ownership, size, and geographic

region: United States, August 1973-April 1974

Certification, ownership, size and

geographic region

All residants ....................................

Certification status

Both Medicare and Madicaidl .........................

Medicaid only:

SNH’+’ .......................................................

ICF’S ..........................................................

Not certified ....................................................

Ownership

Proprietary ...........m................... .......................

Nonprofit and government ..............................

Size

Less than 50 beds .................... ........................

50-99 beds .......................................................

100-99 beds .....................................................

200 beds or more ............................................

Geographic region

Northeast ........................................................

North Central ..................................................

South ..............................................................

west ................................................................

Median length

of stay

since current

admission

In

days

547

~

397

608

691

762

485

751

635

538

472

667

581

614

532

430

In

yaara

1.5

1.1

1.7

1.9

2.1

1.3

2.1

1.7

1.5

1.3

1.8

1.6

1.7

1.5

1.2

lof these residents, 23,500 were in facilities cefiified by

Medicare only.

20f these residents, 129,600 were in facilitiesce~ified ~

both SNH’Sand ICF’S.

to the home from four general categories. These

categories were listed as “physical reasons,”

“social reasons,” “behavioral reasons,” and

“economic reasons.” (See question 7 of the

Resident Questionnaire , appendix III.) Over 80

percent of persons residing in nursing homes

during the survey entered the home because of

physical reasons (figure 5). In fact, regardless

of sex, age, or length of stay of the resident

(table G) or of any of the facility characteristics

(table H), a significantly larger portion of residents were admitted to homes because of physical pr~blems. Although nearly one-eighth of all

residents were admitted because of behavioral

ao

70

60

20

10

0

REASON FOR ADMISSION

Uu!mlIl Economic

Ils131 s”’”’

m

Bahavlord

u “’s’’”

Figure 5. Percent distribution of residents by tha primary reason for admission to the nursing home: United States,

August 1973-April 1974

problems, about one-third of the younger residents (under 65 years of age) were admitted because of behavioral problems (table G). In

contrast, a significantly smaller percent of residents in the older age groups was admitted for

behavioral problems. Nearly 7 percent of residents were admitted primarily for social reasons

and only 1 percent for economic reasons. Tables

3 and 4 present additional information on

reason for admission.

Living Arrangements Prior to Admission

Of the 1,075,800 persons in nursing homes

during August 1973-April 1974,38 percent were

admitted from a private residence and 59 percent from another facility (table J). (See question 6a of the Resident Questionnaire, appendix

III.) For 35 percent of all residents, the place of

residence prior to admission was a general or

short-stay hospital. This percent is significantly

larger than any for the other types of facilities.

As many as half of the residents admitted to
Table G. Parcent distribution of residents by primary reason for admission, according to sex, age, and length of stay since currant

admission: United States. .-Auaust 1973 -A~ril 1974

Sax, age, and Iangth of stay since current admission

Both sexes ................................................................................

Less than 65 years ....................................................................................

65-74 years ...............................................................................................

75 years or more ......................................................................................

Male ...............................................................................................

Less than 65 years ....................................................................................

65-74 years ...............................................................................................

75 years or more ......................................................................................

Female ...........................................................................................

Less than 65 years ....................................................................................

65.74 years ...............................................................................................

75 years or more .................................................... ..................................

Lenath of stav since current admission

Lessthan 3 months ..................................................................................

3 to lessthan 6 months ............................................................................

6 to lessthan 12 months ..........................................................................

1 to lessthan 3 years ................................................................................

3 to lassthan 5 years ................................................................................

5 to lessthan 10 years ..............................................................................

10 years or mora ......................................................................................

NOTE: Figures may not add to totals due to rounding.

homes certified by both Medicare and Medicaid

were admitted from general or short-stay hospitals. Since Medicare residents are generally admitted to ECF’s following discharge from a

hospital, many of them were probably admitted

to recuperate from an operation or acute illness.

Also, homes certified by both Medicare and

Medicaid generally provide a higher level of nursing care, which is appropriate for persons

recuperating from a hospital stay. Table 5 shows

in more detail the distribution of residents

according to their living arrangements prior to

admission.

Admissions

About 1,110,800 persons were admitted to

nursing homes during 1972. (See question 13 of

the Facility Questionnaire, appendix 111.) Over

Al I reasons

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Primary reason for admission

Physical

I

Social I

Behavioral

I

Economic

Percent distribution

80.9

59.4

76.6

84.9

79.0

57.7

77.3

85.1

81.8

60.8

76.2

84.8

87.2

84.7

84.2

81.3

79.0

74.1

56.3

6.5

5.5

5.4

6.8

6.5

5.7

5.7

6.9

6.4

5.4

5.3

6.8

5.0

4.5

4.5

5.6

6.9

10.5

20.2

11.6

33.9

16.9

7.4

13.4

35.3

15.8

6.9

10.9

32.7

17.6

7.5

7.5

10.1

10.5

12.2

12.9

14.1

19.4

1.0

*

*

1.0

1.2

*

*

*

0.9

*

*

0.9

*

●

*

1.0

*

*

*

half of these admissions (table K) were to the

one-quarter of homes that were” certified by

both Medicare and Medicaid. The fact that these

homes, on the whole, were larger accounts for

this significantly large portion of the admissions.

An examination of admissions according to

ownership of the home shows a significantly

larger percent of admissions to proprietary

homes in 1972. Since about three-fourths of all

homes were operated under proprietary

auspices, this could be expected.

Examination of admissions according to geographic location of the home revealed no significant difference among the percents for the four

regions—they ranged from 22 percent of the

admissions for homes in the Northeast Region

to 28 percent of those for homes in the North

Central. Table 6 presents additional data on

admissions.

9
Tabla H. Percent distribution of residents by primary reeson for admission, according to certification status, ownership, size, and

geographic region: United States, August 1973-April 1974

Certification, ownership, size, and geographic region

All residents .............................................................................

Certification status

Both Medicare and Medicaidl ..................................................................

Medicaid only:

SNH’S2 ................................................................................................

ICF’S ...................................................................................................

Not certified .............................................................................................

Ownership

Proprietary ...............................................................................................

Nonprofit and Government ......................................................................

—Size

Lessthan 50 beds .....................................................................................

50-99 beds .... ............................................................................................

100-199 beds ............................................................................................

200 beds or more .....................................................................................

Geographic region

Northeast .................................................................................................

North Central .......................................,,,.,,,,,....,.,.,.. ................................

South .......................................................................................................

West .........................................................................................................

Primary reason for admission

Al I reasons

Physical I

Social IBehavioral IEconomic

Percent distribution

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

ICIf these re$idents, 23,500 were in facilities certified by Medicare only.

Zofthese residents, 129,600 were in facilities cefiified as both SNH>sand ICF)s.

NOTE: Figures maynotadd tototals dueto rounding.

Table L shows a comparison of the admissions to nursing homes in 1962, 1968, and 1972.

(Data have been adjusted to reflect similar populations.) For the 10-year period since 1962,

admissions to nursing homes increased by 210

percent, but the number of beds increased by

only 131 percent. This might indicate increased

utilization of previously unoccupied beds and a

reduction in the length of stay.

Rate of Patient Turnover

A relative measure of turnover, which allows

a comparison to be made among the various

types of institutions, is the number of admissions per bed. This ratio varied somewhat in

1972 according to the certification, ownership,

80.9

87.1

83.0

78.3

63.3

82.3

77.7

75.5

81.8

83.0

79.4

82.4

77.3

82.2

84.3

6.5

4.0

5.2

6.6

16.1

4.3

11,5

8.2

5.2

6.4

7.7

7.9

7.7

5.2

4.0

11.6

8.2

11.2

14.5

17.4

12.8

8.7

14.7

12.1

9.9

17.5

8.1

14,1

11.7

11.1

1.0

0.7

*

●

3.2

0.5

2.2

1.6

0.9

0.7

1.5

1.7

0.9

0.9

●

size, and geographic region of the home. An

examination of ;able M- reveals a significantly

higher rate of turnover of residents in homes

certified by both Medicare and Medicaid, homes

with a proprietary type of ownership, and

homes in the West Region of the United States.

Admissions per bed per year ranged from 0,7

for homes in the largest size group (200 beds or

more) to 1.1 for homes in the 100-199 bed-size

group. In fact, homes with 200 beds or more

had a significantly smaller rate of turnover than

homes in the bed-size groups 50-99 and 100-

199.

The rate of turnover has varied over the

years as shown in table L. Admissions per bed

varied from 0.7 for 1962 to 1.1 for 1968 to 0.9

for 1972. The lower ratio for 1972 as compared

10
Table J. Number and percent distribution of residents by living arrangements prior to admission, according to certification status,

ownership, size, and geographic region: United States, August 1973-April 1974

Certification, ownership, size, and

geographic region

All residents ........................

Certification status

Both Medicare and Medicaidl ............!

Me&Na~d~~nly:

...........................................

ICF’S ..............................................

Not certified .......................................4

Ownership

Proprietary ..........................................

Nonprofit and government ..................

—Size

Lassthan 50 beds ................................

50.99 beds ...........................................

100-199 beds .......................................

200 bedsor mora ................................

Geoma~hic reaion

Northeast ............................................

North Central .,...,,..,,,.,,, ......................

South .,................o...............................

Wast ....................................................

Number

1,075,BO0

406,900

292,500

236,700

139,800

756,200

319,700

162,600

367,700

386,100

159,300

236,100

366,700

278,200

192,800

Total

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Other health facility

I

GenAI I

eral or

facil- shortities stay

hospital

58.8

69.7

57.5

50.0

44.4

64.2

45.9

54.9

59.4

61.6

54.6

60.B

56.5

52.0

70.4

34.8

50.0

32.9

21.7

16.5

38.6

25.8

24.1

35.5

39.6

32.2

41.0

30.5

29.6

42.8

Mental

hospital or

other

longterm

care

specialty

hospital

Another

nursing

home

or related

facility

Percent distribution

7.9

5.5

7.7

10.6

10.4

9.2

4.8

11.0

8.0

6.5

7.9

4.8

10.2

7.7

7.5

13.9

12.2

14.7

16.2

13.2

14.6

12.4

16.9

14.0

13.2

12.4

12.1

13.9

13.5

16.6

Boarding

home

or other

place

2.2

2.0

2.1

1.5

4.3

1.9

3.0

2.8

1.9

2.3

2.1

2.8

1.9

1.2

3.5

Private

residence

37.5

27.3

38.9

46.0

49.4

32.7

46.6

42,1

36.7

34.9

40.6

37.1

39.0

43.7

25.9

Unknown

3.8

3.0

3.6

4.0

6.2

3.1

5.4

3.0

3.9

3.5

4.8

2.1

4.5

4.3

3.7

@f these residents, 23,500 were in facilities certified by Medicare Only.

20f these residents, 129,600 were in facilities certified as both SNH’S andICF’S.

NOTE: Figures may not add to totals due to rounding.

with that for 1968 is probably due to the greater This can be indicated by the number of homes

increase in the number of beds (37 percent) maintaining a waiting list and the number of

when compared with the increase in the number persons on these lists. During the survey, 72 perof admissions (17 percent). cent of all homes (or 11,300) maintained

waiting lists (table N). These lists contained the

Waiting Lists names of 152,300 persons who, if admitted,

would have utilized 13 Percent of all beds.

Another measure of utilization of nursing Because one pekon may have had his name on

homes is the demand for nursing home beds. several lists, the number 152,300 overestimates

11
Table K. Number and percent distribution of admissions to

nursing homes, by certification status, ownership, size, and

aeoaraohic ----reaion: United States, 1972

Certification, ownership, size, and

geographic region

All admissions .....................

Certification status

Both Medicare and Medicaidl ..............

Medicaid only:

SNH’S2 ...........................................

ICF”S ..............................................

Not certified ........................................

Ownership

Proprietary ..........................................

Nonprofit and government ..................

—Size

Less than 50 beds ................................

50-99 beds ...........................................

100-199 beds .......................................

200 beds or more .................................

Geographic region

Northeast ....................................... .... ..

North Central ......................................

South ...................................................

West .....................................................

Number

1,110,800

624,100

223,600

164,900

98,200

852,800

258,000

148,900

397,000

441,200

123,700

238,700

306,900

289,100

276,100

Percent

distribution

100.0

56.2

20.1

14.8

8.8

76.8

23.2

13.4

35.7

39.7

11.1

21.5

27.6

26.0

24.9

lof these homes, 8 percent were certified by Medicare

only.

20f these homes, 3S percent were certified as both SNH’S

and ICF’S.

NOTE: Figures may not add to totals due to rounding.

Table L. Number of admissions to nursing homes and admissions

per bed: United States, 1962, 1968, and 1972

Admissions and

admissions per bed I

19621 I

19681 I1972

Number of admissions ...... 358,500 946,000 1,110,800

Admissions per bed .......... 0.7 1.1 0.9

lThese figures were adjusted to include only homes providing some level of nursing care. For sources of data see references

6 and 20, respectively.

the demand. Nevertheless, the fact that 72 percent of all homes maintained waiting lists indicated that the demand for beds exceeded the

supply in a majority of homes.

Of the homes not certified by Medicare or

Medicaid, 61 percent maintained waiting lists

Table M. Rate of resident turnover (admissions per bed), by

certification status, ownership, size, and geographic region:

United States, 1972

Certification, ownership, size, and

geographic region

All homes ..................................................

Certification status

Both Medicare and MedicaidI ....................................

Medicaid only:

SNH’S2 .................................................................

ICF’S ....................................................................

Not certified ....................................................... .......

Ownership

Proprietary ........................ .......................................

Nonprofit and government ........................................

—Size

Less than 50 beds ......................................................

5099 beds ........................................... ......................

100-199 beds .............................................................

200 beds or more .......................................................

Geographic region

Northeast ...................................................................

North Central ............................................................

South ....................................................... ..................

West ...........................................................................

Admissions

per

bed

.9

1.4

.7

.7

.6

1.0

.7

,8

1.0

+ 1.1

.7

1.0

.8

1,0

1.3

@f these homes, 8 percent were certified by Medicare

only.

20f these homes, 3S percent were certified as both SNH’S

and ICF’S.

NOTE: See appendix II for additional information concerning ratios.

(table N). This percent was significantly smaller

than the percents for homes in the other three

certification categories. The 77 percent of nonprofit and government homes with waiting lists

was not significantly greater than the 70 percent

of proprietary homes. Significantly fewer hoties

(67 percent) with less than 50 beds than those

with 50-99 beds (76 percent) maintained waiting

lists. About 75 percent of all homes in the two

larger bed-size groups maintained these lists.

Discharges

About 1,077,500 persons were discharged

from nursing homes in 1972–approximately

12
Tabla N. Number and percent distribution of nursing homes by whether or not a waiting list was maintained, according to certification

status. ownershim size, and ~eographic region: United States, Augu~ 1973-April 1974

Certification, ownarship, size, and geographic region

All homes.......................................................................................

Certification status

Both Medicare and Madcaidl ........................................................................

Me~~~s~ly:

.....................................................................................................

lCF's .....................................................................................................O...

Not certified ................+.................................................................................

Ownershi~

Proprietary ...........m........o...........................m....................................................

Nonprofit and government .............................................................................

Size —

Lessthan 50 beds...........................................................................................

50-99 beds .....................................................................................................

100-199 beds .................................................................................................

200 beds or more ...........................................................................................

Geographic region

Northeast .......................................................................................................

North Cantml .................................................................................................

South ...................................................................................................O.O......-

West ...............................................................................................................

10f these homes, 8 percent were certified by Medicare only.

20f these homes, 35 percent were certified as both SNH’S and ICF’S.

NOTE: Figures may not add to totala due to rounding.

33,000 less than the number of persons admitted. As might be expected, discharges in 1972

followed the same pattern as that of admissions:

Over half of the discharges were from homes

certified by both Medicare and Medicaid.

‘ ‘About three-fourths of all discharges were

from proprietary homes.

A significantly smaller portion of the discharges were from homes in the smallest and

largest bed-size groups.

Discharges were rather evenly distributed

among homes in the four geographic regions.

Total

15,700

4,200

3,500

4,400

3,600

11,900

3,900

6,400

5,500

3,200

600

3,100

5,600

4,100

2,900

With

waiting

Iist

11,300

3,200

2,800

3,100

2,200

8,300

3,000

4,300

4,200

2,400

500

2,400

4,000

3,000

2,000

Without

waiting

Iist

4,400

1,000

700

1,300

1,400

3,500

900

2,100

1,300

800

●

800

1,600

1,100

900

IIIWith Without

Total wait- wait- ing

Iist

ing

list

Percent distribution

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

72.0

77.1

79.2

70.2

61.2

70.3

77.0

66.9

76.1

74.0

75.8

75.4

70.7

72.4

70.1

28.1

22.9

20.8

29.8

38.8

29.7

23.0

33.1

23.9

26.0

●

24.6

29.3

27.7

29.9

Almost 70 percent of all persons discharged

in 1972 were ‘dive and 30 percent were dead

(table O). Although only 30 percent of the discharges were due to death, for 1972 the death

rate for nursing homes residents of 304 per

1,000 was 5.1 times the rate for the U.S. population aged 65 and over.

The percent of discharges due to death was

significantly larger for homes not certified (47

percent) than for homes certified as SNH’S or

ICF’S (34 percent) or by both Medicare and

Medicaid (25 percent).

Homes in the smallest size group (less than

50 beds) had a significantly larger percent of

discharges due to death (41 percent) than homes

13
Table O. Number and gercent distribution of dischames by discharge status, according to cer’tificaticm status, Ownership, size, and

geogra~hic region: Un;ted States, 1972

Certification, ownership, size, and geographic region

All dscharges .......................................................................................................

Certification status

Both Medicare and Medicaidl ..............................................................................................

Me~zttsjnl y:

...........................................................................................................................

ICF’S...............................................................................................................................

Not certified ...............................................................!........................................................

Ownership

Proprietary ...........................................................................................................................

Nonprofit and government ...................................................................................................

Size —

Lessthan 50 beds ............................................................................................... ..................

50-99 beds ...........................................................................................................................

100-199 beds .......................................................................................................................

200 beds or more .................................................................................................................

Geographic region

No~heafi .............................................................................................................................

North Central .......................................................................................................................

South ...................................................................................................................................

West .....................................................................................................................................

10f these homes, 8 percent were certified by Medicare only.

20f these homes, 35 percent were certified as both SNH’S and ICF’S.

NOTE: Figures may not add to totals due to rounding.

with 50-99 beds or 100-199 beds had. Table 6

presents additional data on discharges.

Table P shows the number of discharges

both alive and dead for 1962, 1968, and 1972.

Data for 1962 and 1968 have been adjusted to

reflect a population similar to the one included

in the 1973-74 survey. Although percent change

in discharges since 1962 follows a pattern similar

to that for admissions, the amount of change is

slightly larger. Since 1968, discharges increased

by 24 percent over the 4-year span, or 6 percent

per year. For the 10-year period since 1962, the

number of discharges increased by 218 percent,

or about 22 percent per year. There was a significant decline in the percent of discharges due to

Number

of

discharges

1,077,500

599,300

209,400

153,600

115,300

833,800

243,700

164,500

378,900

415,500

118,600

223,300

307,800

273,300

273,100

~

Total

Dis- 1

Discharged chargad

alive dead

Percent distribution

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

69.6

74.9

66.3

66.3

52.7

70.5

66,4

59.2

71.7

72.1

68.7

70.9

62.4

‘70.0

76.4

30.4

25.1

33.7

33.7

47.3

29.5

33.6

40.8

, 28.3

27.9

31.3

29.1

37.6

30.0

23.6

Table P. Number and percent distribution of discharges bv

discharge status: United States, 1862,1968, and 19~2

Discharges 1 19621 I 19681 I 1972

Number of discharges .........

Total ................

Discharged alive ...............

Discharged dead ...............

Percent distribution

100.0 100.0 100.0

58.9 69.6

41.1 ::: 30.4

lThese figures were adjusted to include ordy homes providing some level of nursing care. For sources of data see references

6 and 20, respectively.
death over the 10-year span. Between 1962 and

1972, the percent of discharges due to death

dropped from 41 percent to 30 percent.

STAFFING AND FINANCIAL

CHARACTERISTICS

Full-Time Equivalent Employees

Employees of nursing homes may be examined best in terms of full-time equivalent (FTE)

employees rather than actual employees.

Because a full-time equivalent employee is

defined as one who works a minimum of 35

hours per week, part-time employees were converted to FTE’s by dividing the number of hours

worked per week by 35. By using this equivalent, the variation between homes in the proportion of part-time staff was held constant.

During the 1973-74 survey, there were about

713,100 full-time equivalent employees in nursing homes; of these, over half were members of

the nursing staff (figure 6) and about 46 percent

were nurse’s aides. As the level of education and

training of the nursing staff increased from

~.. .

AdmmKtratwe, medical,and therapeutic

is’”’

llBIHLp”s

~ Nurre%aides

H

All other ssaff

I I I I [ 1 I I I I I

o 10 20 30 40 50 60 70 80 90 Im

PERCENT OF FULL.TIME EQUIVALENT EMPLOYEES

Fiaure 6. Percent distribution of full-time equivalent employees

in nursing homes by occupation category: United Statas,

August 1973-April 1974

nurse’s aide to licensed practical nurse (LPN) to

registered nurse (RN), the percent of FTE’s decreased from 46 percent for nurse’s aides to 9

percent for LPN’s to 7 percent for RN’s (table

Q and table 8). In fact, the percent of nurse’s

Table Q. Percent distribution of full-time equivalent employees by occupation category, according to certification status of the home:

United States, August 1973-April 1974

Occupation cetegory

—

All occupations ...............................................................................................

Administrative and medica13 ......................................... .................................................

Therapeutic ..................................................................................................................

Nursing staff:

Registered nurse ........................................................................................................

Licensed practical nurse .......................... ..................................................................

Nurse’s aide ................................................... ............................................................

All other staff .................................................................................................................

All

homes

II Certification

IIand I I I

certlMedi- SNH’+’ ICF’S fied

II caidl I II

11 1 1 I

Percent distribution

I

100.0 100.0

3.8 3.0

1.8 2.4

7.4 9.1

8.8 8.9

46.3 45.9

31.9 30.7

100.0

3.4

1.6

7.5

9.4

45.5

32.5

100.0

4.7

1.1

4.2

8.5

49.5

32.0

100.0

6.3

1.4

6.4

7.2

44.0

34.8

10f these homes, 8 percent were certified by Medicare only.

20f these homes, 3S percent were certified as both SNH’S and ICF’S.

31nclude5 administrators, phy~i~ians, dentists, pharmacists, dietitians, medical records administrators, and other professional staff.

41n~ludes occupational therapists, physical therapists, speech pathologists, audiologists, activities directors, social workers, and their

assistants.

NOTE: Figures may not add to totals due to rounding.

15
Table R. Number of full-time aquivelent employees per 100 residents, by occupation category and certification status of the home:

United States, August 1973-April 1974

Certification

Both Medicaid only

Occupation category

All Medihomes care

Not

and certiMedi- SNH’S2 ICF’S fied

caidl

Number of employees per 100 residents

All occupations ............................................................................................... 66.3 72.3 68.7 57.5 58.5

Administrative and medica13 .......................................................................................... 2.5 2.2 2.4 2.7 3.7

Therapeutic .................................................................................................................. 1.2 1.7 1.1 0.7 0.8

Nursing staff ................................................................................................................... 41.4 46.1 42.9 35.8 33.6

Registered nurse ................................. .............. ......................................................... 4.9 6.5 5.2 2.4 3.7

Licensed practical nurse ........................................... .. ............................................... 5.8 6.4 6.5 4.9 4.2

Nurse’s aide ............................................................................................................... 30.7 33.2 31.2 28.5 25.7

All other staff ................................................................................................................. 21.2 22.2 22.3 18.4 20.4

lof these homes, 8 percent were certified by Medicare only.

20f these homes, 35 percent were certified as both SNH’S and ICF’S.

31nclude~ administrators, ~hYsicians, dentists, pharmacists, dietitians, medical records administrators, and other professional staff.

41ncludes occupational therapkt~, physical therapists, speechpathologists, riurliologkts, activitiesdirectors, social workers, and their

assistants.

NOTE: See appendix II for additional information concerning ratios.

aides was significantly greater than the percent

of RN’s or LPN’s were. Administrative, medical,

and therapeutic FTE’s comprised less than 6 percent of the total nursing home staff.

The percents of FTE nursing staff (RN’s,

LPN’s, and aides) ranged from 58 percent for

homes not certified to 64 percent for homes

certified by both Medicare and Medicaid. When

the percents and their sampling variabilities were

compared, the percent of FTE nursing staff was

significantly smaller for homes with no certification.

The ratio of FTE’s per 100 residents provides a crude measure of the workload as well as

the availability of staff to provide care for residents. Overall, there were 66 full-time equivalent

employees per 100 residents, or about 1 FTE

employee for every 1.5 residents (table R).

Forty-one percent of FTE’s were part of the

nursing staff. Homes certified by both Medicare

and Medicaid or as SNH’S had significantly more

FTE’s per 100 residents than those certified as

ICF’S and those that were not certified.

Over a 10-year span, the number of FTE’s

per 100 residents increased by 22, from 44 per

100 in 1964 to 66 in 1973-74 (table S). This

increase indicates that residents in the 1973-74

survey received more staff time and care than

residents in prior survey years did.

Table S. Number of full-time equivalent employees per 100

nursing home residents for 1964, 1968, and August 1973-

April 1974: Unitad States

FTE’s

per

Year 100

rasi -

dents

1973.74 .............................................. ......................... 66.3

19681 61.5

l964l:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: 44.1

lThese figures were adjusted to include only homes providing some level of nursing care. For sources of data see references

7 and 23, respectively.

NOTE: See appendix H for additional information concerning ratios.

Level of Skill of Person in Charge

Another measure of the availability of care

in nursing homes is the number of shifts in the

16
home and the level of skill of the nurse in charge

who is on duty (that is, awake, dressed, and serving the residents) for each of the shifts. (See

questions 22 and 23 of the Facility Questionnaire, appendix III.) Most nursing homes in the

survey (86 percent) had three shifts and had an

on-duty charge nurse available around the clock

(figure 7).

As the level of certification of the home decreased, the percent of homes with three shifts

decreased (table 9). A significantly smaller percent of homes not certified (64 percent) than of

those with some type of certification (86 percent or more) had three shifts.

Since the proportion of homes with three

shifts represents such a large percent (86 percent) of all the homes, the examination of the

level of skill (education) of the nurse in charge

was based on those in these homes. In 78 percent of these homes, RN’s and/or LPN’s were

the on-duty persons in charge. Slightly over

90 -

80 -

70 -

60 -

z

~

S

!!? 60

E

E

2 40 -

:

2

30 -

20 -

10 -

0 -

m2 Shifrs

NUMBER OF SHIFTS PER DAY

\t!rl 11,,h, than 1 pmcnt .1 hmnc, “,,1, a ,har$e nurse on ,.11 r,,imr ,1>,” o“ d.,, .,, ,nclud,d m the

1 .h,ft , 4,,*<.,,

Figure 7. Percent distribution of nursing homes by number of

shifts per day: United States, August 1973-April 1974

one-fourth of the homes had an RN on duty for

all three shifts (table T and table 9).

Examination of table T shows that as the

certification status of the home decreased so

did the level of skill of the charge nurse on

duty. Homes certified by both Medicare and

Medicaid had an RN, LPN, or some combination

of the two on duty for three shifts in a significantly larger percent of homes—over 94 percent.

This pattern is directly related to certification

requirements in effect at the time of the survey—that homes certified by Medicare were

required to provide 24-hour nursing services

with an RN on duty for 40 hours per week.

(This requirement could be waived in certain

special situations, such as in rural nursing homes

that were unable to assure the presence of a

full-time RN.) On the other hand, 61 percent of

ICF’S and only 49 percent of homes not certified had a combination of RN’s and LPN’s on

duty.

When level of skill of person in charge is

considered in relation to size of the home, all

homes having 200 beds or more had an RN or

some combination of RN’s or LPN’s in charge

for all three shifts. This is probably true because

most of these larger homes were certified by

both Medicare and Medicaid or were providing

a high level of nursing care.

Data relating to RN’s on duty for all three

shifts are available from the 1968 Nursing Home

Surveyzs as well as from this 1973-74 survey. In

1968, 95 percent of the 15,200 homes operated

three shifts of employees each day (table U). Of

these homes, 2,900 (or 19 percent) had an RN

on duty for all three shifts. In contrast, fewer

homes (86 percent) operated these shifts in

1973-74 but more homes (approximately 3,700

or 23 percent) had an RN on duty for all of the

three shifts. When sampling vanabilit y was

examined, however, there was no significant

difference in the percent of homes with an RN

on duty for three shifts between 1968 and 1973-

74.

Average Total Monthly Charge for Care

Data on average total monthly charge for

care were based on the answer to the question,

“Last month, what was the total charge for the

17
Table T. Percent distribution of nursing homes with person in charge on duty for thrae shifts by level of skill of the person in charge,

according to certification status, ownership, and size of home: United States, August 1973-April 1974

.

Certification, ownership, and siza

All homes with three shifis ...................................................

Certification status

Both Medicare and Me~caid2 ........................................................ .......

Medicaid only:

SNH’S3 ............................................................................................

ICF’S ....... ........................................................................................

Not certified .........................................................................................

Ownership

Proprietary ......................................... .......... ........................................

Nonprofit and government ........................................................... ........

—Size

Less than 50 beds ................ .................................................................

50-99 beds ........... .................................................................... .............

100-199 beds .......................................... ..............................................

200 beds or more ..................................................................................

II Skill of charge person on duty in homes with

three shifts

Total

100.0

~

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

!,%RN’s all l%!ii&r’’lN

I I

shiftsl

I I I

27.4

53.2

32.0

6.5

11.9

25.0

34.3

12.1

21.1

52.6

79.3

Percent distribution

45.1

40.9

60.6

44.1

32.4

47.5

38.1

37.7

58.4

39.8

*

5.8

*

●

10.1

*

5.6

6.5

7.7

6.1

*

*

lIncludes homes with RN ‘Son duty for two of three shifts and homes with LPN’s for twO Of three shifts.

20f these homes, 8 percent were certified by Medicare only.

30f these homes, 3S percent were certified as both SNH’S and ICF’S.

NOTE: Figures may not add to totalsdue to rounding.

Table U. Number and percent of nursing homas with three shifts

and percent with RN’s in charge for three shifts: United

States, 1968 and August 1973-April 1974

Percent

Per- with

Num- cent RN’s

Year ber of with in

homes three charge

shifts for

three

shifts

1973 -74 ........................................ 15,700 85.5 23.4

19681 ........................................... 15,200 94.8 19.3

lThese figures were adjusted to include only homes providing some level of nursing care. For source of data see reference 23.

*.

4.9

*

5.0

19.5

5.5

*

12.0

*

●

16.7

*

*

34.3

31.6

16.3

18.1

30.6

12.9

*

●

resident’s care, including all charges for special

services, drugs; and spe;ial medi&l supp”fies?”

(See question 25c of the Resident Questionnaire, appendix III.) Since the question asked

for total charges for last month, data were not

collected for those residents living in nursing

homes for less than one full month. The average

monthly charge data included about 15,700

residents who were covered by “life-care” plans

or “no-charge” plans.

For the survey period, the average total

monthly charge for the 1,012,000 residents who

had been in the home for at least a month

ranged from no charge to over $1,000. About 3

percent of these residents paid over $1,000

while only about 1 percent paid no charge at(all.

18
In fact, the average total charge for all residents

was $479 per month with about two-thirds of

all the residents being charged less than $500.

Table W presents the average total monthly

charge by selected resident characteristics. When

examined according to length of stay since current admission, the average total charge ranged

from under $390 per month for those residents

with a length of stay of 10 years or more to

$542 for residents with stays of less than 3

months. In fact, residents with 10 years or more

paid significantly less than those staying less

Table W. Average total monthly charge and number of rasidents,

by age, sex, length of stay since current admission, and

primary reason for admission: United States, August 1973-

April 1974

Age, sex, length of stay since current

admission, and primary raason for

admission

All residents in home 1

month or more ...............

Arts

Lessthan 65 years..............................

66-74 yeers ........................................

75 years or more ................................

—Sex

Mele ...................................................

Femele ...............................................

Length of stay since current

admission

Lessthan 3 months ............................

3 to lessthan 6 months ......................

6 to lessthan 12 months ....................

1 to lessthan 3 years..........................

3 to lessthan 5 years..........................

6 to lessthan 10 years........................

10 years or more ................................

Primarv reason for admission

Physical..............................................

Social .................................................

Behavioral ..........................................

Economic ...........................................

Average

total

monthly

charge 1

.$479

434

473

466

466

464

542

521

499

479

459

420

383

499

369

419

294

Number

of residents

1,012,000

107,500

152,000

752,500

294,800

717,200

91,500

103,800

155,700

357,700

149,700

116,200

37,300

815,200

66,400

119,800

10,500

,lIncludes basic charge plus any specird charges for medicd

or nursing services, medical supplies, equipment, and so forth.

NOTE:Figures may not add to totals due to rounding.

than a year did. Since over 21 percent of the

residents participating in life care (resident made

an initial payment for lifetime care) or no-charge

plans had a length of stay of 10 years or more,

the significantly lower charge for these longer

term residents was related to these arrangements.

The primary reason for admission was related to the average total monthly charge for

care. Residents admitted because of physical

problems paid significantly higher charges per

month than persons admitted for social, behavioral, or economic reasons did. Since those

admitted for physical problems generally require greater care and increased services, it is not

surprising that the charges for those residents

were greater. Additional data on average total

monthly charge are presented in table 10.

Data on the average total monthly charge for

care were collected in the sample surveys conducted in 1964 and 1969. Table Y shows how

these monthly charges increased over the 10

years from 1964 to 1974. Since 1964, the

increase in charges was 159 percent (or about 16

percent per year), but since 1969 it increased by

only 43 percent (or about 11 percent per year).

Table Y. Average total monthly charge: United States, 1964,

1969, and August 1973-April 1974

Average

Yea r

total

monthly

chargel

1973.74 ............... .................................................... $479

19692 335

l9642:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: 185

lIncludes basic charge plus any special charges fOr medical

or nursing services, medical supplies, equipment, and so forth.

Based on data for residents in the home for 1 month or more.

2These figures were adjusted to include only homesprovidlng some level of nursing care. Residents with life care and

no-charge arrangements were included in these figures. For

sources of data see references 11 and 18, respectively.

Primary Source of Payment

Data on the resident’s primary means of

paying for care are based on responses given to

the question, “What was the primary source of

payment for care last month?” (See question

26b of the Resident Questionnaire, appendix

19
Table Z. Percant distribution of residents by primary source of payment according to age, sex, length of stay since current admission,

and primary reason for admission: United States, August 1973-April 1974

Age, sex, length of stay since current admission,

and primary reason for admission

All residents in home 1 month or more ..................................................

Aqe

Lessthan 65 years..................................................................................................

65-74 years ............................................................................................................

75 years or more ....................................................................o...............................

—Sex

Male .......................................................................................................................

Female ...................................................................................................................

Length of stay since current admission

Lessthan 3 months ................................................................................................

3 to lessthan 6 months ..........................................................................................

6 to lessthan 12 months ................................................................................... .....

1 to lessthan 3 years..............................................................................................

3 to lessthan 5 years..............................................................................................

5 years or more ......................................................................................................

Prima~ reason for admission

Physical .............................................. ...... .............................................. ................

Social .....................................................................................................................

Behavioral ..............................................................................................................

Economic ...............................................................................................................

NOTE: F@sres may not add to totals due to rounding.

III.) As shown in table Z, Medicaid was the

primary source of payment for almost half (48

percent) of the residents in nursing homes

during the survey, and about 37 percent of the

residents used their own income. Medicare was

the primary payment source for about 1 percent

of the residents. Table Z and table 11 show the

primary sources of payment according to selected resident characteristics. Regardless of age

or sex of the resident, Medicaid was the most

frequent primary source of payment. It was also

the most frequent source for residents staying 1

year or more. In contrast, residents staying less

o 0

II Primary source of payment

Percent distribution

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

36.7

18.1

30.8

40.6

35.9

37.1

40.5

43.5

42.6

35.9

32.2

30.4

37.0

48.0

29.8

22.7

1.1

*

*

1.1

0.9

1.1

7.8

*

*

*

*

●

1.3

●

●

●

47.9

53.9

51.9

46.2

46.5

48.4

40.5

44.8

46.4

51.0

51.3

45.2

50.0

28.9

45.5

27.7

11.4

22.3

13.3

9.4

12.3

11.0

8.3

7.3

8.9

10.8

13.3

17.9

9.5

13.7

21.9

18.2

3.0

5,6

2.5

2.7

4.4

2.4

2.9

2.6

1.7

2.2

3.1

6.3

2.2

9.3

2.4

30.8

than 1 year used their own income as freauentlv . .

as they- used Medicaid.

When the primary source of payment is

examined according to the reason for the resident’s admission to the home, Medicaid was the

most frequent primary source for residents admitted because of physical or behavioral reasons.

Residents admitted for social reasons most frequently used their own income as the primary

source of payment.

Detailed tabulations and an in-depth analysis

of resident charges and primary source of payment will be presented in a future report.

o ,L

20
REFERENCES

1National Center for Health Statistics: Selected

operating and financial characteristics of nursing homes,

United States: 1973-74 National Nursing Home Survey.

Vital and Health Statistics. Series 13-No. 22. DHEW

Pub. No, (HRA) 76-1773. Health Resources Administration, Washington. U.S. Government Printing Office, Dec.

1975.

2National Center for Health Statistics: Characteristics,

social contacts, and activities of nursing home residents,

United Stqtes, 1973-74 National Nursing Home Survey.

Vital and Health Statistics. Series 13-No. 27. DHEW Pub.

No. (HRA) 77-1778. Health Resources Administration.

Washington. U.S. Government Printing Office,JuIy 1977.

3National Center for Health Statistics: Institutions

for the aged and chronically ill, United States, AprilJune 1963. Vital and Health Statistics. PHS Pub. No.

1000-Series 12-No. 1. Public Health Service. Washington.

U.S. Government Printing Office, July 1965.

4National Center for Health Statistics: Characteristics of residents in institutions for the aged and chronically ill, United States, April-June 1963. Vital and

Health Statistics. PHS Pub. No. 1000-Series 12-No. 2.

Public Health Service. Washington. U.S. Government

Printing Office, Sept. 1965.

5National Center for Health Statistics: Characteristics of patients in mental hospitals, United States, AprilJune 1963. Vital and Health Statistics. PHS Pub. No.

1000-Series 12-No. 3. Public Health Service. Washington.

U.S. Government Printing Office, Dec. 1965.

6National Center for Health Statistics: Utilization

of institutions for aged and chronically ill, United States,

April-June 1963. Vital and Health Statistics. PHS Pub.

No, 1000-Series 12-No. 4. Public Health Service. Washington. U.S. Government Printing Office, Feb. 1966.

7National Center for Health Statistics: Employees

in nursing and personal care homes, United States, MayJune 1964. Vital and Health Statistics. PHS Pub. No.

1000-Series 12-No. 5. Public Health Service. Washington.

U.S. Government Printing Office, Sept. 1966.

8National Center for Heslth Statistics: Employees

in nursing and personal care homes: Number, work experience, special training, and wages, United States, MayJune 1964. Vital and Health Statistics. PHS Pub. No.

1000-Series 12-No. 6. Public Health Service. Washington.

U.S. Government Printing Office, Jsm. 1967.

‘National Center for Health Statistics: Chronic illness among residents of nursing and personal care

homes, United States, May-June 1964. Vital and Health

Statistics. PHS Pub. No. 1000-Series 12-No. 7. Public

Health Service. Washington. U.S. Government Printing

Office, Mar. 1967.

1‘National Center for Health Statistics: Prevalence

of chronic conditions and impairments among residents

of nursing and personal care homes, United States, MayJune 1964. Vital and Health Statistics. PHS Pub. No.

1000-Series 12-No. 8. Public Health Service. Washington.

U.S. Government Printing Office, July 1967.

11National Center for Health Statistics: Charges for

care in institutions for the aged and chronically ill,

United States, May-June 1964. Vital and Health Statistics. PHS Pub. No. 1000-Series 12-No. 9. Public Health

Service. Washington. U.S. Government Printing Office,

Aug. 1967.

12National Center for Health Statistics: Nursing and

personal care services received by residents of nursing

and personal care homes, United States, May-June 1964.

Vital and Health Statistics. PHS Pub. No. 1000-Series

12-No. 10. Public Health Service. Washington. U.S. Government Printing Office, Sept. 1968.

13National Center for Health Statistics: Use of special aids in homes for the aged and chronically ill, United

States, May-June 1964. Vital and Health Statistics. PHS

Pub. No. 1000-Series 12-No. 11. Public Health Service.

Washington. U.S. Government Printing Office, Dec.

1968.

14Nation~ Center for Health Statistics: Marital

status and living arrangements, before admission to

nursing and personal care homes, United States, MayJune 1964. Vital and Health Statistics. PHS Pub. No.

1000-Series 12-No. 12. Public Health Service. Washington. U.S. Government Printing Office, May 1969.

15National Center for Health Statistics: Administrators of nursing and personal care homes, Education

and training, United States, June-August 1969. Vital

and Health Statistics. Series 12-No. 18. DHEW Pub. No.

(HSM)73-01703. Health Services and Mental Health

Administration. Washington. U.S. Government Printing

Office, Feb. 1973.

16National Center for Health Statistics: Characteristics of

United

residents in nursing and personal care homes,

States, June-August 1969. Vital and Health

21
statistics. Series 12-No. 19. DHEW Pub. No. (HSM)73-

01704. Health Services and Mental Health Administration. Washington. U.S. Government Printing Office, Feb.

1973.

17National Center for Health Statistics: Administrators of nursing and personal care homes, Work experience, United States, June-August 1969. Vital and Health

Statistics. Series 12-No. 20. DHEW Pub. No. (HSM) 73-

01705. Health Services and Mental Health Administration. Washington. U.S. Government Printing Office, Msx.

1973.

18National Center for Health Statistics: Charges for

care and sources of payment for residents in nursing

homes, United States, June-August 1969. Vital and

Health Statistics. Series 12-No. 21. DHEW Pub. No.

(HRA)74-1706. Health Resources Administration. Washington. U.S. Government Printing Office, July 1973.

1‘National Center for Health Statistics: Chronic

conditions and impairments of numing home residents,

United States, 1969. Vital and Health Statistics. Series

12-No. 22. DREW Pub. No. (HRA)74-1 707. Health

Resources Administration. Washington. U.S. GovernmentPrinting Office, Dec. 1973.

20 National Center for Health Statistics: Selected

characteristics of nursing homes for the aged and chronically ill, United States, June-August 1969. Vital and

Health Statistics. Series 12-No. 23. DHEW Pub. No.

(HRA)74-1708. Health Resources Administration.

Washington. U.S. Government Printing Office, Jan.

1974.

21 National Center for Health Statistics: Measures of

chronic illness among residents of nursing and personal

care homes: United States, June-August 1969. Vital and

Health Statistics. Series 12-No. 24. DHEW Pub. No.

(HRA)74-1709. Health Resources Administration. Washington. U.S. Government Printing Office, Mar. 1974.

22National Center for Health Statistics: Vital Statistics of the United States, 1973, Vol. II, Sec. 5, Life

Tables. DHEW Pub. No. (HRA)76-1104. Health

Resources Administration. Rockville, Md. pp. 5-15.

23 National Center for Health Statistics: Employees

in nursing homes: United States, April-September 1968.

Vital and Health Statistics. Series 12-No. 15. DHEW

Pub. No. (HSM)73-1700. Health Services and Mental

Health Administration. Washington. U.S. Government

Printing Office, Oct. 1972.

24vm Nos@md, J. F.: Development of sweY

methodology to measure cost smd quality of care in

nursing homes. Paper presented at 10lst Annual Meeting

of American Public Health Association, Ssm Francisco,

NOV. 8, 1973.

25 National Center for Health Statistics: Development and maintenance of a National Inventory of Hospitals and Institutions. Vital and Health Statistics. PHS

Pub. No. 1000-Series l-No. 3. Public Health Service.

Washington. U.S. Government Printing Office, Feb.

1965.

26 National Center for Health Statistics: Design

and methodology of the 1967 Master Facility Inventory Survey. Vital and Health Statistics. PHS Pub. No.

1000-Series l-No. 9. Public Health Service. Washington.

U.S. Government Printing Office, Jan. 1971.

27 National Center for Health Statistics: The agency

reporting system for maintaining the National Inventory

of Hospitals and Institutions. Vital and Health Statistics.

PHS Pub. No. 1000-Series l-No. 6. Public Health Service. Washington. U.S. Government Printing Office, Apr.

1968.

28 National Center for Health Statistics: Arrangements for physician services to residents in nursing and

personal care homes. United States–May-June 1964.

Vital and Health Statistics. PHS Pub. No. 1000 -Series

12-No. 13. Public Health Service. Washington. U.S.

Government Printing Office. Feb. 1970.

29 Nation~ Center for Health Statistics: Desifw

and methodology for a national survey of nursing

homes. Vital and Health Statistics. PHS. Pub. Series 1-

No. 7. Public Health Service. Washington. U.S. GovernmentPrinting Office, Sept. 1968.

30 National Center for Health Statistics: Inpatient

health facilities as reported from the 1971 Master

Facility Inventory Survey. Vital and Health Statistics.

Series 14-No. 12. DHEW Pub. No. (HRA) 74-1807.

Health Resources Administration. Washington, U.S.

Government Printing Office, Feb. 1970.

22

.
LIST OF DETAILED TABLES

1,

2.

3,

4.

5,

6,

7.

8.

9.

10,

11.

Number and percent distribution of residents in nursing homes by length of stay since current admission, eccording to age and

sex: United States, August 1973-April 1974 ................................................................................................................................

Number end percent distribution of residents in nursing homes by length of stay since current admission, according to certification status, ownership, size, and geographic region: United States, August 1973-April 1974 ...................................................

Number and percent distribution of residents in nursing homes by primary reason for admission, according to sex, age, and

length of stay since current admission: United States, August 1973-April 1974 ...........................................................................

Number and percent distribution of residents in nursing homes by primary reason for admission, according to certification

stetus, ownership, size, and geographic region: United States, August 1973-April 1974 ..............................................................

Number and percent distribution of nursing home residents by living arrangements prior to admission, according to certification stetus, ownership, siza, and geographic region: United States, August 1973-April 1974 .......................................................

Measures of utilization for 1972 and number of residents and certified beds for August 1973-April 1974, by certification

status, ownership, size, and geographic region: United States ......................................................................................................

Number and percent distribution of nursing homes by certification status, according to ownership, size, and geographic region:

United States, August 1973-April 1974 .......................................................................................................................................

Total number and number per 100 residents of full-time equivalent staff in nursing homes, by occu~ation and certification

status: United States, August 1973 -Apri\ 1974 ............................................................................................................................

Number of nursing homes by skill of parson in charge on duty for each shift, certification status, ownership, and size: United

States, August 1973-April 1974 ................................................................................................................................ .................

Number of nursing home residents by average monthly charge for care, aga, sex, length of stay sinca current admission, and

primary raason for admission: United States, August 1973-April 1974 .......................................................................................

Numbar of residants by primary source of payment, age, sax, primary reason for admission, length of stay since current admission, and median Iangth of stay from current admission: United States, August 1973-April 1974 ...............................................

24

26

28

29

30

31

32

33

34

36

37

23
Table 1. Number and percent distribution of residents in nursing homes by length of stay since current admission, according to age and

sex: United States, August 1973-April 1974

II Length of stay since current admission

All Less 3 to less 6 to less 1 to less residents 3 to less

than 3 than 6 than 12 than 3 than 5

5 years

months months months years years

or more

Age and sex

Both sexes

All ages ..................................................

Number

1,075,800 155,400 103,800 155,700 357,700 149,700 153,500

Under 45 years ......................................................

45-54 years ............................................................

55-64 years ............................................................

65-69 years ............................................................

70-74 years ............................................................

75-79 years ............................................................

80-84 years ............................................................

85-89 years ............................................................

90-94 years ............................................................

95 years and over ...................................................

Male

All ages ..................................................

Under 45 years ......................................................

45-54 years ............................................................

55-64 years ............................................................

65-69 years ............................................................

70-74years ............................................................

75-79 years ............................................................

80-84 years ............................................................

85-89 years ............................................................

90-94 years ............................................................

95 years and over ...................................................

Female

AH ages ..................................................

23,500

28,300

62,500

64,700

98,400

162,700

222,100

233,300

137,000

43,300

318,100

3,500

3,400

9,600

10,300

16,700

27,000

35,500

30,700

14,700

4,000

54,400

2,700

2,700

5,300

7,900

10,000

17,200

22,700

22,200

10,800

2,400

33,300

3,300

3,800

9,000

9,200

16,500

25,700

32,900

33,500

16,800

5,000

46,800

7,200

8,800

20,200

20,000

31,100

55,200

76,100

79,800

46,800

12,400

102,300

3,700

4,500

8,500

8,700

12,300

19,800

30,000

32,500

21,900

7,900

40,300

3,200

5,100

9,900

8,600

11,800

17,800

25,000

34,600

26,000

11,500

41,000

12,600

12,600

27,200

28,700

36,500

47,200

55,100

56,600

32,800

8,900

757,700

10,900

15,700

35,300

36,100

61,900

115,500

167,000

176,700

104,200

34,400

*

*

4,600

4,500

6,800

9,300

10,000

10,700

3,800

*

101,000

*

*

5,000

5,800

9,900

17,700

25,500

20,000

10,900

2,800

*

●

2,400

3,400

3,800

5,200

5,800

6,300

3,100

●

70,600

*

●

3,800

4,300

5,600

6,700

8,900

8,100

4,500

*

108,900

3,700

4,300

8,700

8,600

11,500

15,100

18,400

18,400

11,400

*

255,300

●

●

3,700

3,700

3,800

5,700

5,800

7,300

4,700

*

109,400

●

4,1;

4,100

5,100

5,100

6,200

5,900

5,300

●

112,500

Under 45 years ......................................................

45-54 years ............................................................

55-64 years ............................................................

65-69 years ............................................................

70-74 years ............................................................

75-79 years ............................................................

80-84 years ............................................................

85-89 years ............................................................

90-94 years ............................................................

95 years and over ...................................................

*

●

3,000

4,500

6,300

12,000

16,900

15,900

7,700

*

*

●

5,200

4,900

10,900

19,000

24,000

25,400

12,300

3,800

3,500

4,500

11,500

11,400

19,600

40,100

57,700

61,400

35,400

10,200

*

2,600

4,700

5,000

8,500

14,000

24,200

25,300

17,200

6,100

●

3,200

5,900

4,500

6,700

12,700

18,800

28,700

20,700

9,800

NOTE: Figures may not add to totals due to rounding.

24
Table 1. Number and percent distribution of residents in nursing homes by length of stay since current admission, according to age and

sex: United States, August 1973-April 1974–Con.

II Length of stay since current admission

All Less 3 to less 6 to less 1 to less 3 to less residents than 3 than 6 than 12 than 3 than 5

5 years

months months months years years

or more

Age and sex

Both sexes

All agas ..................................................

Under 45 years ......................................................

45-54 years ............................................................

55-64 yaars ............................................................

65-69 years ..........................................................m.

70-74 years ............................................................

75-79 years ............................................................

80-64 years ............................................................

85-89 years ............................................................

90.94 years ......m..........m..........................................

95 years and ovar ...................................................

Mela

Percent distribution

100.0 14.4 9.7 14.5 33.2 13.9 14.3

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

14.8

12.2

15.3

15.9

16.9

16.6

16.0

13.1

10,7

9.3

17.1

11.4

9.4

8.5

12.2

10.2

10.6

10.2

9.5

7.9

5.6

10.5

14.0

13.4

14.4

14.3

16.8

15.8

14.8

14.4

12.3

11.5

14.7

30.8

31.2

32.3

30.9

31.6

33.9

34.3

34.2

34.1

28.8

32.2

15.6

15.9

13.5

13.4

12.5

12.2

13.5

13.9

16.0

18.3

12.7

13.5

18.0

15.9

13.3

12.0

11.0

11.2

14.8

19.0

26.5

All ages .................................................. 12.9

Undar 45 years ......................................................

45-54 years ............................................................

55-64 years ............................................................

65-69 years ............................................................

70-74 years ............................................................

75-79 years ..h.........................................................

80-84 years ............................................................

85-89 years ............................................................

90.94 years ............................................................

95 years and over ...................................................

Female

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

*

●

8.7

12.0

10.3

10.9

10.5

11.1

9.4

*

9.3

*

●

14.0

15.1

15.3

14.3

16.2

14.3

13.8

*

14.4

29.5

34.0

32.0

30.0

31.5

32.1

33.4

32.5

34.7

●

33.7

●

☛

14.9

14.4

13.8

10.9

11.3

10.4

16.1

*

14.8

*

●

16.7

15,6

18.6

19.7

18.1

18.9

11.7

●

13.3

●

☛

13.7

12.9

10.4

12.2

10.5

12.8

14.3

*

All ages .................................................. 14.4

Under 45 years ......................................................

45-54 years ............................................................

55-64 years ............................................................

65-69 years ............................................................

70-74 years ............................................................

75-79 years ............................................................

80-84 years ............................................................

85-89 years ............................................................

90-94 yaars .,,,,.......................................................

95 years and ovar ...................................................

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

*

*

14.2

16.2

16.0

15.3

15.3

11.3

10.4

8.2

●

●

8.4

12.3

10.1

10.4

10.1

9.0

7.4

*

●

☛

14.7

13.6

17.6

16.4

14.4

14.4

11.8

11.1

32.3

28.9

32.6

31.6

31.7

34.7

34.5

34.8

34.0

29.5

*

16.8

13.4

13.8

13.7

12.2

14.5

14.3

16.5

17.8

*

20.3

16.7

12.5

10.9

11.0

11.2

16.2

19.9

28.4

NOTE: Figures may not add to totals due to rounding.

25
Tabla 2. Number and parcant distribution of residents in nursing homes by length of stay since current admission, according to

certification status, ownershirx size, and craomaghic reaion: United States. Auaust 1973-Arxil 1974

Certification, ownership, size,

and gaographic region

All homes ..............................................

Certification status

Both Medicare and Medicaidl ................................

Medicaid only:

SNH’S2 .............................................................

ICF’S ................................................................

Not certified ..........................................................

Ownership

Proprietary ............................................................

Nonprofit and government ....................................

—Size

Lessthan 50 beds ..................................................

50-99 beds .............................................................

100-199 beds ........................................... ..............

200 beds or more ...................................................

Geographic region

Northeast ...............................................................

North Central ........................................................

South .....................................................................

West .......................................................................

--- -

Length of stay since current admission

All Less 3 to less 6 to less 1 to less residents 3 to less

than 3 than 6 than 12 than 3 than 5

5 years

months months months years years

or more

II i I I 1 1

1,075,800

406,900

292,500

236,700

139,800

756,200

319,700

162,600

367,700

386,100

1!59,300

236,100

368,700

278,200

192,800

155,400

81,700

35,300

24,300

14,100

121,100

34,300

19,700

54,700

63,400

17,500

34,400

43,300

40,500

37,200

103,800

46,000

24,800

22,100

11,000

78,400

25,400

16,700

33,700

39,900

13,500

22,600

34,500

25,600

21,200

10f these residents 23,500 were in facilities certified by Medicare only.

20f the5e re5idents 129,600 were in facilities certified as both SNHY~ and ICF>s.

Number

155,700

66,400

40,900

30,900

17,500

114,000

41,700

19,000

53,700

60,000

22,900

33,200

51,800

41,100

29,600

357,700

134,600

103,100

78,000

42,000

261,100

96,600

52,300

126,100

128,200

51,100

74,900

122,200

98,100

62,500

149,700

45,100

44,300

39,300

21,000

100,500

49,200

25,700

51,200

50,600

22,300

33,400

53,400

39,800

23,100

153,500

33,100

44,100

42,006

34,200

81,000

72,500

29,300

48,200

44,000

31,900

37,500

63,500

33,200

19,300

NOTE: Figures may not add to totals due to rounding.

26
Table 2. Number and percent distribution of residents in nursing homes by length of stay since current admission,

certification status, ownership, size, and geographic region: United States, August 1973-April 1974–Con.

according to

Certification, ownership, size,

and geographic region

All homes ..............................................

Certification status

Both Medicare and Medicaidl ................................

Medicaid only:

SNH’S2 .............................................................

ICF’S ..............................0.................................

Not certified ..........................................................

Ownership

Proprietary ............................................................

Nonprofit and government ....................................

—Size

Lessthan 50 bads ..................................................

50.99 beds .............................................................

100-199 beds .........................................................

200 beds or more ...................................................

Geographic region

Northaast ...............................................................

North Central ........................................................

South .....................................................................

West ..................................o....................................

II Length of stay since current admission

All Less 3 to less 6 to less 1 to less residents 3 to less

than 3 than 6 than 12 than 3 than 5

5 years

months months months years years or more

Percent distribution

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

14.4

20.1

12.1

10.3

10.1

16.0

10.7

12.1

14.9

16.4

11.0

14.6

11.7

14.6

19.3

9.7

11.3

8.5

9.3

7.8

10.4

7.9

10.3

9.2

10.3

8.5

9.6

9.4

9.2

11.0

@f these residents 23,500 were in facilities certified by Medicare Only.

@f these ~e~idents 129,600 were in facilities certified as both SNH>~ and I(JF>s,

14.5

16.3

14.0

13.1

12.5

15.1

13.0

11.7

14.6

15.5

14.4

14.1

14.1

14.8

15.3

33.2

33.1

35.3

32.9

30.0

34.5

30.2

32.1

34.3

33.2

32.1

31.7

33.1

35.2

32.4

13.9

11.1

15.1

16.6

15.0

13.3

15.4

15.8

13.9

13.1

14.0

14.2

14.5

14.3

12.0

14.3

8.1

15.1

17.8

24.5

10.7

22.7

18.0

13.1

11.4

20.0

15.9

17.2

11.9

10.0

NOTE: Figures may not add to totals due to rounding.

27
Table 3. Number and percent distribution of residents in nursing homes by primary reason for admission, according to sex, age, and

Ienath of stav since current admission: United States. Auaust 1973-Arwil 1974

Sex, age and length of stay

since current admission

Both sexes ..................

Under 65 years ...........................

65-74 years .................................

75-84 years .................................

85 years and over ........................

Males ....................... ...... ...

Under 65 years ...........................

65-74 years .................................

75-84 years .................................

85 years and over ........................

Females ............................

Under 65 years ...........................

65-74 years .................................

75-64 years .................................

85 years and over ........................

Length of stay since current

admission

Lessthan 3 months .....................

3 to lessthan 6 months ...............

6 to lessthan 12 months .............

1 to lessthan 3 years ..................

3 to lessthan 5 years ..................

5 years or more ...........................

II Primary reason for admission

All

residents Physical Social Behav- Ecoioral nomic

Number

1,075,800

114,300

163,100

384,900

413,600

318,100

52,400

65,100

102,300

98,300

757,700

61,900

98,000

282,600

315,300

155,400

103~oo

155,700

357,700

149,700

153,500

870,700

67,900

124,900

321,000

356,900

251,200

30,200

50,300

86,200

84,500

619,500

37,600

74,600

234,800

272,400

135,500

88,000

131,100

290,700

118,300

107,100

69,400

6,300

8,900

24,300

28,900

20,600

3,000

3,700

6,300

7,600

48,900

3,300

5,200

18,000

22,300

7,700

4,700

7,100

19,900

10,300

19,800

125,000

38,700

27,600

35300

22,800

42,700

18,500

10,300

8,700

5,200

82,300

20,200

17,300

27,200

17,700

11,700

10,500

16,300

43,500

19,400

23,600

10,700

*

*

3,700

3,900

3,700

●

*

*

*

7,000

*

●

2,600

2,800

●

●

●

3,600

*

3,000

II Primary reason for admission

Percent distribution

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

BO.9

59.4

76.6

83.4

86.3

79.0

57.7

77.3

84.3

85.9

81.8

60.8

76.2

83.1

86.4

87.2

64.7

84.2

81.3

79.0

69.8

6.5

5.5

5,4

6.3

7.2

6.5

5.7

5.7

6.1

7.7

6.4

5.4

5.3

6.4

7.1

5.0

4.5

4.5

5.6

6.9

12.9

11.6

33.9

16.9

9.3

5.5

13.4

35.3

15.8

8,5

5.3

10.9

32.7

17.6

9.6

5.6

7.5

10.1

10.5

12.2

12.9

15.4

1.0

●

●

1.0

0.9

1.2

●

*

*

●

0.9

●

●

0.9

0.9

●

*

●

1.0

●

1.9

NOTE: Figures may not add to totals due to rounding.

28
Table 4. Number and percent distribution of residents in nursing homes by primary reason for admission, according to certification

status, ownership, size, and geographic region: United States, August 1973-April 1974

Certification, ownership, size,

and geographic region

All homes ...................

Certification status

Both Medicare and Madicaidl .....

Mer&a~~~;nl y:

..................................

ICF’S .....................................

Not certified ...............................

Ownership

Proprietary .................................

Nonprofit and government .........

Size

—

Lass than 50 beds .......................

50-99 beds ..................................

100-199 beds ..............................

200 beds or more ........................

Geographic region

Northeast ....................................

North Central .............................

South ..........................................

West ............................................

II Primary reason for admission

All

residents Physical Bahav- Eco. Social ioral nomic

1,075,800

406,900

292,500

236,700

139,800

756,200

319,700

162,600

367,700

366,100

159,300

236,100

368,700

278,200

192,800

870,700

354,300

242,700

185,300

88,500

622,400

248,300

122,900

301,000

320,500

126,400

194,400

285,100

228,800

162,400

Number

69,400

16,200

15,100

15,700

22,400

32,800

36,600

13,400

19,100

24,800

12,200

18,700

28,600

14,500

7,700

125,000

33,500

32,700

34,400

24,400

97,200

27,800

23,900

44,600

38,300

18,300

19,000

52,000

32,500

21,500

10,700

2,800

*

*

4,500

3,800

6,900

2,500

3,100

2,700

2,400

3,900

3,100

2,500

●

lof these residents 23,500 were in facilities certified by Medicare only.

20f these residents 129,600 were in facilities certified as both SNH)s and I(JF>s.

II Primary reason for admission

~;’tmmiil

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

Percent distribution

80.9

87.1

83.0

78.3

63.3

82.3

77.7

75.5

81.8

83.0

79.4

82.4

77.3

82.2

84.3

6.5

~

4.0

5.2

6.6

16.1

4.3

11.5

8.2

5.2

6.4

7.7

7.9

7.7

5.2

4.0

11.6

8.2

11.2

14.5

17.4

12.8

8.7

14.7

12.1

9.9

11.5

8.1

14.1

11.7

11.1

1.0

0.7

*

*

3.2

0.5

2.2

1.6

0.9

0.7

1.5

::;

0.9

*

I NOTE: Figures may not add to totals due to rounding.

29
Table 5. Number and percent distribution of nursing home residents by living arrangements prior to admission, according to certification status, ownership, size, and geographic ragion:

United States, August 1973-April 1974

Living arrangements prior to admission

Another facility Private residmce

Mental

All Board- With otherslAnother hospital Unarrange- nursing m other General ing Un- known

ments home or 10ng- or short- home Alone Other Non- knovm

related term stay or

facility

Total Spouse Children rela- if with

hospital other

reIasp3cialty tivzs tives othws

hospital place

Certification, ownership, size, a“d

geographic region

All homes. ...................... 1,075,80C

~

406,BO0

292,500

236,70C

139,800

758,21X

319,700

162,6oO

367,700

386,100

I 59,300

236,100

368,700

278,200

192,800

149.600 84,600 374,200 23,800 127,900 231,900 B3,8W

19,900

18,200

16,800

8,800

41,100

22,70+3

10,100

23,300

20,600

9,800

12,700

22,000

19,800

9,300

101,403

30,200

30,200

27,900

13,000

66,9W

32,500

16,100

34,800

36,480

14,000

19,S+30

34,300

33,100

14,100

59,800

15,900

16,600

17,100

10,200

38,400

21,400

11,200

19,200

19,800

9,6CKI

13,000

21 ,Zoil

20,6012

5,000

5.6

12,20Q

3,600

2,700

3,100

2,800

7,500

4,600

3,500

4,400

2,800

.

2,800

4,000

4,400

.

1.1

43,100

13,500

13,600

9,700

6,300

24,9oO

18,200

4,600

10,400

16,100

12,000

11,900

12,700

13,800

4,700

4.0

40,7W

~

12,100

10,400

9,500

8,70Q

23,300

17,400

4,900

14,400

13,600

7,70Q

5,000

16,500

12,100

7,100

3.8

Certification stmus

Both Medicare and Mediczid2 ........

Medicaid only:

SNH’S3 .....................................

ICF’S .........................................

Not certified ..................................

48,8oo

43,100

38,300

18,400

I 10,000

39,6oo

27,500

51,500

51,000

19,700

28,700

51,300

37,600

32.000

22,50=3

22,600

25,200

14,500

68,400

15,300

17,800

28,200

24,8CQ

12,500

11,300

37,500

21,400

14,400

7.9

5.5

7.7

10.6

10.4

9.2

4.s

11,0

8.o

6.6

7.9

4.8

10.2

7.7

7.5

203,400

88,300

51,400

23,100

281,600

82,500

39,200

130,600

153,000

51,400

96,900

112,500

82,300

82,600

34.8

50.0

32.9

21.7

16.5

38.6

25.8

24.1

35.5

38.6

32.2

41.0

30.5

28.6

42.8

8<000

6,300

3,400

6,100

14,30+3

9,500

4,600

7,000

8,900

3,300

8,700

7,100

3,300

6,700

2.2

2.0

2.1

1.5

4.3

1.9

3.0

2.8

1.9

2.3

2.1

2.6

1.8

1.2

3.5

28,BO0

33,700

35,900

28,400

70,900

57,0CM

24,100

44,800

40,700

18,200

28,700

52,200

30,7W

16,300

67,700

66,600

63,300

34,300

151,700

80,200

39,700

79,800

77,900

34,500

46,900

78,900

77,100

29,000

Ownership

Proprietary .....................................

Nonprofit and government .............

—size

Less than 50 beds...........................

50-99 beds .....................................

lCQ-188 beds .................................

200 beds or more ........................

Geographic region

Northeast .......................................

North Central..., .............................

South .............................................

West ...............................................

Perc3nt distribution

21.6 5.9 9.4

16.6 4.8

22.8 6.2

26.7

24.5 :;

20.1 5.4

25.1 7.1

24.4 6.2

21.7 6.3

20.2

21.7 E

18.9 5.4

21.4 6.0

27.7 7.1

15.0 4.8 7.3

All homes....................... 13.9 11.8

7.3

11.5

15.2

20.4

9.4

17.6

14.8

12.2

10.6

11.4

12.1

14.2

11.0

8.5

Certificzticm status

Both Medicare and Medicaid2 ........

Medicaid only:

SNH’S3 .....................................

ICF’S.........................................

Not certified ..................................

Ownership

Pr0pr4et2ry .....................................

Nonprofit and government .............

100.0 12,2

14.7

16,2

13.2

14.6

12.4

16.8

14.0

13.2

12.4

12.1

13.9

13.5

7.4

10.3

11.8

9.3

9.1

10.2

8.9

9.5

8.4

8.B

B.4

9.3

11.9

3.9

5.7

7.2

7.3

5.1

6.7

6.9

5.2

5.1

6.0

5.5

5.7

7.4

2.6

0.9

0.9

;:

1.0

1.4

2.2

1.2

0.7

●

1.2

1.1

1.6

●

3.3

4.7

4.1

4.6

3.3

5.7

2.8

2.8

4,2

7.6

5.1

3.4

4.9

2.4

2.9

3.6

4.0

6.2

3.1

6.4

3.0

3.9

%

2.1

4.5

4.3

3.7

100.0

100.0

100.0

100.0

100.0

Size

.

Lessthan 50 beds., .........................

50-99 beds .....................................

100-189 beds .................................

ZOObeds or more.,., .......................

100.0

100.0

100.0

100.0

Geographic region

Northeast .......................................

North Central ................................

South .............................................

west ...............................................

100.0

100.0

100.0

100.0 16.6 —

1Because residents may have lived with more than one c.ztegory of person, the sum of the subparts exceeds the total.

20f these residents, 23,500 were in facilities certified by Medicare only.

30f these residents, 129,600 were in facilities certified as both SNH’Sand ICF’S.

NOTE: Figures may not add to mtal due to rounding,

30
Table 6. Measure; of utilization for 1972 and number of residents and certified beds far IUS 1973 -Apri[ 1974, bv certificatmm status, ownersh!p. size, and geographic region:

United S s

—

Residents

1973-74

1,075,800

Admissions

I,11 0,80+3

Measures of utilization, 1972 —

occupancy

ratez

86.51

Beds,l 1973-74

Discharges Medicare SNH ICF

Live

750,100

Certified

beds

287,400

—

Per.

cent

filled

last

night

—

12.3

—

Per.

cent

filled

last

Certlflcation, ownership, size,

and geographic region

Percent

filled

last

night

59.6

Total

beds

I,177,300

Cert4-

f,ed

beds

579,5fXl

Certt.

fied

beds

373,200

Total

1,077,600

night

All types of certification and ownership ....

Proprietary ....................................

Nonprofit and government ............

8oth Medicare and Medi.

cald3 ...............................

PrOpriOtafy,, ..................................

Nonprofit and government..,., .......

Medicaid only: SNH4 .........

Proprietaw ....................................

Nonprofit and government..,,,, ......

Medicaid only: ICF ............

Proprietary,.,, ................................

Nonprofit and Wvernment . ...........

Not certified ......................

Proprietary ...................................

Nonprofit and government ...........

*

Lessthan 60 beds.......................

W.99 badt .!.......................!..........

100.199 badt ................................

200 beds or more ..........................

Geographic region

Northeast ......................................

North Central ...............................

South ...........................................

west .........................+...................

327,400

—

58.7

852,800

25S,000

624,100

497,700

126,400

223,800

169,900

63,700

164,9oO

121,300

43,600

9S,200

63,900

34,300

14 B.900

397,00+3

441,200

123,700

238,700

306,900

289,100

276,100

833,800

243,700

599,30J3

4S0,1CKI

119,20CI

209,400

158,600

60,800

153,600

113,000

40,600

116,300

62,21Xl

33,100

164,500

37s,900

415,500

118,600

223,30+3

307,600

273,30Q

273,1 W

568,200

161,900

44s,s00

360,500

8B,300

t 38,800

108,400

29,400

101,s00

74,300

27,500

60,700

44,100

16,700

97,400

271,500

299,700

81,500

158,300

191,900

191,200

20B,700

245,60+3

81 ,Wf3

150,500

119,600

30,90+3

70,600

49,200

21,400

51,800

38,700

13,103

54,500

36,100

16,400

67,000

I07,4C0

115,BO0

37,100

65,000

l15,90il

S2,1 0+3

64,400

86.42

86.72

S4.87

S5.09

84.14

85.72

64.06

89.26

S9.17

69.56

B8.07

B8.36

90.60

B5.56

89.16

B8.60

B6.27

80.10

B8.97

66.21

B6.49

84.22

756,200

319,700

406,900

313,900

93,000

292,500

193,700

98,800

236,700

170,100

66,600

139,600

76.500

61,300

162,600

367,700

3S6,100

159,300

236,100

36s,700

27S,200

192,800

832,300

345,000

442,300

339,500

102,s00

321,200

218,900

102,300

253,200

1s4,100

69,100

160,600

S9,BO0

70,800

17S,600

392,500

417,900

188,000

250,S00

406,800

303,700

214,100

224.90Q

62,500

287,400

224,900

62,500

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

18,60+3

106,600

119,500

42,700

81,400

49,800

51,400

104,900

11.3

15.7

12.3

11.3

15.7

. .

. . .

. . .

. . .

. . .

.

18.8

11.1

12.0

13.0

12.4

20.0

15.8

6.7

440.3oi2

139,200

337,500

269,400

68,200

242,000

170,900

71,100

. . .

. . .

. . .

. . .

. . .

43,3W

193,700

244,900

97.700

140,400

150,400

126,000

162,80fJ

68.9

58.1

54.9

55.0

54.5

63.9

64.9

61.5

. . .

. . .

. . .

. . .

. . .

. . .

58.3

56.3

57.9

65.5

66.6

49.7

60.7

58.6

272,700

100,500

70,100

52,S00

17,300

66,3o2

42,000

24,300

236,700

177,800

58,900

. . .

. . .

. . .

75,900

134,8&l

117,200

45,300

53,000

147,200

129,200

43,900

61.6

53.3

62.6

50.5

59.1

60.4

64.4

53.5

61.2

64.5

51.5

. . .

. . .

. . .

61.8

57.6

60.4

58.6

74.4

51.2

69.4

39.9

lThe sum of certified beds exceeds the total number Of beds because some beds may have dud certification.

2X Aggregate number of days of care provided to residents in 1972 X 100

Number of beds X 366

For those homes which had changes i“ size in ] 972, the ““mber of be& hm bee” adjusted accorcfingly.

30f these homes, 8 percent were certified by Medicare oniy.

40f these homes, 35 percent w,ere certified m both SNH’S and ICt%

NOTES: Estimates for beds differ by an average of O 3 percent fmm those presented i“ reference 2 due to inclusion of a bed-ratio adjustment factor in the weighting as described

In appendix 1.

See appendix 11for rtdditiomd information co”ceming mticm

Figures may not add to totals due to rounding.

31
Table 7. Number and percent distribution of nursing homes by certification status, according to ownership, size, and geographic region:

Ownership, size, and geographic region

All homes.....................................

Ownershio

ProprietaW ...................................................

Nonprofit and government ...........................

Size —

Lessthan 50 beds.........................................

50-99 beds ...................................................

100-199 beds ...............................................

200 beds or more .........................................

Geoararshic reqion

Northeast .....................................................

North Central ...............................................

South ..........................................................

West .............................................................

United States, August 1973-April 1974

m

II 1 I I

Number

15,700

11,900

3,900

6,400

5,500

3,200

600

3,100

5,600

4,100

2,900

4,200

~

3,200

900

600

1,800

1,500

300

1,000

900

800

1,400

10f these h~mes. 8 ~ercent were certified for Medicare onlv.

3,500

2,500

1,000

1,000

1,400

900

200

800

1,100

900

600

4,400

3,500

900

2,300

1,600

500

*

600

2,000

1,500

400

3,600

2,700

1,000

2,500

800

300

*

800

1,600

900

400

All II Both I Medicaid onlv I

Percent distribution

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

26.5

27.1

24.4

3?:

46,7

48.2

31.3

16.3

20.1

50.3

22.4

21.2

25.9

15.9

24.8

29.1

32.9

27.1

19.9

22.4

22.0

28.1

29.3

24.4

35.9

28.5

16.0

*

17.7

35.6

36.5

12.8

23.1

22.3

25.3

38.8

14.9

8.2

*

24.0

28.2

21.0

15.0

20 f these homes; 34 percent were certified as both SNH’S ~nd ICF’S.

NOTE: Figures may not add to totals due to rounding.

32
“----

Table 8, Total number and number per 100 residents of full-time equivalent staff in nursing homes, by occupation and certification

status: United States, August 1973-April 1974

Certification

All typas ..........................................................

Both Madicare and Madicaid3 ..........................................

Mec&rIIs~l y:

,

........................................................................

ICF’S ...........................................................................

Not certified .,, ,.,.,.,!.,,..... ..................................................

All typas ..........................................................

Both Medicare and Medicaid3 ..........................................

Medicaid only:

SNH’S4 ........................................................................

ICF’S ......................................................... .................

Not certified ....................................................................

Admin- ~.

Total istrative Thare- Regis- censed

Nurse’s All

and peutic tered practi - other staff medical staffp nurse cal aide slaff

staffl nurse

Number of full-time equivalent staff

7

713,100 27,200 13,000 52,700 62,500 330,000 227,BO0

294,200 8,800 7,000 26,600 26,100 135,200 90,400

201,000 6,900 3,300 15,100 19,000 91,400

136,200 6,400

65,400

1,600 5,700 11,600 67,400 43,500

81,800 5,100 1,100 5,200 5,900 36,000 28,500

Numbar of full-time equivalent staff per 100 residents

66.3 2.5 1.2 4.9 5.8 30.7 21.2

72.3 2.2 1.7 6.5 6.4 33.2 22.2

68.7 2.4 1.1 5.2 6.5 31.2 22.3

57.5 2.7 0.7 2.4 4.9 28.5 18.4

58.5 3.7 0.8 3.7 4.2 25.7 20.4

lIncludes administrators, physicians, dentists, pharmacists, dietitians, medical records administrators, and other professional Staff.

21n~l~des occupational therapists, physical therapists, speech pathologists, audiologists, activities directors, social workers, and their

assistants.

30f these homes, 8 percent were certified by Medicare only.

40f these homes, 35 percent were certified as both SNH’S and ICF’S.

NOTES: See appendix II for additional information concerning ratios.

Figurea may not add to totala due to rounding.

33
..-.’

Table 9. Number of nursina homes by skill of person in charm on duty for each shift, certification status, ownership, and size: Unitad

States, Au&st 1973-April 1974

Certification, ownership, and size

Total ..................................................................................................

Certification status

Both Medicare and Medicaidl ............................................................................

Madicaid only:

SNH’S2 ..........................................................................................................

ICF’S..............................................................................................................

Not cartified .......................................................................................................

Ownership

Proprieta~ .................c........................................................................................

Nonprofit and government ..................................................................................

—Size

Lessthan 50 beds................................................................................................

50-99 beds ..........................................................................................................

100-199 beds ......................................................................................................

200 beds or more ................................................................................................

Total

homes

15,700

4,200

3,500

4,400

3,600

11,900

3,900

6,400

5,500

3,200

600

;harge

wrse

‘n call

●

✎ ✎ ✎

☛

☛

☛

☛

●

☛

☛

Homes with 1 shift

RN

500

=

. . .

*

*

*

200

200

*

*

●

*

LPN

300

=

. . .

*

*

●

300

*

200

●

*

●

Nurse’s

aide

300

. . .

●

300

300

*

300

*

Other

staff

300

. . .

●

300

300

●

300

*

*

lof these homes, 8 percent were certified for Medicare ordY.

20f these homes, 35 percent were certified as both SNH’S and ICF’S.

NOTE: Figures may not add to totals due to rounding.

34
United Statesr Augus~ 1973-April 1974–Con.

I Table 9. Number of nursing homes bv skill of person in charge on duty for each shift, certification status, ownership, and size:

Both

RN’s

200

. . .

+!

*

*

*

*

*

*

*

●

Homes with 2 shifts

Both

LPN’s

*

. . .

*

*

*

*

●

☛

☛

Both

nurse’s

aides

*

. . .

*

*

*

*

*

*

Both

other

staff

*

. . .

*

*

*

All

other

combinations

300

. . .

*

*

200

200

●

300

●

*

*

All

RN’s

3,700

2,100

1,000

300

300

2,500

1,200

600

1,100

1,600

500

All

LPN’s

800

*

*

400

●

600

200

400

300

*

*

All

nurse’s

aides

700

. . .

200

500

600

*

600

●

*

Homes with 3 shifts

All

other

staff

*

*

*

*

*

RN’s

for 2

of 3

shifts

2,500

800

1,000

400

400

2,000

600

700

1,100

600

●

LPN’s

for 2

of 3

shifts

3,600

900

1,000

1,300

400

2,800

700

1,200

1,800

500

●

Nurse’s

aides

for 2

of 3

shifts

1,400

*

*

800

500

1,000

400

1,000

300

*

●

All

other

combinations

800

*

*

500

200

600

*

400

300

●

35
Table 10. Number of nursing home res(de.ts by avera9emonthly charge for care, we, sex, length of stay sm.e current zdmisnon, and zmmaw reasonfor admtswan: Umted States, August 1973.

— Awl 1974

L,fe

care

Total momhly chargd

Average

baste

nonth!y

charge

kverags

tO1al

nonthly

chargel

Age, sex, lengthof stay since

current admissionand primary reasonfor admmmn

Total

res,dents I

$150.I

$300.

ch%e $?49 I

$400. I

$502. I

$6@3. I

$700. S800.

$299 $399 $499 $5s9 S699 $796 $699

2S4,500

32,10fl

38,600

92,1 W

101,600

82,200

182,3W

19,500

24,90d

37,70U

94,100

44,700

43,70d

209,3w

17,700

36,2oo

.

Numbs

All res,dentsm home

1 month or more $466

422

462

476

474

455

473

621

504

486

470

460

404

467

362

412

288

$479

434

473

468

485

456

484

542

521

488

479

459

411

499

369

419

294

1,012,000 6,200

.

2,50+3

3,400

.

5,700

.

.

.

.

.

3,000

.

.

.

.

9,6oo

.

.

3,400

3,200

3,200

6,40+3

.

.

.

.

.

4,000

6,200

.

.

.

9,400

=

.

.

2,800

3,400

3,300

6,100

.

.

.

.

.

4,400

4,400

2,900

.

.

—

104,200

18.100

19,400

33,100

33,502

36,200

67,900

6,100

7,300

12,500

35,009

18,oOO

26,200

62,9fN

16,1OC

23,100

.

274,100

30.300

42,200

95,61J3

I 06,800

76,900

I97,1OO

24,800

26,700

44,300

104,000

39,300

34,8oo

228,400

12,000

31.700

.

I33,400

10,200

18,400

49,900

55,00+3

37,70+3

95,700

14,100

16,300

23,200

46,61X

17,100

16,1W

115,1C4

5,5Ck7

11.900

.

96.200 39,8IXI

=

.

5,200

16,304

17,100

9,560

30,200

6,600

5,300

7,3fM

12,300

5,00f3

4,000

35,200

.

3,1W

.

22,200

.

3,2@3

6,200

9,200

5,710

16,600

2,800

3,300

4,400

7,700

.

.

20,700

.

.

20.200 32.300

107,500

152,000

359,500

393,000

5,700

I 3,9m

35,400

41,200

25,8oo

70,4W

9,6IX

11,90C

15,802

35,80C

12,90C

10,3W

83.51X

4,50(

7,80i

.

.

3,100

7,900

7,602

5,6U0

14,6J20

3,40C

2,30C

3,200

6,2oc

2,5W

2,60C

18,100

.

.

.

2,700

4,8Q3

13.2@3

294,800

717,200

8.100

24,104

5.102

4,700

5,100

10,6CQ

4,200

2.600

29,900

.

.

.

Length of stay sincecurrent

adm8ss,0n

Lessrhan 3 months ..................

3 to lessthan 6 months ............

6.to lessthan 12 months ..........

1 to lessthan 3 years................

3 to lessthan 5 years................

5 yearsor more ......... ....... ......

Primary reasonfor admissmn

Physical....................................

Social ......... ........................ ....

Behavioral............. ........ ...... ..

Economic.................................

81,500

103,803

155,700

357,700

149,7f13

153,5042

815,200

66,4W

119,800

1o.5fKl

llncludes bdsic charge plus any special ch.rge. for medicd or n.rhittg wrvices, medtct.1 mpplie$ tmd equipment, md so forth.

NOTE: I:iguresmay not udd lo totits due III rmmdmg.

36
.

Table 11, Number of residents by primary source of payment, age, sex, primary reason for admission. length of stay since current

admission, and madian length of stay from current admission: United States, August 1973-April 1974

Age, sex, primary reason for admission, and length of stay

since current admission

All rasidents in home 1 month or more ........................

Aae

Lessthan 65 years.........................................................................

65-74 years ...................................................................................

75-84 yaars ...................................................................................

85 years or more ...........................................................................

—Sex

Male ..............................................................................................

Female ..........................................................................................

Prima~ reason for admission

Physical.........................................................................................

Social ............................................................................................

Behavioral .....................................................................................

Economic ......................................................................................

Length of stay since current admission

Lessthan 3 months .......................................................................

3 to lessthan 6 months .................................................................

6 to lessthan 12 months ...............................................................

1 to lessthan 3 years.....................................................................

3 to lessthan 5 years.....................................................................

5 yeare or more ......o......................................................................

Median length of stay from current admission ..............................

Primary source of payment

Other

Al I Own Medi- Medi- public

sources

Other income care caid assistance

Number

1,012,000

107,500

152,000

359,500

393,000

294,800

717,200

815,200

66,400

119,800

10,500

91,500

103,800

155,700

357,700

149,700

153,500

371,700

19,500

46,800

149,500

155,900

105,700

266,000

301,700

31,900

35,700

2,400

37,000

45,200

66,400

128,200

48,200

46,700

10,800

*

*

5,000

3,400

2,600

8,200

10,400

*

*

*

7,100

●

●

●

●

*

484,300

57,900

78,900

163,300

184,300

137,200

347,200

407,700

19,200

54,600

2,900

37,100

46,600

72,200

182,300

76,800

69,400

114,900

24,000

20,200

30,900

39,800

36,200

78,700

77,600

9,100

26,300

*

7,600

7,600

13,900

38,600

19,900

27,400

30,200

6,000

3,700

10,900

9,600

13,100

17,100

17,900

6,200

2,900

3,200

2,600

2,700

2,600

7,800

4,700

9,700

Days

547 II 507 I 68 I 630 I 816 I 1,058

NOTE: Figures may not add to totals due to rounding.

37
APPENDIXES

I.

II.

m.

Iv.

I.

11,

III.

Iv.

v.

VI.

VII.

CONTENTS

Technical Notes on Methods .............................................................................................................

Survey Design ..............................................................................................................................

General ...................................................................................................................................

Sampling Frame .....................................................................................................................

Sampling Design .....................................................................................................................

Data Collection Procedures for the 1973-74 National Nursing Home Suwey ..........................

General Qwfifications .................................................................................................................

Nonresponse and Imputation of Missing Data ........................................................................

Rounding of Numbers ............................................................................................................

Data Processing ......................................................................................................................

Estimation Procedures ............................................................................................................

Refiabifity of Estimates ...............................................................................................................

Definitions of Certain Terms Used in This Report ............................................................................

Terms Relating to Residents ........................................................................................................

Terms Relating to Facilities .........................................................................................................

Terms Relating to Employees .................................................................................................."..

Geographic Terms ........................................................................................................................

Ratio ...........................................................................................................................................

Selected Questionnaires Used in the 1973-74 Nationaf Nursing Home Survey ..................................

Criteria for Classifying Nursing Homes According to Level of Nursing Care ......................................

Types of Facilities Included in the Survey ...................................................................................

LIST OF APPENDIX TABLES

Distribution of homes in the 1973-74 National Nursing Home Survey. universe and disposition of

sample homes according to primary sampling strata: Conterminous United States .........................

Summary of data collection procedures ............................................................................................

Standard errors of percentages for establishments .............................................................................

Standard errors of percentages for beds ............................................................................................

Standard errors of percentages of residents .......................................................................................

Standard emors of percentages for adtilons and discharges ...........................................................

Standard errors of average monthly resident charge ..........................................................................

VIII. Standard errors of occupancy rate ....................................................................................................

LIST OF APPENDIX FIGURES

I. Relative standard errors for estimated numbers of admissions and discharges, beds, residents, and

estabhshments ................................................................................................................................

IL Relative standard emor for estimated number of resident days .........................................................

III. Provisional relative standard errors for estimated numbers of full-time equivalent employees ...........

39

39

39

39

40

?2

42

42

42

43

43

51

51

51

52

52

52

5!?

77

77

40

42

47

47

48

48

49

50

44

45

46

38
APPENDIX I

TECHNICAL NOTES ON METHODS

SURVEY DESIGN

General

From August 1973 to April 1974, the

Dhision of Health Resources Utilization Statistics (DHRUS) conducted the National Nursing

Home Survey (NNHS)–a sample survey of

nursing homes, their residents, and staff in the

conterminous United States. The survey was

designed and developud by the DHRUS in

conjunction with a group of experts in various

fields encompassing the broad area of long-term

care.z4 It was specifically designed as the first of

a series of surveys to satisfy the diverse data

needs of those who establish standards for, plan,

provide, and assesslong-term care services.

Sampling Frame

The 1973-74 NNHS focused on nursing

homes which provided some level of nursing

care. Only homes providing nursing care were

included because detailed questions on facility

services and resident health status were relevant

only to these facilities. These homes included

both nursing care homes and personal-care-withnursing homes, while personal care homes and

domiciliary care homes were excluded. Homes

were either freestanding establishments or

nursing care units of hospitals, retirement centers, and similar institutions. A definition of

nursing care and detailed ctiteria for classifying

homes providing such care are presented in

appendix IV.

The survey universe consisted of two groups

of homes: those providing some level of nursing

care as classified in the 1971 Master Facility

NOTE:Thelistof referencesfollowsthetext.

Inventory (MFI) and homes opening for business

in 1972. The major group (93 percent) was

composed of all nursing homes providing some

Ievel of nursing care as classified by the 1971

MFI. The MFI is a census of all inpatient health

facilities conducted by mail every 2 years by the

National Center for Health Statistics. A detailed

description of how the MFI was deveIoped, its

content, and procedures for updating and assessingits coverage have been published.z 5‘z T

In order for data collection to begin in

August, the sampfing frame was “frozen” in the

spring of 1973 so that the sample could be

selected in ample time to permit the scheduling

of nationwide data collection. To obtain as

current a sampIe frame as possibIe, aIl nursing

homes which opened for business during 1972

were also included in the universe. (Homes

opening in early 1973 could not be included

since data about them were not yet available.)

The homes which opened in 1972 comprised the

second, and smaller (7 percent), group of facilities in the universe. Although the universe

included only homes providing nursing care, all

homes opened in 1972 were included because

the level of nursing care they provided was

unknown prior to the survey. Once the NNHS

was conducted, facilities not meeting the criteria

were classified as out of scope (see table I for

details).

Although the NNHS was conducted in

1973-74, it should be noted that estimates will

not correspond precisely to figures from the

1973 MFI census for several reasons. In comparison to the MFI, the NNHS universe excluded

the following: (1) personal care homes and

domiciliary care homes; (2) homes that opened

in 1973; and (3) homes that, between 1971 and

1973, upgraded the level of care they provided,

39
-“

Table 1. Distribution of homes in the 1973-74 National Nursing Home Survey universe and disposition of sample homes according to

primary sampling strata: Conterminous United States

Number of homes in sample

In scope and

in business

Universe

(sampling

frame) 1

out of

scope

or out

of business

Certification status and size of home

Nonrespending

Total

homes Respending

All types .............................................................................. .....................

Both Medicare and Medicaid and Medicare only ...........................................

Unknown beds ..........................................................................................................

Less than 25 beds .......................................................................................... ...........

25-49 beds ................................................................................................................

50-99 beds ................................................................ ................................................

100-199 beds ............................................................................................................

200-299 beds ............................................................................................................

300499 beds ...................................... ......................................................................

500 beds or more ......................................................................................................

Medicaid only .......................................... ......................................................

Unknown beds ..................................................................... .....................................

Less than 15 beds .....................................................................................................

15-24 beds ................................................................................................................

25-49 beds ................................................................................................................

50-99 beds ................................................................................................................

100-199 beds ............................................................................................................

200-299 beds .................................................. ..........................................................

300-499 beds ............................................................................................................

500 beds or more ......................................................................................................

Not certified ..................................................................................................

Unknown beds ..........................................................................................................

Less than 15 beds ..................... ................................................................................

15-24 beds ................................................................................................................

2549 beds .......................................................................................... ......................

50-99 beds ................................................................................................................

100-199 bads ................................................................................. ...........................

200-299 beds ............................................................................................................

300-499 beds ............................................................................................................

500 beds or more ......................................................................................................

17,685 2,118 147 63 1,908

4,099 803 20 26 757

2

149

538

1,713

1,385

224

68

20

7,473

0

4

35

228

370

100

46

20

790

0

0

0

7

8

4

1

0

34

0

1

1

7

11

3

2

1

24

0

3

34

214

351

93

43

19

732

3

250

967

2,253

2,688

1,108

145

43

16

6,113

0

5

36

123

293

241

52

24

16

525

0

1

5

11

4

3

5

3

2

93

0

2

1

3

8

6

3

1

0

13

0

2

30

109

281

232

44

20

14

419

0

13

29

71

121

116

31

23

15

19

1,279

1,062

1,575

1,334

652

120

52

20

0

23

38

87

145

141

43

28

20

0

10

9

13

19

21

12

4

5

0

0

0

3

5

4

0

1

0

lT’he universe consisted of nursing homes providing some level of nursing care as classified in the 1971 MFI and homes ouened for

business in 1972.

thereby meeting the “nursing care” Critefia

when surveyed in the 1973 MFI. Data from the

NNHS are also subject to sampling variability,

while data from the MFI are not, since the MFI

is a census.

tion of establishments and the second stage was

a selection of residents and employees of the

sample establishments. In preparation for the

first-stage sample selection, establishments listed

in the MFI were sorted into three types of strata

based on Medicare and Medicaid certification:

(1) Both Medicare and Medicaid and Medicare

only; (2) Medicaid only; and (3) Not certified.

Homes in each of these three strata were sorted

into bed-size groups, producing 26 primary

Sampling Design

The sampling was a stratified two-stage

probabilityy design: The first stage was a selec40
strata as shown in table I. The nursing homes in

the universe were ordered by type of ownership,

geographic region, State, and county. The sample was then selected systematically after a

random start within each primary stratum. Table

I shows the distribution of establishments in the

sampling frame and the final disposition of the

sample with regard to response and in-scope

status. The number of homes estimated by the

survey (15,7 49) is less than the universe figure

(17,685) because some homes went out of

business or out of scope between the time the

universe was “frozen” and the survey was

conducted. Differences ranging from

2,100-2,900 between survey estimates and universe figures occurred in the 1963,3 1964,28

and 196920 nursing home surveys for the same

reason.

The second-stage selection of residents and

employees was carried out by the interviewers at

the time of their visits to the establishments in

accordance with specific instructions given for

each sample establishment. The sample frame

for residents was the total number of residents

on the register of the establishment on the

evening prior to the day of the survey. Residents

who were physically absent from the facility due

to overnight leave or a hospital visit but had a

bed maintained for them at the establishment

were included in the sample frame. An average

of 10 residents were in the sample per home.

The sampling frame for employees was the

Staff Control Record on which the interviewer

listed the names of all staff (including those

employed by contract) and sampled professional, semiprofessional, and nursing staff. Those

generally not involved in direct patient care,

such as office staff, food service, housekeeping,

and maintenance personnel were excluded from

the sample. The interviewer used predesignated

sampling instructions that appeared at the head

of each column of this form. An average of 14

staff were in the sample per home.

Data Collection Procedures for the 1973-74

National Nursing Home Survey

I The 1973-74 NNHS utilized eight questionnaires (see appendix III for copies of questionnaires relevant to this report. For all other data

collection instruments see reference 1.)

Administrator Letter and

Facility Questionnaire

Expense Questionnaire

Resident Control Record

Resident Questionnaire

Worksheet

Staff Questionnaire-Parts I and H

Staff Control Record

Data were collected according to the following procedure.

A letter was sent to the administrators of

sample homes informing them of the survey

and the fact that an interviewer would

contact them for an appointment. On the

back of the letter was a worksheet which the

administrateor was requested to fill out prior

to the interviewer’s visit. This worksheet

asked for those data that required access to

records and some time in compiling (such as

total admission and discharges, inpatient

days of care, etc.). Included with this introductory letter were letters of endorsement from the American Nursing Home

Association and the American Association of

Homes for the Aging urging the administrators to participate in the survey.

Several days to 1 week after the mailing of

the letters, the interviewer telephoned the

sample facility and made an appointment

with the administrator.

At the time of the appointment, the following procedures were used: The Facility

Questionnaire was completed by the interviewer who interviewed the administrator

or owner of the home. After completing this

form, the interviewer secured the administrator’s permission to send the Expense

Questionnaire to the facility’s accountant.

(If financial records were not kept by an

outside firm, the Expense Questionnaire was

filled out by the administrator, with the

interviewer present.) The interviewer completed the Staff Control Record (a list of all

currently employed staff both full and part

time), selected the sample of staff from it,

41
and prepared Staff Questionnaires, Parts I

and II, which were left for each sample staff

person to complete, seal in addressed and

franked envelopes (one for each part of the

questionnaire), and return either to the interviewer or by mail. The interviewer then

completed the Resident Control Record (a

list of all residents currently in the facility),

selected the sample of residents from it, and

filled out a Resident Questionnaire for each

sample person by interviewing the member

of the nursing staff familiar with care provided to the resident. “The nurse referred to

the resident’s medical records. No resident

was interviewed directly.

If the Expense Questionnaire was not returned within 2 weeks, the interviewer telephoned the accountant requesting its prompt

return. If the Staff Questionnaires were not

returned in one week, the interviewer contacted

the staff member and requested the return of

the form.

Table II presents a summary of the data

collection procedures.

Table Il. Summary of data collection procedures

Questionnaire

Facility .........

Expense ........

Resident ........

Staff ..............

Respondent

Administrator

Facility’s accountant

Member of nursing staff

familiar with care provided to the resident/

resident’s medical records

(10 sampled residents per

facility)

Sampled staff membar (14

per facility)

Interview

situation

Personal

interview

Self-an umerated

questionnaire

Personal

interview

Self-enumerated

questionnaire

GENERAL QUALIFICATIONS

Nonresponseand Imputation

of Missing Data

Response rates differed for each type of

questionnaire as indicated:

42

Questionnaire Response rate

Facility 97 percent

Expense 88 percent

Resident 98 percent

Staff 82 percent

Generally, response rates were higher

questionnaires administered in a personal

for

in-

~erview situation (facility and resident) than for

those which were self-enumerated (expense and

staff). Statistics presented in this report were

adjusted for failure of a home to respond. Data

were also adjusted for nonresponse which resulted from failure to complete one of the

questionnaires (expense, resident, staff) or from

failure to complete an item on a questionnaire.

Those items left unanswered on a partially

completed questionnaire (facility, expense, resident, staff) were generally imputed by assigning a value from a responding unit with

major characteristics identical to those of the

nonresponding unit.

Rounding of Numbers

Estimates of homes, residents, resident days,

beds, etc., have been rounded to the nearest

hundred. For this reason detailed figures within

tables do not always add to totals. Percents were

calculated on the basis of original, unrounded

figures and will not necessarily agree precisely

with percents that might be calculated from

rounded data.

Data Processing

A series of checks was performed during the

course of the survey. This included field followups for missing and inconsistent data, some

manual editing of the questionnaires, and extensive editin~ as cond;cted by computer to

assure that all responses were accurate, consistent, logical, and complete. Once the data

base was edited, the computer was used to

calculate and assign weights, ratio adjustments,

recodes, and other related procedures necessary

to produce national estimates from the sample

data.
--%_

Estimation Procedures

Statistics reported in this publication are

derived by a ratio estimating procedure. The

purpose of ratio estimation is to take into

account all relevant information in the estimation process, thereby reducing the variability

of the estimate. The estimation of number of

establishments and establishment data not related to size are inflated by the reciprocal of the

probability of selecting the sample establishment

and adjusted for the nonresponding establishments within primary certification-size strata.

Two ratio adjustments, one at each stage of

selection, were also used in the estimation

process. The first-stage ratio adjustment (along

with the above inflation factors) was included in

the estimation of establishment data related to

size, resident data, and staff data for all primary

certification-size strata from which a sample of

homes was drawn. The numerator was the total

beds according to the Master Facility Inventory

data for all homes in the stratum. The denominator was the estimate of the total beds

obtained through a simple inflation of the

Master Facility Inventory data for the sample

homes in the stratum. The effect of the firststage ratio adjustment was to bring the sample in

closer agreement with the known universe of

beds. The second-stage ratio adjustment was

included in the estimation of resident and staff

data within establishments. The second-stage

ratio adjustment is the product of two fractions: The first is the inverse of the sampling

fraction for residents (or staff) upon which the

selection is based; the second is the ratio of the

number of sample residents (or staff) in the

establishment to the number of residents (or

staff) for whom questionnaires were completed

within the home.

RELIABILITY OF ESTIMATES

As in any survey, the results are subject to

reporting and processing errors and errors due to

nonresponse. To the extent possible, these types

of errors

built into

Since

based on

were kept to a m~nimum by meth;ds

survey procedures.

statistics presented in this report are

a sample, they will differ somewhat

from figures that would have been obtained if a

complete census had been taken using the same

schedules, instructions, and procedures.

The standard error is primarily a measure of

the variability that occurs by chance because

only a sample, rather than the entire universe, is

surveyed. The standard error also reflects part of

the measurement error, but it does not measure

any systematic biases in the data. It is inversely

proportional to the square root of the number

of observations in the sample. Thus, as the

sample size increases, the standard error generally decreases.

The chances are about 67 out of 100 that an

estimate from the sample differs from the value

that would be obtained from a complete census

by less than the standard error. The chances are

about 95 out of 100 that the difference is less

than twice the standard error and about 99 out

of 100 that it is less than 2?42 times as Iarge. The

relative standard error of an estimate is obtained

by dividing the standard error of the estimate by

the estimate itself. According to the NCHS

standards, reliable estimates are those that have

a relative standard error of 25 percent or less.

Relative standard errors of estimated number of admissions and discharges, beds, residents,

establishments, and resident days of care are

shown in figures I and IL Provisional relative

standard errors of estimated number of full-time

equivalent employees are presented in figure III.

Because of the relationship between the

relative standard error and the estimate, the

standard error of an estimate can be obtained by

multiplying the estimate by its relative standard

error. Thus, for example, in figure I, an estimate

of 2,300 residents has a relative standard error

of 25 percent. Its standard error is .25 X 2,300 =

575.

The particular figure or table to which one

refers to obtain a standard error is contingent on

the type of estimate (e.g., residents) and whether the estimate is a level or a percent. Tables

III-VI show the standard errors for percent

estimates used in this report for establishments

(table III), beds (table IV), residents (table V),

and admissions and discharges (table VI). Table

VII shows the standard errors for average

monthly charge, and table VIII shows the

standard errors of the occupancy rate.

43
-H-H-+ ?H+fd#&- —: f-l

!,

~ CURVE A Admissions, dmchwges W .,, ,.! --,

100

90

80

70

60

50

40

- 30

k

Lu 20

0

E

Lu

~ 10

m:07

26

UJ’

n’$

53

SIZE OF ESTIMATE

Figure 1. Relative standard errors for estimatad numbers of admissions and discharges, beds, residents, and establishments

Example of statistical tests used for this

report to determine whether the differences

between selected characteristics in the classifications breakdown are statistically significant are

presented here for average monthly charge,

full-time equivalent employees, and discharges.

These tests are based on comparisons of confidence intervals for the estimates in question. If

there is no overlapping of the confidence intervals, the estimates are considered statistically

different.

Example I.–The average monthly nursing

home charge for females between August 1973

and April 1974 was $473, and the approximate

standard error of this charge (from table VII)

was $8.76. The chances are 95 out of 100 (the

95-percent confidence interval) that the true

value being estimated is contained in the interval

between $455 and $491 ($473 * 2($8.76)).

Since this interval overlaps with the 95-percent

confidence interval for males ($428-$482 as

obtained above), the difference between the

average monthly charge in these two sex classifications is not considered statistically significant

in this method.

Example 2.–An example of a ratio such as

full-time equivalent (FTE) employees per 100

residents can be calculated as follows: Suppose

the provisional standard error (crR,) for the ratio

of FTE employees per 100 residents is desired

for nursing homes certified as skilled nursing

homes under Medicaid. In table 8 the total

number of FTE employees per 100 residents for

SNH homes is 68.7, which is equal to a total of

201,000 full-time equivalent employees divided

by 292,500 residents times 100. The relative

standard error of 201,000 FTE employees

(figure III, curve A) is approximately 2.1 percent, and the relative standard error of 292,500

residents (figure I, curve C) is approximately 2.4

percent. The square root of the sum of squares

of these two relative standard errors provides an

44
100

90 , ,!,!1,,,, , , I I + I

1 1 1

80 I 111IItIll I [ I 1 8

1 I I 1 1

70 I

60 I

I r

>“ . , 1 ! 1 I 1 1 111 I I I 1

40 111111111 I I I I

~n

I , , , r 1

I 11111

.n I I I I I I t 1 I 1 1 1 111111 I 1 1 1 1 1 1 I , I I I , , ,

‘1’’’’

10

9

8

7

6

1

K ,

tllllllll 1111

, , , , , , I I

I

I I I

, , I , , 1 1

L

I

, , 1

111111111 I

I I I

5—1

I I I I I I I 1111111111 I I I I I I Iullllllllll

1

4’

3.

I I I I

I I I I

I ,8 , r 1

11111111 ,

2

.0

.9

,8

.7

.6

.5

.4

.3

.2

.1

f 2 34 56789A 2 3 4 56789A 2

10 100

SIZE OF ESTIMATE (IN MILLIONS)

Figure 11.Reletive standard error for estimated number of resident days

approximation for the relative standard error of = (.024)2

the desired ratio. In other words, letting VXt be = .006 +

the relative standard error of number of total

FTE employees, VV1 be the relative standard = .0010

error of ‘number of residents, and VRI be the

3

?!

456789A

1,Too

+ (.021)*

.004

—

relative standard error of the ratio R‘ =-k ‘/y’ = .032

V;j = v:, + v? The approximate standard error of the ratio of

Y total .- ...- —FTE emrslovees -1-– ,. –,-..~er 100 residents mav, now

45
Lu

100

90

80

70

60

50

40

30

2,0

10

9

8

7

6

5

4

3

2

1

.9

.8

.7

.6

.5

.4

.3

.2

“’ A 23 456789A 23 4 56789A 2 3 4 56789A 2

100 1,000

3 456789A

10,000 100,000 1,000,000

SIZE OF ESTIMATE

Figure I I 1. Provisional reletive standard errors for estimated numbers of full-tima equivalent employees

be obtained by multiplying the relative standard

error by the ratio as follows:

rJRl=v~/xR’

=.032 X 68.7

= 2.20

The confidence interval now may be obtained at

the 95-percent confidence level as 64.3 to 73.1

FTE’s per 100 residents.

Example 3. –To test whether or not homes

with less than 50 beds had more discharges due

to death (40.8 percent) than homes with 50-99

beds (28.3 percent) had, standard errors were

obtained from table VI. Using the percentage

base of 164,500 from table 6 (total discharges in

the “less-than-5 O beds” group) and interpolating

from table VI, a standard error of 3.6 was

obtained. The confidence interval then at the

95-percent level for the percent of discharges

due to death in homes with less than 50 beds is

33.6 percent to 48.0 percent (40.8 percent *

2(3.6)). Similar calculations give a confidence

interval of 24.1 percent to 32.5 percent for

these discharges from homes with 50-99 beds,

Since these two intervals do not overlap, the

percent of discharges due to death from homes

with 50 beds may be considered significantly

larger than the percent of these discharges from

homes with 50-99 beds.
-.. ... .

Iarxel ii. Wanctarcserrors of percentages for establishments

Base of estimated percent

(number of establishments)

100 ..........................................................................................

200 ..........................................................................................

300 ..........................................................................................

4w ..........................................................................................

600 ..........................................................................................

600 ..........................................................................................

700 ..........................................................................................

800 ..........................................................................................

1,000.......................................................................................

2.000 .......................................................................................

3.mo ...........................m....o......................................................

4.000 ......................................m................................................

5,000 .......................................................................................

6,000 .......................................................................................

7,000 .......................................................................................

8.000 .......................................................................................

9,000 .......................................................................................

10,000 ,,, ,,.,,.............................................................................

20,000 .....................................................................................

Estimated percent

1

I

2

I

5

I

10 I

20

or 99 or 98 or 95 or 90 or 80

30 I40 I

50

or 70 or 60

3.33

2.36

1.93

1.67

1.49

1.36

1.26

1.18

1.11

1.05

0.75

0.61

0.53

0.47

0.43

0.40

0.37

0.35

0.33

0.24

4.69

3.32

2.71

2.35

2.10

1.92

1.77

1.66

1.56

1.48

1.05

0.86

0.74

0.66

0.61

0.56

0.52

0.49

0.47

0.33

Standard error in percentage points

7.30

5.16

4.22

3.65

3.27

2.98

2.76

2.58

2.43

2.31

1.63

1.33

1.15

1.03

0.94

0.87

0.82

0.77

0.73

J

0.52

10.05

7.11

5.80

5.03

4.50

4.10

3.80

3.55

3.35

3.18

2.25

1.84

1.59

1.42

1.30

1.20

1.12

1.06

1.01

0.71

Table IV. Standard errors of percentages for beds

Baseof estimated percent

(numbar of beds)

7.000 .......................................................................................

8.000 .......................................................................................

9,000 ..,, ...................................................................................

lo.ow .....................................................................................

20.000 .....................................................................................

30.000 .........................................m...........................................

40.000..$ .....................................................m............................

50,000 ,,,. ,,,.,,.,,,,..., ..................................................................

60.000 .....................................................................................

70.000 .....................................................................................

80.000 .....................................................................................

90.000 .....................................................................................

loo.oooa ..................................................................................

2oo.ooo ...................................................................................

3oo.ooo ...................................................................................

400,000 ...................................................................................

5oo.ooo ...................................................................................

600.000 ...................................................................................

700,000 ...................................................................................

8W.000 ...................................................................................

9oo.wo ...............m.............................mm.m..m ...............................

l.ooo.ooo ................................................................................

2.mo.wo ....m...........................................................................

13.41

9.48

7.74

6.70

6.00

5.47

5.07

4.74

4.47

4.24

3.00

2.45

2.12

1.90

1.73

1.60

1.50

1.41

1.34

0.95

15.36

10.86

8.87

7.68

6.87

6.27

5.80

6.43

5.12

4.86

3.43

2.80

2.43

2.17

1.98

1.84

1.72

1.62

1.54

1.08

16.42

11.61

9.48

8.21

7.34

6.70

6.21

5.80

6.47

5.19

3.67

3.00

2.60

2.32

2.12

1.96

1.84

1.73

1.64

1.16

16.76

11.85

9.67

8.38

7.49

6.84

6.33

5.92

5.59

5.30

3.75

3.06

2.65

2.37

2.16

2.00

1.87

1.77

1.68

1.18

Estimated percent

1 2

I

5 10 20 30 40

or 99 or 98 or 95 or 90 or 80 50

or 70 or 60

2.46

2.30

2.17

2.06

1.46

1.19

1.03

0.92

0.84

0.78

0.73

0.69

0.65

0.46

0.38

0.33

0.29

0.27

0.25

0.23

0.22

0.21

0.15

3.47

3.24

3.06

2.90

2.05

1.67

1.45

1.30

1.18

1.10

1.02

0.97

0.92

0.65

0.53

0.46

0.41

0.37

0.35

0.32

0.31

0.29

0.20

Standard error in percentage points

5.39

5.05

4.76

4.51

3.19

2.61

2.26

2.02

1.84

1.71

1.60

1.50

1.43

1.01

0.82

0.71

0.64

0.58

0.54

0.50

0.48

0.45

0.32

7.43

6.95

6.55

6.21

4.39

3.59

3.11

2.79

2.54

2.35

2.20

2.07

1.96

1.39

1.13

0.98

0.88

0.80

0.74

0.69

0.65

0.62

0.44

9.90

9.26

8.73

8.28

5.86

4.78

4.14

3.70

3.38

3.13

2.93

2.76

2.62

1.85

1.51

1.31

1.17

1.07

0.99

0.93

0.87

0.83

0.59

11.34

10.61

10.00

9.49

6.71

5.48

4.74

4.24

3.87

3.59

3.36

3.16

3.00

2.12

1.73

1.50

1.34

1.23

1.13

1.06

1.00

0.95

0.67

12.13

11.34

10.69

10.15

7.17

5.86

5.07

4,54

4.14

3.83

3.59

3.38

3.21

2.27

1.85

1.60

1.43

1.31

1.21

1.13

1.07

1.01

0.72

12.38

11.58

10.91

10,35

7.32

5.98

5.18

4.63

4.23

3.91

3.66

3.45

3.27

2.32

1.89

1.64

1.46

1.34

1.24

1.16

1.08

1.04

0.73

47
Table V. Standard errors of percentages of residents

Base of estimated percent

(number of residents)

2.000 .. . .. ... .. ... . ... .. ... . ... .. .. . ... . .. ... .. .. .. .. .. .. ... . ... ... . ... . .. ... .. .. .. .. .. .. ...

4.000 . .. . .... . ... . ... .. .. ... . .. .. .. ... . .. .... .. . .. ... .. . .... . .. .. . .... . ... .. .. .. .. ... . .. ... .

6.000 .. .. ... . .. .. .. ... .. ... . .. .... . .. .. .. ... . .... . . ... .. ... .. . ... . ... .. .. ... . .... . .. .. .. .. ..

8.000 .. . .. .. ... .. .. ... .. .. .. .. ... . ... . .. .. ... ... .. . .. . ... ... .. .. .. .. .. .. . .... .. .. .. .. .. . ....

lo.ooo . .. .. .. ... .. . ... . .. .... . ... . .. ... . ... .. .. .. .. .. .. ... . .. ... . .... . ... .. . ... .. .. .. .. .. ..

20.000 . .... .. . ... . .... . ... .. .. ... . ... . ... . .. .. ... . .... . . .... . .. .. ... .. . ... .. ... .. . .. .. .. ...

30.000 .. ... .. ... .. ... .. .. .. . .. .. . . ... .. .. ... .. .. . .. ... .. ... . ... .. . ... . .. ... .. ... .. .. .. . ....

40.000 . ... ... .. .. .. .. .. ... .. . ... ... .. . .. .... . ... . . .... . . .... . ... . .... . .. ... . ... .. . ... .. .. ..

50,000 . ... .. . .... .. .. . ... .. .. ... .. ... .. ... .. . ... .. . ... .. .. .. .. ... . ... . ... .. .. ... . . ... .. ... .

60,000 . ... .. .. .. .. .. .. .. ... . .. ... . ... .. .. .. ... .. . . ... .. . .... . ... .. .. .. . ... . ... ... . ... . .. .. .

70.000 . . .. .. .. ... .. .. .. . ... ... . ... .. .. . . .. .. ... . .. ... . .. ... . ... .. .. ... . ... .. .. .. . ... .. . ....

80.000 . .... . ... .. .. ... . ... . .. .. .. .. ... . .. ... . .... ... .. .. ... .. .. .. .. ... . ... . .. ... .. . ... . ... .

90.000 . . ... . .. .. . .. .. .. .... . .. ... . ... . .. ... .. .. .. . ... .. .. .. ... . ... .. .. .. .. .. . .... . .. .. .. ...

loo.ooo .. .. .. .. ... .. .. ... . .. .... .. ... .. .. .. ... . .. ... .. . ... . ... .. .. .. .. ... .. . ... .. .. .. .. ...

2oo.ooo .. .. .. .. .. ... .. .. . ...! . .. .. ... . .. .. .. .. .. .. .. .. ... .. . ...m.... . . ... .. ... .. . ... .. .. ..

3oo.ooo . .. .. .. .. .. ... . .... . ... .. . ... .. . ... . ... .. . ... .. . ... .. ... . ... .. . ... .. .. .. .. .. ... . ...

400,000 .. ... .. . .. ... . ... .. .. ... .. . ... . .. ... .. .. . .. .. . .. .. .. .. ... . ... . ... .. .. .. .. . ... .. .. ..

5m.ooo . .. . . .. . . .. . ... .. .. .. .. .. .. .. .. .. ... . ... . .. .. .. .... . . ... .. .. .. . ... .. . .. .. . ... . .. ...

600.000 . . ... .. ... . .. .. ... ..o... . ... .. .. .. .. .. ... . .. .. .. ... .. . ... .. ... . .. .. .. ... . .. ... . ... .

7oo.ooo ... . ... . .. .. ... .. .. .. ... . .. .. .. . .... . .. .. .. ... . ... ...o... . .. .. .. ... . ... . .. ... .. .. ..

800.000 . .. .. .. ... ... .. . .. .. .. ... . ... .. .. .. .. .. .. . ... . ... .. .. .. .. .. ... .. .. .. .. .. .. . ... .. .. .

9m.ooo . .. . .. ... .. .. .. ... .. . ... . ... .. . ... ... .. .. . .. .. . .. .. . ... .. .. .. .. .. .. . ... .. .. ... .. ...

l.ooo.ooo .. ... .. . ... .. . .. . ... ... . .. .. . ... .. ... . . .... . ... . . .. .. .. .. .. .. .. .. .. .. .. ... . .... .

l.loo.ooo . . . ... .. ... .. .. .. .. ... .. .. .. .. .. . ... .. . ... .. .. ... . .. .. .. ....m. ... .. ... .. .. . .. .. .

Table Vi. Standard errors o

Base of &timated percent

(number of admissions and discharges)

lo.ooo .....................................................................................

20.000 . .. .. .. .. .. .. .. .. .. ... ... .. . ... .. .. .. .. .. .. . ... .. .. ... . .. .. ... .. . ... .. . .... . ... . . ....

30.000 .. ... . ... .. .. .. .. .. ... .. .. .. .. .. .. . ... .. .. .. .. .. .. ... . ... .. .. ... . . ... . .... .. .. .. . ... .

40.000 .. .. ... .. .. . ... .. . ... . ... .. . ... .. . ... .. ... . ... .. . ... .. . ... .. .. ... .. .. . ... .. .. .. .. ... .

50;ooo . . ... ... .. .. . .... . .. .. .. .. .. .. .. . .. .. . .. .. .. ... .. . .... ... .. .. .. .. ... .. .. .. . ... .. .. .. .

60.000 . ... .. .. ... . .... . ... .. . ... . ... .. . ... .. .. .. .. . ... . .... . .. ... . ... .. .. .. .. ... . .. ... .. . ..

70.000 . . .... .. .. .. ... .. . ... .. ... .. . ... . ... .. .. . .. .... . . ... .. . ... .. .. ... . ... . ... .. . ... . ... ..

80.000 . . ... .. ... . ... ... . ... . .. ... .. ... . .. .. .. . ... . .... . .. ... . ... . .. .. .. ... .. . .. .. . .. .. . ....

90;ooo . . .. .. .. .. .. ... .. ... .. . ... . ... .. .. .. .. .. .. .. .. .. .. ... . .. ... .. .. .. .. ... . ... . .. ... . ... .

loo.ooo . ... .. . .. .. .... .. .. . ... .. . ... .. .. .. .. .. .. .. ... . ... . ... .. .. . ... .. .. .. .. .. .. .. .. ... ..

200,000 . . .. .. ... ... . .. ... .. .. .. .. .. .. .. .. .. .. .. .. .. .. .. .... .. .. .. .. .. . ... .. . ... . ... .. . ... .

3oo.ooo .. . .. .... . ... .. . ... .. .. .. . .... . .... . .. .. .. .. .. . .... . .. ... . ... . .. .. .. ... .. . ... .. .. ..

4oo.ooo . .. .. ... .. . ... .. ... . .. ... . ... .. . ... .. ... . ... .. .. .. .. . ... .. .. .. .. ... . ... .. . ... . .. ...

5oo.ooo . . ... .. .. .. ... . ... . ... ... ... ... . ... . ... .. .. .. . ... .. .. .. .. .. ... . ... . .. ... .. .. .. . ... .

600.000 . ... .. .. .. .. .... .. .. .. .. . ... .. . ... .. .. .. .. .. . ... ... . .. .. .. ... .. .. .. . ... ... . .. ... .. .

7oo.ooo . .. .. .. .. . .... . ... .. .. ... . ... . .. ... .. .. .. .. ... . .. .. .. ... .. .. .. .. ... . . ... .. ... . .. ...

800.000 ... .. . ... .. ... . .. ... . ... .. ...o.. .. .. .. .. .. ... . ... ... .... . . .... . ... .. ... . .. .. .. .. .. .

9oo.ooo . ... . ... .. ... .. .. .. . .. ... .. .. .. ... .. .. .. .. . .. . . .... . .. .. .. .... . .... . .... . .. ... . ... .

l.ooo.ooo . . .. .. ... ... . .. .. .... . .. .. .. .. .. .. ... . . ... . . .. ... . ... ... . .. .. .. .. .. ... . ... . ... ..

2.000.000 . ... .. .. .. .. .. .. .. ... . .... .. .. .. . .. ... . ... .. . ... .. .. .. .. .. .. .. .. .. ... . ... .. . ....

1

or 99

2.69

1.90

1.56

1.35

1.21

0.85

0.70

0.60

0.54

0.49

0.46

0.43

0.40

0.38

0.27

0.22

0.19

0.17

0.16

0.14

0.13

0.13

0.12

0.10

2

or 98

Estimated percent

5 10 20

or 95 or 90 or 80 or 70 or 60

3.79

2.68

2.19

1.90

1.70

1.20

0.98

0.85

0.76

0.69

0.64

0.60

0.57

0.54

0.38

0.31

0.27

0.24

0.22

0.20

0.19

0.18

0.17

0.17

Standard error in percentage points

5.90

4.17

3.41

2.95

2.64

1.87

1.52

1.32

1.18

1.08

1.00

0.93

0.88

0.63

0.59

0.48

0.42

0.37

0.34

0.32

0.30

0.28

0.26

0.24

8.12

5.75

4.69

4.06

3.63

2.57

2.10

1.82

1.62

1.48

1.37

1.28

1.21

1.15

0.81

0.66

0.57

0.51

0.47

0.43

0.41

0.38

0.36

0.35

10.83

7.66

6.25

5.42

4.84

3.43

2.80

2.42

2.17

1.98

1.83

1.71

1.61

1.53

1.08

0.88

0.77

0.69

0.63

0.58

0.54

0.51

0.48

0.46

12.41

8.78

7.17

6.21

5.55

3.92

3.20

2.78

2.48

2.27

2.10

1.96

1.85

1.76

1.24

1.01

0.88

0.78

0.72

0.66

0.62

0.59

0.66

0.53

13.27

9.38

7.66

6.63

5.93

4.20

3.43

2.97

2.65

2.42

2.24

2.10

1.98

1.88

1.33

1.08

0.94

0.64

0.77

0.71

0.66

0.63

0.59

0.57

13.54

9.58

7.82

6.77

6.06

4.28

3.50

3.03

2.71

2,47

2.29

2.14

2.02

1.92

1.35

1.11

0.96

0.86

0.78

0.72

0,68

0.64

0,61

0.57

ercentages for admissions and discharges

Estimated percent

1 2 5 10 20 30 40

or 99 or 98 or 95 or 90 or 80 50

or 70 or 60

Standard error in percentage points

2.87

2.03

1.66

1.44

1.28

1.17

1.09

1.02

0.96

0.91

0.64

0.52

0.4!5

0.41

0.37

0.34

0.32

0.30

0.29

0.20

4.04

2.86

2.33

2.02

1.81

1.65

1.53

1.43

1.35

1.28

0.90

0.74

0.64

0.57

0.52

0.48

0.45

0.43

0.40

0.29

6.29

4.45

3.63

3.15

2.81

2.57

2.38

2.22

2.10

1.99

1.41

1.15

0.99

0.89

0.81

0.75

0.70

0.66

0.63

0.44

8.66

6.13

5.00

4.33

3.87

3.54

3.27

3.06

2.89

2.74

1.94

1.58

1.37

1.23

1.12

1.04

0.97

0.91

0.87

0.61

11.55

8.17

6.67

5.77

5.17

4.72

4.37

4.08

3.85

3.65

2.58

2.11

1.83

1.63

1.49

1.38

1.29

1.22

1.15

0.82

13.23

9.36

7.64

6.62

5.92

5.40

5.00

4.68

4.41

4.18

2.96

2.42

2.09

1.87

1.71

1.58

1.48

1.39

1.32

0.94

14.15

10.00

8.17

7.07

6.33

5.77

!3.35

5.00

4.72

4.47

3,16

2.58

2.24

2.00

1.83

1.69

1.58

1.49

1.41

1.00

14.44

10.21

8.34

7.22

6.46

5.89

5.46

5.10

4.81

4.57

3.23

2.64

2.28

2.04

1.86

1.73

1.61

1.52

1.44

1.02

48
Estimated number of

residents

3,500 ............................

4,000 ............................

5,000 ............................

6;000 .....................,,,...,

7,000 .........................

8,000 ............................

9,000 ............................

10,000 ..........................

20,000 ..........................

30,000 ..........................

40,000 ..,,.,,,,.,,.,..,,, ,,.,,.,

50,000 ..........................

60,000 ..........................

70,000 ..........................

80,000 ..........................

90,000 ..........................

100,000 ....................

200,000 ........................

300,000,.., ....................

400,000,..,., ..................

600,000 ........................

600,000 ........................

700,000 ........................

800,000 ........................

900,000 ........................

1,000,000 .................

1,100,000 .....................

Table Wt. Standard errors of average monthly resident charge

Average monthly resident charge

$150 $200 $250 $300 $325 $350 $375 $400 $425 $450 $475 $500 $525

Stendard error in dollers

●

☛

☛

●

☛

36

34

32

23

19

16

15

13

12

11

11

10

7

6

5

5

4

4

4

3

3

3

●

☛

☛

●

47

44

42

39

28

23

20

18

16

15

14

13

12

9

7

6

6

5

5

4

4

4

4

●

●

☛

60

55

52

49

46

33

27

23

21

19

17

16

15

15

10

8

7

6

6

5

5

5

4

4

*

*

74

68

63

59

55

53

37

30

26

24

21

20

19

18

17

12

10

8

7

7

6

6

5

5

5

●

●

79

72

67

62

59

56

39

32

28

25

23

21

20

19

18

12

10

9

8

7

7

6

6

5

5

*

*

64

76

71

66

62

59

42

34

30

26

24

22

21

20

19

13

11

9

8

7

7

6

6

6

5

●

●

88

80

74

70

z

44

36

31

28

25

23

22

21

20

14

11

10

9

8

7

7

6

6

6

●

9;

84

78

73

z

46

38

33

29

27

25

23

22

21

15

12

10

9

8

8

7

7

6

6

●

9;

89

82

77

72

69

48

40

34

31

28

26

24

23

22

15

12

11

10

9

8

7

7

7

6

*

*

101

93

86

60

76

72

51

41

36

32

29

27

25

24

23

16

13

11

10

9

8

8

7

7

7

●

118

106

97

89

84

79

75

53

43

37

33

31

28

26

25

24

17

14

12

10

9

9

8

8

7

7

●

123

110

101

93

87

82

78

55

45

39

35

32

29

28

26

25

17

14

12

11

10

9

8

8

8

7

●

128

115

105

97

91

85

81

57

47

41

36

33

31

28

27

26

18

15

13

11

10

9

9

8

8

7

49
Table V1l. Standard errors of average month Iy resident charge–Con.

Average monthly resident charge

$550 $575 $600 $625 $650 $675 $700 $750 $6I3o $850 $800 $950

Estimated number of

residents

Standard error in dol lam

169

158

141

129

119

111

105

100

70

58

50

45

41

38

35

33

31

22

18

16

14

13

12

11

10

10

9

174

163

145

133

123

115

108

103

73

59

51

46

42

39

36

34

32

23

19

16

14

13

12

11

10

10

9

164

172

154

141

130

122

115

109

77

63

54

49

44

41

38

36

34

24

20

17

15

14

13

12

11

10

10

195

182

163

149

138

129

121

115

81

66

57

51

47

43

41

::

26

21

18

16

14

13

12

12

11

10

.

3,500 .........................

4,000 .........................

5,000 .........................

6,000 .........................

7,000 .........................

8,000 .........................

9,000 .........................

10,000 .......................

20,000 .......................

30,000 .......................

40,000 .......................

50,000 .......................

60,000 .......................

70,00 .........................

80,000 .......................

90,000 .......................

100,000 .....................

200,000 .....................

300,000 .....................

400,000 .....................

500,000 .....................

600,000 .....................

700,000 .....................

800,000 .....................

900,000 .....................

1,000,000 ..................

1,1 00,000 ..................

*

133

119

109

101

94

89

84

60

49

42

38

34

32

30

28

27

19

15

13

12

11

10

9

9

8

8

*

143

128

117

108

101

95

90

64

52

45

40

37

34

32

30

28

20

16

14

13

11

11

10

:

8

*

148

132

121

112

105

99

94

66

54

47

42

38

35

33

31

29

21

17

15

13

12

11

10

10

9

9

215

201

180

164

152

142

134

127

90

73

64

57

52

48

45

42

40

28

23

20

18

16

15

14

13

12

12

226

211

189

172

160

149

141

133

94

77

67

60

54

50

47

44

42

30

24

21

18

17

15

14

13

13

12

236

221

197

160

167

166

147

140

88

81

70

62

57

53

49

46

44

31

25

22

19

18

16

15

14

13

13

● ✎

138

124

113

104

98

92

87

62

50

44

39

36

33

31

29

28

19

16

14

12

11

10

9

9

8

8

●

153

137

125

115

108

102

9/

68

56

48

43

39

36

34

32

30

21

17

15

13

12

11

10

10

9

9

205

192

171

157

145

136

128

121

86

70

61

54

49

46

43

40

38

27

22

19

17

15

14

13

12

12

11

Table Vlll. Standard errors of occupancy rate

Estimated number of beds

Occupancy rate

10 20 30 40 50 60 70

I

80 I

90 I

100

Standard error in percentage points

14.10

11.48

9.91

8.83

8.04

7.42

6.91

6.50

6.14

4.20

3.30

2.74

2.35

2.04

1.79

1.58

1.39

1.22

1.06

15.70

12,77

11.02

9.83

8.94

8.24

7.68

7.22

6.82

4.64

3.63

3.01

2.56

2.21

1.92

1.67

1.45

1.24

1.04

17.27

14.05

12.12

10.80

9.82

9.06

8.44

7.92

7.49

5,08

3.96

3.26

3.76

2.36

2.03

1.75

1.49

1.24

0.99

20,000 ................................................................

30.000 ................................................................

40.000 ................................................................

50.000 ................................................................

60.000 ................................................................

70.000 ................................................................

80.000 ................................................................

90.000 ................................................................

loo.ooo ..............................................................

2m#ooo ..............................................................

3m.ooo ..............................................................

4oo.ooo ..............................................................

5oo.ooo ..............................................................

6M.000 ..............................................................

7oo.ooo ..............................o...............................

800.000 ..............................................................

9oo.ooo ..............................................................

l.ooo.ooo .........................................o........o........

l.loo.ooo ...........................................................

*

*

*

*

*

*

2.38

2.24

2.12

1.49

1.21

1.04

0.92

0.83

0.76

0.71

0.66

0.62

0.59

*

*

4.97

4.44

4.05

3.74

3.49

3.29

3.12

2.17

1.75

1.49

1.31

1.18

1.07

0.98

0.91

0.85

0.79

*

7.32

6.33

5.65

5.15

4.76

4.44

4.18

3.96

2.74

2.19

1.85

1.62

1.44

1.30

1.18

1.08

1.00

0.92

*

8.77

7.58

6.76

6.16

5.69

5.31

4.99

4.72

3.25

2.58

2.17

1.89

1.67

1.49

1.34

1.21

1.10

1.00

12.46

10.15

8.76

7.82

7.11

6.57

6.12

5.76

5.45

3.73

2.95

2.47

2.13

1.86

1.65

1.47

1.31

1.17

1.05

18.82

15.31

13.20

11.76

10.69

9.86

9.18

8.62

8.14

5.50

4.28

3.50

2.95

2.51

2.14

1.81

1.51

1.22

0.91

20.36

16.55

14.27

12.71

11.55

10.65

9.91

9.31

8.79

5.92

4.59

3,74

3.13

2.64

2.23

1.86

1.52

1.17

●

50
APPENDIX II

DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT

\

Terms Relating to Residents

Resident.–A person who has been formally

admitted but not discharged from an establishment. AU such persons were included in the

survey whether or not they were physically

present at the time of the survey.

Age.–Age of resident at date survey was

conducted.

Length Oj- stay since current admission.–

Length of stay refers to the current stay of a

resident in the facility. It means the period of

stay starting from the date of most recent

admission to the institution to the date of the

survey.

Living arrangements pn”or to admission.-A

resident’s prior living arrangement refers to the

place of residence immediately preceding admission to the facility, regardless of length of

time in the previous arrangement.

Total monthly charge. -This is the total

amount charged to the resident each month by

the establishment, and it includes basic charge

plus any special charges for medical or nursing

services, medical supplies or equipment, and so

forth. It does not include charges that are not

part of the bill rendered by the institution, such

as those for physicians’ services.

l%mary source of payment. –Primary source

of payment refers to private income or medical

assistance used in payment for resident’s stay in

the nursing home,

Own income is any private source or income

from investments, Social Security, or pension plans.

Medicare refers to payments from Medicare

program described below.

Medicaid refers to payment from Medicaid

program described below.

Other public assistance refers to any public

assistance other than Medicare and Medicaid.

Other refers to all other methods of payment or support including church support,

VA contract, intitial payment for life care,

cases for which no charge was made, and

miscellaneous sources.

Terms Relating to Facilities

Nursing home. –This term refers to all institutions that were within the scope of the

1973-74 National Nursing Home Survey (see

appendix IV).

Nursing care. –Nursing care is defined as a

service that provides one or more of the following treatments: hypodermic injection; intramuscular injection; taking of temperature, pulse,

respiration, or blood pressure; application of

dressings or bandages; bowel and bladder retraining; nasal feeding; catheterization; irrigation; oxygen therapy; full-bed bath; and

enema.

Type of ownership. –Type of ownership

refers to the type of organization that controls

and operates the nursing home.

Proprietary facility is a facility operated

under private commercial ownership.

Nonprofit facility is a facility operated

under voluntary or nonprofit auspices, including both church-related facilities and

those not church-related.

Government facility is a facility operated

under Federal, State, or local government

auspices.
Bed.–One set up and regularly maintained

for patients or residents. Beds maintained for

staff and beds used exclusively for emergency

services are excluded.

Certification status.—Certification status

refers to the facility certification by the Medicare and/or Medicaid progyams.

Medicare refers to the medical assistance

provided in Title XVIII of the Social Security Act. Medicare is a health insurance

program administered by the Social Security

Administration for persons aged 65 years

and over who are eligible for benefits.

Extended care facility refers to certification

as an extended care facility under Medicare.

Medicaid refers to the medical assistance

provided in Title XIX of the Social Security

Act. Medicaid is a State-administered program for the medically indigent.

Skilled nursing home refers to certification

as a skdled nursing home under Medicaid.

Intermediate care facility refers to certification as an intermediate care facility under

Medicaid.

Not certified refers to facilities which are

not certified as providers of care either by

Medicare or Medicaid.

T *rms Relating to Employees

Employee. –This term refers to any person

who was on the staff of the facility or was

employed under contract. It includes any paid

worker, proprietor, or member of a religious

order who contributes his services.

Full-time. –Employees who worked 35

hours or more in the week prior to the survey

are designated “full-time.”

Part-time.–Employees who worked less than

3!5 hours in the week prior to the survey are

designated “part-time.”

Full-time equivalent. –For the purposes of

the report, 35 hours of part time employees’

work per week are counted as equivalent to one

full-time employee.

Geographic Terms

Classification of homes by geographic area is

provided by grouping the States (excluding

Alaska and Hawaii) into regions. These regions

correspond to those used by the U.S. Bureau of

the Census and are as follows:

Re~”on

Northeast . . .

North

Central . . .

States included

Maine, New Hampshire,

Vermont, Massachusetts,

Rhode Island, Connecticut,

New York, New Jersey,

Pennsylvania

Michigan, Ohio, Illinois,

Indiana, Wisconsin, Minnesota, Iowa, Missouri, North

Dakota, South Dakota,

Nebraska, Kansas

South . . . . . . . . Delaware, Maryland, District of Columbia, Virginia,

West Virginia, North Carolina, South Carolina,

Georgia, Florida, Kentucky,

Tennessee, Alabama, Mississippi, Arkansas, Louisiana,

Oklahoma, Texas

West . . . . . . . . Montana, Idaho, Wyoming,

Colorado, New Mexico,

Arizona, Utah, Nevada,

Washington, Oregon, California

Ratio

Ratios presented in this report were calculated by the following generaI formula:

where:

X = numerator of the ratio

Y = denominator of the ratio

w = weight

Detailed information concerning this formula

has been published.z 9 Results from the formula

will differ somewhat from those obtained when

the ratio is calculated for each individual facility

and then weighted.

52
APPENDIX Ill

SELECTED QUESTIONNAIRES’ USED IN THE 1973-74

NATIONAL NURSING HOME SURVEY

@

>,,.r,,,<

(’([~ ‘“j DEPARTMENT OF HEALTH, EDUCATION, AND

‘%O ,*” 18,.

PUBLIC HEALTH SERVICE

HEALTH RESOURCES ADMINISTRATION

ROCKVILLE, MARYLAND 20S52

WELFARE

NATIONAL CENTER FOR

HSALTH STATISTICS

Dear Administrator:

The National Center for Health Statistics (NCHS) of the U. S. Public

Health Service is conducting a sample survey of resident facilities

providing nursing and personal care to obtain basic data on their

policies, services, and staff. This survey is being conducted as a

part of the Department of Health, Education, and Welfare’s nursing

home improvement program. The information from this survey will be

used to compile statistics on the number and kinds of such facilities

in the United States. Enclosed are two summary reports from previous

surveys, which are illustrative of the kinds of data to be obtained

from this survey. These statistics will be used to meet the needs of

Congress, State legislatures, Federal, regional, and local health

planners, national health associations, and man y others who plan and

provide health services to the aged.

As you can see from these reports, it is not possible to identify any

particular facility. We wish to as sure you that any information which

permits the identification of the services provided by your facility,

or the residents and staff will be held strictly confidential. This

information will be used only by persons engaged i.~ and for the purposes

of the survey, and will not be disclosed or released to others for any

purpose. Because the NCHS is committed to provide a factual basis for

planning national programs designed to advance the health of the American

people, limited basic information abOut your facility (such as name,

address, size, type, and ownership) will be made available upon request

to the NCHS.

Within about one week an interviewer will contact you for an appointment; ,’,

I this person will be with Applied Management Sciences, the firm under

~ 1See reference 1 for copies of all questiomaires used in the survey.

53
Federal contract to conduct this survey. In preparation for this call,

please review the worksheet printed on the back of this letter. These

questions request necessary information which may take time to assemble

from your records. I have enclosed them so that you may do this at

your convenience prior to the interviewer’s visit.

This survey includes a small, carefully selected nationwide sample of

nursing homes and similar facilities. Because this ntirsing home repre -

s ents several facilities of similar type, your participation is vital in

obtaining accurate and complete data. We would appreciate your cooperation

in this effort.

Sincerely yours,

Edward B. Perrin, Ph.D.

Acting Director

54
THE FOLLOWING QUESTIONS ON ADMISSIONS AND DISCHARGES CONCERN CALENDAR YEAR 1972,

WHICH IS THE PERIOD OF JANUARY 1, 1972 THROUGH DECEMBER 31, 1972.

From —— through

Month Year = Year

● HOW MANY PERSONS WERE ADMITTED TO THIS FACILITY DURING 1972?

Admksions

● HOW MANY PERSONS WERE DISCHARGED FROM THIS FACILITY DURING 1972, EXCLUDING DEATHS?

Dlschar@c

● HOW MANY PERSONS DIED DURING 1972 WHILE RESIDENTS OR PATIENTS OF THIS FACILITY?

Deeths

● IN 1972, WHAT WERE THE TOTAL INPATIENT DAYS OF CARE PROVIDED? (THE SUM OF THE DAILY PATlENT CENSUS

COUNT FROM 1/1/72 THROUGH 12/31 /72,)

Days

● HOW MANY ROOMS FOR RESIDENTS DOES THIS FACILITY HAVE THAT CONTAIN:

a. 1 bedonly O None

b, 2 beds O None

c, 3 beds ❑ Nona

d, 4 or morebeds O None

RETAIN THIS FORM AND DATA FOR THE INTERVIEWER TO COLLECT.

55
FACILITY QUESTIONNAIRE I OMB# 06W-72172 I I

1973 Nursing Home Survey Expires 7-31-74

National Center for Health Statiwics

1

Health Resources Administration

Rockville, Maryland

Name and address label

TELEPHONE NUMBER

Area Code Number

ccl-1 CC2 cdl-f CC12

CC24 CC27

SECTION A -FACILITY INFORMATION

1.a,

2a.

Is THE CORRECT

(nameof facility on label)

NAME FOR YOUR FACILITY?

34-1 ❑ yes

-2 ❑ ~+ b. WHAT IS THE CORRECT NAME? <

Is THE CORRECT

(addresa on label)

MAILING ADDRESS FOR YOUR FACILITY?

35-1 ❑ yes

.2 ❑ m~b. WHAT IS THE ENTIRE CORRECT~

MAiLING hDDREss?

A

Correct Name of Facility if Different from Above

Number Street P.O. BOX, Route,

Ctc.

City or Town County

1

State Zip Code

●3. WHICH CATEGORY BEST DESCRIBES THE TYPE OF SERVICE THIS FACILITY OFFERS THE MAJORITY OF ITS

RESIDENTS OR PATIENTS? (Mark (X) only one box.)

36-1 1“-J a. Nursing home (includes Medicare certified Extended care Facilities and Mcdiccid certified Skilled Nursing Homes)

-2 ❑ b. I ntermadiete care fecilit y (includes Medicaid certif iad Intermediete Cere Facilities)

-3 •1 c. Convalescent or rest home

-4Dd, Homa for the aged

{

-5 •l e. Extend& care unit of a hospitel

r

~of. Nursing owe unit of a retirement center

-7 ❑ g. Other resident facility (Describe) 37-

INTERVIEWER: IF BOX e OR f IS CHECKED, RECORD DATA ONLY FOR THE UNIT AND NOT FOR THE ENTIRE FACILITY.

●4a WHAT IS THE TYPE OF OWNERSHIP WH ICH OPERATES THIS FACILITY? (Mark (X) only one kx.)

3B,39 -23 ❑ a.

-24 ❑ b.

-25 ❑ c.

-20 ❑ d,

-21 ❑ e.

-22 ❑ f.

-11 ❑ g.

-12 ❑ h.

-13 ❑ i.

-14 ❑ j.

-15 ❑ k.

-16 ❑ 1.

-17 ❑ m.

-18 ❑ n.

-19 ❑ o.

Form 73N HS-1

56

Individual

Partnership

1

/

4.b. IS THIS HOME A MEMBER OF A GROUP OF HOMES OPERATING

UNDER ONE GENERAL AUTHORITY OR GENERAL OWNERSHIP?

Corporation

40-1 ❑

Church raletad

yas

-20 ~

Nonp+ofit corporation

J

Other non~ofit ownership

State

Count y

City

City-Count y

Hospital District

U.S. Public Heelth Service

Armed Forces

Veterans Administration

Other Federal Agency -- Specify 41-
5. DOES VOUR FACILITY ACCEPT: (Mark (X) only one box.)

44-1 ❑ Males only?

-2 ❑ Females only?

“3 ❑ BOth males end femede~?

6a. DOES YOUR FACILITY ACCEPT PERSONS OF ALL AGES, INCLUDING INFANTS AND CHILDREN?

45-1 ❑ Yes(Skipto Question7)

-2

L

No

b. WHAT IS THE MINIMUM AGE ACCEPTED? ❑ No minimum .geor _ yrs.

cc’%,47

.

c. WHAT IS THE MAXIMUM AGE ACCEPTED? ❑ No maximum age or yrs.

CC48. 49

7, WHAT IS THE TOTAL NUMBER OF BEDS_REGULARLY MAINTAINED FOR RESIDENTS? (INCLUDE ALL BEDS SETUP

AND STAFFED FOR USE WHETHER OR NOT THEY ARE IN USE BY RESIDENTS AT THE PRESENT TIME. DO ~

INCLUDE BEDS USED BY STAFF OR OWNERS OR BEDS USED EXCLUSIVELY FOR EMERGENCY PURPOSES, SOLELY

DAY CARE, OR SOLELY NIGHT CARE.)

Total beds

CC50

8a. WAS THERE AN INCREASE OR DECREASE IN THE TOTAL NUMBER OF BEDS DURING THE LAST YEAR?

54.2 H No (Skip to Question 9)

.1

%

Yes

b. I ncreasa of

CC55

c, Decrease of

CC58

beds

bads

9,a, WHAT WAS THE TOTAL NUMBER OF RESIDENTS ON THE REGISTER OF THIS FACILITY LAST NIGHT? (INCLUDE ALL

RESIDENTS, EVEN THOUGH THEY MAY HAVE BEEN TEMPORARILY AWAY OR ON OVERNIGHT LEAVE, DO NOT

INCLUDE STAFF OR OWNERS,)

Total residents

CC61

b. HOW MANY OF THESE WERE:

(1) Males? ❑ No”,.,

CC65

(2) Females? ❑ Noneor

CS69

CARD 2

ccl 1-2

10,a, IS THIS FACILITY PARTICIPATING IN THE MEDICARE (TITLE XVIII) PROGRAM?

(

h WHAT IS THE PROVIDER NUMBER?

I

CC13

H No provider # give”

12.1 ❑ Yes ~ c. HOW MANY BEDS ARE CERTIFIED FOR MEDICARE?

\

beds

CC19

d. HOW MANY OF THESE CERTIFIED BEDS WERE OCCUPIED BY MEDICARE

PATIENTS LAST NIGHT?

~ ciNOneOr ~c23 beds

‘2 ❑ NO (Skip to Question 1 I)

Form 73 NHs-1

57
11.a. IS THIS FACILITY PARTICIPATING IN THE MEDICAID (TITLE XIX) PROGRAM?

/

❑ Yes ❑ No (Skip to Question 12)

29-1 -2

b.(1) DOES IT HAVE ANY SKILLED NURSING BEDS?

b.(2) WHAT IS THE PROVIDER NUMBER?

Cc31 •1

No provider # given

b.(3) HOW MANY BEDS ARE CERTIFIED AS SKILLED NURSING BEDS?

❑ No.ecw bads

CC44

b.(4) HOW MANY OF THESE CERTIFIED BEDS WERE

OCCUPIED BY MEDICAID PATIENTS LAST NIGHT?

❑ None or beds

CC46

C!(1) DOES IT HAVE ANY INTERMEDIATE CARE BEDS?

❑ No ❑ Yes. —

52-2

[

c.(2) WHAT IS THE PROVIDER NUMBER?

-1 CC53

/

❑

No provider # given

/

c.(3) HOW MANY BEDS ARE CERTIFIED AS INTERMEDIATE CARE BEDS?

❑ None or beds

CC66

c.(4) HOW MANY OF THESE CERTIFIED BEDS WERE

OCCUPIED BY MEDICAID PATIENTS LAST NIGHT?

1

❑ None or beds

CC70

SECTION B - CLASSIFICATION INFORMATION (CONFIDENTIAL)

ASSURANCE OF CONFIDENTIALITY - All information which would permit identification of the individual facility will be held in

strict confidence, will be used only by persons engaged in and for the purposes of the survey, and will not be disclowd or

releasedto others for any purposes.

12.a. WAS THIS BUILDING ORIGINALLY CONSTRUCTED FOR USE AS A NURSING HOME, REST HOME, CONVALESCENT

HOME, HOME FOR THE AGED?

CARD 3

ccl 1-3 ❑ Yes

F

❑ No

12-1 -2

(Skip to next page)

b. WHAT WAS THE ORIGINAL PURPOSE AND USE OF THIS BUILDING? (Mark (X) only one box.)

13-1 ❑

“2 •1

-3 •1

I

~cl

-5 •1

~cl

Private home (i.e., singlefamily dwelling)

Duplex (2 to 4 units)

Apartmant house(5 or more units)

Hotel or motel

Hospital

Other (Spscify) 14-

Form 73 NHS-1

5B
Intawlawar:

tin back of

War to

dmlnlctmtor

for qu09t10ns

13 throuoh 17.

THE FOLLOWING QUESTIONS ON ADMISSIONS AND DISCHARGES CONCERN CALENDAR YEAR 1972,

WHICH IS THE PERIOD OF JANUARY 1,1972 THROUGH DECEMBER 31, 1972. IF YOUR ANSWERS TO

THESE QUESTIONS COVER A PERIOD OTHER THAN CALENDAR YEAR 1972. WHAT IS THIS OTHER TIME PERIOD7

From _ _ through _ _

Month Year Month Year

ccf5,16 CC17,16 CC19,20 CC21,22

13. HOW MANY PERSONS WERE ADMITTED TO THIS FACILITY DURING 1972?

Admissions

CC23

14. HOW MANY PERSONS WERE DISCHARGED FROM THIS FACILITY DURING 1972, EXCLUDING DEATHS?

Dlaahsrgas

C027

15; HOW MANY PERSONS DIED DURING 1972 WHILE RESIDENTS OR PATIENTS OF THIS FACILITY?

Deaths

CC31

16, IN 1972, WHAT WERE THE TOTAL INPATIENT DAYS OF CARE PROVIDED? (THE SUM OF THE DAILY PATlENT CENSUS

COUNT FROM 1/1/72 THROUGH 12/31 /72.)

Days ❑ (mark (X) if estirrwtad)

CC35 41-1

17. HOW MANY ROOMS FOR RESIDENTS DOES THIS FACILITY HAVE THAT CONTAIN:

a, ❑ None or 1bad only

CC44

b. ❑ Nonaor 2 beds

CC4S

c. ❑ None or 3 bsds

CC52

d. ❑ None or 4 or more beds

CC56

●18, ARE ANY OF THE FOLLOWING SERVICES ROUTINELY PROVIDED TO RESIDENTS IN ADDITION TO ROOM AND BOARD?

a.

b.

c,

d,

a.

f.

9.

h,

1.

Supervision over medications which may be self -administarsd

Medications and treatments administered in accordance with

physicians’ ordars

Rub and masaaga

Halp with tub bath or shower

Halp with dressing

Help with correspondence or shopping

Help with walking or getting about

Help with sating

OR

None of the above sewices routinely provided, room and

board providad only

W-1 ❑ Yes -2 ❑ No

61-1 ❑ Yes -2 ❑ No

62-1 ❑ Yes -2 ❑ No

63-1 ❑ Yas -2 ❑ No

64-1 ❑ Yes -2 ❑ No

65-1 ❑ Yes -2 ❑ No

66-1 ❑ Yas -2 ❑ No

67-1 ❑ Yes -2 ❑ No

66-1 ❑ Yes

Form 73NHS-1

59
‘ 19. DURING THE PAST SEVEN DAYS, HOW MANY RESIDENTS RECEIVED EACH OF THE FOLLOWING SERVICES?

CARD 4

ccl 1-4

a. Nasal fading b. B Iwd pressure raading c. Enema

ccl 2 IX16 CC26

d. Cetheterization e. Full bed-both f. Bowel or bledder

CC24 CC28 retraining CC32

g. OxWCn therapy h. Application of dres- i. TemparaturqxcleeCC36 sing or bandage CC40 respiration

j. Hy@ermic injection k. Irrigation L I ntravanous injection

CC4S rx52

cd4

C=256

’20, DOES THIS FACILITY PROVIDE ANY OF THE FOLLOWING PROFESSIONAL REHABILITATION SERVICES ON THE

PREMISES? (THE THERAPISTS MUST BE LICENSED OR REGISTERED IN THEIR SPECIFIC PROFESSIONS.)

a.

b.

c.

d.

e.

f.

Physical therapy

Occu~tional therapy

Recreational therapy

Spaach and hawing therepy

Counseling by social worker, psychologist, or mental health

worker

Other rehabilitation services (Specify)

6s60-1 n Yes

61-1 ❑ Yes

62-1 ❑ Yes

63-1 ❑ Yes

S4-1 ❑ Yes

S6-1 ❑ Yes

-2 c1 No

-2 a No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 D No

21. DOES THIS FACILITY CONDUCT TRAINING PROGRAMS FOR PEOPLE NOT ON YOUR STAFF IN COOPERATION

WITH AN EDUCATIONAL INSTITUTION?

o Yes ~ No

67-1

22. WHAT ARE THE ACTUAL HOURS FOR EACH SHIFT? (Circle am or pm)

CARD 5

a. Dey Shift from am

ccl 1-5 to

ccl 2 pm

am

.x16 Pm

b. Evanicg Shift from am to am

C&U Pm CC24 Dm

c. Night Shift from am to

CC26 pm

am

IX32 Pm

❑ No such $hift

O No such shift

Form 73 NHS.I

60
23a, 1, FOR THE DAY SHIFT YESTERDAY, WAS THE PERSON IN CHARGE OF NURSING CARE (FOR THE ENTIRE

FACI LITYJ: (Mark (X) Only One Box)

‘To”’’” ‘27’~G’z’’g;ke’

[

23,b, 1,

-3

-4

WHAT IS THE LEVEL OF a.3. WHAT HOURS DID~PERSON

SKILL OF THIS PERSON? WORK YESTERDAY? (circle

(Mark (X) Only One Box) am or pm.)

❑ RegisteredNurse

❑ Licemed Practical Nurse

❑ N.rse’s Aide

n Othr

am am

from to —

cdl pm CC45 pm

— _40-

Specify Occupation

FOR THE EV ENING SHIFT YESTERDAY, WAS THE PERSON IN CHARGE OF NURSING CARE (FOR THE ENTIRE

FACILITY): (Mark (X) Only One Box)

49-1 ON CALL -2

L

ON DUTY - that isawake, -3

?

NO SUCH SHIFT

dreacad,and sewingthe

redklents

(Skip to Part 23.c.]

b.2. WHAT IS THE LEVEL OF b.3. WHAT HOURS DID THIS PERSON

SKILL OF THIS PERSON? WORK YESTERDA~rcle

(Mark (X) Only One Box) am or pm.]

w-1 •1

“2 •1

-’cl

-$0

am am

Ragiaterad Nurse from to

CC52 pm CC66 pm

Licensed Practical Nurse

Nurse’s Aide

Other 51-

Specify Occupstio”

23,c. 1. FOR THE NIGHT SHIFT YESTERDAY, WAS THE PERSON IN CHARGE OF NURSING CARE (FOR THE ENTIRE

FACILITY): (Mark (X) Only One Box)

~“”c’’’”’e:‘3uN0sucHs

61-1

-2

-3

4

❑

•1

•1

•1

5p3cify OccupatiOn

~(Sk,p to Question 24)

WHAT IS THE LEVEL OF c.3. WHAT HOURS DID THIS PERSON

SKILL OF THIS PERSON? WORK YESTERDA~rcle

(Mark (X) Only One Box) am or pm.)

am am

RagicceradNurse from to

CC63 pm a67 pm

Licensed Practicsl Nurse

Nurse’s Aide

Other 62-

.

24. HOW MANY DIFFERENT PHYSICIANS CURRENTLY ATTEND THEIR OWN PRIVATE PATIENTS IN THIS FACILITY?

(DO NOT COUNT PHYSICIANS WHO ARE ONLY ON THE STAFF OF THE FACILITY OR ARE ONLY EMPLOYED

UNDER CONTRACT.)

Physicians

CC71

Form 73N HS-1

61

(:
--

.

25a. WHAT TYPE OF STAFF MEMBER EXERCISES DAILY, ON-DUTY SUPERVISION OVER ALL CLINICAL SERVICES

IN THIS FACILITY? (Mark (X) Only One Box.)

Administrator . . . . . . . . . 76-1 -b. IS THE ADMINISTRATOR ALSO A:

physician 76-1 ❑ Yes -2 a No

ragieterad nurse 77-1 ❑ Yes .2 a No

Iksnsed practical 78.1 f’-J Yes -2 a NCJ

nurse

Physician . . . . . . . . . . ..76-2n

Ragisterad Nuraa . . . . . . .

*CI

Other . . . . . . . . . . . . . . -4

Y

Sfmoifv 78-

●26. DOES THIS FACILITY PROVIOE ANY OF THE FOLLOWING SERVICES TO PERSONS WHO ARE NOT RESIDENTS OF

THIS FACILITY?

a, Day care (sarvices provided during the day to pareons who

CARO 6 do not sleep in the home overnight. Oay cara services can

CC1l-6 include nursing sare, physical or occupational therapy,

racraat”mna I activities, at beet one full meal a day) . .. . . . . 12-1 a Yes -2 ❑ No

b. Meals eithar home delivered or in a group sating . . . .’. . 13-1 ❑ Yes -2 ❑ No

c. Transportation andlor escort sawices, . . . . . . . . . . . . . 14-1 ❑ Yes -2 ❑ No

d. Homemaker orchureeavices . . . . . . . . . . . . . . . . 15-1 l_J Yes -2 0 No

e, Information andlor raferral for health needs . . . . . . , . 16-1 ❑ Yes -2 n No

f. Friendly visiting . . . . . . . . . . . . . . . . . . . . . . . . . . 17-1 ❑ Yes -2 ~ No

9. Oailytelephone checking sawice . . . . . . . . . . . . . . . . 18-1 ❑ Yes -2 ❑ No

h, Arrangement orprovision ofrecreational activities . . . ...19-1 ❑ Yes -2 ❑ No

i. Laundry aarvke . . . . . . . . . . . . . . . . . . . . . . . ...20-1 ❑ Yes -2 ❑ No

i. Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

P

21-1 Yes -2 ❑ No

Specify 22-

27a. DOES THIS FACILITY KEEP A WAITING LIST OF PERSONS TO BE ADMITTED WHEN A BED BECOMES AVAILABLE?

Al ‘es

❑ No (SkiP to Question 28)

-2

b. HOW MANY PEOPLE ARE ON THIS WAITING LIST?

❑ Noneor — r=wle

CC24-26

c. DO YOU PROVIDE ANY SERVICES TO THE PERSONS ON THIS WAITING LIST?

P

Yes ❑ No (Skip to Q.essio. 28)

27-1 -2

* c.(1) WHICH OF THE FOLLOWING SERVICES DO YOU PROVIDE?

a,

b.

c.

d.

0,

f.

91

h.

i,

i.

Day care (sarvices lxovided durirrg tha day to paraons who

do rwt daep in the home overnight. Day care sarvicaa can

include nursing care, physical or occupational therapy,

racraationel activities, at least one full meal a day). . . . . . . 28-1 ❑ Yes -2 •1 No

Meals either home delivered or in a group setting . . . . .. 28.1 ❑ Yes -2 ❑ No

Transportation and/or eecort earvicas. . . . . . . . . . . . . . 30.1 ❑ Yes -2 ❑ No

Homemaker orclwres.ewices . . . . . . . . . . . . . ...31.1 ❑ Yes -2 ❑ No

Information awJ/or refwral for health needs . . . . . . . . 32-1 ❑ Yes -2 ❑ No

Friendly visiting . . . . . . . . . . . . . . . . . . . . . . . . 33.1 ❑ Yas -2 ❑ No

Daily telephone checking service . , , . . . . . . . . . . ...34.1 ❑ Yes -2 ❑ No

Arrangement or provision of recreational activities . . . . . . 35-1 l-J Yes -2 ❑ No

Leumlry aervioe . . . . . . . . . . . . . . . . . . . . . . . ...38.1 a Yes -2 ❑ No

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...37-1

P

Yes -2 ❑ No

SPacif y 38-

Form 73NHS-1

62
●28. DOES THIS FACILITY INCLUDE AS PART OF ITS BASIC CHARGE TO EACH RESIDENT THE CHARGES FOR:

Yes No

●. Physician servims . . . . . . . . . . . . . . . . . . . . . . . . 39-1 ❑ “2 ❑

b. Private dutynursing . . . . . . . . . . . . . . . . . . . . . . 40-1 ❑ -2 ❑

c. Other nursing services . . . . . . . . . . . . . . . . . . . ...41-1 ❑ -2 ❑

d. Therap y . . . . . . . . . . . . . . . . . . . . . . . . . . ...42-1 •1 “2 •1

●. Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . ...43-1 •1 “2 •1

f,. Medkalsupplies . . . . . . . . . . . . . . . . . . . . . . . . 44-1 ❑ “2 o

0. Specialdlet, . . . . . . . . . . . . . . . . . . . . . . . . ...45-1 c1 -2 0

h, Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...46-1

P

-2 c1

Specify 47-

29. HASTHISNURSING HOME BEEN IN BUSINESSATTHISADDRESS FOR LESSTHAN TWOYEARS? (COUNT FROMTHE

TIMEITFIRSTOPENED ATTHISADDRESS ASANURSINGHOME EVENTHOUGHTHE OWNERSHIP ORTHE SERVICES

OFFEREDMAYHAVE CHANGED.)

1- Yes ; No

50-1

Do Not Administer Expenea Questionnaire

63
RESIDENT CONTROL RECORD

1973 Nursing Home Survey

National Center for Health Statmlcs

Health Remurces Admmmration

Rockville, Maryland

Sheet_ _Sheets &

ESTABLISHMENT NO.

TOTAL RESIDENTS IN HOME ccl .6 111111 CC12-15 CC2 ccl 1.1

IN SAMPLE

CC16-19

1

RESIDENTS IN NURSING HOME

SAMPLE

DESIGNATION

Sw

TE

a

NAME OF RESIDENT

b

LINE

No.

c

I

01

02

03

04

05

06

07

08

09

10

11

12

13

14

15

16

17

1S

19

20

21

22

23

24

25

SAMPLE NAME OF RESIDENT

DESIGNATION

Sw I

I

I

LINE

NO.

c

26

27

28

29

30

31

32

33

34

35

36

37

3S

39

40

41

42

43

44

45

46

47

4S

49

50

Form 73NHS.6 If More Lines Are Needed CONTINUE ON THE BACK

64
RESIDENT CONTROL RECORD

I RESIDEP rs IN IURSING HOME —

SAMPLE NAME OF RESIDENT

DESIGNATION

SAMPLE NAME OF RESIDENT

DESIGNATION

Sw

TE

a b

LINE

Uo.

LINE

NO.

Sw I

TE I

c a b —c

76

77

—

78

51

52

53

54

55

79

m

56 81

57 82

58

59

63

64

85

86

60

61

62 87

63 88

64

65

66 91

67

68

92

93

69 94

70

71

72

95

.

96 —

97

I

73

74

75

98

99

.

00

—

Form 73NHS43 If More Lirm Are Needed Use A New RESIDENT CONTROL RECORD

And Renumber The Lines Beginning With # 101

65
RESIDENT QUESTIONNAIRE

1973 Nursing Home Survey =

National Center for Heelth Statistics

Health Resources Administration

Rockville, Maryland

1-7

ASSURANCE OF CONFIDENTIALITY – All information which WOUM permit identification

ESTABLISHMENT NO.

of ttw individual will be held in strict mnfklence, will bc used only by persons engcgad in and for

the purpwes of the survey, and will not be disclosed or released to others for any purpases.

CC2

LINE NO.

ccl 1

ccl 4-1

1. WHAT IS – DATE OF BIRTH?

Onn”rn

Month Day Year A%

CC15,16 17, 18 19-21 CC22-24

2. WHAT IS – SEX? ❑ Male $1 Female

25-1

3. WHAT IS – ETHNIC BACK- 26-1 ❑ Caucasion -2 ❑ Negro -3 ❑ Oriwstal

GROUND? (Mark (X) only

one box) -4 ❑ Spanish American -5 ❑ American I miian -6 ❑ Other

4. WHAT IS – CURRENT MARITAL 27-1 ❑ Marriad -2 ~ widowed

STATUS? (Mark (X) only

-3 ❑ Divorced

one box) 4 ❑ Separated -5 ❑ Never Married

5. WHAT WAS THE DATE OF – CURRENT ADMISSION TO THIS PLACE?

000

Month Day Year

CC28, 29 30-31 32-34

6a. WHERE DID – LIVE AT THE TIME OF ADMISSION? (Mark (X) orslyone box)

(1) In a boarding home 35-1 ❑

(2) In anothaf nursing home or related facility

-2 •1

(3) In e mental hospital or other Iong-tarm specialty hospital

“3 •1

(4) In a general or short-stey hospital “cl

(5) in a private apartment or house

}

“5 •1 ~b

(6) Other place,(Specify) ~o”

2&

(7) Don’t know

-7 ❑

(1)

(2)

(3)

(4)

(5)

(6)

AT THE TIME OF ADMISSION

DID – LIVE WITH: (Mark (X)

ell that apply)

Yes

spouse? 37-1 ❑ .2

Children? 38-1 ❑ -2

Other relativea? 38-1 ❑ .2

Unrelated parsons? 40.1 ❑ -2 ❑

Lived alone? 41-1 ❑ -2 ❑

Don’t knaw? 42-1 ❑

7. WHAT IS THE PRIMARY REASON FOR – ADMISSION TO THE HOME? (Enter”1” in box for primary reason; if secondary

reason given, enter W“.)

43- ❑ Physical reesons (e.g., illness or need for treatments)

44D .Scmial reesons (e.g., no family, or lack of family intarast)

‘%-n 8ehwiorel reaaans (e.g., disruptive bahcvior, mental detariomtio”)

46-U Economic reasans (e.g., no money .snd/or reaoarcas)

Form 73NHS-7

66
8. WHAT WAS THIS RESIDENT’S PRIMARY DIAGNOSIS: (Mark(X) onlyonebox in=h ~lumd

a. AT ADMISSION? b. AT THE TIME OF–LAST EXAMINATION?

49,50 •1 001 51,52 ❑ bill

•1 002 ❑ b02

❑ 803 ❑ bm

•1 KM clbcM

•l aCE ❑ b05

•1 rim ❑ lbos

•1 ,07 ❑ b07

•l aOS ❑ bOB

•1 .09 clbo9

•l alO ❑ b10

•1 ,11 ❑ bll

•l a12 ❑ b12

•1 .13 ❑ b13

❑ ●14 ❑ b14

•l a16 ❑ b15

❑ a16 ❑ b16

•l a17 ❑ b17

•1 ala ❑ b18

•1 ,19 ❑ b19

•l a20 ❑ b20

❑ *21 ❑ b21

•l a22 ❑ b22

Senility, old age, and other symptoms and illdefined conditions (e.g., coma, uramia)

Heart attack (a.g., ischemic heart disease)

Stroka (a.g., cerebrova.tcular diseasca)

Hardening of arteries (e.g., arteriosclerosis, disaasas of the arterias, areriolas, capillaries)

Other disaaa?s of the circulatory system (e.g., NOT heart attack, stroke, or h=dening of the arteries)

Accidanta, poisonings, and violence (e.g., fractura of hip, other bmkan bones, burns, concussion)

Mental disorders (a.g., mental retardation, psychoses, neurosas, mental illness, emotional problems)

Oisea.sasof the musculoskeletal system and connective tissue (e.g., arthritis, rheumatism, &k psi”)

Endocrine, nutritional, and metabolic diseases (e.g., goiter, diabetes, gwt)

Oisecsas of the respiratory system (e.g., pneumonia, amphyssma)

Neoplaams (e.g., cancer, tumors)

Oiseases of tha nervous system and senss organs (e.g., Parkinson’s dkecse, glaucoma, cataracta,

blindness, multiple sclerosis, spastic paralysis, epilepsy)

Disaasas of the digestive systam (e.g., cirrhosis of Iivw, ulcer, intestinal obstruction)

Infective and parasitic diseases (a.g., T. B., polio, syphilis)

Diseases of the genitourinary system (e.g., nephrosis, chronic pelvic infection, hyperplasia of prostate)

Oiseasas of tha skin and subcutaneous tissue (e.g., cellu Iitis, abscess, chrcmic ulcer)

Disecsas of the blwd and blood-forming organs (e.g., anemia)

Congenital anomalities (e.g., hydrocaphalus)

Complications of pregnancy, childbirth and the puerparium (a.g., infections,hamorrhaga, toxamias)

Certain causes of parinatal morbidity and morWity (e.g., birth injury or immaturity of infant)

Oon’t know

Other (Specify) 54-

\ Specify:

9, DOES – HAVE ANY OF THE FOLLOWING CONDITIONS OR IMPAIRMENTS? (Mark (X) ail that apply}

CC55.65 -1

-2

.3

-4

-5

-6

-7

-8

-9

.0

.&

❑ a. Sanility (includes decline in intellect, memory, and judgement, loss of orientation, difficulty in speaking; feckdeness.)

❑ b. Mental illnass (Psychiatric or emotional problems)

l-J c, Mental retardation

❑ d. Arthritis or rheumatism

%

Paralysis or palay other than arthritis

a. (1) IS THIS THE RESULT OF A STROKE?

❑ f. Glaucoma or cataracts

•1 9. Oiabates

❑ h. Any CHRONIC trouble with back or spit-m

❑ Yas ❑ No

66-1 -2

❑ ❉✎ Amputation of axtremitias or limbs or permanent stiffness or any deformity of tha foot, lag, fingars, arm, or back

❑ L Heart trcmbla

OR

❑ k Resident has none of the above conditions or impairments

Form 73N KS-7

67
10. DOES THIS RESIDENT REGULARLY USE ANY OF THE FOLLOWING AIDS?

No

CARD 2

14-2 a, Walkar 15-2 Q

b. Crutches 16-2 ❑

c. Bracas 17-2 ❑

d. Wheelchair 1s-2 ❑

a. Artificial Limb 19-2 ❑

f. Salf-faedar 20-2 ❑

9. Any other aids (do not count glaasas or hearing aids) 21-2 ❑

Yes

-1 •1

-1 •1

-1 c1

-’ c1

-1 c1

“’ •1

-’ c1

\

Specify 22-

11. DURING THE LAST MONTH, HOW MANY TIMES DID–RECEIVE AN’f OF THE FOLLOWING THERAPY SERVICES? (INCLUDE

ONLY SERVICES PROVIDED BY A LICENSED OR REGISTERED PROFESSIONAL WHETHER INSIOE OR OUTSIDE THE hOME.)

NUMBER OF

TIMES

a.

b.

c.

d.

e.

f.

Physical therapy ❑ None.r I I

CC23

❑ Noneor 1 I

w25

Occupational tharapy ❑ None or I 1

cc27

Speech therapy ❑ Nonaor I

CC29

Hearing therapy ❑ Nc.”eor I

CC31

Profeational counseling by seeial

worker, psychologist or other

marital health worker ❑ Ncmaor \ I

CC33

12. DURING THE PAST 7 DAYS, WHICH OF THESE SERVICES DID–RECEIVE? (Mark (X) all that apply)

CC35-62 -01 ❑ a.

-02 ❑ b,

-03 0 c.

-04 ❑ d.

-05 ❑ e.

.06 ❑ f.

-07 •1 9.

-OB ❑ h.

-09 ❑ i.

-10 c1 i.

-11 ❑ k.

-12 ❑ 1.

-13 ❑ m.

OR

-14 ❑ n.

Rub or maesage

Admirsiatration of treatmant by staff

Spatial diet

Application of sterila drasinga or bandagas

Temperatu~pulsa-respiration

Full bad-bath

Enema

Catheterization

Blood praesure reeding

Irrigation

Oxygen therapy

Intrevenous injection

Hypodermic injection

None of tha almva eervicas racaivad

Form 73NHS-7

68
13. DURING THE PAST 7 DAYS, DID – RECEIVE ANY MEDICATIONS?

CARD 3

T

g ‘“(sk~ ‘es

WHICH TYPES OF MEDICATIONS DID – RECEIVE?

cc16-45 .01 ❑ a.

-02 ❑ b.

-03 f-J c.

-04 ❑ d.

-05 ❑ e.

-06 ❑ f.

-07 ❑ g.

-IX ❑ h.

-09 ❑ i,

-10 H j.

-11 ❑ k.

-12 ❑ 1.

-13 ❑ m.

-14 ❑ n.

-15 ❑ 0.

(Mark (X) All That Apply)

Tranquilizers (e.g., Thorazine, Mellaril)

Hypnotics - Sadatives (e.g., Nembutal, Seconal, Phenobarbital, Butisol, Placidyl, Chloral Hydrate)

Stool softeners (e.g., Peri-COlace)

Anti-Depressant (e.g., E Iavil)

Anti-Hyper’tensives (e.g,. Ismelin)

Diuretics (e.g., Diuril, Esidrex)

Analgesics (e.g., Aspirin, Darvon, Demerol, Percodan, Empirin with Codeine)

Diabetic agents (e.g., Orinase, I MI Iin)

Anti-inflammatory agents (e.g., Cortisone, Sodium Salicylate, Butazolidin, Indocin)

Anti-infwtives (i.e., antibiotics)

Anti.Anginal drugs (e.g., Nitroglycerin, Peritrate)

Cardiac Glycosidas (e.g., Digitalis, Lanoxin)

Anti-Coagulants (e.g., D icumarol, Warfarin)

Vitamins or iron

Other types of medications not Iismcl z?to.

14. THE FOLLOWING ACTIVITIES FOR DAILY LIVING LIST ~. I I . Js LEVELS OF CARE THAT MAY BE NEEDED BY A

RESIDENT. PLEASE INDICATE THE ONE THAT 131%TDESiXIBES THE LEVEL OF CARE NEEDED BY ~RESIDENT.

FOR EACH ACTIVITY, THE LEVELS ARE GIVEN IN ASCENDING ORDER: IN OTHER WORDS, THE LEVEL DESCRIBING

THE MINIMUM CARE IS FIRST AND THE LEVEL DESCRIBING THE MOST CARE 1S LAST. IF YOU ARE UNDECIDED

WHICH OF TWO LEVELS TO INDICATE, CHOOSE THE ONE DESCRIBING THE LESSER AMOUNT OF CARE:

a. CONSIDERl;dG THE FOLLOWING FOUR HYGIENE ACTIVITIES (WASHING FACE AND HANDS, BRUSHING TEETH OR

DEPJ-I IJI?E5, COMBING HAIR, AND SHAVING OR APPLYING MAKE-UP) DOES THIS RESIDENT:

(IWi (A] CIIIIVOne Box)

“’”1 ❑ perform all four with “o assi~ta”ce?

‘2 ❑ pefiOrm all four with no assistance, but needs help in getting and/cm p“tti”g away ~uiPme”t?

‘3 ❑ ‘erfwm threa Or fOur with no WSkt&W3, but requires help with a complete bath?

‘4 ❑ R~uire a$si$tance with one or two of these hygi~”e ~ctivitie~?

“5 ❑ Rwire a~istanca with all four of these hygiene~tivitie~?

b. CONCERNING DRESSING, DOES THIS RESIDENT:

(Mark (X) Only One Box)

47.1 ❑ Get clothes from closets and drawers and completely dress without assistance?

.2 ❑ Get clothes from clo~ets and drawers and cOmpletaW dra~ with sOme assistance (tying shOes, fastening braces, closing buttons or

zippers in back of garments) ?

“3 ❑ Receave a=istance in *tting clOthes. or in dre=ing (dO nOt cOunt Wing shOes, faflening brwes, closing buttons or zippers in back

of garments as assiatanca) ?

.4 ❑ StaY PartlY Or completely undressed?

c, CONCERNING FEEDING, DOES THIS RESIDENT:

(Mark (X) Only One Box)

4s-1 ❑

“2 •1

“3 c1

-40

-5 •1

Feed self without assistance?

Faad self with minor assistance (cutting meat or buttering bread)?

Receive major asaietance in feading (do not count cutting meat or buttarmg bred)?

Raquire intravenous feeding?

Require tubs f-ding?

Form 73N HS-7

69
d. CONCERNING AMBULATION TO REACH THE TOILET ROOM, IS THIS RESIDENT

(Mark (X) Only One Box)

51-1 ❑ Able to go to the toilet room without nurses’ assistance (may use cane, walker, wheelchair, or other tiject of support), may

menage badpan or commode at night?

-—

-2 ❑ Receiving nurSaS’ easistwsca in going to the toilet room (do not count use of cane, walkw, or other object of SUppOII),

using bedpan or commode ●t night, or c!eening self or arranging clothes after elimination?

‘3 n Unable to go to the toilet room for the elimination pro-?

e. CONCERNING MOVING IN AND OUT OF A BED OR CHAIR, IS THIS RESIDENT

Receiving no assistance?

Walking with asai$tanm of one person?

Walking with asai$tence of two persons?

UP in a chair with assistance once in 8 hours?

Up in e their with assistance twice in 8 hours?

Bedfast with assistance in turning every two hours?

Bedfast with aetistance in turning every hour?

f. CONCERNING CONTINENCE, IS THIS RESIDENT:

In control of both trowels and bladder?

An ostomy patient?

In control of bladder only?

In control of bowels only?

Not in control of bowels or bladder?

[Mark (X) Only One Box)

52-1 ❑

-2 •1

-3

7

-4 •1

F

-5 ❑ 53-1

e.(1) DOES – HAVE

7 ‘es 9

No

-6 •1 BED SORES?

-7 •1 (continue with part f,)

(Mark (X) Only One Box)

54-1 ❑

-2 El

k

-3 •1

-40 f.(1) IS – RECEIVING BOWEL AND/OR

BLADDER RETRAINING?

“5 ❑ 55-1 ❑ Yes (Skip to Question 15a.)

+fJ2) WOULD RETRAINING GIVE THIS

RESIDENT CONTROL OVER

BOWELS AND/OR BLADDER?

FOLLOWING BEHAVIOR?

No

(1) Depressed 57-2 ❑ -1

(2) Agitated, nervous 59-2 ❑ -1

(3) Abusive, a~essive 61-2 n -1

(4) Confusad, smile 63-2 a -1

(5) Disturbad sleep 65-2 ❑ -1

(6) other Problembehavior 67-2 ❑ -1

15a. DOES THIS RESIDENT EXHIBIT ANY OF THE b. DOES THIS RESIDENT EXHIBIT THIS BEHAVIOR

MORE OFTEN THAN ONCE A WEEK OR ONCE A WEEK

OR LESS?

Yes More often than

once a week

5S-1 ❑

•1 - 60-1 ❑

-

62-1 ❑

•1 - 64-1 ❑

•1 s 66-1f-J

@ (Spacify) 56- ~ 69-1 ❑

Once ● week

or less

-2 •1

.2 •1

-2 •1

-2 ❑

-2 •1

.’2 •1

Form Z3NHS-7

70
1Be. DURING THIS RESIDENT’S STAY HERE, WHEN DID – LAST SEE A PHYSICIAN FOR TREATMENT, MEDICATION, OR FOR

AN EXAMINATION?

‘s===7 OR ,7, Ha$ NaverSaenA Doctor While Here (Skip to

Question 17a.)

b,

c,

d.

AT THAT TIME, DID – RECEIVE :

Yes

(1) An examination? 22-1 ❑ -2 L1

(2) Treatment? 23-1 ❑ “2 •1

(3) Prescription? . 24-1 ❑ “2 ❑

(4) Other? 25-1

Y

-2 •1

specify 26.

DID THE PHYSICIAN ATTEND THE RESIDENT: (Mark (x) Only One Box)

27-1 ❑ as a private physician?

.2 H for the home it*lf which furnishes the medical care?

‘3 ❑ temWrarilY as a replacement fOr the resident’s private physician who was unable to attend the re$ide”t?

-4 ❑ under aema other arrangement? (Specify) 2sDOES A PHYSICIAN EXAMINE THIS RESIDENT: (Mark (X) Only One BOX)

29-1 ❑ only when called?

“2 ❑ im%darlY, but without being called?

-3

\

on ● achaduled basis?

d. (1) HOW OFTEN DOES THE PHYSICIAN EXAMINE THE RESIDENT?

(Mark (X) Only One Box.)

301 ❑ once a week

-2 ❑ every 2 weeks

-3 ❑ once a month

-4 ❑ ewery three months

-5 ❑ once a year

-6 D other (Specify) 31-

17a, DOES - WEAR EYE GLASSES?

Yas No

9

32-1

9

-2

b, IS - SIGHT WITH GLASSES: (Mark (X) Only One Box) c. IS – SIGHT: (Mark (X) Oniy Onc Box)

33-1 ❑ not impaired? (e.g., can mad ordinary newspaper 33-1 ❑ not impaired? (e.g., can read ordinary newspaper

print) print without glaasaa)

.2 ❑ partially impaired? (e.g., can watch television 8 to ‘2 •l pa~ially impaired? (e.g., can watch television 8 to

12 feet across the room) 12 feet acroes the room)

‘3 ❑ weraly iIWMiti? [e.g., can recognize the features

of familiar persons if they are within 2 to 3 feet)

-3 ❑ Swerely impaired? (e.g., can racognize the faatures

of familiar pcraons if thay are within 2 to 3 feat)

.4 ❑ completely lost? (e,g., blind) -4 ❑ @mPl@teW 10*? (e.g., blind)

18a, DOES - USE A HEARING AID?

Yes

w

b, IS - H~ARING WITH A HEARING AID: c.

(Mark (X) Only One Box)

35-1 ❑

“2 ❑

“3 ❑

“4 •1

No

%-2

IS –HEARING: (Mark (X) Only One Box)

not impaired? (e.g., can hear a telephone conversation

an an ordinary telephone)

partially impaired? (a.g., can hear most of tha things

a person WYS)

aevarely impaird? (a.g., can haar only a few words a

Wrson aeys or loud noims)

completely loet? (e.g., deaf)

35-1 ❑

-2 •1

-3 ❑

~cl

not impaired? (e.g., can hesr a telephoc-a conwraation

on an ordinary telephone)

partially impaired? (e.g., can hear moat of the things

a person cays)

severely impaired? (e.g., can hear only a fcw words a

person says or loud noises)

completely lost? (e.g., deaf)

Form 73NHS-7

71
19. IS – ABILITY TO SPEAK: (Mark (X) Only One Box)

38-1 ❑ not impaired? (e.g., is able to be understood; can carry on a normal conversation)

‘2 ❑ PartiallY impaired? (e.9., is able to be understmd but has difficulty pronoumi”g some words)

‘3 ❑ s~erely im~irad? (.%9., cannot carry on a nOrIIIal conversation; is understood only with difficulty)

‘4 •l completely lost? (e.g., is mute)

20a. DOES THIS RESIDENT HAVE DENTURES?

•1 Yes

7

~ No (Skip to Questicm 21..)

39-1

b, DOES – USE THE DENTURES?

❑ Ye, ~ No

40-1

21a. DURING THE LAST MONTH, DID – LEAVE THE HOME FOR ANY RECREATIONAL OR LEISURE ACTIVITIES?

A ‘es AN’

b. FOR-WHICH OF THE FOLLOWING ACTIVITIES c. WHY-DIDN’T – LEAVE THE HOME TO PARTICIPATE IN

OID – LEAVE THE HOME? (Mark {X) All That Apply) ANY ACTIVITIES DURING THE LAST MONTH? (Mark (Xl

CC42-52 -1 ❑

-2 •1

-3 •1

-4 •1

-5 •1

-5 ❑

-7 •1

-8 ❑

-9 •1

-0 •1

-&U

All That Apply)

Get books, etc., from the library CC42-52 -1 ❑

Attend plays, movies, concerts, etc.

-2 •1

Attend arts and crafts classes outside the home

-3 •1

Visit museums, parks, fairs, etc.

Goon shopping trips organized by the home 40

Goon independent shopping trips organized

by the resident or visitors “5 •1

Visit a beauty shop or barber shop

~u

Visit community clubs (such as community ten. -7 •1

ters, senior citizen clubs, service clubs, bridge

clubs, unions, etc.) -8 ❑

Attend religious sewices or other religious activities

Go for a walk

Other. (Spacify) 53-

Resident was too Ill or was not abla ~ move

well enough to participate

Resident wac not interested

Staff was unable to determine resident’s interests

at this point

Staff feek that the resident’s behawor

will not be toleratad outside the home

No one was available to accompany the resident

Resident cannot afford these activities

Leek of transportation

Other, (Specify) 53.

22a. DURING THE PAST YEAR, HAS THIS RESIDENT BEEN ON ANY KIND OF LEAVE OVERNIGHT OR LONGER,

EXCLUDING LEAVE FOR MEDICAL REASONS?

❑ Yes D No Ekip to Question 233.)

? -2

❑ Oo”t kmwv (Skip m (l&sticm 23a,)

54-1 -3

b. WHERE DID – USUALLY GO WHEN ON LEAVE? (Mark (X) Only One BOXI

55-1 ❑

-2 •1

-3 •1

-4 El

“5 •1

-6 ❑

-7 •1

To own home or apartment

To home of family or relatwes

To home of unrelated friends

To foster home

To boardinghouse or mom

To another placa, (Specify) 56-

Don’t know

c. ABOUT HOW OFTEN DID THIS RESIDENT GO ON LEAVE? (Mark (X) Only One 80X)

57-1 •1

-7- •1

“3 •1

-4 •1

“5 •1

-6 ❑

-7 ❑

Form 73N HS-7

Nearly every week

About once a month

About once every two months

Saveral timas a year

About onca a year or less

Other (Specify) 56-

Don’t know

72
23a, DOES - HAVE ANY VISITORS?

* p’” ,goue,.:’tkn”w

b. HOW FREQUENTLY DO VISITORS SEE THE RESIDENT? (Mark (X) Only One Box)

16-1 ❑ Nearly wery week ‘5 ❑ AbOut once a year w Ie~~

‘2 ❑ About once a momh

-6 ❑ Other (Specify) 17.

‘3 ❑ AbOut once every two momtw

-7 ❑ Don’t know

.4 ❑ Several times a year

24, HOW MANY BEDS ARE IN – ROOM? (Mark (X) Only One Box)

18-1 ❑ One bed (i.e., the resident’sown bed) -4 ❑ Four beds

-2 n Two beds -5 ❑ Five or more beds

-3 ❑ Three bsds

25a, HAS THIS RESIDENT LIVED IN THIS FACILITY FOR ONE FULL MONTH OR LONGER?

❑ Yes ~ N07

19.1

Stop; goon to next

questionnaire.

b. LAST MONTH, WHAT WAS THE BASIC CHARGE FOR THIS RESIDENT’S LODGING, MEALS, AND NURSING CARE

NOT INCLUDING PRIVATE DUTmSING OR OTHER SPECIAL CHARGES?

❑ Noctrarge isrnedeforcare (Skip to Question 28a.) $

●

CC20-25

c. LAST MONTH, WHAT WAS THE TOTAL CHARGE FOR THIS RESIDENT’S CARE, INCLUDING ALL CHARGES FOR

SPECIAL SERVICES, DRUGS, AN=IAL MEDICAL SUPPLIES?

❑ Nochqa ismadeforcare LSkiptoflmstion 26a.)

~ ‘ cc=-” “—

(1) DID THIS AMOUNT INCLUDE SPECIAL CHARGES FOR

No Yes

(a) physicianservices? 32-2 ❑ -’ ❑

(b) private duty nursing? 33-2 ❑ -’ •1

(c) therapy? 34-2 ❑ -1 •1

(d) drugs? 3%2 ❑ -1 ❑

(e) special medical suppli=? 36-2 n

-’ •1

(f) special diet? 37-2 n

“’ •1

(g) other?

P

38-2 ❑ -1

Specify -39

2Ba. WHAT WERE *THE SOURCES OF PAYMENT FOR THIS RESIDENT’S CARE LAST MONTH?

(Mark (X) All That APPW)

CC40-48 ❑ (1) Own income or family ❑ (4) Other p.blicaasistance

support (private plans,

❑ (7) Initial lmymemor welfare Iife care

retirement funds. social

security, etc.) ❑ (5) Church aupmrt ❑ (8) N0.hww is made

❑ (2) Medicare (Title XVIII) ❑ (6) VA comract

❑ (3) Medicaid (Title XIX)

for care

❑ (9) Othai (Specify) ~ ~ob, WHAT WAS THE PRIMARY SOURCE OF PAYMENTS FOR: CARE LAST MONTH?

(Mark (X) Only One Box.)

60.1 ❑

-2 •1

-3 •1

Own income or family

4 ❑ Other Public assistance -7 •1

WWft (prtiate plans, or welfare

retirement funds, eocial

security, etc.) . -5 ❑ Church wpport =0

Medicare (Title XVI II) -6 ❑ VA contract

-9 c1

Medicaid (Title XIX)

Initial paymentIife care

No char~ is made

for care

Other (Specify) ~

51-

Form 73NHS-7

73
STAFF CLASSIFICATION CARD

1973 Nursing Home Survey

National Center for Health Statistics

Health Resources Administration

Rockville, Maryland

WHICH OF THE FOLLOWING JOB CATEGORIES BEST FITS THE JOB WHICH THIS EMPLOYEE DOES IN THIS FACILITY?

01.

02.

03.

04.

05.

06,

07.

08.

08.

10.

11.

12.

13.

14.

15.

16,

17.

18.

19,

20.

21.

22.

23.

ADMINISTRATOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PHYSICIAN (M.D. OR D.O.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DENTIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PHARMACIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

REGISTERED OCCUPATIONALTHERAPIST . . . . . . . . . . . . . . . . . . . .

REGISTERED PHYSICALTHERAPIST . . . . . . . . . . . . . . . . . . . . . . . . . .

ACTIVITIES DIRECTOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DIETITIAN OR NUTRITIONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

REGISTERED MEDICAL RECORD ADMINISTRATOR . . . . . . . . . . . . . .

SOCIALWORKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SPEECHPATHOLOGISTAND/OR AUDIOLOGIST . . . . . . . . . . . . . . . . . .

OTHER PROFESSIONAL OCCUPATIONS (INCLUDES INTERN,

RESIDENT,THERAPEUTIC RECREATOR) . . . . . . . . . . . . . . . . . . . . . .

OCCUPATIONTHERAPISTASSISTANT . . . . . . . . . . . . . . . . . . . . . . . .

PHYSICALTHERAPISTASSISTANT . . . . . . . . . . . . . . . . . . . . . . . . . .

SOCiALWORKERTECHNICIAN/ASSISTANT . . . . . . . . . . . . . . . . . . . .

OTHER MEDICAL RECORD ADMINISTRATORS ANDTECHNICIANS . . . .

GROUP A

EnterinColumni

of Staff Control Record

REGISTEREDNURSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LICENSED PRACTICALNURSEOR LICENSED VOCATIONAL NURSE . . .

NURSE’SAIDEANDORDERLY. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CLERICAL, BOOKKEEPING,OR OTHEROFFICESTAFF . . . . . . . . . . . .

FOOD SERVICE PERSONNEL(COOK, KITCHEN HELP,ETC.) . . . . . . . .

HOUSEKEEPING AND MAINTENANCE PERSONNEL (MAID,

LAUNDRYMAN, MAINTENANCE MAN, ETC.) . . . . . . . . . . . . . . . . . . . .

JOBOTHERTHAN THOSE LISTED ABOVE (PLEASE SPECIFY JOB

TITLEON THE INDIVIDUALLINEOF STAFFCONTROL RECORD) . . . .

GROUP B

Enter in Column j

of Staff Control Record

GROUP C

Enter in Column k

of Staff Control Record

GROUP D

Enter in Column I

of Staff Control Record

GROUP E

EnterinColumnm

of Staff Control Record

74
STAFF CONTROL RECORD

\hL., . ..t.f —

1973 Nurmg Home S.rwV

Nat!..&l center for Health Statmcs EziEl

Health R,,o.,ct, Adm,”,,,,,t,o”

17mkv,!l,, M,r”hnd

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mmd tdr ,hesurcaMsol ,he,. rwe”,,ndw,ll ”ot~d, slo~dorrelt.~ mother,

10, ,“” LW,FO,C$

INE

IR

STAFF SEX ETHNICBACKGROUND EMPLOYER HOURSwORKED OccUpATlON LINE

NR

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If mow hms are neededCONTINUE ON 6ACK Ccmt,nuesmplu,s pattern ON BACK

. - ,W”>s

75
LINE

NR, STAFF SEX m4NIc SACKGROUND EMPLOYER HOURSWWIKEO CM2CUPATION

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76
APPENDIX IV

CRITERIA FOR CLASSIFYING

ACCORDING TO LEVEL OF

NURSING HOMES

NURSING CARE

Types of Facilities Included

In the Survey

Institutions included in the 1973-74 Nursing

Home Survey were those classified as either

nursing care homes or personal care homes with

nursing according to data collected in the 1971

Master Facility Inventory Surveys 0 conducted

by the National Center for Health Statistics.

Definitions for these two classes of nursing

homes were as follows:

Nursing care home is one in which

Fifty percent or more of the residents

received nursing care during the week prior

to the survey. (Nursing care is defined as the

provision of one or more of the following

services: taking temperature, pulse, respiration, or blood pressure; full bed bath;

application of dressings or bandages; catheterization; intravenous, intramuscular, or

hypodermic injection; nasal feeding; irrigation; bowel and bladder retraining; oxygen

therapy; and enema.)

At least one full-time (35 or more hours per

week) registered nurse (RN) or licensed

practical nurse (LPN) was employed.

Personal care home with nursing is one in

which

Some, but less than 50 percent of the

residents received nursing care during the

week prior to the survey.

At least one full-time RN or LPN was

employed.

or

Some of the residents received nursing care

during the week prior to the survey.

No full-time RN or LPN was employed.

The institution either:

Provided administration of medicines or

supervision over self-administered medicines.

or

Provided assistance with three or more activities for daily living (such as help with tub

bath or shower; help with dressing, correspondence, or shopping; help with walking

or getting about; and help with eating).

I *US

000

.GOVERNMENT PRINTING OFFICE 1977- 241-10S22

I

NOTE: The list of references follows the text.

77
Series 1.

Series 2.

Series 3.

Series 4.

VITAL AND HEALTH STATISTICS PUBLICATIONS SERIES

Formeriy Public Health Service Publication No. 1000

Programs and Collection Procedures. -Reports which describe the general programs of the National

Center for Health Statistics and its offices and divisions, data collection methods used, definitions, and

other material necessary for understanding the data.

Data Evaluation and Methods Research. –Studies of new statistical methodology including experimental

tests of new survey methods, studies of vital statistics collection methods, new analytical techniques,

objective evaluations of reliability of collected data, contributions to statistical theory.

Analytical Studies. –Reports presenting analytical or interpretive studies based on vital and health

statistics, carrying the analysis further than the expository types of reports in the other series.

Documents and Committee Reports. –Final reports of maior committees concerned with vital and

health statistics, and documen~s such as recommended mo~el vital registration laws and revised birth

and death certiilcates.

Series 10. Data jiom the Health Interview Survey. –Statistics on illness; accidental injuries; disability; use of

hospital, medical, dental, and other services; and other health-related topics, based on data collected in

a continuing national household interview survey.

Series 11. Data born the Health Examination Survey. –Data from direct examination, testing, and measurement

of national samples of the civilian, noninstitutionalized population provide the basis for two types of

reports: (1) estimates of the medically defined prevalence of specific diseases in the United States and

the distributions of the population with respect to physical, physiological, and psychological characteristics; and (2) analysis of relationships among the various measurements without reference to an

explicit finite universe of persons.

Series 12. Data from the Institutionalized Population Survey s.–Discontinued effective 1975. Future reports from

these surveys will be in Series 13.

Series 13. Data on Health Resources Utilization. –Statistics on the utilization of health manpower and facilities

providing long-term care, ambulatory care, hospital care, and family planning services.

Series 14. Data on Health Resources: Manpown and Facilities. -Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other health occupations, hospitals, nursing homes, and outpatient facilities.

Sties 20. Data on Mortality. –Various statistics on mortality other than as included in regular annual or monthly

reports. Special analyses by cause of death, age, and other demographic variables; geographic and time

series anal yses; and statistics on characteristics of deaths not available from the vital records, based on

sample surveys of those records.

Sm”es 21. Data on Natality, Marriage, and Divorce. –Various statistics on nat alit y, marriage, and divorce other

than as included in regular annual or monthly reports. Special analyses by demographic variables;

geographic and time series analyses; studies of fertility; and statistics on characteristics .of bwths not

available from the vital records, based on sample surveys of those records.

Sm”es 22. Data from the National Mortality and Natdity Surveys. –Discontinued effective 1975. Future reports

from these sample surveys based on vital records will be included in Series 20 and 21, respectively.

Series 23. Datu from the Nah”onal Survey of Family Growth. -Statistics on fertility, family formation and dissolution, family planning, and related maternal and infant health topics derived from a biennial survey of

a nationwide probability sample of ever-ma.mied women 1544 years of age.

For ~ list of tities of reports pubiished in these series, write to: Scientific and Technical Information Branch

National Center for Health Statistics

Public Health Service, HRA

Efyattsville, Md. 20782

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