Data from the

NATIONAL HEALTH SURVEY

Characteristics,SocialContacts,and

Activities of NursingHome Residents

United States:

1973-74 National Nursing Home Survey

Presents statistics on nursing home residents by sex, age, marital

status, race or ethnicit y, and length of stay since current admission,

I

prior living arrangements, outside leisure activities, overnight leave,

and frequency of visitors. Based on data collected in the 1973-74

National Nursing Home Survey.

DHEW Publication No. (HRA) 77-1778

Series 13

Number 27

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

Public Health Service

Health Resources Administration

National Center for Health Statistics

Rockville, Md. May 1977
I

Library of Congress Cataloging in Publication Data I

Zappolo, Aurora

Characteristics, social contacts, and activities of nursing home residents, United States,

1973-74 National Nursing Home Survey.

(Vital and health statistics: Series 13, Data from the National Health Survey; no. 27)

(DHEW publication no. (HRA) 77-1778)

Includes bibliographical references.

Supt. of Dec.: HE 20.6209: 13/27

1. Nursing home patients—United States—Statistics. 2. Nursing homes—Unit ed St at cs—

Statistics. 3. Health surveys-United States. I. Title: Characteristics of nursing home residents, and social contacts and activities. . . 11. Series: United States, National Center for

Health Statistics. Vital and health statistics: Series 13, Data from the National Health Survey, Data on health resources utilization; no. 27. III. Series: United States. Dept. of Health,

Education, and Welfare. DHEW publication; no. (HRA) 77-1778.

RA407.3.A349 no. 27 [RA997] 362.1’1’0973s

ISBN 0-8406-0085-2 [362.1’6] 76-608397

For sale by the Superintendent of Documeuts, U.S. (government Printiig OtHce

Washington, D.C. 20402

Stock No. 017-020-00060-7
NATIONAL CENTER FOR HEALTH STATISTICS

DOROTHY P. RICE, Director

ROBERT A. ISRAEL, Deputy Director

JACOB J. FELDMAN, Ph.D., Associate Directorfor Analysis

GAIL F, FISHER, Associate Directorfor the Cooperative Health Statistics System

ELIJAH L. WHITE, Associate Director for Data Systenzs

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

ROBERT C. HUBER, Associate Directorfor Management

MONROE G. SIRKEN, Ph.D., Associate Director for Mathematical Statistics

PETER L. HURLEY, Associate Directorfor 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

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

JAMES E. DeLOZIER, Chief Ambukztoy Care Statistics Branch

MANOOCHEHR K. NOZARY, ChieJ Technical Seruices Branch

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

Vital and Health Statistics-Series 13-No. 27

DHEW Publication No. (HRA) 77-1778

Library of Congress Catalog Card Number 76-608397
CONTENTS

Introduction ...........................................................................................................................................

Background .............................................................................................................................................

Sources and Qualifications of Data ...................................................................................................

Revious Surveys and Reports ............................................................................................................

Description of Residents ........................................................................................................................

Sex, Age, and Marital Status .............................................................................................................

Race or Ethnicity ..............................................................................................................................

Length of Stay Since Current Admission ...........................................................................................

Ownership and Certification of Nursing Home ..................................................................................

Comparison With United States Population Aged 65 Years and Over ................................................

Social Contacts and Activities ................................................................................................................

Information Collected .......................................................................................................................

Prior Living Arrangements ................................................................................................................

Outside Leisure Activities and Overnight Leave ................................................................................

Visitors ..............................................................................................................................................

Outside J.Asure Activities, Overnight Leave, and Vkitors ..................................................................

Final Comments .....................................................................................................................................

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

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

Appendixes . .

1.

2.

A.

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

IL Definitions of Certain Terms Used in This Report ..................................................................

III. Selected Questionnaires Used in the 1973-74 NationsJ Nursing Home Survey .......................

Iv. Criteria for Classifying Nursing Homes According to Level of Nursing Care ............................

LIST OF FIGURES

Percent of nursing home residents by sex, age, and marital status: United States, 1973-74 ..............

Percent of nursing home residents who did not take overnight leave or ptwticipate in outside leisure

activities by mobility status: United States, 1973-74 .....................................................................

LIST OF TEXT TABLES

Number and percent of nursing home residents by race or ethnicity: United States, 1973-74 ..........

B. Percent distribution of nursing home residents by marital status, according to race or etbnicity:

United States, 1973-74 ...................................................................................................................

C. Percent distribution of nursing home residents by length of stay since current admission, according

to race or ethnicity: United States, 1973-74 ...................................................................................

D. Number and percent of nursing home residents by certification status of facility: United States,

1973-74 ..........................................................................................................................................

1

1

1

2

2

2

3

4

4

5

6

6

:

11

13

13

15

18

34

42

44

63

3

10

3

4

4

5

...

Ill
E. Number and percent of nursing home residents 65 years and over, August 1973-April 1974, with

the noninstitutionalized population of the United States 65 years and over in March 1974 by

., selected characteristics ...............................................................................................................

F. Percent distribution of nursing home residents by type of living arrangement prior to admission

to nursing home: United States, 1964 and 1973-74 ..................................................................

G. Percent distribution of nursing home residents by type of living arrangement prior to admkion

according to primary reason for admission: United States, 1973-74 ..........................................

H. Percent d~tri%ution of nursing home residents by type of living arrangement prior to admission

according to certification status of facility and primary source of payment: United States,

1973-74 .......................................................................................................................................

J. Number and percent of nursing home residents taking overnight leave and participating in outside leisure activities by number of chronic conditions: United States, 1973-74 ..........................

K. Number and percent of nursing home residents taking overnight leave and participating in outside leisure activities by primary source of payment: United States, 1973-74 .............................

L Number and percent of nursing home residents by marital status and frequency of visitors:

United States, 1973-74 ...............................................................................................................

M. Number and percent of nursing home residents by frequency of visitors and living arrangements

prior to admission: United States, 1973-74 .................................................................................

N. Number and percent of nursing home residents by frequency of visitors and primary reason for

admission: United States, 1973-74 ...........................................................................................

O. Number and percent of nursing home residents by frequency of visitors: United States, 1964

and 1973-74 ..............................................................................................................................

P. Percent of nursing home residents taking overnight leave, participating in outside leisure activities

and frequency of vWors: United States, 1973-74 ......................................................................

I I

SYMBOLS

I

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

I

I

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

I

Quantity zero----------------–— ------------

Quantity more than Obut less than 0.05-— 0.0

Figure does not meet standards of

reliability or precision (more than

25-percent relative standard error)--—— *

6

7

8

8

10

11

11

12

12

13

14

I I

iv
CHARACTERISTICS, SOCIAL CONTACTS, AND

ACTIVITIES OF NURSING HOME RESIDENTS

Aurora Zappolo, Division of Health Resources Utilization Statistics

INTRODUCTION

This report presents data on characteristics

of residents of nursing homes providing some

level of nursing care during the period August

1973 to April 1974. Most of the items presented, such as age, sex, marital status, and

length of stay since current admission were also

collected in previous survey years and provide a

basis for examining changes in the composition

of the nursing home population at different

points in time. A few new items are presented;

these include the proportion of residents who

are Spanish American and details on the Medicare and Medicaid certification of the facility.

The report also presents data on the social

contacts and activities of the residents. These

data provide details on some aspects of the residents’ lives which are frequently ignored, since

the emphasis is generally placed on physical

health status. However, contact with others on a

personal basis, as well as exposure to a variety of

experiences in daily life, are recognized as important contributors to recovery from illness

and to creation of a stimulating environment in

which to live.

The aspects of social contacts and activities

which are described in this report are the resident’s living arrangements before admission,

whether he leaves the facility for leisure activities or for overnight visits, and whether he receives visitors.

Highlights of the report are:

● The “typical” nursing home resident is

white, female, widowed, age 79, and has

Iived in the facility 2.6 years.

● Most of the residents lived in another

institution prior to entering the nursing

home.

● During their residence in the facility,

few (12 percent) ever spend the night

away from the facility for social or personal reasons.

● Most residents (88 percent) receive visitors.

BACKGROUND

Sourcesand Qualifications of f)atd

The data presented in this report are based

on the National Nursing Home Survey conducted from August 1973 to April 1974 by the

Division of Health Resources Utilization Statistics. The survey was conducted in a sample of

facilities in the conterminous United States

which provide some level of nursing care (i.e.,

nursing care homes and personal care homes

with nursing). Facilities which provided only

custodial care at the time the sample was drawn

are not included, even if they subsequently began to provide nursing care to residents.

Within each sampled facility, subsamples of

both residents and employees were selected to

obtain detailed information about the population served and persons involved in providing

direct care. Data in this report are based primarily on the resident questionnaire, which was

completed by interviewing knowledgeable nursing home staff members who referred to the resident’s medical records when necessary.

1
A description of the survey, the sampling

frame used, the sample design, and the survey

procedures are presented in appendix I. Also in

appendix I are descriptions of imputation procedures, estimation techniques, and estimates of

sampling variation. Since the data in this report

are national estimates based on a sample, they

are subject to sampling errors. Charts of relative

standard errors are provided in appendix I. Definitions of certain terms used in this report can

be found in appendix II. Facsimiles of selected

questionnaires and forms used in the survey are

shown in appendix III. Criteria for classifying

nursing homes providing some level of nursing

care are presented in appendix IV.

Previous Surveys

and Reports

The 1973-74 National Nursing Howe Survey

is the first in a continuing series of surveys collecting data on the characteristics of nursing

homes, their expenses, residents, and staff. Prior

to the creation of this continuing data collection

system, the National Center for Health Statistics

(NCHS) conducted a series of three ad hoc sample surveys of nursing and personal care homes

called the Resident Places Surveys (RPS 1, 2,

and 3). These surveys were conducted during

April-June 1963, May-June 1964, and June-August 1969, respectively. Also, the 1968 Nursing

Home Survey (actually a census of all such facilities) collected information on nursing homes

and the services they provide.

The universe of the 1973-74 National Nursing Home Survey is not precisely the same as

that of the previous surveys, basically because it

does not include personal care homes. Nevertheless, valid comparisons can be made with these

earlier surveys since only about 5 percent of the

resident population in RPS-3 were in personal

care homes. RPS-1 (1963), the first of these surveys, collected data on nursing homes, chronic

disease and geriatric hospitals, and nursing home

units and chronic disease wards of general and

mental hospitals. Findings of RPS-’1, as well as a

description of its design and methodology, may

be found in several previously published reports.1’5 RPS-2 (1964), is the second of these

ad hoc surveys and concentrated mainly on nursing homes and geriatric hospitals. This second

survey collected more detailed information

about each institution, its residents, and its employees.6’14 The 1968 Nursing Home Survey,

conducted during April-September 1968, collected data on the characteristics of institutions

which provided nursing or personal care. It did

not collect sample data on residents or staff.

Data from this survey are presented in several

reports.1s’1s The most recent survey prior to

the 1973-74 Natiomd Nursing Home Survey was

RPS-3 conducted in 1969. This was a sample

survey of nursing and personal care homes in the

conterminous United States. A number of reports resulted from this survey.19 ‘z 5 Reports

from these earlier surveys which are especially

relevant to data presented in this report are

“Marital Status and Living Arrangements Before

Admission to Nursing and Personal Care Homes:

United States, May-June 1964;”13 “Services and

Activities Offered to Nursing Home Residents:

United States, 1968 ;“l 8 and “Characteristics of

Residents in Nursing and Personal Care Homes:

United States, June-August 1969.”20 Two reports have already been published on the

1973-74 National Nursing Home Survey-an

overview of provisional survey resultszG and information on selected operating and financial

characteristics.z T

DESCRIPTION OF RESIDENTS

Sex, Age, and

Marital Status

Approximately 1,075,800 persons were residents of nursing homes in the conterminous

United States in 1973-74. They resided in about

15,700 facilities providing some level of nursing

care. This section of the report describes the residents and gives some information about the

nursing homes in which they lived.

As in previous surveys, the data showed a

preponderance of women in nursing homes–

about 70 percent of all residents (figure 1). This

fact is not merely related to the greater longevity of women but also to the disproportionate

representation of elderly women in nursing facilities as compared to elderly men. A further discussion of this point appears in the section com2
& I

LetI than 65 yearn

66.74 war:

76.84 wars

85 years or more k!

MARITAL STATUS

Married

Widowed

Divorced or saparatnd

Never married

64

~

o 80

PERCENT OF RESIDENTS

Figure 1. Percentof nursinghome residents by sex, age. and merital status: United States, 1973-74

paring nursing home residents to the noninstitutionalized population. Nursing home residents

arc an elderly population: most (89 percent)

were 65 years of age or older, and 38 percent

were 85 years of age or older (table 1). The

mean age for residents was 79.

Another characteristic of nursing home residents which was similar to that found in earlier

surveys is the large proportion of widows and

widowers. A greater proportion of the residents

were widowed than were married, divorced, separated, or never married. Furthermore, between

the ages of 6.5 and 90 the proportion of residents who were widowed increased directly with

age. From age 90 the proportion of nursing

home residents who were widowed leveled off.

An important distinction, however, is found

when marital status of male and female residents

is compared—73 percent of the women were

widowed compared to only 42 percent of the

men. From the opposite point of view, only 8

percent of the women had a living spouse who

could presumably visit them or be responsible

for them away from the facility, while 22 percent of the men had a living spouse.

When marital status is examined by characteristics of the facility, there are differences by

re,gion and certification status. A somewhat

greater proportion of residents living in facilities

in the Northeast and North Central Re@ons than

of those living in the South or West had never

been married. ALso, a greater proportion of

those in uncertified facilities than of those in

certified facilities had never been married (table

2).

Race or Ethnicity

The 1973-74 National Nursing Home Survey

shows greater detail on race or ethnicity than

the earlier NCHS surveys did. The question on

resident’s race or ethnicity was as follows:

What is (name) ethnic background? (Mark (X)

only one box)

❑ Caucasian

❑ Negro

❑ Oriental

❑ Spanish American

H American Indian

❑ Other

Only one answer category was permitted for

each resident. Because of this feature of the

questionnaire, raciaI background of the Spanish

American residents was not obtained. Therefore

in this report “white” refers exclusively to those

residents for whom the category “Caucasian”

was checked. Whenever cell size permits, detail

on the other racial or ethnic groups is shown

separately.

Table A shows the number of nursing home

residents by racial or ethnic group. Most of the

residents were white (excIuding Spanish Americans), which is true of the American population

Table A. Number and percent of nursing home residents by

race or ethnicity: United States, 1973-74

Race or ethnicity Number Percent

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

Whitel ...................................................

Black .....................................................

Spanish American., ................................

Other .....................................................

1~xcl,,LIe~ Sp:lnisll Anwrkm1,010,400 I 93.9

49,300 4.6

12,000 1.1

4,200 ] 0.4

3
Tabla B. Percent distribution of nursin~ honle resident$ bY marital status, according to race or ethnicity: United States, 1973-74

Marital status

Race or ethnicity

Total Married Widowed

Divorced or Never

separated married

Percent distribution

All residents ............................. 100.0 12.4 63.9 4.7 19.0

Whitel .......................................... 100.0 12,4 64.3 4.5 18.9

Black .......... .................................. 100.0 11.1 60.7 8.3 19.8

Spanish American ......................... 100.0 21.4 47.4 ●

24.0

Other ............................................ 100.0 *

55.6 * ●

1

Excludes Spanish American.

in general. However, there are some differences

by age and marital status. White persons (excluding Spanish Americans) constitute a somewhat

greater proportion of nursing home residents 75

years of age or older than of residents under 75

years (table 3). The proportion of nursing home

residents who were widowed vaned by race or

ethnicity–only 47 percent of the approximately

12,000 Spanish Americans were widowed compared to 64 percent of the white persons (table

B).

Length of Stay Since

Current Admission

For each resident the current length of stay

was computed using the resident’s date of admission to the facility and the survey date. Table 4

shows the range of lengths of stay from less than

3 months to 10 years or more. Overall, the mean

length of stay was 2.6 years and the median was

1.5 years. .

In comparison to the white residents, a

greater proportion of the Spanish American residents had been in the nursing home less than a

year. About 56 percent of the Spanish Americans were admitted to the nursing home less

than a year before the survey, whereas ordy 38

percent of the white residents had been admitted recently (table C). An NCHS report on utilization of nursing homes which presents an exTable C. Percent distribution of nursing home residents by

length of stay since current admission, according to race or

ethnicity: Unitad States, 1973-74

Length of stay since current admission

—

Race or ethnicity 1 year 2 years

Total :;:n to less to less 5 years

1 year

than 3 than 5 or more

years years

Percent distribution

All residents ....... 100.0 38.6 33.2 13.9 14.3

Whitel .................... 100.0 38.1 33.2 14.0 14,6

Black ...................... 100.0 41.7 36.2 12.8 9.2

Spanish American ... 100.0 56.2 27.4 ● ●

Other ...................... 100.0 * * ● “

1E~~ludes Spanish Amerhzm.

tensive discussion on ler+gth of stay will soon be

released.

Ownership and Certification

of Nursing Home

Most residents of nursing homes resided in

proprietary facilities rather than in nonprofit or

government facilities. About 70 percent of the

residents lived in proprietary facilities and 30

percent lived in nonprofit or government facilities (table 5).

4
Table D. Number and percent of nursing home residents by

certification status of facility: United States, 1973-74

1 I

Certification status I

Number I

Percent

of facility

All facilities ................................. 1,075,800 100.0

Both Medicare and Medicaidl .......... 406,900 37.8

Medicaid only:

Skilled nursing home2 .. ............... 292,500 27.2

Intermediate ~are facility ............ 236,700 22.0

Not certified .................................... 139,800 13.0

123,500 of the residents were in facilities certified by Medieereonly. 21~g,~~o of the re5ide~t~were in facilities certified as both

skilled nursing home and intermediate care facility.

In 1965 two amendments to the Social Security Act of 1935 were passed under Public Law

89-97. They were Titles XVIII, Health Insurance

for the Aged (Medicare), and XIX, Grants to

States for Medical Assistance Programs (Medicaid). According to the regulations and terminology in effect at the time this survey was designed, a nursing h~me certified under Medicare

was caIled an “extended care facility, ” and one

under Medicaid could be either a “skilled nursing home” (SNH) or an “intermediate care facility” (ICF). A Medicare extended care facility

was comparable to the Medicaid skilled nursing

home, both providing similar levels of care.

Since July 1, 1973, both terms have been replaced by the term “skilled nursing facility” because they represent the same standards. An ICF

is a facility which provides health-related care

and services to those who do not need care in

skilled nursing facilities.

The results of the 1973-74 survey include

some of the first data on a national basis showing residents by whether the facility they live in

is certified by Medicare or Medicaid. Overall, 38

percent of the residents were in facilities certified by both Medicare and Medicaid,a 49 percent were in facilities certified by Medicaid only

(either an SNH, an ICF, or both), and 13 percent were in facilities not certified by either

aThi5 fiWre includes a small number of residents

(23,500) in facilities certified by Medicare only.

pro~am (table D). I.ater in this report the relationship of certification status of the nursing

home and prior living arrangement of the resident will be discussed.

Comparison With

United States Population

Aged 65 Years and Over

Although most nursing home residents are

elderly, most elderly Americans are not institutionalized. In fact only 5 percent of the United

States population 65 years and over reside in

nursing homes and only 25 percent of those 85

years and over. A comparison of these institutionalized elderly persons with their counterparts in the noninstitutionalized environment indicates several major differences (table E).

Although females exceeded males overall in

both groups, the difference was far more pronounced among the nursing home population,

indicating that females enter nursing home at a

greater rate than males. Due to the small number

of nursing home residents who were black, Spanish American, American Indian, or some other

ethnicit y, it is not clear whether a similar dlff erential entry rate applies to race or ethnicity.

Lack of an able and willing caregiver is frequently cited as a major reason for admission to

and continued stay in a nursing home. The striking difference which occurs in the distribution

of marital status in the two groups (noninstitutionalized population and nursing home population) is a reflection of this point. While 54 percent of the U.S. noninstitutionalized population

age 65 years and over were married, only 12

percent of the nursing home population were in

this category (table E). About 37 percent of the

noninstitutionalized population in this age group

were widowed, in contrast to 69 percent of the

nursing home population. Approximately 6 percent of the U.S. noninstitutionalized poptdation

65 years and over had never been married compared to 15 percent of the nursing home population.

Another pronounced difference between the

older nursing home population (65 years and

over) and the older noninstitutionahzed population is in the age distribution. Whereas 83 percent of the older nursing home population were
Table E. Number and percent of nursing home residents 65

years and over, August 1973-April 1974, with the noninstitutionalized population of the United States 65 years and

over in March 1974 by selected characteristics.

Characteristics

Total 65 years

and over ...........

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

Sex —

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

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

Race/ethnicity

White .............................

All other races...............

Marital status

Married ..........................

Widowed .......................

Divorced or separated...,

Never married ................

—Age

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

76 years and over .........

‘ZE12iEE

Number

961,500 [ 20,602,000

Percent

100.0

27.6

72.4

294.8

5.2

12.2

69.4

3.4

15.0

17.0

83.0

100.0

41.4

58.6

91.0

9.0

54.3

36.7

3.5

5.6

63.5

36.5

lSOURCI: U.S. Bmeau of the census: Marital status and living arrangements: March 1974. Current Population Reports.

Series P-20, No. 271. Washington. US. Government Printing

OffIce, Oct. 1974.

2Exchsdes Spanish American.

75 years of age and over, only 37 percent of the

older noninstitutionalized population were in

that category.

SOCIAL CONTACTS

AND ACTIVITIES

Information Collected

The survey included several questions which

provide @formation about the residents’ contacts with persons outside of the facility, both

before and after admission. The resident’s prior

living arrangements were determined from the

question, “Where did (name) live at the time of

admission?” If the prior abode was “a private

apartment or house, ” details on with whom the

resident lived were collected. Categories were

spouse, children, other relatives, unrelated persons, and lived alone (appendix III resident questionnaire; no. 6).

Two questions obtained information on the

resident’s outside activities after entering the

facility. The first question was “During the last

month did (name) leave the home for any recreational or leisure activities?” If he did leave

the facility, the followup question was “For

which of the following activities did (name)

leave the home?” If he did not leave the facility

during the last month, the next question was

“Why didn’t (name) leave the home to participate in any activities during the last month?”

(appendix III resident questionnaire, no. 21).

The second general question concerning outside

contacts after admission was “During the past

year, has this resident been on any kind of leave

overnight or longer, excluding leave for medical

reasons?” If the answer was “yes,” there were

two additional questions asking where and how

often the leave was taken (appendix III resident

questionnaire, no. 22). The final question of this

set obtained information on whether visitors are

received by the resident and on the frequency

(appendix III resident questionnaire, no. 23).

Prior Living

Arrangements

Although more than half of the residents (59

percent) were transferred from some type of institution,b the largest single category of residents lived in private accommodationsprior to admission to the nursing home. Thirty-seven percent moved from a private residence, usually

having lived with family or relatives. The next

largest category of prior living arrangements was

“general or short-stay hospital.” Thirty-five percent moved to the nursing home from a general

bFor this analysis, “institution” is broadly defined

to include boarding homes and “other” places as well as

other nursing homes and hospitals.

6
or short-stay hospital. This represents a substantial shift since 1964 in the proportion of nursing

home residents whose residence immediately

preceding admission to the nursing home was a

general or short-stay hospital (table F). In 1964

only 12 percent moved to the facility from a

general or short-stay hospital.13 This change is

probably due in large part to Medicare regulations, since Medicare allows extended care (up

to 100 days) only if the patient had recently

been discharged from a hospital after a stay of 3

c@s or more. (Because the proportion of residents in personal care homes in the 1964 study

WM too small (6 percent) to affect this comparison, no adjustment was made to the 1964 data.)

The shift toward prior institutionalization

can also be seen by comparing the proportions

moving to the facility from a private residence in

1964 and 1973-74. In 1964, 69 percent of nursing and personal care home residents lived in

private accommodations (with relatives or unrelated persons or alone) prior to admission, while,

as noted in the previous paragraph, in 1973-74

only 37 percent lived in private accommodations

prior to admission.

Table F. Percent distribution of nursing home residents, according to type of living arrangement prior to admission to nursing home: United States, 1964 and 1973-74

4

Prior living arrangement

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

Another nursing home or related

facility .........................................

Mental hospital or other long-term

specialty hospital .........................

General or short-stay hospital .........

Boarding home or other place .........

Unknown ...................................... ..

Private residence:

Family or relatives ..... ................

Alone or with unrelated

persons ...................................

Unknown if with others .............

19641 I

1973-74

Percent

100.0

10.9

6.0

11.8

2.7

-..

38.9

29.7

-..

100.0

13.9

7.9

34.8

2.2

3.8

20.4

13.0

4.0

lIncludes personal care homes and geriatric hospitals.

For source of 1964 data see reference 13.

The type of prior living arrangement is associated with age, sex, and to some extent race “or

ethnicity. Younger residents (those under 65

years of age) were more likely to have been

transferred from a mental hospital or other

long-term specialty hospital than were older residents (those 85 years and over). Twenty-eight

percent of the younger residents compared to 2

percent of the older were transferred from ment al or other long-term specialty hospitals.

Younger residents were less likely to have transferred from a general or short-stay hospital or

from living with their own children. Twenty-six

percent of the younger residents compared to 36

percent of the older residents were admitted

from a general or short-stay hospital; and 2 percent of the younger residents compared to 12

percent of the older had previously been living

in a private residence with their own children

(table 6).

When prior living arrangements for male and

female residents are compared, several additional

differences become evident. A greater proportion of the females (11 percent) than of the

males (5 percent) lived with their own children

prior to admission. A smaller proportion of the

females (6 percent) than of the males (12 percent) had been transferred from a mental or

other long-term specialty hospital.

Residents had similar prior living arrangements regardless of race or ethnicity with two

exceptions. A smaller proportion of the white

residents (excluding Spanish Americans) (7 percent) than of the other racial or ethnic groups

(14 percent) had lived in mental or other longterm specialty hospitals prior to admission to

the facility. Also, a larger proportion of the

white persons (12 percent ) than of others (6 percent) had previously lived alone (table 7).

There were some differences by prior living

arrangements which indicate that the living arrangement is related to the reason for admission.

Overall, 81 percent of all residents were admitted primarily for physical reasons, 6 percent

for social reasons (e.g., lack of family or lack of

family interest), 12 percent for behavioral problems (e.g., disruptive behavior or mental deterioration), and 1 percent for economic reasons

(e.g., no money and/or resources). Among persons admitted for physical reasons, 58 percent
came directly from a hospital or other nursing

home, with the largest single category (41 percent) admitted from general or short-stay hospitals. Similarly, 63 percent of the residents admitted for behavioral reasons came from a hospital

or other nursing home, but the largest category

(38 percent) was admitted from mental or other

long-term specialty hospitals. However, among

persons admitted for social reasons only 27 percent came directly from a hospital or other nursing home (table G).

Other factors with which the type of living

arrangement prior to admission is associated are

the certification status of the facility and the

primary source of payment for care received.

Fifty percent of persons in facilities certified by

both Medicare and Medicaid were admitted directly from a general or short-stay hospital compared to only 17 percent of those in facilities

not certified by either program (table H). This

difference is probably due to the previously

cited Medicare regulation allowing for extended

care coverage only if preceded by hospitalization. A comparison of prior living arrangements

by primary source of payment (collected only

Table G. Percent distribution of nursing home residents by type

of living arrangement prior to admission according to primary

reason for admission: United States, 1973-74

Prior living

arrangements

All arrangements .....

Another nursing home or

related facility ...............

Mental hospital or other

Iong-tarm spacialty

hospital ..........................

General or short-stay

hospital ..........................

Boarding home or othar

place ..............................

Unknown ..........................

Private residence

Alone ...........................

Unknown if with

others .......................

With others ..................

—

Primary reason for admission

‘hysical

100.0

13.9

3.5

40.9

2.1

3.8

II.(I

4.2

20.8

Social

100.0

12.6

8.4

6.3

*

6.4

29.2

5.4

28.3

3ehavioral

100.0

13.9

38.0

10.8

2.4

2.5

7.5

2.1

22.9

EcoIomic

100.0

26.6

●

●

●

●

24.9

●

●

Table H. Percent distribution of nursing home residents by type of living arrangement prior to admission, according to certification status of facilitv. and orimarv . source of Davment: . . United States. 1973-74

Certification status of facility

Prior living arrangement r

Both

Medicare

and

Medicaid]

All arrangements ............................... ~ 100.0

Another nursing home or related facility .....

r

12.2

Mental hospital or other long-term

spacialty hospital ...................................... 5.5

General or short-stay hospital ...................... 50.0

Boarding home or other place ..................... 2.0

Unknown ....................................................

I

3.0

Private residence

Alone .................................................... 7.3

Unknown if with othars ........................ 3.3

With others ............................................ 16.6

Wiled

wsing

homez

100.0

14.7

7.7

32.9

2.1

3.6

11.5

4.7

22.8

+

lntarmediate Not

care certifiad

Facilityz

100.0 100.0

16.2 13.2

10.6 10.4

21.7 16.5

1.5 4.3

4.0 6.2

J-- 15.2 20.4

4.1 4.5

26.7 24.5

Own

ncome

100.0

12.1

3.9

32.8

1.9

3.6

17,3

4.1

24.4

Primary source of payment3

T

fiedicare Medicaid

● 15.6

* 8.8

72.7 37.0

2.1

● 4.1

* 8.1

* 4.6

* 19.6

Other

public

assistance

Other

100.0I100.0

1

I

15.2 8,9

18.1 ! 13.2

21.8 18.6

2,9 8.0

1

4.0 ●

10.0 23.3

3.0 ●

25.0 19.5

123,500 of the residents were in facilities certified by Medicare only.

2129000 of the regide~ts w~e ~ feciliti~ c~tiied sssboth Sldlled nursing home end intermediate care facility.

31nc3;des only those residents in the nursing home for 1 month or more at the time of the survey.

8
tor remdents 01 1 month or more J prOVldeS a

stronger basis for this conclusion. Fully 73 percent of the 10,800 residents of 1 month or more

whose primary source of payment was Medicare

were admitted from general or short-stay hospitals compared to less than half of any other

group. Among the Medicare recipients not transferred from a hospital, some had stayed in other

health care facilities and others were reported to

have been in private residences. (Although Medicare coverage in a nursing home requires a hospital stay prior to admission, there may be a brief

interim stay in a private residence if it is medically appropriate or if no nursing home bed is

available. Due to the questionnaire wording residents were categorized according to their location immediately preceding admission, regardless

of duration.) A greater proportion of those

whose primary source of payment was their own

income (46 percent) than of those whose primary source was Medicaid (32 percent) or other

public assistance (38 percent) were admitted

from a private residence.

Outside Leisure Activities

and Overnight Leave

Social contacts and activities outside the

home provide the resident with stimulation and

interest which may often be therapeutic. Although the survey collected data on whether the

resident had a living spouse, it did not collect

data on any other living relatives. Nevertheless,

it is clear that at the time of admission about 20

percent had been living with relatives (spouse,

children, or other relatives) (appendix III resident questionnaire, no. 6). Some of the Iiving

reIatives may be ill themselves or live too far

from the nursing home to provide regular or frequent social contacts for the resident. Furthermore, various government programs may set restrictions on a resident’s outside contact. For

example, Medicaid limits overnight leave of nursing home residents to 18 days’ a year. Conclusions about the frequency of outside social contacts of the residents must be tempered by these

considerations as well as the nature and extent

of the resident’s physical or mental limitations.

In this report “outside leisure activities”

refers to daytime outings only, as opposed to

similar activities which include overnight leave.

Overall only 32 percent participated in outside

leisure activities (i.e., visiting friends and relatives, going shopping, attending social events or

religious services, etc.). A greater proportion of

the residents under 65 years of age participated

in outside leisure activities (44 percent) than did

residents 85 years of age and over (27 percent).

Also, a greater proportion of the white residents

(excluding Spanish Americans) participated in

outside leisure activities (32 percent) than did

others (23 percent) (table 8).

In comparison to the 32 percent of the residents who participated in outside leisure activities, an even smaller proportion of residents

took overnight leave (12 percent) for nonmedica.1 reasons. Most (66 percent) of ,the residents

did not have either form of outside contact.

Furthermore, of those who did take overnight

leave over half (58 percent) did so only a few

times a year or less. The table below shows

where the 127,700 residents who took overnight

leave went and how frequently they did so.

Total numberof residentswho

took overnightleave......................... 127,700,

Percent

Placeof leave

Ownhome........................................... 3.3

Homeof family................................... 82.2

Homeof friends.................................. 5.1

Other................................................... 3.0

Unknown............................................ 6.4

Frequencyof leave

Weekly................................................. 7.5

Monthly.............................................. 17.4

Everyother month.............................. 9.6

Twiceor severaltimes

ayear............................................... 34.3

Once ayear or less............................... 23.4

Otheror frequency

unknown.......................................... 7.8

Family visits were a common outside contact. Most of those who did take overnight leave

stayed in the home of a family member (82 percent), and 38 percent of those who participated

in leisure activities outside of the nursing home

visited family or personal’ friends on their excursions (table 8).
Table J. Number and percent of nursing home residents taking overnight leave and participating in outside leisure activities by number of

chronic conditions: United States, 1973-74

Overnight Ieavel and outside leisure activities

Number of chronic conditions Total

number Both Overnight Outside

leave

Neither

of residents Total leave leisure leave nor

and only activities

activities

activities

only

Percent

o-1 ......................................................... 354,800 100.0 12.9 2.2 26.4 56.5

2 or more ................................ ............... 721,100 100.0 7.5 2.B 20.4 69.3

1 Ex~~udes leave for medical reasons.

The most obvious explanation for a nursing

home resident’s lack of social activities outside

of the facility is illness and disability. In fact the

most common reason cited for a resident not

leaving the facility for leisure activities was that

he was too ill (58 percent).

Level of outside social activity is associated

with health factors (number of chronic conditions and mobility status). Thirteen percent of

the residents with O-1 chronic conditions participated in leisure activities outside of the facility

and also went on overnight leave, while only 8

percent of persons with 2 or more chronic conditions did so (table J). The ability to move

around freely is a necessary ingredient in planning most outside excursions. Sixteen percent of

those requiring no assistance in walkh-ig took

both overnight leave and participated in outside

leisure activities compared to only 5 percent of

those requiring assistance to walk and even

fewer (2 percent) of those who were chairfast or

bedfast (figure 2). Leave-taking was only slightly

less among residents exhibiting confusion or senility than residents in general-5 percent took

both kinds of leave compared to 8 percent of

residents in general.

To some extent primary source of payment

is related to outside social activities: among the

10,800 residents of 1 month or more whose primary source of payment was Medicare, 85 percent took neither kind of leave, whereas a

smaller proportion (64 percent) of those whose

20

r

I 15.9

&

0

Walks Walks Chalrfm

wit bout with

asistam assistance bw%sr

MOaI LITV STATUS

Figure 2. Percent of nursing home residents taking overnight

leave and participating in outside leisure activities by mobility

status: United States, 1973-74

primary source of payment was their own income, Medicaid, or other public assistance fell

into that category (table K). Since Medicare

gives a particular type of service–posthospital

care for a limited period of time (a maximum of

100 days) –this finding was expected.

Overall the typical nursing home resident

does not usually leave the home for social or

recreational purposes. Health problems account

for a substantial part of this situation, but other

factors, such as lack of family or financial resources, play a part as well.

10
Table K. Number and percent of nursing home residents taking overnight leave and participating in outside leisure activities by primary

Primary source of paymentl

Own income.,., .......................................

Medicare ......................................... .......

Medicaid ...................... .... .............. ........

Other public assistance..., .......................

Other ................. ......................... ...........

source of

Total

number

of residents

371,700

10;800

484,300

114,900

30,200

]yment: United States, 1973-74

Overnight leave2 and outside leisure activities

~

Percent

100.0 10.4 2.5

100.0 ●

100.0 8.0 2.8

100.0 13.4 3.0

100.0 17.8 *

l!n~ludes only those residents in the nursing home for 1 month or more at the time of the s~eY.

2Exclude~ leave for medical remona.

Visitors

.

Although in the previous section the data

showed the gloomy fact that most nursing home

residents do not leave the facility for any social

activities, in this section the data show a much

more positive picture. The vast majority of nursing home residents received visitors—88 percent

received visitors at least occasionally, and only

11 percent never received visitors. Also, most

residents (61 percent) received visitors at Ieakt

once a week (table 9). The data do not show

\l,ho the visitors were, so it is not knom what

proportion were family or personal friends as

opposed to clergymen, volunteers, or the like.

The frequency of visitors is related to the

resident’s age, sex, race or ethnicity, and marital

status. Older persons, females, whites (excluding

Spanish Americans), and married persons received visitors more frequently than younger

pm-sons, males, persons of other racial or ethnic

groups, or those who were not married at the

time of the survey. In particular, 65 percent of

persons 75 years of age and older received visitors at least weekly (and many daily) compared

to 50 percent of persons under 75 years of age.

Sixty-four percent of females received visitors

weekly compared to 53 percent of males; 62

percent of white residents (excluding Spanish

25.2

*

21.4

24.9

25.1

61.9

85.1

67.7

58.6

54.4

Americans) received visitors weekIy compared to

49 percen( of persons of other racial o_rethnic

groups. Seventy-nine percent of married persons

received visitors weeldy compared to 65 percent

of widowed residents and even fewer of those of

other marital statuses (table L).

Table L. Number and percent of nursing home residents by

marital status and frequency of visitors: United States,

1973-74

I I

Frequency of

Divorced

Married Widowed or

Never

visitors married

separated

I I I

t Number

All residents ...........1133.700 ]687.100 I 50,6001204,400

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

I

No visitors .............. ......

Unknown .....................

Visitors .............. ... .......

Daily .........................

Weekly ......................

Monthly ....................

Less often than

monthly ................ ..

Unknown frequency.

100.0

4.2

*

94.5

16.5

62.7

9.9

4.3

*

Percent

100.0

7.7

1.7

90.6

7.8

57.6

15.7

8.2

1.4

100.0 100.0

24.0 22.3

*

2.1

75.2 75.7

*

3.2

38.6 36.3

16.6 19.2

15.0 15.9

‘1 ●

11
Table M. Number and percent of nursing home residents by frequency of visitors and living arrangements prior to admission: United

States, 1973-74

Total

lumber of

residents

149,600

84,600

374,200

23,800

40,700

127,900

43,100

231$00

Frequency of visitors

IT- No Unknown

Total

visitors if

visitors

Received visitors

m

Prior living arrangement

Frequency

unknown

●

*

1.3

*

●

●

●

1.2

II I

Percent

Another nursing home or related facility .........

Mental hospital or other long-term

specialty hospital ................................. ........

General or short+tay hospital ..... ............ ........

Boarding home or other place ................. ........

Unknown ........................... ..................... .........

Private residence

Alone .................. .............................. .........

Unknown if with others .... ................ ........

With others ....................................... ........

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

13.5

35.0

8.2

22.7

12.6

7.9

10.6

4.5

1.8

*

1.9

*

*

*

*

*

27.2

37.6

21.4

35.0

30.7

26.7

26.9

22.2

84.7

63.9

89.9

76.0

83.1

90.9

85.5

94.5

56.3

25.2

67.3

40.4

50.6

63.0

57.1

71.1

An indication of the relationship between rangements (64 percent) (table M). Likewise, a

greater proportion of persons admitted for

physical reasons received visitors weekly (65 percent) than persons admitted for social (50 percent), behavioral (39 percent), or economic (50

percent) reasons (table N) did.

- Just as age was associated with frequency of

visitors, a resident’s length of stay was also re-

,

frequency of visitors and a residents personal

background can be seen by examining prior living arrangements and reason for admission.

Fewer of the residents admitted from mental

hospitals or other long-term specialty hospitals

(25 percent) received visitors weekly than did

residents who had other types of prior living arTable N. Number and percent of nursing home residents by frequency of visitors and primary reason for

admission: United States. 1973-74

Frecruency of visitors

IINo Unknown

Total visitors if

visitors

J__L

100.0 8.5 1.7

100.0 13.5 *

100.0 24.6 *

100.0 % ●

Received visitors

Total

number of

residants m Frequency

unknown

Primary raason for admission

Percent

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

Social ...................................~.............................

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

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

870,700

69,400

125,000

10,700

B8.e 65.4 23.1 1.3

49.6 32.9 ●

38.7 34.3 *

49.9 32.8 *

73.9

83.2

12
Table O. Number and percent of nursing home residents by

frequency of visitors: United States, 1964 and 1973-74

Frequency of visitors

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

No visitors .........................................

Unknown if visitors ...........................

Wsitors .................................. ............

Once a week or more.., ................

Monthly ..................... .................

Less often than weekly .............

Unknown ....................................

EcE!E

Number

564,000 I “1 ,075,800

Percent

9.5

. . .

90.5

58.1

19.4

13.0

---

10.8

1.7

87.5

61.1

15.7

9.5

1.2

lIncludes personal care homes and geriatric hospitals.

NOTE: For source of 1964 data, see reference 13.

kited. Although older persons received visitors

more frequently than did younger persons, those

who had been in the nursing home longer received fewer visitors than did persons whose

length of stay was shorter. Fifty-five percent of

residents who had been in the facility for a year

or more received visitors weekly compared to 71

percent of persons admitted less than a year before the survey date (table 9).

The 1964 Resident Places Survey (RPS-2)

also collected data on frequency of visitors.1 t

The question asked in that survey was “How

often do friends or relatives visit him?” Since

this question excludes impersonal visitors such

as volunteers and the 1973-74 survey did not,

one mi~ht expect the data to show less frequent visits in 1964 than in 1973-74. The comparison shown in table O does not bear this out.

In 1964, 91 percent of the residents received

visitors compared to 88 percent in 1973-74.

However, the data do show a somewhat smaller

frequency of visitors in the 1964 survey than in

the recent one.

Outside Leisure Activities,

Overnight Leave, and Visitors

The last several sections have dealt with data

on social contacts and activities of nursing home

.

residents. The data showed that most residents

had stayed in some type of institution (broadly

defined for this analysis to include a boarding

home as well as another nursing home, a hospital, or the like) rather than in a private residence

prior to entering the nursing home. Most residents did not leave the facility for recreational

activities, and even fewer left the facility for an

overnight stay with friends or relatives. Also, the

data showed that there is a strong relationship

between taking overnight leave and participating

in other outside leisure activities. In the last section data were presented showing that most residents did receive visitors, with many receiving

them weekly.

In this final part of the discussion data will

be presented which show the relationships

among the entire set of social variables. Table 10

shows that a larger percentage of the residents

who took overnight leave (97 percent) than of

those who did not (86 percent) received visitors.

Among the residents under 65 years of age the

difference is more pronounced–92 percent of

those taking overnight leave received visitors

compared to only 74 percent of those who did

not.

Only 10 percent of all residents had ng social contact outside of the nursing home (i.e., no

outside leisure activities, no overnight leave, and

no visitors). Another 9 percent had all three

types of social contact. Fifty-six percent had

visitors but did not leave the home for either

recreational activity or overnight trips (table P).

A partial explanation for the level of social

contact may be obtained by examining the type

of prior living arrangement. As table P shows, a

smaller proportion of those who stayed in another institution prior to admission had all three

types of social contact (6 percent) than did

those who had lived in a private residence, either

alone (16 percent) or with others (12 percent).

FINAL COMMENTS

The latter part of this report has concerned

itself with nursing home residents’ socia.I contacts and activities. Social contacts and activities

are important both as aspects of general well

being and because they may affect a resident’s

13
Table P. Percent of nursing home residents taking overnight leave, participating in outside leisure activities, and frequency of visitors:

United States, 1973-74

Prior living arrangement and

frequency of visitors

All residents

No visitors or unknown ..............................................

Wsitors .......................................................................

Once a week or more ..............................................

Residents previously living alone

No visitors or unknown ..............................................

Visitors .......................................................................

Once a wek or more ..............................................

Residents previously living in institutions

No visitors or unknown ..............................................

Visitors .......................................................................

Once a week or more ..............................................

Residents previously living with others

No visitors or unknown ..............................................

Visitors .......................................................................

Once a week or more ..............................................

Overnight Ieavel and outside leisure activities

Both Overnight Outside

leave leisure

Neither

leave leave nor

and

a only activiti es

activity

activities

only

0.3

9.0

6.8

●

15.9

12.1

*

6.2

4.6

●

12.4

9.8

●

2.5

1.8

*

2.5

*

*

1.9

1.3

●

4.0

3.0

2.1

20.3

15.2

2.2

27.5

21.4

2.5

1B.2

13.3

●

22.0

17.6

10.0

55.7

37.3

6.2

45.0

27,9

12.4

58.3

38.8

4.4

56.1

40.7

1E~~ludes l~~~e for medical reasons.

2For this ~na]Y~i~, ~~In~titution~~ is broadly defined to inci~de boarding homes and ‘~other>) places as well as other nursing homes and

hospitals.

health. That is, a sad or lonely person may lack there may be outside contacts which are not

the motivation to recover or to maintain his face-to-face, such as letters and telephone calls.

functional state. The situations covered in this Also, the level and quality of interpersonal exreport are all face-t o-face encounters. There are periences within the facility with other residents

several other factors which may contribute to and staff could be evaluated. These areas of enunderstanding the social-psychological environ- couragement and motivation for the residents

ment of nursing home residents. For example, were beyond the scope of this survey.

—ooo —

14
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19 National Center for Health Statistics: Administrators of nursing and personaI care homes: Education and

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

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

(HSM) 73-1703. Health Services and Mental Health Administration. Washington. U.S. Government Printing Office, Feb. 1973.

2° National Center for Health Statistics: Characteristics of residents in nursing and personal care homes,

United States, June-August 1969. Vital and Health Statistics. Series 12-No. I 9. DHEW Pub. No. (HSM)

73-1704. Health Services and Mental Health Administration. Washington. U.S. Government Printing Office, Feb.

1973.

21 National 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)

7.3-1705. Health Services and Mental Health Administration. Washington. U.S. Government Printing Office, Mar.

1973.

22 National Center for Health Statistics: Charges for

care and sources of payment for residents in nursing

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

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

(H RA) 74-1706. Health Resources Administration.

Washington. U.S. Government Printing Office, .J@y

1973.

23 National Center for Health Statistics: Chronic

conditions and impairments of nursing home residents,

United States, 1969. Vital and Health Statistics. Series

12-No. 22. DHEW Pub. No. (HRA) 74-1707. Health Resources Administration. Washington. U.S. Government

Printing Office, Dec. 1973.

24 Nation~ 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.

25 Nation~ Center for Health Statistics: Measures of

chronic illness among residents of nursing and personal

care homes, United States. 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.

26National Center for Health Statistics: Nursing

Homes: An overview of national characteristics for

1973-74. Monthly Vital Statistics Report. VOL 23-No. 6.

Supplement. DHEW Pub. No. (HRA) 75-1120. Health

Resources Administration. Washington. U.S. Government Printing Office, Sept. 5, 1974.

27 National 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, Jan.

1976.

28Van Nostrand, J. F.: Development of Survey

Methodology to Measure Cost and Quality of Care in

Nursing Homes. Paper presented at 101st Annual Meeting of American Public Health Association, San Framcisco, Nov. 8, 1973.

29 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.

30 National Center for Health Statistics: Design and

Methodology of the 1967 Master Facility Inventory Survey. Vita 1 and Health Statistics. PHS Pub. No.

1000 -Series 1-No. 9. Public Health Service. Washington.

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

31 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 1-No. 6. Public Health Service. Washington. U.S. Government Printing Office, Apr.

1968.

32National 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.

16
1.

2.

3.

4,

5,

6.

7.

8,

~

9,

I

I 10.

I

I

LIST OF DETAILED

Number and Dercent distribution of residents in nursing homes by sex and

TABLES

marital status, according to age: United States,

1973-74 ................................................................................................................................ ................................ .....................

Number and percent distribution of residents in nursing homes by marital status and race or ethnicity, according to salected

characteristics of facility: United States, 1973-74 .....................................................................................................................

Number and percent distribution of residents in nursing homes by sex and race or ethnicity, according to age: United States,

1973.74 .............................................................................................................................................. .................... ...................

Number and parcent distribution of residents in nursing homes by length of stay since currant admission, according to sex and

age: United States, 1973-74 .................................................................................................................................... ...................

Number and percant distribution of residants in nursing homes by age and sex, according to selacted characteristics of facility:

Unitad States, 1973-74 ..... ........................................................................................... ................................ ................................

Number and percent distribution of residents in nursing homes by sex and living arrangements prior to admission, according to

age: United States, 1973-74 .................................................................................................................................................. .....

Number and percent distribution of residents in nursing homes by race or ethnicity and living arrangements prior to admission,

according to age: Unitad States, 1973-74 ................................................................................................................................

Numbar and percent distribution of rasidants in nursing homes by participation in outsida Ieisura activities, according to age,

sex, and race or athnicity: United Statas, 1973-74 ............................................................... ................. .....................................

Numbar and percent distribution of residants in nursing homes by sex, race or ethnicity, and frequancy of visitors, according

to length of stay since current admission: United States, 1973-74 ................ ...............................................................................

Number and parcent distribution of residents in nursing homes by’ frequancy of visitors and overnight leave status during the

last yaar, according to age: United States, 1973-74 .............................................................................. ......................................

19

21

22

24

26

27

28

28

30

31
Table 1. Number and percent distribution of residents in nursing homes by sex, and marital status,

according to age: United States, 1973-74

Age

All ages--------------------------

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-----------------------

Under

45-54

55-64

65-69

70-74

75-79

80-84

85-89

90-94

All ages--------------------------

45 years--------------------------

years-----------------------------

years -----------------------------

years-----------------------------

years-----------------------------

years-----------------------------

years-----------------------------

years-----------------------------

95 years and over-----------------------

Both sexes

Divorced

Total Married Widowed or

Never

separated married

1,075,800

23,500

28,300

62,500

64,700

98,400

162,700

222,100

233,300

137,000

43,300

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

133,700

*

4,000

10,800

12,200

17,900

27,300

27,500

22,600

7,800

*

Number

687,100

*

3,200

15,700

24,700

50,400

104,800

158,600

180,300

112,500

35,800

50,600

Percent distribution

*

4,900

11,000

8,500

7,600

6,300

5,300

3,200

*

*

12.4

*

14.0

17.3

18.8

18.2

16.8

12.4

9.7

5.7

*

63.9

*

11.4

25.0

38.1

51.3

64.4

71.4

77.3

82.1

82.8

4.7

*

17.4

17.5

13.2

7.7

3.9

2.4

1.4

*

*

204,400

18,700

16,200

25,100

19,400

22,400

24,300

30,800

27,200

15,100

5,400

19.0

79.4

57.2

40.1

29.9

22.8

14.9

13.9

11.7

11.0

12.4

NOTE: Numbers and percents may not add to totals due to rounding.

18
Table 1. Number and percent distributionof residentsin nursing.homesbysex, and marital status,

accordingto age: United States, 1973-74—Con.

Male Female

Divorced

Total Married Widowed Never Divorced

or Total Married Widowed or

Never

separated married separated married

Number

318,1OOI

12,600

12,600

27,200

28,700

36,500

47,200

55,100

56,600

32,800

8,900

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100● o

100.0

69,300

*

72

4,400

6,600

9,000

14,700

13,800

12,500

5,300

*

21.8

*

*

16.1

23.1

24.6

31.2

25.1

22.0

16.2

*

134,700

*

*

4,100

6,300

11,300

18,900

28,000

34,600

23,100

6,600

42.3

*

*

15.1

22.0

31.0

40.1

50.8

61.2

70.4

74.1

26,800

>’C

*

5,700

5,200

4,400

3,400

2,700

*

*

*

87,300

10,200

8,600

13,000

10,500

11,700

10,200

10,600

7,700

3,600

*

757,700

1

10,900

15,700

35,300

36,100

61,900

115,500

167,000,

176,700~

104,200

34,400

Percent distribution

8.4

*

*

21.0

18.1

12.2

7.2

4.9

*

*

*

27.4

81.2

68.5

47.9

36.8

32.2

21.6

19.3

13.7

10.8

*

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

64,300

*

2,800

6>400

5,500

9,000

12,600

13,700

10,100

2,500

*

552,500

*

*

11,500

18,400

39,100

85,900

130,600

145,700

89,400

29,300

8.5 72.9

* *

17.6 *

18.3 32.7

15.4 50.9

14.5 63.2

10.9 74.4

8.2 78.2

5.7 82.4

2.4 85.8

* 85.0

23,800

*

3,100

5,300

3,300

3,100

2,900

2,600

*

*

*

3.1

*

19.8

14.9

9.2

5.0

2.5

1.6

*

*

*

117,100

8,500

7,500

12,000

8,800

10,700

14,100

20,200

19,400

11,500

4,300

15.5

77.4

48.0

34.1

24.5

17.3

12.2

12.1

11.0

11.1

12.6

19
Table 2. Number and percent distributionof residents in nursing homes by marital status and race or ethnicity, according to se.

lected cbaracteristics of facility: United states. 1973-74

Characteristic

All facilities-----------------

Region

Northeast----------------------------

NO&Central------------------------

------------------------------

West---------------------------------

Bed size

Leas than 50 beds--------------------

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

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

200 beds or mre---------------------

Ownership

Proprietary--------------------------

Nonprofit and government-------------

Certificationstatus

Both Medicare and Medicaid]----------

Medicaid only:

Skilled nursing homez--------------

Intermediatecare facility---------

Not certified------------------------

All facilities-----------------

e

Northeast----------------------------

~;~ Central------------------------

----.-+-------------------------

West---------------------------------

Bed size

Less than 50 beds--------------------

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

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

200 beds or more---------------------

Ownership

Proprietary--------------------------

Nonprofit and government-------------

Certificationstatuf+

Both Medicare and Medicaidl----------

Medicare only:

Skilled nursing home2--------------

Intermediatecare facility---------

Not certified------------------------

Marital status Race or ethnicity

II I I I I I I I

Total

Divorced

Married Widowed or Never White3 Spanish All other

married Black

separated American ‘aces 0= ethnicities

1,075,BO0 133,700

7r

236,100 24,500

36B,700 44,500

278,200 36,OOO

192,BO0 28,600

162,600 17,800

367,700 47,300

386,100 50,800

159,300 17,700

756,200 95,900

319,700 37,800

406,900 56,800

292,5oo 36,000

236,700 27,400

139,800 13,500

Number

687,100 50,600 204,400 1,010,400

153,100

227,300

185,200

121,500

101,100

233,800

252,500

99,700

484,000

203,100

267,700

188,800

147,800

82,800

100.0

lr

12.4 63.!

100.0

100.0

100.0

100.0

100.0

100.0

100,0

100.0

J

100.0

100.0

100.0

100.0

100.0

100.0 !

10.4

12,1

12.9

14.9

11.0

12.9

13.2

11.1

12.7

11.8

14.0

12.3

11.6

9.6

64.5

61,6

66,6

63.C

62.2

63.6

65.4

62.6

64.o

63.5

65.8

64.6

62,5

59.2

7>400 51,000 228,400

17,400 79,6oo 353,900

13>700 43,400 246,800

12,100 30,500 181,300

8,800 34,900 152,900

16,400 70,200 346,600

17>000 65,900 362,6oo

8,500 33,400 148,300

36,700 139,600 703,800

13,900 64,900 306,600

17,300 65>100 3B1,400

13,700 54,000 274,800

11,900 49,500 221,000

7,700 35,800 133,100

Percent distribution

4.7

::+

4.9

6.3

5.4

4.4

2::

$:

4.2

4.7

5.0

5.5

21.6 96.B

21,6 96.0

15.6 88.7

15.8 90.4

21.5 94.0

19.1 94.2

17,1 93.9

21.0 93.1

18.5 93.1

20.3 95.9

16.0 93.8

18.5 93.9

20.9 93.4

25.6 95.2

6,300

13,300

26,400

3,300

B,200

15,400

17,400

8,300

39,600

9>700

17,500

12,800

12,600

6,4oo

4.6

::;

9.5

1.7

5.0

::;

5.2

5.2

3.0

4.3

2:2

4.6

* *

*

4,00: *

6,500 *

*

4,30: *

4,100 *

* *

9,30C

2,6oo

5,800

3,800

*

>!

1.1

*

*

M

1.;

1.1*

M

1.4

1.3

*

*

~23 500 of the residents were in facilities certifiedby Medicare only.

124,600 of the residents were in facilitiescertified as both skilled nursing home and intermediatecare facility.

.’Excludes Spanish American.

3,400

‘k

*

*

*

*

0.4

*

*

*

*

*

*

*

*

0.5

*

*

*

*

*

NOTE: Numbers and percents may not add to totals due to rounding.

21
Table 3. Number and percent distributionof residentsin nursing homes by sex and race Or eth.

nicity, accordingto age: u~i,tedstates, 1973-74

Age

All ages--------------------------

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-----------------------

Under

45-54

55-64

65-69

70-74

75-79

80-84

85-89

90-94

All ages--------------------------

45 years--------------------------

years-----------------------------

years-----------------------------

years-----------------------------

years-----------------------------

years--..,---- ----------------------

years--------.--------------------

years---------------.-------------

years-----------------------------

95 years and over-----------------------

‘ExcludesSpanishAmerican.

Both sexes

Total Whitel Spanish Other races

Black American or

ethnicities

1,075,800

23,500

28,300

62,500

64,700

98,400

162,700

222,100

233,300

137,000

43,300

4

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.OI

,010,400

20,100

24,400

54,700

58,OOO

89,100

152,800

213,300

224,500

132,200

41,400

Number

49,300

2,400

3,000

6,200

5,400

6,800

7,500

5,900

6,600

3,900

*

12,000

Percent distribution

93.9

85.4

86.2

87.5

89.6

90.6

93.9

96.0

96.2

96.5

95.8

4.6

10.2

10.8

9.9

8.4

6.9

4.6

2.7

2.9

2,8

*

*

*

*

*

*

*

*

*

*

*

1.1

*

*

*

*

*

*

*

*

*

*

4,200

*

*

*

*

*

*

*

*

*

*

0.4

*

*

*

*

*

*

*

*

*

*

NOTE: Numbers and percentsmay not add to totals due to rounding.

22
Table 3. Number and percent distribution of residents in nursing homes by sex and race or ethnicity, according to age: United States, 1973-74—Con.

Male Female

All other

Total Spanish

All other

White1 Black races or

American Total Whitel Black Spanish races or

ethni- American ethnicities cities

Number

19,100 6,400 * 757,700 720,000 30,200 *

*

*

*

*

*

*

*

*

*

*

*

318,100 !90,40(3 5,600

12,600

12,600

27,200

28,700

36,500

47,200

55,100

56,600

32,800

8,900

100.0

10,700

10,800

23,300

25,100

32,300

43,700

51,900

53,000

31,300

8,300

91.3

*

*

3,300

2,500

2,900

2,500

*

*

*

*

6.0

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

10,900

15,700

35,300

36,100

61,900

115,500

167,000

176,700

104,200

34,400

9,300

13,600

31,400

32,900

56,800

109,100

161,400

171,400

100,900

33,100

*

*

2,900

2,900

4,000

5,000

4,400

4,400

2,700

*

4.0

*

*

*

*

*

*

*

*

*

*

0.7

Percent distribution

2.0 * 100.0 II 95.0

100.0 85.4

100.0 86.6

100.0 89.1

100,0 91.2

100.0 91.7

100.0 94.4

100.0 96.6

100.0 97.0

100.0 96.9

100.0 96.3

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

100.0

85.3

85.8

85.4

87.6

88.6

92.6

94.1

93.7

95.3

93.8

*

*

12.2

8.8

7.8

5.3

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

8.1

8.0

6.4

4.3

2.7

2.5

2.6

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

*

23
Table 4. Number and percent distribution Of residents in nursing homes by length of stay since

current admission, according to sex and age: United States, 1973-74

Length of stay since current admission

I

5 years 10

to less years

than 10 or

years more

Sex and age

Both sexes Number

All ages------- 103,800 155,700 357,700 .49,700 37,300

*

2,60;

2,500

2,500

3,800

5,500

8,100

7,000

3,200

10,300

,075,800

23,500

28,300

62,500

64,700

98,400

162,700

222,100

233,300

137,000

43,300

L55,400

3,500

;,:;;

10:300

16,700

27,000

35,500

30,700

14,700

4,000

54,400

16,200

3,90:

7,300

6,200

9,300

14,000

19,500

26,500

19,000

8,200

30,700

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

7,200

8,800

20,200

20,000

31,100

55,200

76,100

79,800

46,800

12,400

3,700

;,;:;

8;700

12,300

19,800

30,000

32,500

21,900

7,900

40,300

Under

45-54

55-64

65-69

70-74

75-79

80-84

45 years-------

years----------

years----------

years----------

years----------

years----------

years----------

years----------

years----------

85-89

90-94

95 years and over----

Male

All ages-------

45 years-------

years ----------

years----------

years----------

years----------

years----------

years----------

years----------

vears----------

318,100 46,800 102,300

12.600 *

3,80;

4,300

5,600

6,700

8,900

8,100

4.500

3,700

4,300

8,700

8,600

11,500

15,100

18,400

18,400

11,400

*

*

3,70:

3,700

3,800

5,700

5,800

7,300

4,700

*

.09,400

2,60;

4,700

5,000

8,500

14,000

24,200

25,300

17,200

6,100

*

2,90:

3,300

3,900

3,800

4,700

4,400

4,000

*

85,400

*

*

*

*

*

*

*

*

*

*

27,100

Under

45-54

:;-::

70:74

7.5-79

80-84

85-89

90-94

95 yea~s and over----

*

4,60;

4,500

6,800

9,300

10,000

10,700

3,800

*

101,000

*

*

2,400

3,400

3,800

5,200

5,800

6,300

3,100

*

70,600

*

3,00;

4,500

6,300

12,000

16,900

15,900

7,700

*

12;600

27,200

28,700

36,500

47,200

55,100

56,600

32,800

8,900 *

Female

All ages------- 757,700 108,900 255,300

Under

45-54

55-64

65-69

70-74

75-79

80-84

85-89

90-94

95 years and over----

45 years-------

years----------

years----------

years----------

years----------

years----------

years----------

years----------

years----------

10,900

15,700

35,300

36,100

61,900

115,500

167,000

176.700

*

5,00:

5,800

9,900

17,700

25,500

20,000

10,900

2,800

*

5.20;

3,500

4,500

11,500

11,400

19,600

40,100

57,700

61,400

35,400

10,200

2,60;

4,400

2,800

5,400

10,200

14,800

22,100

15,000

7,000

*

*

*

*

2,50;

4,000

6,600

5,700

2,700

4;900

10,900

19,000

24,000

25,400

12,300

3,800

104;200

34,400

NOTE: Numbers and percents may not add to totals due to rounding.

24
Table 4. Number and percent distribution of residents in nursing homes by length of stay since ---- -.

current admission, according to sex and age: United States, 1973-74—Con.

Length of stay since current admission

(50m::;: 1 year to 3 years to 5 yesrs to

less than less than less than 10 years

than 1

3 years 5 years 10 years

or more

year

?ercent distribution

100.0 14.4 9.7 33.2 3.5

11.4

::2

12.2

10.2

14.5

14.0

13.4

14.4

14.3

16.8

13.9 10.8

30.8 15.6

15.9 13.:

11.7

9.5

9.5

:::

11.4

13.9

19.0

*

4.;

3.8

14.8

12.2

15.3

15.9

16.9

16.6

16.0

13.1

10.7

9.3

31.2

32.3

30.9

31.6

33.9

34.3

34.2

34.1

28.8

13.5

13.4

12.5

12.2

13.5

2.5

2.3

2.5

3.5

:.;

.

10.6

10.2

9.5

R

15.8

14.8

14.4

12.3

11.5

13.9

16.0

18.3

100.0 10.5 14.7 32.2 12.7 9.7 3.2

29.5

34.0

32.0

30.0

31.5

32.1

*

*

*

10.:

11.6

10.8

u

1;::

*

*

*

*

*

*

*

*

*

*

*

100.0

100.0

100.0

100.0

*

16.;

15.6

18.6

19.7

18.1

18.9

11.7

*

*

*

8.7

12.0

10.3

14.0

15.1

15.3

14.3

16.2

14.3

13.8

13.7

12.9

10.4

12.2

10.5

12.8

14.3

100.0

100.0

100.0

100.0

100.0

100.0

10.9

10.5

11.1

9.4

33.4

32.5

34.7

* * *

100.0 13.3 9.3 14.4 33.7 14.4 11.3 3.6

32.3

28.9

32.6

31.6

31.7

34.7

34.5

*

16.8

13.4

13.8

*

*

*

*

2.;

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

12:

10.1

10.4

14.7

13.6

17.6

16.4

14.4

14.4

11.8

11.1

13.7

12.2

14.5

14.3

8.9

1!:;

14.4

20.4

100.0

100.0

100.0

100.0

100.0

2.4

3.7

5.5

8.0

10.1

9.0

7.4

34.8

34.0

29.5

16.5

17.8

25
Table 5. Number and percent distribution of residents in nursing homes by age and sax, according to selected

characteriatica of facility: United States, 1973-74

Characteristic

All facilities---------------

Region

Northeast--------------------------

North Central----------------------

South------------------------------

West -------------------------------

Bed size

Less than 50 beds ------------------

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

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

200 beds or more-------------------

ownership

Proprietary------------------------

NonprOfit and government-----------

Certification statua

Both Medicare and Medicaidl--------

Medicaid only:

Skilled nursing home 2------------

Intermediate care facility-------

Not certified----------------------

All facilities---------------

Region

Northeast--------------------------

North Central----------------------

South------------------------------

West -------------------------------

Bed size

Less than 50 beds------------------

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

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

200 beds or more -------------------

Ownership

Proprietary------------------------

Nonprofit and government-----------

Certification statua

Both Medicare and Medicaidl--------

Medicaid only:

Skilled nursing homez ------------

Intermediate care facility-------

Not certified----------------------

Age

All Under 65-74 75-84 85-94

ages 65 years

95 yeara

yeara years yeara and over

Number

Y~

236,100

368,700

;;; ,xl:

>

162,600

367,700

386,100

159,300

756,200

319,700

406,900

292,500

236,700

139,800

18,700 34,100 89,800 84,100

39,700 55,400 128,200 1;;,;;;

31,600 46,100 102,100

24,300 27,500 64,800 67;300

20,900 23,800

38,400

54,700 56,200

54,000 128,000 132,000

38,700 58,300 1%,;:: 130,500

16,300 27,000 , 51,600

90,100 120,000 267,700 249,500

24,200 43,100 117,200 120,800

37,900 I 61,500 I 151,100 I 138,900

28,700 44,900 104,200 104,100

29,600 37,300 80,300

18,100 19,500

79,400

49,200 47,900

Percent distribution

100.0 10.6

100.0 7.9

100.0 10.8

100.0 11.4

100.0 12.6

100.0 12.9

100.0 10.5

100.0 10.0

100.0 10.2

100.0 11.9

100.0 7.6

100.0 9.3

100.0

100.0 1?::

100.0 12.9

15.2

14.5

15.0

16.6

14.2

14.6

14.7

15.1

16.9

15.9

13.5

15.1

15.3

15.8

13.9

35.8

38.0

34.8

36.7

33.6

33.6

34.8

37.0

37.3

35.4

36.7

37.1

35.6

34.0

35,2

34.4

35.6

;;.:

34:9

34.5

35.9

33.8

32.4

33.0

37.8

34.1

35.6

33.6

34.3

43,300

9,400

14,200

10,800

9,000

7,100

15,400

15,900

5,000

28,900

14,400

17,500

10,800

10,000

5,100

4.0

4.0

3.8

::;

4.3

:::

3.1

::!

4.3

::;

3.6

318,100

62,100

L14,1OO

82,300

59,600

47,900

LO9,1OO

L;;,;IJ~

a

226,800

91,300

L12,800

87,000

76,600

41,700

29.6

26.3

30.9

29.6

30.9

29.5

29.7

29.4

29.9

30.0

28.6

27,7

29.7

32.4

29.8

123,500 of the residents were in facilities certified by Medicare only.

2129,600 of the residenta were in facilities certified as both skilled nursing home and intermediate

cility.

757,700

173,900

;;;,:::

133;200

114,700

258,600

272,600

111,700

529,400

228,300

294,000

205,500

160,000

98,100

70.4

73.7

69.1

70.5

69.1

70.5

70.3

70.6

70.1

70,0

71.4

72.3

70.3

;5.;

.“

care faNOTE: Numbers and percents may not add to totala due to rounding.

26
Tabln G, Number and percent distributionof residents in nursing homes by sex and living arrangementspriorto admission, according

to age: United states, 1973-74

Sex and prior

living arrangements

Both Sexes

Total----------------------------------

Another nursing home or related facility-----

Mental hospital or other long-term specialty

hospital------------------------------------

General or short-stayhospf.tal---------------

Boarding home or other place-----------------

unknown--------------------------------------

Private residence:

Alone--------------------------------------

Unknown if with others---------------------

with othersl-------------------------------

spouse-----------------------------------

Children---------------------------------

Other relatives--------------------------

Unrelated persons------------------------

~

Total----------------------------------

Another nursing home .x related facility-----

Mental hospital or other long-term specialty

hospital------------------------------------

General or short-stayhospital---------------

Bnarding home or other place-----------------

Unknown--------------------------------------

Private residence:

Alone--------------------------------------

Unknown if with others---------------------

With othersl-------------------------------

spouse-----------------------------------

Children---------------------------------

Other relatives--------------------------

Unrelated persons------------------------

Female

Total----------------------------------

Another nursing home or related facility-----

Menta1 hospital or other long-term specialty

hospital------------------------------------

General or short-stayhospital---------------

Boarding home or other place-----------------

Unknown--------------------------------------

Pr~O~ residence:

--------------------------------------

Unknown if with others---------------------

with Othersl-------------------------------

Spouse-----------------------------------

Children---------------------------------

Other relatives--------------------------

Unrelated persons------------------------

ZEE3zEE”

1,075,s00

149,600

84,600

374,200

23,S00

40,700

127,900

43,100

231,900

63,800

101,400

59,800

12,200

318,100

45,500

3s,100

108,600

10,100

11,100

28,700

9,700

66,300

29,600

17,200

18,300

2,900

757,700

104,200

46,500

2f:,;L):

29;600

99,100

33,400

165,600

34,200

84,100

41,500

9,300

Number

114,300 163>100

T

19,400 22,400

31,600 23,200

29,500 56,900

3,800 4,400

3,600 5,300

3,100 14,200

* 5>400

21,200 31,300

4,700 10,300

2,700 9,600

13,400 10,200

* 2,500

T

52,400 65,100

9,600 S,400

16,000 10,700

12,200 23,300

1,900 2,s00

* *

* 4,700

7,90: 11,80;

* 4,900

2,500

5,90: 4,100

* *

T

61,900 98,000

9,800 14,000

15,600 12,400

17,200 33,600

*

* 3,50;

* 9,500

* 3,s00

13,300 19,600

3,200 5,400

2,400 7,100

7,500 6,100

* *

384.900

50,700

20,200

139,600

8,400

14,100

50,000

16,600

55,200

27,000

37,700

17,700

4,200

102,300

14,000

7,400

36,700

3,100

3,700

11,000

3,s00

22,700

12,400

5,Soo

4>100

*

282,600

36,700

12,900

102,900

5,300

10,400

39,000

12,800

62,600

14>600

32,000

13,600

3,400

413.600

57,100

9,700

148,200

7,100

17,700

60,500

19,000

94,200

21,700

51,400

18,600

4,600

98,300

13,500

4,000

36,300

2,300

3,300

11,700

3,300

24,000

10,900

8>700

4,200

*

315,300

43,700

5,700

112,000

4,800

14,300

4S,800

15,Soo

70,200

10,900

42,700

14,300

3,600

ePercent distribution m

LOO.O 100.0

13.9 17.0

27.6

3i:: 25.8

2.2 3.3

3.8 3.2

11.9 2.7

4.0 *

21.6 18.6

5.9 4.1

9.4

5.6 1::;

1.1 .%

100.0 100.0

14.3 18.3

12.0 30.6

34.1 23.3

3.6

R *

9.0 *

2;:; 15.;’

9.3 *

5.4

5.8 11.;

0.9 ,>

100.0 100.0

13.7 15.s

25.1

3;:: 27.8

*

i:: *

13.1 *

2?:; 21.;

4.5 5.2

11.1

5.5 1;:?

1.2 *

‘ResidentsmaY have lived with more than one category of person, so the sum of the subparts exceeds the total.

14.2

34.9 32:; 3$:

2.7 2.2

3.2 3.7 ::;

8.7

3.3

19.2

!:;

6.3

1.5

13.0

4.3

22.1

7.0

:::

1.1

l&.6

2+:!

12::

4.5

1.1

16.5 7.2

35.8 35.9 3:::

4.3 ;.: $:

* -

12.7

34.3 32:: 3~::

;V

3.6 ;:? 4:5

I-L9.7 13.8 15.5

2::: 2::; 2:::

5.5 5.2 3.4

7.2 11.3 13.5

6.2 ;.; 4.5

*. 1.1

NUTE: Numbers and percents may not add to totals due to rounding.

27
Table 7. Number and percent distributionof residents in nursing homes by race or ethnicity and living arrangementsprior to admission, according to age: United States, 1973-74

Race or ethnicity and living

arrangementsprior tO admission

All races or ethnicities

Total----------------------------------

Another nursing home cm related facility-----

Mental hospital or other long-term specialty

hospital------------------------------------

General on short-stayhospital---------------

Boarding home or other place-----------------

Unknown--------------------------------------

Private residence:

Alone--------------------------------------

Unknown if with others---------------------

With others]-------------------------------

Spouse-----------------------------------

Children---------------------------------

Other relatives--------------------------

Unrelated persons------------------------

Whitez

Total----------------------------------

Another nursing home or related facility-----

Mental hospital or other long-term specialty

hospital------------------------------------

General or short-stayhospital---------------

Boarding home or other place-----------------

unknown--------------------------------------

Private residence:

Alone--------------------------------------

Unknown if with others---------------------

With othersl-------------------------------

Spouse-----------------------------------

Children---------------------------------

Other relatives--------------------------

Unrelated persons------------------------

Other races or ethnicities

Total----------------------------------

Another nursing home or related facility-----

Mental hospital or other long-term specialty

hospital------------------------------------

General cm short-stayhospital---------------

Boarding home .arother place-----------------

Unknown--------------------------------------

Private residence:

Alone--------------------------------------

Unknown if with others---------------------

With othersl-------------------------------

spouse-----------------------------------

Children---------------------------------

Other relatives--------------------------

Unrelated persons------------------------

1,075,80u

149,600

84,600

374,200

23,BO0

40,700

127,900

43,100

231,900

63,800

101,400

59,800

12,200

1,010,400

141,800

75,300

350,700

22,100

39,400

124,200

40,000

216,900

60,300

96,000

54,100

11,300

65,400

7,900

9,300

23,500

*

*

3>700

3,000

15,000

3,400

5,&oo

5,700

*

Number

31,600 23,200

29,500 56,900

3,800 4>400

3>600 5,300

3,100 14,200

5,400

21,20: 31,300

4,700 10,300

2,700 9,600

13>400 10>200

* 2,500

+

99,200 147,100

17,700 20,100

27,600 20,700

24,100 51,400

3,300 3,700

3,200 4,700

2,800 13,100

4,700

18,60: 28,600

4>100 9,500

8,900

11,90: 9,100

* *

15>200 16,000

* 2,30C

4,000 2,50C

5,400 5 ,50C

* *

* *

* ‘J

2,60; 2,70;

* *

* *

* *

* ‘J

384,900

50,700

20,200

139,600

8,400

14,100

50,000

16,600

85,200

27,000

37,700

17,700

4,200

366,000

48,400

18>400

132,700

8,oOO

13,900

48,700

15,600

80,400

25,900

35>700

16,200

3,900

18,800

*

6,90;

*

*

*

4,80;

*

‘A

*

*

L13,600

57>100

9,700

148>200

7,100

17,700

60,500

19,000

94,200

21,700

51,400

18,600

4,600

398,100

55,600

8,700

142,500

7>000

17,600

59,500

18>000

89,300

20,900

f;,;cl:

4;200

15,400

*

5,80;

*

*

*

4,90;

*

*

*

*

II I I I

85

All U;ger 65-74 75-84 y:$s

lges years years years

over

100.0

13.9

31:

2.2

3.B

11.9

4.0

21.6

5.9

9.4

5.6

1.1

100.0

14.0

3::;

2.2

3.9

12.3

2?::

6.0

H

1.1

100.0

12.1

14.3

35.9

*

*

5.7

2::;

5.3

8.2

8.8

*

Percent distribution

100.0

1

17.0

27.6

25.8

3.3

3.2

2.7

18.;

4.1

1;:;

*

100.0

17.8

27.8

24.3

3.3

3.3

2.9

18.:

4.2

12.:

*

100.0

*

26.2

35.4

*

*

*

17.;

*

*

*

*

100.0

1

13.8

14.2

34.9

2.7

3.2

8.7

1;:;

!5:;

6.3

1.5

100,0

13.7

14.1

35.0

2.5

3.2

8.9

3.2

19.4

6.4

6.0

6.2

*

100.0

14.5

15.6

34.3

*

*

*

17,;

*

*

*

*

‘Residentsmay have lived with more than one category of person, so the sum of the subparts exceeds the total.

‘Excludes Spanish American.

100.0

13.2

32::

2.2

3.7

13.0

2:::

7.0

‘?::

1.1

100,0

~

13.2

3?;

2.2

3,8

13.3

2j::

1::

1,1

100.0

*

36.;

*

*

*

25.;

*

*

*

*

100.0

13,8

3::2

i:;

14.6

2::!

5,3

12.4

4.5

1.1

100.0

14.0

3::;

:::

1~.;

22:4

12::

4.3

1:1

100.0

*

37.:

*

*

*

31.;

*

*

*

NOI!E: Numbers and percents may not add to totals due to rounding.

28
Table 8, Number and percent distributionof residents in nursing homes by participation in outside leisure activities,according

to age. sex, and race or etbnicity: United States, 1973-74

Participation in outside

leisure activities

All residents ---------------------

Residents participating in selected

outside leisure activitiesz------------

Vfsitcd friends or relatives or

went home----------------------------

Went shopping independently-----------

Went shupping, home-sponsored---------

Attended plays, movies,.concerts,etc.-

Attendcd religious services,etc-------

Went for automobile ride--------------

Visited beauty or barber shop---------

Visited comnunity clubs, etc----------

Visited museums, parks, fairs, etc----

Went nut to dinner--------------------

Went to library-----------------------

Reaidcnts not participatingin outside

l;~ur@1activities2--------------------

-------------------------------

No one available to accompany---------

Uninterested--------------------------

Staff feels behavior won’t be

accepted outside of home-------------

Lack of transportation----------------

In home les~ than 1 month-------------

Cannot afford outside activities------

Residents participatingin selected

outside leisure activitiesz------------

Visited friends, relatives or

went home----------------------------

Went shopping independently-----------

Went shopping,home-sponsored---------

Attended plays, movies, concerts,etc.-

Attended religious services, etc------

Went for automobile ride--------------

Visited beauty or barber shops--------

Visited community clubs, etc----------

Visited museums, parks, fairs, etc----

Went out to dinner--------------------

Went to library-----------------------

J

Total

II Age I

Sex I Race or ethnicity

=+

1,075,800

340,800

129,400

74,100

34,100

48,300

46,100

36,300

28,000

23,200

21,400

17,800

6,600

735,000

423,800

165,000

162,200

69,500

13,600

8,500

6,400

Under

65 65-74 75-84 S5 years

years

Male Female

years

years or more

Number

.14,300 163,100 384,900 413,600

I I I

49,900I 57,4001 121,4001

14,300 19,000 50,400

10,700 13,700 26,200

7,000 6,800 11,100

7,200 ;,::: 17,Soo

6,800 16,500

4,500 5:900 12,500

3,000 3,600 11,200

4,000 3,700 8,600

5,400 4,000 6,400

2,800 3,10LJ 6,OOO

>? 2,600

64,500 105,700 263,400

30,800 ;-/,;5: 151,200

1s,900 60,000

14,100 23;400 58,700

10,700 11,600 25,300

* * 5,400

* * 3,200

* * 2,400

112,100

45,600

23,500

9,100

14,200

15,500

13,300

10,300

7,000

:,:::

>*

301,400

1:~,:::

66:000

22,000

4,800

2,900

*

100.0 100,0

38.0 28.8

21.7 21.4

10.0 14.1

14.2 14.5

13.5 13.6

10.6 9.0

8.2 6.0

6.8

6.3 1$;

5,2

1.9 “*

1:;.; 1:;.:

22;4 29:3

22.1 21.9

9.5 16.6

1.9 *

1.2 *

0.8 *

100.01

Residents not participatingin outside

l;$i;lactivitiesz --------------------

-------------------------------

No one available to accompany---------

Uninterested--------------------------

Staff feels behavior won’t be

accepted outside of home-------------

Lack of transportation----------------

In home less than 1 mcmth-------------

Cannot affard outside activities------

1Excludes Spanish American,

2Subparts exceed total due to multiple counting.

N3TE: Numbers and percents may not add to totals due to rounding.

33.2

23,8

11.9

15.9

12.8

1:.$

6:5

;::

*

100.0

54.4

23.1

22.1

11,0

*

*

*

318,100

105,200

33,900

21,600

9,900

16,800

11,800

13,000

7,100

7,400

8,200

4,000

*

212,900

108,400

55,400

52,500

22,600

5,400

2,600

2,600

Percent distribution

100,OI 100.0

100.0 100.0

;;.: 61.1

20.4

22:3 21.9

9.6 7.3

2,0 1.6

1.2 1.0

0.9 *

100.0

32.2

20.6

9.4

15.9

11.2

1:.;

7:1

;.;

“*

100.0

50.9

26.0

24.6

10.6

2.5

1.2

1.2

757,700

235,500

95,400

52,400

24,100

31,600

34,300

23,300

20,900

15,800

13,200

13,800

4,600

522,200

315,400

L09,600

109,700

47,000

8,300

6,000

3,700

100.0

40.5

22,3

10.3

13.4

14.6

H

2:;

5.9

2.0

100.0

.55.:

21:0

9.0

1.6

;:;

L,O1O,4OO

325,500

124,300

72,000

32,700

45,900

43,700

35,100

27,700

22,100

20,100

17,200

6,500

684,900

397,000

149,700

152,900

63,900

12,200

8,000

5,500

100.0

38.2

22.1

10.1

14.1

13.4

10.8

8.5

6.8

6.2

5.3

2.0

100.0

58.0

21.9

22.3

9.3

1.8

1.2

0.8

65,400

15,300

5,000

*

2,50;

2,500

*

*

*

*

>,.

,!<

50,200

26,800

15,300

9,300

5,600

*

*

*

100.0

33.0

*

*

*

*

*

*

100.0

53.3

;:.:

11.2

:

*

29
Table 9. Number and percent distribution ok residents in nursing homes by sex, race or ethnic it y, and frequent y ok visitors, ac -

cording to length ok stay since current admission: United States, 1973-74

Sex, race or ethnicity

and frequency of visitors

All residents --------------

No visitors received -------------

Unknown if visitors received -----

Visitors received ----------------

Daily --------------------------

Weekly -------------------------

Monthly ------------------------

Several times a year -----------

Frequency unknown --------------

&

Male -------------------------

No visitors received -------------

Unknown if visitors received -----

Visitors received ----------------

Daily --------------------------

Weekly-------------------------

Monthly------------------------

Several times a year-----------

Frequency unknown--------------

Female-----------------------

No visitors received-------------

Unknown if visitors received-----

Visitors received----------------

Daily--------------------------

Weekly-------------------------

Monthly------------------------

Several times a year-----------

Frequency unknown--------------

Race or ethnicity

White}-----------------------

NO visitors received-------------

Unknown if visitors received-----

Visitors received----------------

Daily--------------------------

Weekly-------------------------

Monthly------------------------

Several times a year-----------

Frequency unknown--------------

Other races or ethnicities---

NO visitors received-------------

Unknown if visitors received-----

Visitors received----------------

Daily--------------------------

Weekly-------------------------

Monthly------------------------

Several times a year-----------

Frequency unknown--------------

‘ExcludesSpanish American.

Length of stay since current admission

Number

1,075,80011414,900

T

116,200 36,500

18,100 8,200

941,600 370,200

84,300 46,500

573,4C0 249,700

168,600 48,4oo

101,900 19,100

13,400 6,500

318,100 134,500

53,500 18,200

6,600 3,400

258,000 112,800

21,700 14,200

147,500 71,800

49,600 16,300

35,400 8,300

3,800 *

757,7001I 280,500

62,700 18,300

11,500 4,800

683,500 257,400

62,600 32,300

425,900 177,900

118,900 32,000

66,600 10>800

9,600 4,200

1,O1O,4OOI] 385,400

103,900 31,200

17,000 7,800

889,500 346,400

80,200 44,000

545,100 235,000

158,100 44,000

;;,;:: 17,200

6,300

J

65,400

12>300

52,00~

4,000

28,200

10,500

8,700

*

29,500

5.300*

23,800

2,500

14,700

4,300

*

*

357>700 149,700] 153,500

,

38,700

5,600

313,400

24,000

188,900

61,200

35,600

3,800

17,400

130,70:

8,000

71,400

28,900

20,900

*

23,500

2,600

127,400

5,800

63,400

30,100

26,400

*

102,300 40,300 41,000

17,400 7,300 10,600

83,10; 32,50; 29,60;

4,800

47,500 15,10: 13,10:

17,300 8>600 7,400

12,500 6,800 7,900

* * *

255,300/ 109,400I 112,500

21,400 10,100 12,900

3,800

230,200 98,20; 97,70:

19,200 6,300 4,800

141,300 56,300 50,300

43,900 20,300 22,700

23,100 14,100 18,500

2,700 * *

335,400 141,700 147,800

22,3001 8,0001 5,700

3,500 2,300 *

18,30; 5,50: 4,50;

*

9,40: 2,50; *

3,900 * *

3,600 * *

* *

I I

Length of stay since current admission

1 year 3 years

Total Less than to less to less 5 years

1 year than 3 than 5 or more

years years

II I I I

Percent distribution

100.0

10.8

8;:;

5;:!

15.7

9.5

1.2

100.0

16.8

8!:;

4;::

15.6

11.1

1.2

100.0

8.3

9;:;

5:::

15.7

8.8

1.3

100.0

10.3

8;:;

51::

15.6

9.2

1.3

100.0

18.8

79.;

4;:;

16.0

13.2

*

100.0

8.8

8;:;

11.2

60.2

11.7

4.6

1.6

100.0

13.6

8;::

10.5

53.4

12.2

6.1

*

100,0

6,5

9H?

11.5

63.4

11.4

3.9

1.5

100,0

8.1

8;:;

11.4

61.0

lj.g

1:6

100.0

18.0

80.;

4:::

14.7

*

*

100.0

10.8

8;:;

$;

9:9

1.1

100.0

17.0

81.;

4&i

16.9

12.2

*

100.0

8.4

9::;

5;:2

17.2

9,0

1.1

100.0

10.5

8~:;

53:5

17.1

9.5

1.0

100.0

15.6

82.;

42;;

17.3

16.4

*

100.0

11.6

87.;

4?:;

19.3

13.9

*

100.0

18.1

80.;

37.:

21.3

16.7

*

100.0

9.:

89.8

5;:;

18.6

12.:

100.0

10.6

88.;

4H

19,4

13.7

*

100.0

28.9

68.:

30.:

*

*

100.0

15.3

8;:;

4:::

19.6

Li’.z

*

100.0

25.9

72.;

32.3

18.0

19,3

*

100.0

11.5

8;.;

;;:;

16:4

*

100.0

15.1

83:!

4!::

19.8

16.8

*

100.0

*

78.;

*

*

*

*

*

NOTE: Numbers and percents may not add to totals due to rounding.

30
Table 10. Number and percent distributionof residents in nursing homes by frequenty of visitors and overnight leave status during

the last year, according to age: United States, 1973-74

Frequency of visitors and

overnight leave status

A1l residents ------------------

No visitors received-----------------

Unknown if visitors received---------

Visitors received--------------------

Daily------------------------------

Weekly-----------------------------

Monthly----------------------------

Several times a year---------------

Frequency unknown------------------

overnight leave takenl-----------

No visitors received-----------------

Unknown if visitors received---------

Visitors received--------------------

Daily------------------------------

Weekly-----------------------------

Monthly----------------------------

Several times a year---------------

Frequency unknown------------------

No overnight leave takenz--------

No visitors received-----------------

Unknown if visitors received---------

Vfsitors received--------------------

Daily------------------------------

Weekly-----------------------------

E

Monthly----------------------------

Several times a year---------------

Frequency unknown------------------

All

ages

L,075,SO0

116,200

18,100

941,600

S4,300

;;:,:::

101:900

13,400

127,700

3,700

*

123,600

9,500

83,000

21,000

9,100

*

948,100

112,500

17,700

818,000

74,800

490,400

147,500

92,900

12>400

Under

65 I

65-74 I75-84 I

85 years

years

years years and over

Number

114,300 163,100

24,400 29,100

88,40; 13:$::

5,800 11,700

44,500 76,200

18,900 24,900

18,300 15,900

* *

T

22,400 19,600

* *

20,50; 18,70;

*

11, LO~ 11,400

4,500 4,500

3,900 *

*

1

*HC ludes leave for medical reasons.

Includes residents for which leave status was unknown.

384,900

34,800

6,700

343,300

32,200

215,200

58,400

32,200

5,300

45,700

%

44,80;

3,700

31,700

6,400

2,400

$<

339,200

34,000

6,600

298,500

28,500

183,500

52,000

29,800

4,800

413,600

27,800

6,500

379,300

34,600

237,400

66,400

35,500

5,400

40>100

*

39,60;

3,600

28,8oO

5,600

9.

i<

373,500

27,400

6,400

339,700

31,000

208,600

60,700

34,200

5,200

All IIUnder

65 65-74 I

75-84 85 years

as es

years

years years and over

=4100.0

10.8

8;:;

5:::

15.7

9.5

1.2

----1 100.0

2.9

96.;

7.4

65.0

16.5

7.1

*

1

100.0

11.9

81::

7.9

51.7

15.6

9.8

1.3

Percent distribution

100.0] 100.0 I 100.0 I 100.0

I ,

I

21.4

77.;

$~

16:0

.>

17.9

8$;

4::?

15.2

9.8

*

6.7

9::$’

5;::

16.0

8.6

1.3

91.8 95.7 98.0 98.7

>* 8.1 9.0

49.7 58.; 69.5 71.8

20.2 23.0 13.9 14.1

17.6 ,t 5.3 %-

9. .* >*

100.0 100.0 100.0 100.0

NOTE: Numbers and percents may not add to totals due to rounding.

31
APPENDIXES

CONTENTS

L Technical Notes on Methods................................................................................................... 34

Survey DetiW.................................................................................................................... 34

SamplingFmme............................................................................................................ 34

Sampling Des@ ........................................................................................................... 36

Data Collection Proceduresfor 1973-74 NationalNorsingHome Survey..................... 36

GenemlQticatiom ........................................................................................................ 37

Nonresponseand Imputationof MissingDati............................................................... 37

Rounding of Numbers..................................................................................................

DataRecess@ ............................................................................................................. :;

Estimationhocedwes .................................................................................................. 38

Reliabilityof Estimates...................................................................................................... 38

II. Definitions of OcrtainTermsUsedin This Repoti........................................ .......................... 42

In. Selected QuestionnairesUsedin the 1973-74 NationafNursingHome Survey......................... 44

AdministratorLetter.......................................................................................................... 44

FaciJityQuestiotie ........................................................................................................ 46

Resident Control Record................................................................................................... 54

Resident Questiom&e ...................................................................................................... 56

IV. Criteriafor Qassifying NursingHomes According to Level of NursingCare............................ 63

Types of FacilitiesIncluded in the Suey ......................................................................... 63

LIST OF APPENDIX FIGURES

I. Relativestandarderrorsof estimatednumbersof residents..................................................... 39

IL Relative standarderrorsof percentagesof residents................................................................ 41

LIST OF APPENDIX TABLES

I. Distribution of facilities in the 1973-74 National Nursing Home Survey universe and

dfiposition of sample facilities according to primary sampling strata: contcrminous

United States........................................................................................................................ 35

33
APPENDIX I

TECHNICAL NOTES ON METHODS

SURVEY DESIGN

From August 1973 to April 1974, the Division of Health Resources Utilization Statistics

(D HRUS) 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 clesi~ned and developed by DHRUS in conjunction

with a group of experts in various fields encompassing the broad area of long-term care.z 8 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 assess long-term care services.

Sampling Frame

The 1973-74 NNHS focused on nursing

homes which provided some level of nursing

care. Only facilities providing nursing care were

included because detailed questions on facility

services and resident health status were relevant

only to these facilities. They included both nursing care homes and personal care with nursing

homes, while personal care homes and domiciliary care homes were excluded. Facilities were

either freestanding estabIishments, or nursing

care units of hospitals, retirement centers, and

similar institutions. A definition of nursing care

and detailed criteria for classifying facilities providing such care are presented in appendix IV.

The survey universe consisted of two groups

of facilities: those providing some level of nursNOTE: The list of references is on pages 15-16.

ing care as classified in the 1971 Master Facility

Inventory (MFI) and those opening for business

in 1972. The major group (93 percent) was composed of all nursing homes providing some level

of nursing care as classified by the 1971 MF1.

The MFI is a census of all inpatient health facilities conducted every 2 years by mail by the

National Center for Health Statistics. A detailed

description of how the MFI was developed, its

content, and procedures for updating and assessing its coverage has been published.z g,3 ols I

In order for data collection to begin in August, the sampling 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 sample frame as possible, all nursing homes

which opened for business during 1972 were

also included in the universe. (Facilities opening

in early 1973 could not be included since data

about them were not yet available. ) The facilities which opened in 1972 comprised the second, and smaller (7 percent), group of facilities

in the universe. Although the universe included

only facilities providing nursing care, all facilities

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 tabIe I for details).

Although the hTNHS was conducted in

1973-74, it should be noted that estimates will

not correspond precisely to fibmres from the

1973 hIFI census for several reasons. In comparison to the LIFI, the hThTHSuniverse excluded the

following: 1) personal care homes and clomiciliary care homes; 2) facilities which opened in

34
Table 1, DISTRIBUTION OF FACILITIES IN THE 1973-74 NATIONAL NURSING HOME SURVEY UNIVERSE AND DISPOSITION

OF SAMPLE FACILITIES ACCORDING TO PRIMARY SAMPLING STRATA: CONTERMINOUS UNITED STATES

Number of facilities in sample

In scope and

in business

Total

facilities

Universe

(sarll;$9

Certification status and siza

of facility

I

out of

scope or

out of Nonresponding

17,685

4,099

All types . . . . . . . . . . . . . . . . . . . . . . 147 1,608

8oth Medicare and Medicaid

and Medicare only . . . . . . . . . . . . . . . 20 757

0

3

34

214

351

93

43

19

2

149

538

1,713

1,385

224

68

20

7,473

c

4

3!

22:

37C

10(

4f

2(

79(

o

0

0

7

8

4

1

0

34

[

1

1

i

11

.

:

1

2L

Unknown numbar of beds . . . . . . . . . . .

Lessthan 25 beds . . . . . . . . . . . . . . . . . .

25-49 bads, . . . . . . . . . . . . . . . . . . . . . .

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

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

200.299beds.,,,!,...............

300-499 beds . . . . . . . . . . . . . . . . . . . . .

600 beds or more . . . . . . . . . . . . . . . . . .

732

0

2

30

109

281

232

44

20

14

Medicaid only . . . . . . . . . . . . . . . . . . .

0

2

1

3

8

6

3

1

0

13

Unknown number of beds . . . . . . . . . . .

Lessthan 15 bads . . . . . . . . . . . . . . . . . .

15-24 beds . . . . . . . . . . . . . . . . . . . . . . .

25-49 beds . . . . . . . . . . . . . . . . . . . . . . .

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

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

200-299beds . . . . . . . . . . . . . . . . . . . . .

300499beds . . . . . . . . . . . . . . . . . . . . .

500bads or more . . . . . . . . . . . . . . . . . .

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

Noncertified . . . . . . . . . . . . . . . . . . . . 93 419

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

6

0

0

0

3

5

4

0

1

0

0

13

28

71

121

116

31

23

15

Unknown numberofbeds . . . . . . . . . . .

Lessthan 15beds . . . . . . . . . . . . . . . . . .

15-24bads . . . . . . . . . . . . . . . . . . . . . . .

25-49beds . . . . . . . . . . . . . . . . . . . . . . .

60-99beds . . . . . . . . . . . . . . . . . . . . . . .

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

200-299beds . . . . . . . . . . . . . . . . . . . . .

300499 beds . . . . . . . . . . . . . . . . . . . . .

500beds or mora . . . . . . . . . . . . . . . . . .

lThe universe consisted of nursing homes providing some level of nmsing care as classified in the 1971 MFI andthose opened for

businessin 1972.

35
1973; and 3) facilities which, between 1971 and

1973, upgraded the level of care they provided,

thereby meeting the “nursing care” criteria

when surveyed in the 1973 MF1. Data from the

NNHS are also subject to sampling variability,

while data from the MF1 are not, since the MF1

is a census.

Sampling Design

The sampling was a stratified two-stage probability design: The first stage was a selection 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 baseci

on Medicare and Medicaid certification: 1) both

Medicare and Medicaid and Medicare only; 2)

Medicaid only; and 3) not certified. Facilities in

each of these three strata were sorted into bed

size groups, producing 26 primary strata as

shown in table L 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. TabIe 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 facilities estimated by the survey

(15,749) is less than the universe figure (17,685)

because some facilities 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 occurreWin the

1963,2 1964,1 A and 196924 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

NOTE: The list of references is on pages 15-16.

who were physically absent from the facility duc

to overnight Ieave 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 facility.

The sampling frame for employees was the

Staff Control Record on which the intervie~ver

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 facility.

Data Collection Proceduresfor 1973-74

National Nursing Home Survey

The 1973-74 NNHS utiIized eight questionnaires. (See appendix III for copies of questionnaires relevant to this report. For all other data

collection instruments, see reference 27.)

Administrator Letter and \Vorksheet

Facility Questionnaire

Expense Questionnaire

Resident Control Record

Resident Questionnaire

Staff Questionnaire–Parts I and II

Staft Control Record

Data were colIected according to the following procedure:

1. A letter was sent to the administrators of

sample facilities 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 administrator 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 admissions and discharges, inpatient

days of care, etc.). Included with this

intro ductory letter were letters of endorsement from the American Nursing

36
Home Association and the American Association of Homes for the Aging urging

the administrators to participate in the

survey.

2. Several days to 1 week after the mailing

of the letters, the interviewer telephoned

the sample facility and made an appointment with the administrator.

3. At the time of the appointment, the following procedures were followed: The

Facility Questionnaire was completed by

the interviewer who interviewed the

administrator or owner of the facility.

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 fh-m, 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, 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 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 ancl requested the return of the form.

TIN’ following table presents a summary of the

d~ta collection procedures:

Questionnaire

Facility . . . . .

Expense . . . . . .

Resident . . . . . .

Staff . . . . . . . . .

Respondent

Administrator

Facility ‘S

accountant

Member of nursing staff familiar

with care provided to the

resident or

resident’s medical

records (10 sampled residents

per facility)

Sampled staff

member (14 per

facility)

—

Interview

situation

Personal

interview

Self-enumerated

questionnaire

Personal

interview

Self-enumerated

questionnaire

GENERAL QUALIFICATIONS

Nonresponse and Imputation

of Missing Data

Response rates differed for each type of

questionnaire as indicated below:

Questionnaire Response Rate

Facility . .. . .. .. . .. .. . . . .. . . .. . . . .. . . .. . . 97 percent

Expense................................ 88 percent

Resident............................... 98 percent

Staff ..................................... 82 percent

Generally, response rates were higher for

questionnaires administered in a personal interview situation (facility and resident) as compared to those which were self-enumerated

(expense and staff). Statistics presented in this

report were adjusted for failure of a facility 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.

37
Rounding of Numbers

Estimates of residents 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 which might be calculated from rounded data.

Data Processing

A series of checks were performed during

the course of the survey. This included field folIowups for missing and inconsistent data, some

manual editing of the questionnaires, extensive

editing conducted 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

facilities \vas dra~vn. The numerator ~vas the

total beds according to the Master Facility Inventory data for all facilities in the stratum. The

denominator was the estimate of the total beds

obtained through a simple inflation of the filaster Facility Inventory data for the sample homes

in the stratum. The effect of the first-stage 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 adjust -

ment 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 facility.

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 were kept to a minimum by methods

built into survey procedures.

Since statistics presented in this report are

based on 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 relative standard error of an estimate is

obtained by dividing the standard error of the

estimate by the estimate itself and is expressed

as a percentage of the estimate. According to

NCHS standards, reliable estimates are those

which have a relative standard error of 25 percent or less. For example, figure I shows the

relative standard errors for the estimated number of residents. For a relative standard error of

25 percent or less, the minimum number of residents is 2,300. Thus resident estimates must be

2,300 or larger in order to meet the standards of

reliability. In this report asterisks are shown for

any cell with a number of less than 2,300 or a

38
N

m

*

N

m

d’

m

m

*

39
percentage which represents a number of less

than 2,300, i.e., with more than a 25-percent

relative standard error.

Because of the relationship between the relative standard error and the estimate, the standard error of an estimate can be found by multiplying the estimate by its relative standard error.

For example, table 1 shows that the number of

residents under 45 years of age was 23,500. The

relative standard error corresponding to this estimate (using figure I) is approximately 8 percent.

The standard error is 23,500 x .08 = 1,880. The

chances are about 68 out of 100 that an estimate from the sample differs from the value

which would have been 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 21/2 times

as large. To continue the above example, therefore the chances are 95 out of 100 that the true

value is contained in the interval 23,500 *

2(1,880), or 3,760 (i.e., between 19,740 and

27,260).

Statistical tests to determine whether the

differences between selected characteristics are

statistically significant can be performed by

comparing the confidence intervals for the estimates in question. If there is no overlapping of

the confidence intervals, the estimates are considered statistically different. For example, table

9 shows that 81.1 percent of the 318,100 male

residents received visitors. From figure II the relative standard error for that estimate is between

1.1 (the relative standard error for 300,000) and

0.85 (the relative standard error for 500,000).

Using interpolation, the relative standard error is

1.08 percent. Similarly, 90.2 percent of the

757,700 female residents received visitors. Using

the same procedure as for male residents, the

relative standard error is .47 percent.

The standard errors of the estimates are obtained by multiplying the relative standard error

by the estimates.

SE(81.1 percent of 31.8,100) = .0108 x .811

= .00876

2( SE) = .0175 or 1.75 percent. .

SE(90.2 percent of 757,700) = .0047 x .902

= .0042

2( SE) = .0084 or .84 percent.

81 * 1.75 does not overlap with 90 f .84. The

chances are 95 out of 100 that the estimates are

statistically different.

—ooo —

40
Figure II. Relative standard errors of estimated percentages of residents,

[Base of percentage shown on curves]

100

90

80

70

60

50 50 \ \ I WI \ ! 1 T. t

40 \

. . ~5rooo

\ , \ \

40

\

\ I

.

30 \ . \ .

\

‘vo,ooo~ \

\

- 30

\ 1> I

20

8

7

6

5

100

90

80

70

60

20

Jo

8

7

3 3

2 2

1 1

.9

.8

.9

.8

.7 .7

.6

,5 .5

.4 .4

.3 .3

.2 .2

.1 .1

2 3 4 56789A 2 3456789A

10 100

ESTIMATED PERCENTAGE

41
APPENDIX II

DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT

Resident. –A resident is a person who has

been formally admitted but not discharged from

an establishment. All such persons were included

in the survey whether or not they were physically present at the time of the survey.

Certification status. –Certification status refers to the facility certification by the Medicare

and/or Medicaid programs.

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 pro-

~gramfor the medically indigent.

Skilled nursing home refers to certification as a skilled 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.

Type oj’ ownership. –Type of ownership refers to the type of organization that controls

and operates the nursing home.

Propn-etay 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.

Primary source ofpaymcnt. –Primary source

of payment refers to private income or medical

assistance used as payment for residents’ stay in

the nursing home.

Own income is any private source of income

from investments, Social Security or pension

plans.

Medicare refers to payment from the Medicare program described above.

Medicaid refers to payment from the Medicaid program described above.

Other public assistance refers to Old Age Assistance, Aid to the Blind, Aid to the Pernu~-

nently and Totally Disabled, and Aid to

Families with Dependent Children.

Other refers to all other methods of payment or support including church support,

VA contract, initial payment for life care,

and cases for which no charge was made.

Le)lgtk oj- stay since cumefz t aclm ission. –-

Len@ 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 survev.

Livi)lg arrangem onts prior to admissio)z. –“A

resident’s prior living arrangement refers to the

42
place of residence immediately preceding admission to the facility, regardless of length of time

in the previous arrangement.

Race or ethnicity. –Race or ethnicity refers I

to the resident’s primary racial or ethnic heritage

as perceived by the staff informant. In this ;eport, persons reported as “Caucasian” were classified as “white, ” those reported as “Negro” as

“black;” and those reported as “American Indian,” “ Oriental,” or “other” as “other.”

Marital status. –Marital status is that of a resident at the time of the survey.

Geqp-aphic region. –Classification of facilities by geographic area is provided by groupin~

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 :

Region

Northeast .......

North Central ..

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

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

States Included

Maine, New Hampshire, Vermont,

Massachusetts, Rhode Island,

Connecticut, New York, New Jersey,

Pennsylvania

Michigan, Ohio, Indiana, Illinois,

Wisconsin, Minnesota, Iowa, Missouri,

North Dakota, South Dakota,

Kansas, Nebraska

Delaware, Maryland, District of

Columbia, Virginia, West Virginia,

North Carolina, South Carolina,

Georgia, Florida, Kentucky, Texas,

Tennessee, Alabama, Mississippi,

Arkansas, Louisiana, Oklahoma

Montana, Idaho, Wyoming,

Colorado, New Mexico, Arizona,

Utah, Nevada, Washington, Alaska,

Oregon, California, Hawaii

—ooo —

43
APPENDIX III

44

SELECTED QUESTIONNAIRES USED IN THE

1973-74 NATIONAL NURSING HOME SURVEY

@

.,” r,,, ,

*..

!~%a ~~ ‘“”jDEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

,+? PUBLIC HEALTH SERVICE

“ “s. HEALTH RESOURCES ADMINISTRATION

ROCKVILLE, MARYLAND 20S52

NATIONALCENTER FOR

HEALTH 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 *O 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 ass ociations , and many 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 i+e services provided by your facility,

or the residents and staff will be held strictly confidential. This

information will be used only by persons engaged ifi 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 baais 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;

this person will be with Applied Management Sciences, the firm under

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 interviewers visit.

This survey includes a small, carefully selected nationwide sample of

nursing homes and similar facilities. Because this ntirsing home represents 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,

G?”--J’ B LwQEdward B, Perrin, Ph. D.

Acting Director

.
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 ZxK Yeer

I

● HOW MANY PERSONSWERE ADMITTED TO THIS FACILITY DURING 1972?

I

Admissions

I ● HOW MANY PERSONSWERE DISCHARGED FROM THIS FACILITY DURING 1972, EXCLUDING DEATHS?

Dleehw@s

0 HOW MANY PERSONSDIED DURING 1972 WHILE RESIDENTS OR PATIENTS OF THIS FACILITY?

Deaths

● 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

● HOWMANY ROOMS FOR RESIDENTS DOESTHIS FACILITY HAVE THAT CONTAIN:

a. 1bd only ❑ None

b, 2 beds ❑ None

c, 3 beds ❑ None

d, 4 or more beds ❑ None

RETAIN THIS FORM AND DATA FOR THE INTERVIEWER TO COLLECT.

45
FACILITY QUESTIONNAIRE

1973 Nursing Home Suwey

National Center for Health Statistics

~

Health Resources Administration

Rockville, Maryland

TELEPHONE NUMBER

Area Code Number

,

..74 CC27

Name and addrass label

ccl-1 CC2 ccl 1-1 CC12

SECTION A -FACILITY INFORMATION

1.a.

2a.

Is Correct Name of Facility if Different from Above

(name of facility on label)

NAME FOR YOUR FACILITY?

34-1 ❑ yes

-2 •1

‘HEcORREc>~l

~+ b. WHAT IS THE CORRECT NAME?

Is

(address on label) ‘HEcORREcTA

MAILING ADDRESS FOR YOUR FACILITY?

35-1 ❑ yas

-2 •1 no-- b. WHAT IS THE ENTIRE CORRECT J L~

MAILING ADDRESS?

●3. WHICH CATEGORY BEST DESCRIBES THE TYPE OF SERVICE THIS FACILITY OFFERS THE MAJORITY OF ITS

RESIDENTS OR PATIENTS? (Mark (X) only one box.)

3S-1 ❑ a. Nursing home (includes Medicare cwtified Extended Care Facilities and M~icsid certified Skillsd Nursing Homes)

-2 ❑ b. Intermediate care facility (includes Medicaid certif iad Intermadiate Care Facilities)

-3 •1 c. Convalascant or raet home

4nd. Home for the aged

{

-5 •l a. Extendsd care unit of a hospital

r

+Hf. Nursing care unit of a retirement canter

-7 •1 9. 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 WHICH OPERATES THIS FACILITY? (Mark(X) oniyonebox.)

3S,39 -23 ❑ a.

-24 ❑ b.

-25 IJ c.

-20 ❑ d.

-21 ❑ e.

-22 ❑ f.

-11 IJ g.

-12 a h.

-13 ❑ i.

-14 ❑ j.

-15 ❑ k.

-16 ❑ 1.

-17 ❑ m.

-18 ❑ n.

-19 ❑ 0.

Form 73 NHS-1

46

Individual

Partnership

Corporation

Church relatad

Nonprofit corporation

,/

4.b. IS THIS HOME A MEMBER OF A GROUP OF HOMES OPERATING

UNDER ONE GENERAL AUTHORITY OR GENERAL OWNERSHIP?

40-1 fJ yes

-2 •l no

Other nonprofit ownership J

State

Count y

City

City-count y

Hospital Oiatrict

U.S. Public Health Servica

Armed Forces

Veterans Administration

Other Federal Agency -- Specify 41-
5. DOES YOUR FACILITY ACCEPT: (Mark (X) only one box.)

44-1 ❑ Males only?

-2 ❑ Famales only?

‘3 ❑ Both males and females?

—

6a. DOES YOUR FACILITY ACCEPT PERSONS OF ALL AGES, INCLUDING INFANTS AND CHILDREN?

45-1 ❑ Yes (Skip to Question 7)

-2

L

No

b, WHAT IS THE MINIMUM AGE ACCEPTED? ❑ No rni”irswrn age or _ yrs.

CC46, 47

c. WHAT IS THE MAXIMUM AGE ACCEPTED? ❑ No maxlmumawor yrs.

CC4S, 49

7. WHAT IS THE TOTAL NUMBER OF BED S REGULARLY MAINTAINED FOR RESIDENTS? (INCLUDE ALL BEDS SETUP

AND STAFFED FOR USE WHETHER OR NOT THEY ARE IN USE By RESIDENTS AT THE PRESENTTIME. 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

B.a. WAS THERE AN INCREASE OR DECREASE IN THE TOTAL NUMBER OF BEDS DURING THE LAST YEAR?

54-2

.1

❑ No (Skip to C1.esticm9)

R Yes

\ b. I ncreaca of

CC55

c, Dacreasa of

CC58

bads

beds

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? ❑ None or

CC66

(2) Females? ❑ None or

CC69

*

10.a. 1STHIS FACILITY PARTICIPATING IN THE MEDICARE (TITLE XVIII) PROGRAM?

(

b. WHAT IS THE PROVIDER NUMBER?

I

CC13

❑ No provider #/given

12-1 ❑ Yas ~ c. HOW MANY BEDS ARE CERTIFIED FOR MEDICARE?

\

beds

CC19

CL HOW MANY OF THESE CEFi I“IFIED BEDS WERE OCCUPIED BY MEDICARE

PATIENTS LAST NIGHT?

“2 ❑ NO(skip to Question II)

( ❑ N...., cc,, bds

Form 73N HS-1

47
11.a. IS THIS FACI LITY PARTICIPATING IN THE MEDICAID (TITLE XIX) PROGRAM?

z~ Yes ❑ N. (Skip to Cluesticm 12)

-2

b~l ) DOES IT HAVE ANY SKILLED NURSING BEDS?

❑ No ❑ Yes~

[

b.(2) WHAT IS THE PROVIDER NUMBER?

30-2 -1 cdl

•1

/ I

No provider # given

b.(3) HOW MANY BEDS ARE CERTIFIED AS SKILLED NURSING BEDS?

❑ Ncmeor beds

CC44

/

[

b.(4) HOW MANY OF THESE CERTIFIED BEDS WERE

OCCUPIED BY MEDICAID PATIENTS LAST NIGHT?

❑ Nomor beds

CC4S

c.(1) DOES IT HAVE ANY INTERMEDIATE CARE BEDS?

❑ No ❑ Yes~

52-2 -1

[

c.(2) WHAT IS THE PROVIDER NUMBER?

CC53

I

•1

No provider # given

/1 c.(3) HOW MANY BEDS ARE CERTIFIED AS INTERMEDIATE CARE BEDS?

❑ N.”e or beds

CC66

c.(4) HOW MANY OF THESE CERTIFIED BEDS WERE

OCCUPIED BY MEDICAID PATIENTS LAST NIGHT?

❑ None or ~c,o beds

SECTION B - CLASSIFICATION INFORMATION (CONFIDENTIAL)

ASSURANCE OF CONFIDENTIALITY - All information which would parmit identification of the individual facility will be held in

atriot wnfidance, will be used only by persons engaged in and for the purposes of the survey, and will net be disclosed or

released to others for anv outmoses.

12,a. WAS THIS BUILDING ORIGINALLY CONSTRUCTED FOR USE AS A NURSING HOME, REST HOME, CONVALESCENT

HOME, HOME FOR THE AGED?

CARD3

ccl 1-3 ❑ Yes

F

~ No

12-1

(Skip to next pege)

b. WHAT WAS THE ORIGINAL PURPOSE AND USE OF THIS BUILDING?

13-1 ❑

“2 •l

-3 •1

40

-60

~n

Private home (i.e., single family dwelling)

Duplex (2 to 4 units)

Apartment house (5 or more units)

Hotel or motel

Hospital

Other (Specify) 14-

(Mark (X) only one box.)

Form 73 NHS-1

48
Intervlewer:

see beck of

THE FOLLOWING QUESTIONS ON ADMISSIONS AND DISCHARGES CONCERN CALENDAR YEAR 1972,

:fin&,mr WHICH IS THE PERIOD OF JANUARY 1, 1972 THROUGH DECEMBER 31, 1972, IF YOUR ANSWERS TO

,., ~uanlon, THESE QUESTIONS COVER A PERIOD OTHER THAN CALENDAR YEAR 1972, WHAT IS THIS OTHER TIME PERIOD?

13 through 17.

From _ _ through

Month Year lxx F

CC15,16 CC17,18 CC19,20 CC21 ,22

13. HOW MANY PERSONS WERE ADMITTED TO THIS FACILITY DURING 1972?

Admieeions

CC23

14. HOW MANY PERSONS WERE DISCHARGED FROM THIS FACILITY DURING 1972, EXCLUDING DEATHS?

Dlschmgas

C027

15: HOW MANY PERSONS DIED DURING 1972 WHILE RESIDENTS OR PATIENTS OF THIS FACILITY?

16. IN 1972, WHAT WERE THE TOTAL INPATI ENT DAYS OF CARE PROVIDED? (THE SUM OF THE DAILY PATlENT CENSUS

COUNT FROM 1/1 /72 THROUGH 12/31 /72.)

bays ❑ (mark (X) if estimated)

CC35 41-1

17. HOW MANY ROOMS FOR RESIDENTS DOES THIS FACILITY HAVE THAT CONTAIN:

a. ❑ None or 1bad only

(x44

b. ❑ None or 2 bads

CC4S

c. D None or

d. ❑ None or

3 back

CC52

4 or more beds

CCS8

’18. ARE ANY OF THE FOLLOWING SERVICES ROUTINELY PROVIDED TO RESIDENTS IN ADDITION TO ROOM AND BOARD?

a.

b.

c,

d,

e,

f.

9.

h.

i.

Supervisionovermedicationswhich may be self-cdministercd

Medications end treatments edminiatered in accordance with

physicians’orders

Rub andmsssege

Help with tub bath or shower

Helpwith dressing

Help with correspondence or shopping

Help with walking or getting about

Help with eating

OR

None of the etmve serv,lces routinelY provided, room end

board provided only

W-1 ❑ Yes -2 ❑ No

61-1 ❑ Yes -2 a No

62-1 ❑ Yes -2 ❑ No

63-1 ❑ Yes -2 ❑ No

64-1 IJ Yes -2 ❑ No

65-1 a Yes -2 n No

66-1 ❑ Yes -2 ❑ No

67-1 ❑ Yes -2 ❑ No

6S-1❑ Yes

Form 73 NHS-1
●19. DURING THE PAST SEVEN DAYS, HOW MANY RESIDENTS RECEIVED EACH OF THE FOLLOWING SERVICES?

CARD 4

CC1l-4

a. Nasal feeding b. Blood pressure reading c. Enems

Cal 2 CC16 C&O

d. Cathaterizetiors e. Full bed-bath f. Bowel or bladder

CC24 CC28 retraining ea32

g. Oxygen therapy h. Application of dres- i.Temperature-pulsaCC36 sing or bandage Cc40 reapiretion cc44

j, Hy@ermio injnction k. Irrigation 1. Intravenous injection

Cc46 ca62 CC56

●2o. DOES THIS FACILITY PROVIDE ANY OF THE FOLLOWING PROFESSIONAL REHABI LITATION SERVICES ON THE

PREMISES? (THE THERAPISTS MUST BE LICENSED OR REGISTERED IN THEIR SPECIFIC PROFESSIONS.)

e. Physical therapy

b. OccuWtionel therepy

c. Rea$aatioml tharapy

d. Speech end hearing therepy

e. CWnseling by social worker, psychologist, or mentel heelth

worker

f. Other rehabilitation eatvices (Smcify)

60-1 ❑ Yes -2 ❑ No

61-1 ❑ Yes -2 ❑ No

62-1 ❑ Yes -2 •1 No

63-1 ❑ Yes -2 ❑ No

84-1 ❑ Yes -2 •1 N’J

85-1 ❑ Yes -2 ❑ No

21. DOES THIS FACILITY CONDUCT TRAINING PROGRAMS FOR PEOPLE NOT ON YOUR STAFF IN COOPERATION

WITH AN EDUCATIONAL INSTITUTION?

❑ Yes ; No

87-1

22. WHAT ARE THE ACTUAL HOURS FOR EACH SHIFT? (tircie am or pm)

CARD 5

e. Day Shift from am

to

em

ccl 1-5 cd 2 pm CC16 pm

b. Evenicg Shift from am to am

C&o pm CC24 pm

c. Night Shift from am to am

C&2a pm CC32 pm

❑ No such drift

❑ No such shift

Form 73NHs.1

50
23,a. 1. FOR THE DAY SHIFT YESTERDAY, WAS THE PERSON IN CHARGE OF NURSING CARE (FOR THE ENTIRE

FACILITY): (Mark (X) Only One Box)

I - a.2 WHAT IS THE LEVEL OF a.3. WHAT HOURS DID~PERSON

SKI LLOFTHISPERSON? WORK YESTERDAY? (Circte

(Mark (X) Only One Box) am or pm.)

am

39.1 ❑ R agisterad Nurse

am

from to

cdl pm CC45 pm

/

‘2 ❑ Licensd Practical NW=

-3 ❑ Nurse’s A ide

/

-4 ❑ Other 40.

Specify Occupation

23.b. 1. FOR THE ~V 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

7

ON DUTY - that is awake, -3

Q

NO SUCH SHIFT

dressed, and serving the (Skip to Part 23.cJ

resid ants

~ b.2. WHAT IS THE LEVEL OF b.3.

SKILL OF THIS PERSON?

(Mark (X) Only One Box)

50-1 •1

“’ •1

-3 ❑

~cl

WHAT HOURS DID THIS PERSON

WORK YESTE RDA%%rcle

am or pm.)

am am

Registered Nurse from to

CC52 pm c&6 pm

Licensed Practical Nurse

Nurse’s Aide

Other 51-

.,-. >PCCITy uccup.mon

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)

‘-’ToNCALL “’l’~~~:’y;%:ke’ ‘30N0sucHsH’FT

/

~ C.2.

/

61-1

-2

3

,-

-4

&(Skip to Question 24)

WHAT IS THE LEVEL OF c.3. WHAT HOURS DID THIS PERSON

SKILL OF THIS PERSON? WORK YESTE RDA~rcle

(Mark (X) Only One Box) am or pm.)

❑ Registered Nursa

am am

from to

cffi3 pm CC67 pm

❑ Licemsd Practical N.rs@

❑ Nwsa’sAide

❑ Othar 62-

Specify Occupation

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

51
25a. WHAT TYPE OF STAFF MEMBER EXERCISES DAILY, ON-DUTY SUPERVISION f)VW! PI L CLlf41C’.~.I SER~!KES

IN THIS FACILITY? (Mark (X) Only One BOX.)

Administrator. . . . . . . . . 76-1 &b. IS THE ADMINISTRATOR ALSO A:

physician 76-1 ❑ Yes -2 Q No

ragieterad nuraa 77-1 ❑ Yas -2 ❑ No

Iicenead practical 78-1 ❑ Ye, -2 ❑ No

nurse

Physician . . . . . . . . . . ..75-2n

Registarad Nursa . . , . . . .

-3 •1

Other . . . . . . . . . . . . . . -4

Y

.

6paolf y 78-

●26. DOES THIS FACILITY PROVIDE ANY OF THE FOLLOWING SERVICES TO PERSONS WHO ARE NOT RESIDENTS OF

THIS FACILITY?

a.

CARD 6

cell-6

b.

c.

d.

e.

f.

9.

h.

i.

L

Day care (servicas pmvidad during the day to pereons who

do not sleep in the home overnight. Dey cara services ccn

inclu+ nursing .~r:, physical or occupational therapy,

racraattonal actwmes, at least one full meal a dey) . . . . . . 12-1 ❑ Yes .2 ❑ No

Meals either home daliverad or in a group sening . . . . . . 13-1 ❑ Yes -2 ❑ No

Transportation andlor escort ewvicas. . . . . . . . . . . . . . 14-1 lJ Yes -2 ❑ No

Homerrmker orchore earvices . . . . . . . . . . . . . . . . 15-1 ❑ Yas -2 ❑ No

I nforrnation andlor referral for health needs . . . . . . . . 16-1 ❑ Yes -2 ❑ No

Friendly visitiw . . . . . . . . . . . . . . . . . . . . . . . ...17-I ❑ Yas -2 ❑ No

Daily telephone checking sewice . . . . . . . . . . . . . . . . 18-1 ❑ Yes -2 ❑ No

Arrangement or provision of recreational activities . . . ...19-1 ❑ Yes -2 ❑ No

Laundry s?wice . . . . . . . . . . . . . . . . . . . . . . . ...20-1 ❑ Yes -2 •1 No

Other . . . . . . . . . . . . . . . . . . , . . . . . . . . . . ...21-1

Pyes ‘UN”

Specify = 22-

27a. DOES THIS FACILITY KEEP A WAITING LIST OF PERSONS TO BE ADMITTED WHEN A BED BECOMES AVAILABLE?

Al ‘es a No (Skip to Question 28)

-2

b. HOW MANY PEOPLE ARE ON THIS WAITING LIST?

❑ None or — Wple

CC24-26

c. DO YOU PROVIDE ANY SERVICES TO THE PERSONS ON THIS WAITING LIST?

P

Yes ❑ No (Skip to Question 28)

27-1 -2

* c.(1) WHICH OF THE FOLLOWING SERVICES DO YOU PROVIDE?

e.

b.

c.

d,

e.

f.

9.

h.

i,

i.

Oay care (sarvicas provided during tha day to persons who

do not sleep in tha home overnight. Day care services can

include nursing care, physical or occutmtional thwapy,

recraati.mwl activities, at Ieaet one full maal a day), . . . . . . 28-1 ❑ Yes

Meals either home deliwmd or in a group setting . . . . ...29-1 ❑ Yes

Tranapcrtation and/or escort services. . . . . . . . . . . . . .30-1 ❑ Yes

Homemaker or chore $awices . . . . . , . . . . . . . . . . 31-1 ❑ Yes

Information and/or raferral for health needs . . . . . . . . 32-1 ❑ Yes

Friandly visiting . . . . . . . . . . . . . . . . . . . . . . . .33-1 ❑ Yes

Doily talephone checking sewica . . . . . . . . . . . . . ...34-1 ❑ Yes

Arrangement or provision of recreational activities . . . . . . 35-1 ❑ Yes

Laundry service . . . . . . . . . . . . . . . . . . . . . . . ...36.1 ❑ Yes

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...37-1

P

Yes

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

Form 73NHS-1

52

Specify “ 3s-
●28, DOES THIS FACILITY INCLUDE AS PART OF ITS BASIC CHARGE TO EACH RESIDENT THE CHARGES FOR:

Yes No

a. Physicbnswviws . . . . . . . . . . . . . . . . . . . . . . . . 2s-1 ❑ -2 ❑

b. Privatadutynursicg . . . . . . . . . . . . . . . . . . . . . . 40-1 ❑ “2 ❑

c. Othmnursine swvirns. . . . . . . . . . . . . . . . . . . ...41-1 •1 -2 ❑

d. Therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42-1 ❑ -2 ❑

a. Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43-1 ❑ -2 •1

f. Medicalsupplbs . . . . . . . . . . . . . . . . . . . . . . . . 44-1 ❑ -2 c1

9. Special diet . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45-1 n -2 ❑

h. Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

P

46-1 -2 •1

Specify 47-

29. HAS THIS NURSING HOME BEEN IN BUSINESS AT THIS ADDRESS FOR LESS THAN TWO YEARS? (COUNT FROM THE

TIME IT FIRST OPENED AT THIS ADDRESS AS A NURSING HOME EVEN THOUGH THE OWNERSHIP OR THE SERVICES

OFFERED MAY HAVE CHANGED.)

1- Yes ~ No

60-1

Do Not Administer Expense Qwtbnneire

Form73NHS.1

53
RESIDENT CONTROL RECORD Sheet of Sheets

1973 NursingHome Survey

National Centerfor HealthStatistics

Haalth ResasrcesAdministration

Rockvilia, Maryland

m

ESTABLISHMENT NO.

TOTAL RESIDENTS IN HOME JIUIUIU

CC12-15 acz ccl 1-1

IN SAMPLE

(x16-19

RESIDENTS IN NURSING HOME

SAMPLE NAME OF RESIDENT SAMPLE NAME OF RESIDENT

DESIGNATION DESIGNATION

LINE LINE

Sw

NO. NO.

Sw

TE TE

a b c a b c

01 26

02 27

03 28

04 28

05 xl

06 31

07 32

08 33

09 34

10 35

11 38

12 37

13 38

14 39

15 40

16 41

17 42

18 43

19 44

20 45

21 46

22 47

23 48

24 49

25 50

If MoreLinesAreNeeded CONTUW.. ON THEBACK

54
RESIDENT CONTROL RECORD

RESIDENTS IN NURSING HOME

SAMPLE NAME OF RESIDENT SAMPLE NAME OF RESIDENT

DESIGNATION DESIGNATION

LINE LINE

NO.

sw_ Sw

NO.

TE TE

a b c a b c

51 76

52 77

53 78

54 79

55 60

56 81

67 82

58 63

59 64

60 85

61 86

62 87

63 68

64 69

65 80

66 91

67 92

68 93

69 84

70 95

71 96

72 97

73 98

74 88

75 00

Form 73NHs.s If More LinesAre Needed Use A Naw RESIDENT CONTROL RECORD

And RmumbetThe Lines Beginning With # 101

55
RESIDENT QUESTIONNAIRE

1973 N ureing Ho ma Survey

National Center for Henlth Statistics

Health Rescrurcas Administration

Rockville, Maryland

1-7

ASSURANCE OF CONFIDENTIALITY – All information which would permit identification

ESTABLISHMENT NO.

of tha individual will be held in strict confidence, will ba uasd only by persons engegad in and for

the purposes of the survey, arrd will not be disclosed or released to others for any purpeses.

CC2

LINE NO.

I I 1

cd 1

ccl 4-1

1. WHAT IS – DATE OF GIRTH?

mnn”rn

Month Day Year .AqJ

CC15,16 17,18 19-21 CC22-24

2. WHAT IS – SEX? ❑ Msrle ~ Female

26-1

3. WHAT IS – ETHNIC BACK- 26-1 ❑ Caucasion -2 ❑ Nagro -3 ❑ Oriental

GROUND? (Merk (X) Only

ona box) -4 ❑ Spanish Amarican -5 ❑ American Indian -S ❑ Other

4. WHAT IS – CURRENT MARITAL 27-1 ❑ Married -2 ~ Widowed -3 ❑ Divorced

STATUS? (Mark(X) Only

one box) .4 ❑ Separated -5 ❑ Never Married

5. WHAT WAS THE DATE OF – CURRENT ADMISSION TO THIS PLACE?

clnn

Month Oay Yaar

CC2S, 29 30-31 32-34

6a. WHERE DID – LIVE AT THE TIME OF ADMISSION? (Mark (X) only one box)

(1) In a boarding home 36-1

(2) In another nursing homa or ralatad facility .2

(3) In a mental hospital or othar long-term spacialty hospital -3

(4) In a general or shore-stay ho~ital 4

(5) in a privata apartment or housa -5

(6) Otherplm%(Specify) -6

36-

(7) Oon’t know .-7

•1

❑

❑

•1

1- ❑ ~b

❑ “

•1

(1)

(2)

(3)

(4)

(5)

(6)

AT THE TIME OF ADMISSION

DID - LIVE WITH: (Mark (X)

all that apply)

Yes No

spouse? 37-1 •l -2 ❑

Children? ~-l ❑ “2 •1

Othar relatives? 39-1 ❑ -2 Q

Unrelated parsons? 40.1 ❑ -2 Q

Lived alona? 41-1 ❑ -2 ❑

Don’t know? 42-1 ❑

7, WHAT IS THE PRIMARY REASON FOR - ADMISSION TO THE HOME? (Entar “I” inboxfor primaryraason;if secondary

reason givan, antar “2”.)

43- ❑ Physical raasons (a.g., illness or need for treatments)

44- ❑ Social reasons (a.g., no family, or lack of family interast)

‘“ •1 Behavioral reasons (e.g., disruptive bahcrvior, mental deterioration)

‘- ❑ Economk raawns (0.9., no monay and/or remrm)

Form 73NHS-7

56
8. WHAT WAS THIS RESIDENT’S PRIMARY DIAGNOSIS: (Mark (X) only one box in each column)

a. AT ADMISSION? b. AT THE TIME OF–LAST EXAMINATION?

49,50 ❑ aol 51,52 ❑ bOl

•1 aoz ❑ b02

•1 ao3 ❑ b03

•1 ?04 ❑ b04

•1 W36 a b05

•1 NE ❑ bC6

•l a07 ❑ b07

•l aC% ❑ b08

•1 flr39 ❑ b09

•1 ,10 ❑ b10

•1 all ❑ bll

•l a12 ❑ b12

•1 a13 ❑ b13

•l .14 ❑ b14

❑ .15 ❑ b15

❑ a16 ❑ b16

•1 a17 ❑ b17

❑ .18 ~ b18

•1 .19 ❑ b19

•1 .20 ❑ b20

•1 .21 ❑ b21

\

a22 ❑ b22

Specify:

Senility, old age, and other symptoms and illdefined conditions (e.g., coma, uremia)

Heart attack (e.g., ischemic heart disease)

Stroke (e.g., cerebrovascular diseases)

Hardening of arteries (e.g., arteriosclerosis, diseases of the arteries, arerioles, capillaries)

Other diseases of the circulatory system (e.g., NOT heart atteck, stroke, or hardening of the arteries)

Accidents, poisonings, and violence (e.g., fracture of hip, other broken bones, burns, ~oncu$~ion)

Mental disorders (e.g., mental retardation, psychoses, neuroses, mental illness, emotional problems)

Diseases of the musculoskeletat system and connective tissue (e.g., arthritis, rheumatism, back psi”)

Endocrine, nutritional, and metabolic diseases (e.g., goiter, diabetes, gout)

Diseases of the respiratory system (e.g., pneumonia, emphysema)

Neoplasms (e.g., cancer, tumors)

Diseases of the nervous system and saw organs (e.g., Parkinson’s disease, glaucoma, cataracts,

blindness, multiple sclerosis, spastic paralysis, epilepsy)

Diseases of the digestive system (e.g., cirrhosis of liver, ulcer, intestinal obstruction)

Infective and parasitic dieeases (e.g., T. B., polio, syphilis)

Diseases of the genitourinary system (e.g., nephrosis, chronic pelvic infection, hyperplasia of prostate)

Diseases of the skin and subcutaneous tissue (e.g., cellulitis, ab%as.a, chronic “Icer)

Diseases of the blood and blood-forming organ$ (e.g., anemia)

Congenital anomalities (e.g., hydrocephalus)

Complications of pregnancy, childbirth and the puerperium (e.g., infections,hemorrhage, toxemias)

Certain causes of perinatal morbidiw and mortality (e.g., birth injury or immaturity of infant)

Don’t know

Other (Specify) 54-

53-

9, DOES - HAVE ANY OF THE FOLLOWING CONDITIONS OR IMPAIRMENTS? (Mark (X) all that apply)

CC55435 -1 •l a. Senility (includes decline in intellect, memory, and ]udgement, loss of orientation, difficulty in speaking; feebleness.)

“2 •1 b. Marital illness (Psychiatric or emotional problems)

-3 •1 c. Mental retardation

-4 ❑ d. Arthritis or rheumatism

‘5\

Paralysis or palsy other than arthritis

e. (1) IS THIS THE RESULT OF A STROKE?

-6 ❑ f. Glaucoma or cataracts

“~ •1 g, Diabetes

-8 ❑ h. Any CHRONIC trouble with back or spine

-9 •l i. Amputation of extremities or limbs; or permanent stiffness or any deformity of the foot, leg, fingers, at m, or back

.O •1 j, Heart trouble

OR

-auk Resident has none of the above conditions or impairments

❑ Yes

66-1

❑ No

-2

Form 73N HS-7

57
10. DOES THIS RESIDENT REGULARLY USE ANY OF THE FOLLOWING AIDS?

No

CARD 2

14-2 a. Walker 15-2 ❑

b. Crutchae 16-2 ❑

c, Breoes 17-2 ❑

d. Wheelchair 1s-2 ❑

e. Artificial Limb 19-2 ❑

f, Self.faeder 20.2 ❑

9. Any othar aids (do not count gleamsor hecwingaids) 21-2 ❑

Yes

-1 ❑

-1 •1

-1 •1

-1 •1

-1 •1

-1 ❑

-’ •1

\

Specify 22-

11. DURING THE LAST MONTH, HOW MANY TIMES DID–RECEIVE ANY OF THE FOLLOWING THERAPY SERVICES? (INCLUDE

ONLY SERVICES PROVIDED BY A LICENSED OR REGISTERED pROFESSIONAL WHETHER INSIDE OR OUTSIDE THE fioME.)

a.

b.

c.

do

e.

f.

Physicaltharapy

NUMBER OF

TIMES

❑ None or I I

CC23

Recreationaltherapy ❑ Ncmeor I

CC25

Occupationaltherapy

Spaechtherapy

❑ Ncmaor I I

CC27

H Nona or IC&29 I

Hearingtherapy

Professionalcounselingby social

worker, psychologistor other

mental health worker

❑ Nom or I I

CC31

❑ None or I

CC33

12. DURING THE PAST 7 DAYS, WHICH OF THESE SERVICES DID–RECEIVE? (Mark (X) all that aPPIY)

CC35-62 -01 ❑ a.

-02 ❑ b.

-03 ❑ c.

-~ c1 d.

-05 ❑ e.

.06 ❑ f.

-07 •1 9.

-0S ❑ h,

-09 ❑ i,

-10 IJ L

-11 ❑ k,

-12 a I

-13 ❑ m

on

-14 ❑ n.

Form 73NHS-7

58

Rub or massaea

Administration of treatment by staff

Specialdiet

Application of steriledressingsor bandages

Temperature-pulse-respiration

Full bad-bath

Enema

Catheterization

Stood preswre reading

Irrigation

Oxygen therapy

Intrauenouqinjec*io:7

H,,, mfcrmm tnlcctvm

None of the above earvicaa received
13, DURING THE PAST 7 DAYS, DID – RECEIVE ANY MEDICATIONS?

CARD 3 ,~ No (Skip to Quewlon 14)

143

~ ‘es

WHICH TYPES OF MEDICATIONS DID – RECEIVE? (Mark (X) All That Apply)

CC1B4 .01 ❑ a,

-02 ❑ b,

-03 ❑ c.

Tranquilizers (e.g., Therazine, Melleril)

Hypnotics - Sedativas (e.g., Nembutel, Seconel, Phenobarbital, Butisol, Placidyl, Chloral Hydrate)

Stool softeners (e.g., Pari-COlace)

and. Anti-Depraasant (e.g., Elwil)

-05 ❑ e,

auf,

-07 ❑ g.

.Ot?Uh.

-09 ❑ i.

.10 ❑ j.

-11 ❑ k,

-12 ❑ 1.

-13 ❑ m.

-14 ❑ n.

.15 ❑ o,

Anti-Hy@rtensives (a.g,. Ismalin)

Diuretics (e.g., Diuril, Esidrex)

Analgesics (e.g., Aspirin, Derton, Demerol, Percoden, Empirin with Codeine)

Diebetic agents (e.g., Orinase, Insulin)

Anti-inflammatory agents (e.g., Cortisona, sodium Salicyiete, But~Oli&n, I ~ocin)

Anti-infectives (i.e., antibiotics)

Anti-Anginal drugs (e.g., Nitroglycerin, Peritrate)

Cerdiac Glycosides (e.g., Digitalis, Lenoxin)

Anti-Coagularrts (e.g., Dicumrirol, Wafiari”)

Vitamins or iron

Other types of madicetions not listed above

14. THE FOLLOWING ACTIVITIES FOR DAILY LIVING LIST VARIOUS LEVELS OF CARE THAT MAYBE NEEDED BYA

RESIDENT. PLEASE INDICATE THE ONE THAT BEST DESCRIBES 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 IS LAST. IF YOU ARE UNDECIDED

WHICH OF TWO LEVELS TO INDICATE, CHOOSE THE ONE DESCRIBING THE LESSER AMOUNT OF CARE:

a. CONSIDERING THE FOLLOWING FOUR HYGIENE ACTIVITIES (WASHING FACE AND HANDS, BRUSHING TEETH OR

DENTURES, COMBING HAIR, AND SHAVING OR APPLYING MAKE-UP) DOES THIS RESIDENT:

(Mark (X) Only One Box)

46-1 ❑ Perform all four with no assistance?

“2 ❑ pe~Orm all four with no assistance, but needs help in getting end/or puttin9 ~ay ~uiPment7

4 ❑ parf~m three Or four with no assistance, but requiras halp with a ~mplete bath?

.4 ❑ Require Ss:lstance with one or two of thase hygiene amivitie~?

‘5 ❑ Require assistance with all four of these hygiene ~tivjtias?

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 ❑ ~et clO\he$ from clo~ets and drawers and completely dress with soma assistance (tying shoes, fastening bmces, ~losi”g b“tto”~ or

ztppsws m back of garments)?

‘3 ❑ R=eive assistance \n 9attin9 clOthes, Or in dressing (do not count tying shoes, fastening braces, closing b“tto”s or zippers i“ back

of garments as esmtance) ?

.4 ❑ Stey pertly or completely undressed?

c. CONCERNING FEEDING, DOES THIS RESIDENT:

(Mark(X) OnlyOne Box)

4s-1 ❑

-2 •1

-3 •1

.4 c1

.5 .0

Feed salf without essistanca?

Faad salf with minor assistance (cutting meat or buttering breed)?

Receive major assistance in faading (do not count cutting meat or bunering breed)?

Require intravenous feeding?

Require tube feeding?

Form 73NHS-7

59
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 abject of support), may

managa bedpan or commode at night?

-—

“2 n

Receiving nurses’ assistance in going to the toilet room (do not count use of cane, walker, or other objact of support),

using badpan or commoda at night, or claaning self or arranging clothas after elimination?

-3 ❑ Unable tow to tha toilet room for the elimination process?

e. CONCERNING MOVING IN AND OUT OF A BED OR CHAIR, IS THIS RESIDENT:

Recaiving no assistance?

Walking with assistance of one person?

Walking with assistance of two persons?

Up in a chair with assistance oncein 8 hours?

UP in a chair with assistance twice in 8 hours?

Badfast with assistance in turning every two hours?

Badfast with assistance in turning evary hour?

f. CONCERNING CONTINENCE, lS~HIS RESIDENT:

In control of both bowals and bladder?

An ostomy patient?

In control of bladdaronly?

In control of bowels cd y?

Not in COfltrOl of bowels or bledder?

[Mark (X) Only Ona Box)

52-1 ❑

-2 •1

-3 ❑

1

-40

)- -5 ❑ 53-1

e.(1) DOES – HAVE 7‘es?

No

-6 ❑ BED SORES?

-7 •1 (continue with part f.)

(Mark (X) Only One Box)

54-1 H

-2 •1

-3 ❑

)

“4 •1 f.(1) IS – RECEIVING BOWEL AND/OR

BLADDER RETRAINING?

-5 c1

55-1 ❑ Yes (Skip to Question 15a.)

kf.(z) WOULD RETRAINING GIVE THIS

RESIDENT CONTROL OVER

BOWELS AND/OR BLADDER?

❑ Yes ❑ No ~ Doubtful

56-1 -2

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?

FOLLOWING BEHAVIOR?

No

(1) Depraased 57-2 ❑ -1

(2) Agitatad, newous 69-2 ❑ -1

(3) Abusive, aggressive 61-2 ❑ -1

(4) Confused, senile 63-2 ❑ -1

(5) Disturbed sleep 65.2 ❑ -1

(6) Othar problam behavior 67-2 ❑ -1

Form 73NHS-7

60

Yes

~ (Spacify) 6SMore often than Once a waek

once a week or less

58-1 ❑ “2 c1

60-1 H

-2 •1

62-1 ❑ -2 •1

64-1 ❑ -2 •1

68-1 ❑ -2 •1

~ 69.1 ❑ -2 •1
16e. DURING THIS RESIDENT’S STAY HERE, WHEN DID – LAST SEE A PHYSICIAN FOR TREATMENT, MEDICATION, OR FOR

AN EXAMINATION?

CARD4 Month Day Year

r

001

OR •1 Hes Never Seen A Ooctor While Here (Skip to

21-1 Question17a.)

CC15,16 17,18 19,20

h

b. ~TTHAT T,... r,,l. “1-al-, .,.- .

(1)

(2)

(3)

(4)

IIlvlc, Ulu — Kcbclvc.

Yes

An examination? 22-1 H -2 h

Treatment? 22-1 ❑ “2 •1

Prescription? 24-1 ❑ “2 •1

Othar? 26-1 q -2 ❑

Sp3cify 26-

C. DID THE PHYSICIAN ATTEND THE RESIDENT: (Mark (X) Only One 80x)

27-1 ❑ as a private physician?

‘2 ❑ fOr the =itwlf which furnishes the medical care?

‘3 •l temvrarily as a repl~ment for the resident’s private physician ~hO ws ““*Ie to attend the r~~id~”~j

‘4 ❑ under mme other arrangement? (spdfy) 26-

Cl, DOES A PHYSICIAN EXAMINE THIS RESIDENT: (Mark (X) onty One Box)

28-1 ❑ only when called?

‘2 ❑ i~WularlY, but without being ~alled?

-3

\

on a scheduled basia?

d, (1) HOW OFTEN DOES THE PHYSICIAN EXAMINE THE RESIDENT?

(Mark (X) Only One Box.)

30.1 ❑ once a week

-2 ❑ every 2 weeks

-3 ❑ once a month

-4 ❑ every three months

-5 ❑ once a year

-6 ❑ other (Specify) 31-

17a, DOES - WEAR EYE GLASSES?

Yas

9

No

32.1

9

-2

b, IS – SIGHT WITH GLASSES: (Mark (X) Only One 60x) c. IS – SIGHT: (Mark (X) Onlv One Box)

33.1 ❑ not impsirwf? (e.g., can read ordinary newspwer 33-1 ❑ not impaired? (e.g., can read ordinary nwvepeper

print) print without glasses)

‘2 ❑ PartlaliY impaired? {S$.g.,can watch television 8 to

12 feet across the room)

‘2 •l partiallY impair@? (e.g., can watch teiwi~ion 8 to

12 feet across the room)

-3 ❑ awereiy impaired? (e.g., cen recognize the features ‘3 ❑ severely impaired? (e.g., can recognize the features

of familier persons if they are within 2 to 3 feet) of familier parsons if they ere within 2 to 3 feet)

-4 ❑ cOmplatdy 10at? (e.g., blind) -4 ❑ Wmpletely lost? (e.g., blind)

18a. DOES - USE A HEARING AID?

Yes

m

h IS - H8ARING WITH A HEARING AID: c.

(Mark (X) Only One 80x)

35-1 ❑

“2 •1

-3 •1

-4 •1

No

w-2

IS –HEARING: (Mark (X) Only Ona Box)

not impaired? (e.g., can hear a telephone conversation

on an ordinary telephone)

partially impairad? (e.g., can hear most of the things

a person says)

awarely impaired? (e.g., can hear only a few words a

person seys or loud noises)

completely lost? (e.g., deaf)

35-1 ❑

-2 •1

-3 •1

4U

not impaired? (e.g., cm hear a telephone conversation

on an ordinary telephone)

partially impaired? (e.g., can hear moat of the things

a person says)

swamly impeirad? (e.g., ~n hear only a few wards a

parson says or loud noises)

completely lost? (e.g., deaf)

Form 73NHS-7

61
19. IS – ABI LITY 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 ❑ P~tiallY im~ired? (e.9.t i5 able tO be understood but has difficulty pm”ou”ci”g Some ~~rd$)

‘3 ❑ ~e@Yim@r~? (e.9.r ~nnot cm on a normal cm-tt”ww k under.$to~ only with difficulty)

‘4 ❑ ~mpletely lost? (e.g., is mute)

20a. DOES THIS RESIDENT HAVE DENTURES?

•1 Ye,7

~ No (Skip to CWmtim 21,.)

38-1

b. DOES – USE THE DENTURES?

•1 Y. ~ No

40-1

21a. DURING THE LAST MONTH, DID – LEAVE THE HOME FOR ANY RECREATIONAL OR LEISURE ACTIVITIES?

41 “s AN”

b. FOR WHICH OF THE FOLLOWING ACTIVITIES c. WHY DIDN’T – LEAVE THE HOME TO PARTICIPATE IN

DID – LEAVE THE HOME? (Mark (X) All That Apply) ANY ACTIVITIES DURING THE LAST MONTH? (Mark (X)

CC42-52 -1 ❑

“2 ❑

“3 •1

-40

-5 •1

-6 •1

-~ •1

-8 ❑

-9 •1

-0 •1

au

Get books, etc., from the library

Attend plays, movies, concerts, etc.

Attend srts and wsfts classes outside the home

Visit museums, parks, fairs, etc.

Goon shopping trips organizwl by the home

Go on independent shopping trips organized

by the resident or visitors

Visit a beauty shop or barber shop

Visit community clubs (such as community centers, senior citizen clubs, service clubs, bridge

clubs, unions, etc.)

Attend religious setvices or other religious activities

Go for a walk

All That Apply)

ca42-52 -1 ❑

-2 ❑

-3 ❑

-5 ❑

*CI

-~•1

-s0

Resident was too ill or was not able to move

well enough to participate

Resident was not interested

Staff wss unable to determine resident’s interests

atthis point

Staff feels that the resident’s behavior

will not be toIerstw-1 outside the home

No one was available to accompany the rasldent

Resident cannot afford these activities

Lack of transportation

Other, (Specify) 53-

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?

❑ Yes7

a No (Skip to Qmsticm 23a.) ~ Do”>t k“ ow (Skip to Question 23a.)

54-1 -2

b. WHERE DID – USUALLY GO WHEN ON LEAVE? (Mark (X) Only One Box)

55-1 H

-2 •1

“3 •1

-40

-5 ❑

-6 ❑

“~ •1

To own home or apartment

To home of family or relatives

To home of unrelated friends

To foster home

To boardinghouse or room

To another pkeca, (Specify) 55-

Oon’t know

c. ABOUT HOW OFTEN DID THIS RESIDENT GO ON LEAVE? (Mak (X) Only One Box)

57-1 ❑

-2 IJ

“3 ❑

-4 •1

-5 •1

-6 ❑

-7 ❑ Form 72NHS-7

Nearly every week

About ante a month

About once evsry two months

Sevaral times a year

About once a year or less

Other (Specify] 58-

Don’t know

62
23a. DOES - HAVE ANY VISITORS?

* /% ,~aue,.;n’tknow

b. HOW FREQUENTLY DO VISITORS SEE THE RESIDENT? (Mark (x) Only One Box)

16-1 a Nearly every week -5 ❑ About once a year or less

‘2 ❑ Aboutonce a mtmth -6 a Other (Specify)

‘3 ❑ AbOut once every two ~o”th~

17-

-7 ❑ Oon’t know

.4 ❑ Sweral times a year

24, HOW MANY BEDS ARE IN – ROOM? [Mark (X) Only One Box)

18-1 ❑ One bed (i.e., the resident’s own bad) 4 a Four beds

-2 ❑ Two beds -5 ❑ Five or more beds

-3 ❑ Thrae beds

25a. HAS THIS RESIDENT LIVED IN THIS FACILITY FOR ONE FULL MONTH OR LONGER?

❑ Yes ❑ No

19-1 -2 n

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 DUT~RSING OR OTHER SPECIAL CHARGES?

❑ Nocharga ismdeforcare (Skip to CUatio” 26a.) $

●

CC20-25

c. LAST MONTH, WHAT WAS THE TOTAL CHARGE FOR THIS RESIDENT’S CARE, INCLUDING ALL CHARGES FOR

SPECIAL SERVICES, DRUGS, ANfiCIAL MEDICAL SUPPLIES?

❑ No char@ ismadeforcare (.skipto~.estim 28a.) $

●

CC26-31

(1) DID THIS AMOUNT INCLUDE SPECIAL CHARGES FOR

No Yes

(a) physician services? 32-2 ❑ “’ •1

(b) private duty nursing? 33-2 Q “’ •1

(c) therapy? 342 ❑ -1 •1

(d) drugs? 35-2 ❑ -’ ❑

(e) special medical wppliee? 36-2 ❑ -’ c1

(f) spatial diet? 37-2 ❑ -t c1

(9) other?

P

3a-2 ❑ -1

Specify -39

26a. WHAT WERE &&THE SOURCES OF PAYMENT FOR THIS RESIDENT’S CARE LAST MONTH?

(Mark (X) All That APPIYI

CC4048 ❑ (1) Own income or familv n (4) Otharpublica=istama

support (private plans,

❑ (7) Initial rmyrnentor welfare life care

retirement funde, eocial

eecurity, etc.) ❑ (5) Church support D (8) Nocharga i.smade

❑ (2) Madicare (Title XVIII) ❑ (6) VA contract

❑ (3) Medicaid (Title XIX)

for care

n (9) Other (Specify) ~ ~gb. WHAT WAS THE PRIMARY SOURCE OF PAYMENTS FOR - CARE LAST MONTH?

(Mark (X) Only One 80xJ

50-1❑

.2 •1

“3 •1

Own income or family 4 ❑ ~her Public assistance -~ •1

eupport (pr.wate plans, or welfare

retwement funds, eocial

security, etc.) -5 ❑ Church support -8 •1

Medicare (Title XVI 11) -6 Q VA contract

-9 •1

Medicaid (Title XIX)

Initial paymentIife care

No chargt is made

for care

Other (Specify) 7

51-

Form 73NHS-7

63
APPENDIX IV

CRITERIA FOR CLASSIFYING NURSING HOMES

ACCORDING TO LEVEL OF 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 2 conducted

by the National Center for Health Statistics.

Definitions for these two classes of nursing

homes were as follows:

Nursing Care Home

● 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

● Some, but less than 50 percent of the

residents received nursing care during the

week prior to the survey.

. At least cne 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).

—ooo —

W.S.GOVERNMENT PRINTING OFFICE 1977-241.16(Y16

a4
Series 1.

Sen”es 2.

Series 3.

Series 4.

VITAL AND HEALTH STATISTICS PUBLICATIONS SERIES

Formerly i?eblic Health Service Publication No. 1000

Programs and Collection 140cedures. –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 Re@orts. –Final reports of major committees concerned with vital and

health statistics, and documents such as recommended model vital registration laws and revised birth

and death certificates.

Series 10. Data from the IIealth Znterw”ew Survey. –Statistics on illness; accidental injuries; disability; use of

hospital, medical, dental, and other services; and other health-related topics, baaed on data collected in

a continuing national household interview survey.

/

Series 11. Data ji-om the Health Examination Survey. –Data from direct examination, testing, and measurement

of national samples of the civilian, noninatitutionalized 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.

Sm”es 12. Data from the Institutionalized Population Surveys. –Discontinued effective 1975. Future reports from

these surveys will be in Series 1.3.

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: Manpower and Facilities. –Statistics on the numbers, geographic distribution, and characteristics of b ealth resources including physicians, dentists, nurses, other health occupations, hospitals, nursing homes, and outpatient facilities.

Sen”es 20. Data on Mortality. –Various statistics on mortality other than as included in regular annual or monthly

Series 21.

Series 22.

Series 23.

reports. Special anal yses by cause of death, age, and other demographic variabies; 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.

Data on Natality, Marriage, and Divorce. –Various statistics on natality, 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 births not

available from the vital records, based on sample surveys of those records.

Data from the National Mortality and Natality Surveys. –Discontinued effective 1975. Future reports

from these sample surveys based on vital records will be included in Series 20 and 21, respectively.

Data from the National Survev of Family Gro wth. –Statistics on fertility, familv formation and dissolution, family planning, and related mat ernai and infant health topics derived fro’m a biennial survey of

a nationwide probability sample of ever-married women 1544 years of age.

For a list of tides of reports published in these series, write to: Scientific and Technical Information Branch

National Center for Health Statistics

Public Health Service, HRA

t

., Rockville, Md. 20857
/

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