DATA ON NATIONAL HEALTH RESOURCES

Nursing Homes

in the United States: 1973-74

National Nursing Home Survey

Statistics on nursing homes by original purpose of building, admission policy, certification status, cost per resident day, attending

physicians, type of supervising staff, rehabilitation services, waiting

lists, training programs, room capacity, and bed capacity. Based

on data collected in the 1973-74 National Nursing Home Survey.

DHEW Publication No. (HRA) 78-1812

Series 14

Number 17

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

Public Health Service

Health Resources Administration

National Center for Health Statistics

Hyattsville, Md. October 1977
‘@

Library of Congress Cataloging in Publication Data

Sirrocco, Alvin.

Nursing homes in the United States.

(Vital and health statistics: Series 14, Dat.~ {j]~ n~ti{)n<.i} i]tc[l[h rLs<jurccs; ]]u. 17) (DIIEW

publication; (HRA) 78-1 812)

1. NursinS homes–United States–Statistics. 1. Koch. lI(w(J K.. joint author. 11. Title.

III. Series: United States. National Center I’ot- Ilealth Stati>[ics: Series 14, I)ata on national

health resources, manpower and facilities; no. 17. IV. Scri~s: United States. Dept. of Health,

Education, and Welfare. DHEW publication; (IIRA) 78-1812. II)N I,Af: 1. Xtlrsinx homes--

United States–Statistics. W2 A N 148vn no. 17]

R.4997 .S574 362.6’ 11’0973 77-608075

ISBN 0-8406 -0097-6

I

For sale by the Superintendent of Documents, U.S. Govcrmnrnt Prinliug OffIce

Washington, D. C, 2LW)2

Stock h’o. 0174)22+0588-3

—
NATIONAL CENTER FOR HEALTH STATISTICS

DOROTHY P. RICE, Director

ROBERT A. ISIL4EL, Deputy Director

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

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

ELIJAH L. WHITE, Associate Director for Data Systems

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

ROBERT C. HUBER, Associate Director for Management

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

PETER L. HURLEY, Associate Director fo~ 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 MANPOWER AND FACILITIES STATISTICS

GLORIA KAPANTAIS, Director

SHELDON STARR, Deputy Director

EVELYN MATHIS, Chief, Health Fuci2ities Statistics Branch

JOSEPH BARBANO, chie~ Health Manpower Statistics Branch

CHARLES CRONER, Chief Technical Services Branch

COOPERATION OF THE U.S. BUREAU OF THE CENSUS

Under the legislation establishing the National Health Survey, the Public Health Service is

authorized to use, insofar as possible, the services or facilities of other FederaI, State, or private

agencies.

In accordance with specifications established by the National Center for Health Statistics,

the Bureau of the Census, under a contractual arrangement, participated in planning the survey

and collecting the data.

Vital and Health Statistics-Series 14-No. 17

DHEW Publication No. (HRA) 78-1812

Library of Congress Catalog Card Number 77-608075
CONTENTS

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

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

TheCurrentSuxvey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fkxlings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

OriginalPurposeofBuilding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Admission Policies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CertificationStatus(Medkxre/Medicaid Participation) . . . . . . . . . . . . . . . . . . . . . . .

CostPerResidentDay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Attending Physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

TypeofStaffSupervisingAllClinicalServices . . . . . . . . . . . . . . . . . . . . . . . . . . .

RehabiMationServices. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

WaitingListsandTrainingPrograms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

BedCapacityofRoomsandofHornes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

ListofDetailedTables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Appendixes

I. TechnicalNotesonMethods. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11. DefinitionsofCertainTermsUsedin This Report . . . . . . . . . . . . . . . . . . . . . . .

III. QuestionnairesUsedinthe l973-74NationalNursingHomeSurvey . . . . . . . . . . . . .

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

1.

A.

B.

c.

FIGURE

Estimated percent of nursing homes in each certification category . . . . . . . . . . . . . . . .

LIST OF TEXT TABLES

Percent distribution of nursing homes with restrictions on minimum age by minimum age: United

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

Percent of all nursing homes (15,700), by type of rehabilitation service provided: United

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

Percent of nursing homes with rehabilitation services (10,900), by type of service provided:

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

1

1

1

2

2

2

2

4

4

4

5

5

6

7

8

18

27

29

70

3

2

5

5

...

Ill
SYMBOLS

Data notavtilable ---------------------------------- ---

Catego~ not applicable ----------------------------- . . .

Qunti~ zero ---------------------------------------- -

Quantity morethan Obutless than 0.05---- 0.0

Figure does not meet standards of

reliability or precision (more than

30percent relative standard error) --——— *

iv
NURSING HOMES IN

NATIONAL NURS

Al Sirrocco and H

THE UNITED STATES:

NG HOiME SURVEY

LgoKoch, Division of

Health Manpower an-dFacilities Statisti&

INTRODUCTION

Over the past decade, the Nation’s nursing

homes have become the focus of growing attenticm. An increasing public and private involvement in the problems of providing long-term

cm htis generated a steadily increasing need for

information about the quantity, quality, and

costs of the care rendered by nursing homes

throughout the United States. To partly satisfy

these needs, the National Center for Health

Statistics has conducted a series of national

nursing home surveys beginning in 1963. Data

reported in these pages stem from the most

rcccnt of these surveys, the 1973-74 National

Nursing Home Survey.

Background

Since 1963 the National Center for Health

Statistics (NCHS) has utilized two types of

surveys to gather nursing home data—universe

surveys and sample surveys. The universe surveys, surveys of all known nursing homes in the

United States, consist” of questionnaire mailouts

eliciting basic information on the characteristics

of nursing homes: number of beds, number of

residents, type of ownership, type of care

provided, etc. A series of these universe surveys,

culled the Master Facility Inventory (MFI) surWy s, have been conducted (1963,1 1967,2

1969,~ ]971$ and most recently, 19735). In

1968 ,a special ad hoc universe survey was

conducted~ which obtained more detailed information than the MFI surveys gather (charges

for care, services and activities provided, etc.).

However, these more detailed (and timeconsuming) surveys are perhaps more efficiently

conducted as sample surveys, which cover only a

small fraction of the total universe and can be

conducted via personal interviews rather than

mailouts. The technique has been used a number

of times by NCHS in collecting nursing home

data (1963,7 1964,s 1969,9 and most recently,

1973-741 O). The universe used in drawing the

samples for these surveys has in each case been

the most recent MFI listing with newly opened

nursing homes added to it.

The Current Survey

The survey being discussed in this report is

the 1973-74 National Nursing Home Survey, a

sample survey conducted from August 1973

through April 1974. Since this survey was

conducted prior to the 1973 MFI survey, the

universe used in drawing the sample was the

1971 MFI survey plus all nursing homes that

were found to have begun operation from the

time of the 1971 MFI survey through January

1973.

To be included in the sample, a nursing

home had to qualify by NCHS criteria as either a

nursing care home or a personal care home with

nursing (appendix IV). This sampling provision

excluded homes where the care offered was

entirely personal or domiciliary. Also excluded

from the sample were nursing homes in Alaska

and Hawaii.

Since the universe was based on the 1971

survey, all homes found in that survey to be

personal care or domiciliary care were excluded

1
from the sampling frame even if they had been

upgraded to a personal care home with nursing

or a nursing care home by the time the 1973-74

survey began. As a result of these exclusions, the

estimates from this survey do not correspond

precisely to the figures from the 1973 hlFI

survey.

Before sampling, all the homes included in

the universe were stratified according to the

following criteria: (1) Medicare/Medicaid certification, (2) bed-capacity group, (3) ownership

type, (4) geographic region, (5) State, and (6)

county. The sample was then selected systematically after a random start within each primary

stratum. A more detailed explanation of the

sample design can be found in appendix I.

The survey findings discussed in these pages

are almost always expressed as percents, of the

estimated homes. A table of sampling errors for

these estimated percents appears in appendix I.

Definitions are found in appendix II, and appendix III contains copies of the questionnaires

used in the 1973-74 National Nursing Home

Survey.

FINDINGS

Original Purpose of Building

A substantial majority of all nursing homes

were housed in buildings that were specifically

designed and constructed to support these functions. Findings reveal that an estimated 70

percent of all such homes were originally built

for use as nursing homes, rest homes, convalescent homes, or homes for the aged (table 1). In

size, the homes originally constructed as nursing

homes generally exceeded 50 beds, with the

most substantial proportion of them from 50 to

99 beds in capacity (table 2).

About 18 percent, the most prominent

remaining proportion of nursing homes, were

housed in buildings originally constructed as

private homes (i.e., single-family dwellings). (See

table 1.) As expected, nursing homes adapted

for use from private homes were generally of

small bed capacity (under 50 beds). Other

locations, reported with only scattered frequency, were in buildings originally constructed

as hospitals, duplexes (two to four units),

apartment houses (five or more units), and

hotels or motels.

Admission Policies

An overwhelming number of the Nation’s

nursing homes (93 percent) admitted both male

and female residents, thus placing no sex restriction on admission. Most of the homes (74

percent) did, however, impose minimum age

restrictions on admission.

Minimum age restrictions existed for nearly

every age from 1 to 70 years. Table A shows, for

those homes imposing restrictions on minimum

age, the percents falling into the nine major age

categories presented. These findings indicate

that about one-fourth (24 percent) of all the

homes which had restrictions on minimum age

set those restrictions at ages of 17 years and

younger, ages usually categorized as children.

More than one-fourth (28 percent) set their age

restriction at 18 years, and when the four

youngest age groups are combined, one finds

that almost 3/4 (72 percent) of these homes had

minimum ages of 21 years and under. Few,

therefore, restricted their admissions to the

elderly—less than 10 percent set the minimum

age at65,

Table A. Percent distribution of nursing homes with restrictions

on minimum age by minimum age: United States, 1973-74

Minimum age Percent

All nursing homes with restrictions

on minimum age . . . . . . . . . . . . . . . 100.0

l-15years . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7.3

16-17 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.6

18years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27.9

19-21 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 20.1

22.40 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.8

41-59 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.2

60-64 years . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.2

65 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8.4

66years And over . . . . . . . . . . . . . . . . . . . . . . .

*

Certification Status (Medicare/Medicaid

Participation)

Another area of major emphasis in the 1973-

74 National Nursing Home Survey was the collection of data concerning participation in the

Nation’s Medicare and Medicaid programs. To

2
Mmicare

only

-2%-

SNH

and

ICF

L

Figure 1. Estimated percent of nursing homes in each certification category

participate as a Medicare provider, a home had Figure 1 shows the distribution of nursing

~o be ~ertified as an extended care facility (ECF)

according to the requirements of Medicare legislation in effect at the time of the survey (Title

XVIII of the Social Security Act). To participate

as a Medicaid provider, a home could be

certified as a skilled nursing home (SNH) and/or

as .an intermediate care facility (ICF) according

to the requirements of Medicaid legislation

(Title XIX of the Social Security Act).’

Levels of nursing care varied by type of

certification status. The ECF and the SNH had

about the same level of skilled nursing coverage,

which was higher than the level of nursing

coverage required in the ICF.b

aThe extended care facility and skilled nursing home

designations are used in this report because most of the

survey was conducted prior to the legislation which

created the skilled nursing facility designation.

bThc classification scheme used in the Master Facility

Inventory and described in appendix I (i.e., by NC

homes, PCN homes, etc.), was developed prior to

hiedicaxe and Medicaid legislation and therefore does not

correspond exactly to the classification by certification

status (i.e., by ECF, SNH, or ICF).

homes-b y certification status.

Noncertified homes differed from certified

homes in certain characteristics worthy of note.

Though the noncertified homes comprised about

23 percent of all nursing homes, they served

only an estimated 13 percent of all residents;

thus they were smaller then their certified

counterparts. Carrying this further, an estimated

68 percent of the noncertified homes, as opposed to only 32 percent among Medicare/Medicaid participants, had under 50 beds (table 3).

And, not surprisingly, the certified home generally provided a higher level of skilled nursing

service than the noncertified home did.

The Medicare regulations were a definite

factor in this finding, since one of their requirements called for extended care facilities to

“provide 24-hour nursing service which is sufficient to meet nursing needs” and to have “at

least one registered professional nurse employed

full time.”11 The effect of these requirements

becomes evident upon examination of the person on duty and in charge of nursing for

3
certified and noncertified facilities (table 4). An

estimated 40 percent of noncertified homes had

an RN in charge of one or more shifts, as

compared to 80 percent of certified homes

(Medicare or Medicaid). A nurse’s aide was in

charge of one or more shifts in 53 percent of

noncertified homes, as compared to 20 percent

of certified homes (Medicare or Medicaid).

As expected, the home certified as an SNH

or ECF generally reported higher skill levels for

its charge nurses than the ICF did. For example,

of homes certified as SNH, an estimated 93

percent had an RN on duty and in charge of

nursing for one or more shifts; for homes

certified as solely ECF, the proportion was 77

percent; and for homes certified as solely ICF,

the proportion was 56 percent.

Finally, certification carried with it an increased tendency to perform services other than

nursing care. For example, an estimated 75

percent of the Medicare/Medicaid providers conducted onsite rehabilitation programs; in contrast, only about 50 percent of the noncertified

facilities offered such services (table 5).

More comparisons by certification status

appear throughout the remaining sections of this

report. (See table 6 for selected certification

data.)

Cost Per Resident Day

Approximately 82 percent of all nursing

homes had a cost per resident day of under

$20.00, while less than 10 percent had costs per

resident day of over $25.00. These figures can

be found in table 7, which shows cost per

resident day categories by the certification

status of the home. In comparing the noncertified homes with the certified homes (Medicare,

Medicaid, or both), it can be seen that a much

higher percentage rate of the noncertified homes

had costs per resident day of under $10.00 than

did the certified homes (41 percent versus a

combined 17 percent). In fact, the only certification type that had a percentage comparable to

the noncertified home was the Medicaid ICF

home, Approximately 36 percent of these

homes had costs under $10.00.

Another NCHS report, Series 13, No. 22,12

goes into more detail and presents a number of

tables showing nursing home cost data for

1973-74. That report shows that the average

total cost per resident day was $14.03 for

noncertified homes compared to $11.99 for

ICF’S, $15.58 for SNF’S (which included homes

certified as both SNF and ICF), and $21.17 for

homes certified as both Medicare and Medicaid.

In terms of bed size, it can be seen from

table 8 that the smaller homes tended to have

lower costs per resident day than did the larger

homes. Approximately 43 percent of homes

with less than 25 beds had costs of under

$10.00, whereas only 11 percent of homes with

100 or more beds had costs this low. At the

other end, only 9 percent of homes with less

than 25 beds had costs per resident day of

$20.00 or more, compared to 27 percent of the

homes with 100 or more beds having these same

costs.

Attending Physicians

About 71 percent of all nursing home

residents were attended to by their own physicians (attending physicians). Another 23 percent

were treated by physicians furnished by the

home (either on staff or contract). Table 9

shows the percent of homes having various

numbers of attending physicians (for private

patients) and gives this distribution by bed-size

categories. Only 7 percent of the 15,700 homes

had no attending physicians, using instead physicians on staff or on contract. Again, as would be

expected, the larger homes had the most attending physicians. However, although the difference

was not significant, 10 percent of the largest

homes (100 or more beds) had no attending

physicians, whereas in the smaller homes (less

than 100 beds) approximately 6 percent had no

attending physicians.

The noncertified homes were more likely to

be without an attending physician than the

certified homes were (12 percent versus 5

percent). (See table 10.)

Type of Staff Supervising All Clinical

Services

One objective of the survey wti to explore

who among the staff members exercised daily,

onduty supervision over all clinical services. (See

question 25 of Facility Questionnaire, appendix

4
III.) “Clinical services” are those medical and

nursing services that are part of the day-to-day

activities of the home. “Supervision” was defined as an active role in watching over these

activities in a continuous, responsible fashion.

Thus, for the purposes of the survey, the term

“supervisor” was not confined to clinical specialists such as physicians, RN’s, or LPN’s. The

supervisor could have been, and sometimes was,

a lay administrator not specifically trained as a

clinical specialist to whom such clinical specialists reported and/or were responsible.

In the majority of homes (an estimated 56

percent), the staff member with daily, onduty

supervision over all clinical services was an RN

functioning only in an RN capacity. In another

7 percent of the homes, the onduty supervisor

was the administrator of the home, who, in

addition to functioning in the capacity of

administrator, was also a qualified RN. These

findings indicate that a relatively high level of

clinical skill existed among staff functioning in

this important supervisory position.c

Rehabilitation Services

The survey also explored the nature and

extent of the rehabilitation programs that these

homes provided. An estimated 69 percent of all

nursing homes conducted one or more programs

in which a rehabilitation service was provided

onsite by “professional” therapists or counselors

(table 11). (By “professional” is meant rehabilitation personnel who were licensed or registered

in their vocation.)

The following two tables show the prevalence of these rehabilitation services in nursing

homes. Table B indicates what percent of all

15,700 homes provided each of the various

rehabilitation services, while table C (which

looks at only those homes which provided

rehabilitation services, an estimated 10,900)

shows the relative prevalence of these services.

From table B it can be seen that about

one-half of the 15,700 nursing homes provided

cThc highest potential level of clinical supervisory

skill occurred where the supervisor was either a physician functioning solely in that capacity or an administrator who was ~lso a“ qualified ‘physician.

occurred with only scattered frequency,

fewer than 3 percent of all homes.

These cases

probably in

Table B. Percent of all nursing homes (15,700), by type of

rehabilitation service provided: United States, 1973-74

Type of service Percent

Physical therapy . . . . . . . . . . . . . . . . . . . . . . . .

Occupational therapy . . . . . . . . . . . . . . . . . . . .

Recreational therapy . . . . . . . . . . . . . . . . . . . . .

Speech and hearing therapy . . . . . . . . . . . . . . . .

Counsel ing . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

53

23

31

29

52

5

Table C. Percent of nursing homes with rehabilitation services

(10,900), by type of sarvice provided: United States, 1973-74

Type of servica Percent

Physical therapy . . . . . . . . . . . . . . . . . . . . . . . . 76

Occupational therapy . . . . . . . . . . . . . . . . . . . . 34

Recreational therapy . . . . . . . . . . . . . . . . . . . . . 45

Speech and hearing therapy . . . . . . . . . . . . . . . . 42

Counsel ing . . . . . . . . . . . . . . . . . . . . . . . . . . . 75

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

physical therapy, and one-half provided counseling. Table C takes this a step further, indicating that if a nursing home offered any

rehabilitation services, it more than likely offered physical therapy and counseling. Recreational therapy and speech and hearing therapy

were the next most often provided services.

The larger the home, the more likely it was

to provide rehabilitation services (table 11). Of

the homes with 100 or more beds, an estimated

84 percent provided one or more of these

services, whereas in the homes with less than 25

beds, only 51 percent provided rehabilitation

services.

Waiting Lists and Training Programs

Approximately 72 percent of the nursing

homes maintained waiting lists. Of these homes,

17 percent had no one on their waiting list, 55

percent had between 1 and 10 people on their

list, 24 percent had between 11 and 50, and the

remaining 5 percent had more than 50 people on

their waiting list (table 12).

The homes that tended to have the largest

number of persons on their waiting list were the

larger homes. For example, of the homes with

51 or more people on their waiting list, 51

percent had 100 beds or more; on the other

hand, of the homes with just 1 to 10 people on

their waiting list, only 19 percent had 100 beds

or more (table 13).

5
Of the homes with waiting lists, 24 percent

offered one or more of the following services to

the people on these lists: day care, meals,

transportation services, homemaker or chore

services, information or referral, visiting, telephone checking, recreational activities, laundry

service, and other services.

Approximately 59 percent of the homes that

offered services to people on their waiting list

were certified for Medicaid only, 29 percent

were certified for both Medicaid and Medicare,

and 12 percent were not certified.

Some nursing homes conducted training

programs for people not on their staff in

cooperation with an educational institution. The

survey revealed that about 28 percent of all

nursing homes had such training programs, with

the larger homes being more likely to generally

provide this service. For example, about 44

percent of the homes with 100 or more beds

conducted these programs, as opposed to 13

percent of homes with less than 50 beds

(table 14).

Additionally, certified homes were more

likely to conduct these training programs than

noncertified homes were. Approximately 44

percent of the homes certified for both Medicare

and Medicaid and 29 percent of those certified

for Medicaid only conducted training programs,

as compared to only 11 percent of the noncertified homes (table 15).

Bed Capacity of Rooms and of Homas

Most nursing homes, it was found, had

relatively few rooms with as many as four

resident beds. Almost 3/4 (72 percent) had no

more than 10 percent of their rooms occupied

by four or more beds, and 88 percent of the

homes had no more than 30 percent of their

rooms with four or more beds (table 16).

Approximately 2/3 of all nursing homes had

only one or two beds in over 75 percent of their

rooms (table 17). Homes with more than 50

rooms tended to have a higher percentage of

these one- and two-bed rooms than the homes

with 20 rooms or less had (82 percent compared

to 47 percent).

Looking at these homes by the percent of

rooms with one or two beds shows no trend relative to certification. In other words, the percent

of one- or two-bed rooms in Medicaid only

homes, Medicare and Medicaid homes, and noncertified homes was almost the same (table 18).

Turning from the bed capacity of the rooms

to the total bed capacity of the homes, it was

found that the average bed capacity was 75. In

terms of certification, the homes certified for

both Medicare and Medicaid (which includes

homes certified for Medicare only) were the

largest, with an average size of 105 beds. Homes

certified for Medicaid only were the next largest,

at 73 beds, while the noncertified homes had an

average bed capacity of 45 beds (table 19).

000

6
REFERENCES

1National 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.

‘National Center for Health Statistics: Inpatient

health facilities as reported from the 1967 MFI Survey.

Vital and Health Statistics. Series 14-No. 4. DHEW Pub.

No. (HSM) 72-1065. Health Services and Mental Health

Administration. Washington. U.S. Government Printing

Office, June 1972.

‘National Center for Health Statistics: Inpatient

health facilities as reported from the 1969 MFI Survey.

Vital and Health Stat&%x. Series 14-No. 6. DHEW Pub.

No. (HShl) 73-1801. Health Services and Mental Health

Administration. Washington. U.S. Government Printing

Office, Dec. 1972.

4National Center for Health Statistics: Inpatient

health facilities as reported from the 1971 MFI Survey.

Vital and Health Statistics. Series 14-No. 12. DHEW

Pub. No. (HRA) 741807. Health Resources Administration. Washington. U.S. Government Office, Mar. 1974.

5National Center for Health Statistics: Inpatient

health facilities as reported from the 1973 MFI Survey.

Vital and Health Statistics. Series 14-No. 16. DHEW

Pub. No. (HRA) 76-1811. Health Resources Administration, Washington. U.S. Government Printing Office, May

1976.

6National Center for Health Statistics: Charges for

care in nursing homes, United States, April-September

1968. Vital and HeaJth Statistics. Series 12-No. 14.

DHEW Pub. No. (HSM) 72-1037. Health Services and

Mental Health Administration. Washington. U.S. GovernmentPrinting Office, May 1972.

7National Center for Health Statistics: Institutions

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

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

U.S. Government Printing Office, July 1965.

8National Center for Health Statistics: Charges for

care in institutions for the aged and chronically ill,

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

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

Aug. 1967.

‘National Center for Health Statistics: Charges for

care and sources of payment for residents in nursing

homes. Vital and Health Statistics. Series 12-No. 21.

DHEW Pub. No. (HRA) 74-1706. Health Resources

Administration. Washington. U.S. Government Printing

Office, July 1973.

1‘Van 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 Francisco,

NOV. 8, 1973.

1lSocial Security Administration: Conditions of participation; extended care facilities, in Federal Health

Insurance for the Aged. Code of Federal Regulations,

Title 20, Chapter III, Part 405. U.S. Department of

Health, Education, and Welfare, Feb. 1968.

12National Center for Health Statistics: Selected

operating and financial characteristics of nursing homes,

United States, 1973-74 National Nursing Home Survey.

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

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

1975.
— ..-— — —.— .——

LIST OF DETAILED TABLES

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

8

Percent distribution of nursing homes by original purpose for which building was constructed, according to bed capacity of

home: Unitad States, 1973-74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution of nursing homes by badcepacity of home, according to original purpose forwhich building wasconstrutted: United States,1973-74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution ofnuming homasby bedcapxi~, according tocetiification status: Unitad States, l973-74. . . . . . . .

Percent of nursing homes, by certification status and level of skill of person in charge of nursing semices: United States,

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

Percent of nursing homes providing onsite professional rehabilitation sewices, by certification status andtypaof sewice

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

Percant distributions of nursing homes and nursing home beds, admissions, discharges, residents, anddeaths byceRification

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

Percent distribution of nursing homes bycostper patient day(during 1972), according tocemification stitus: Unitad Stetes,

7973-74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...................... . . . . . . .

Percent distribution of nursing homes by cost per patient day (during 1972), recording to bed capacity: United Stetes,

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

Percent distribution of nursing homes which hadphysicians attending their ownprivate patients by number of attending

physicians, according tobadcapacity ofhome: Unitad States,1973-74. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution of nursing homes which had physicians attending their ownprivate patients by number of attending

physicians, accordingtocertification status: United States, 1973-74. . . . , . . . . . . . . . . . , . . . . . . . . . . . . . . . . .

Percent of nursing homes providing onsite professional rehabilitation sewices, by badcapacity, type ofsewica, and number

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

Number of nursing homes with waiting lists and percent distribution of these homes, by numbarof persons on waiting list

and bedcapacity: United States, 1973-74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution of nursing homes with waiting lists by bdcapmi~, according tonumber ofpersons on waiting list:

UnitadStates, 1973-74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Percent distribution of nursing homes by whethar ornotthey conduct training programs for people noton their staff in

coWeration with educational institutions, *cording to bed capacity: Unitad States, 1973-74. . . . . . . . . . . . . . . . . . .

ParCent distribution of nursing homes by whether ornotthey conduct training programs for people noton their staff in

cooperation with educational institutions, according to certification status: United States, 1973-74 . . . . . . . . . . . . . . .

Percent distribution of nursing homas by parcent of rooms with 4 bads or more per room, according to number of rooms in

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

Percent distribution of nursing homes by percent of rooms with 1 or2beds perroom, according tonumber ofrooms in the

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

Percent distribution of nursing homes by percent of rooms with 1 or2beds perroom, according to certification status:

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

Selected charwtatistics ofnuming homes, byce~ification status: United States, l973-74 . . . . . . . . . . . . . . . . . . . . .

9

9

10

10

11

11

12

12

13

13

14

14

14

15

15

15

16

16

16
Tablel. Percent distribution of nursing homes by original purpose for which building wasconstructed, according to bed capacity of

home: United States, 1973-74

Bed capacity I Total

All bed capacities . . . . . . . . . . . . . . . . . . . . . . . . .

F

100.0

Less than 50 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0

50-99beds, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0

100bedsormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0

originally constructed as:

Duplex,

Nursing Private apartment

Hospital

Something

homel homa house,

hotel, or

else

motel

lInclu&5 nursing homes, rest homes, convalescent homes, and homes for the aged.

NOTE: Figures maynotadd tototals due to rounding.

Table2. Percent distribution of nursing homes by bed capacity of home, according to original purpose for which building was

constructed: United States, 1973-74

Bed capacity

All bedcapacities . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

100bedsormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

II

+

Total Nursing

homel

100.0 100.0

40.5 27.4

35.0 41.5

24.4 31.0

Originally constructed as:

Private

home

100.0

86.3

11.2

+?

4

Duplex,

apartment

Hospital house,

hotel, or

motel

100.0 100.0

Something

else

100.0

38.8

37.9

*

lInc]udes nursing homes, rest homes, convalescent homes, and homes for the aged.

NOTE: Figures maynotadd tototals due to rounding.

9
Table3. Percent distribution ofnursing homes by bedcapacity, according tocertification status: United States,l973-74

Bed capacity

All

certification

statuses

All bed capacities . . . . . . . . . . . . . . . . . . . . . . . . . .

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

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

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

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

200badsormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

100.0

16.5

24.0

35.0

20.5

4.0

Medicaidonlv I

Both

Medicare tand

Medicaidl

Total

100.0I 100.0

●

12.9

42.1

36.1

7.2

11.8

29.7

36.9

18.3

3.2

Tl- Skilled Inter- Not

nursing mediate certified

home2 care

facility

100.0 100.0 100.0

7.7 15.1 43.8

21.0 36.7 24.4

38.8 35.5 22.7

27.9 11.6 7.3

5.8 ● ●

1 g percent of these homes were certified for &!!?&E? onlY.

235 percent of these homes were certified as W SNH and ICF.

NOTE: Figures maynotadd tototak. due to rounding.

Table4. Percent of nursing homes, by certification status and level of skill of person in charge of nursing services: United States,

1973-74

Skill level of person in charge

of nursing setvices

I All

certification

statuses

RN inchargeofoneormore shifts . . . . . . . . . . . . . . . . . . . . . 70.5

LPN in charge ofoneormoreshifts . . . . . . . . . . . . . . . . . . . . . 56.5

Nurse’s aide incharge ofoneormore shifts . . . . . . . . . . . . . . . . 27.4

18 percent of these homes were certified for ~ only.

235 percent of these homes were certified as ~ SNH and ICF.

Both

Medicare

and

Medicaidl

93.6

42.9

*

Medicaid only

Total

72.3

69.5

29.6

Skilled Inter- Not

nursing mediate certified

home2 care

facility

93.3 55.6 40.1

63.7 74.2 43.4

*

50.1 52.B

NOTE: Figures do not add to 100 percent because homes tithmore than oneshift mayhave people with different levels ofskillin

charge of each shift.

10
Table5. Percent of nursina homes rxovidirw onsiteixofessional rehabilitation sewices, bycenification status and type of senrice and

number of services: United States, 1973-74

Type of service and number of services

Physical therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Occupational therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Recreational therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Speech and hearingtherapy . . . . . . . . . . . . . . . . . . . . . . . . . .

Counseling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

3ormoraservices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Noservices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

All

certification

statuses

52.8

23.5

31.3

28.7

52.1

5.0

24.6

30.8

Both

Medicare

and

Vfedicaidl

87.1

45.7

47.5

61.4

76.9

7.5

51.5

7.6

Total

45.3

17.’1

28.3

19.3

49.2

4.9

16.9

34.2

Medicaid only

Skilled

nursing

home2

66.0

26.2

35.0

29.7

62.5

6.3

27.0

18.0

intermediate

care

facility

28.8

9.8

23.0

11.1

38.5

3.9

8.8

47.0

Not

certified

29.8

12.0

19.4

11.7

29.9

2.1

10.5

49.8

1s percent of these homes were certified for Medicare onlY.

235 ~ercent of these homes were certified as~SNHand ICF.

Table 6. Percent distributions of nursing homes and nursing homa beds, admissions, discharges, residents, and daaths by certification

status: United States, 1973-74

Certification status Homes 8eds

Admis- Dis- ResiDeaths sions charges dents

All certification statuses . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0 100.0

Both Medicaraand Medicaidl. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26.5 37.6 56.2 55.6 37.5 46.0

Medicaidonly . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50.5 48.8 35.0 33.7 49.0 37.3

Skillad nursinghomez . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22.4 27.3 20.2 19.4 27.1 21.5

Intermediatecarefacility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.1 21.5 14.8 14.3 21.9 15.8

Notcartified . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.1 13.6 8.8 10.7 13.5 16.7

1 ~ percent of these homes were certified for kk@kW? onlY.

23s percent of these homes were certified as ~ SNH and ICF.

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

11
Table7. Percent distribution of nursing homes by cost perpatiant day (during 1972), according to certification status: United States,

1973-74

Cost per patient day

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

Lessthan $lO.OO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$10.00-$14.99 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$15.00-$19.99 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$20.00-$24.99 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

$25.000rmore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

II Medicaid only

All Both , 1

certifi- Madicare Skilled lntercation and Total nursing mediate

statuses Medicaidl home2 care

facility

7[ 100.0

23.0

36.3

22.9

8.8

9.1

100.0

●

21.0

37.9

18.4

20.1

100.0

25.1

47.9

16.2

5.8

5.0

100.0I 100.0

10.3 36.4

46.4 49.1

26.3 8.5

9.0 ●

B.1 *

Not

certified

100.0

41.5

27.5

20.9

*

5.7

1s percent of these homes were certified for Medicare onlY.

235 percent of these homes were certified as& SNH and ICF.

NOTES: ExcIudes nursing homes that were in business less than2 years.

Figures may not add to totals due to rounding.

Table8. Percent distribution ofnursing homes bycostper petient day(during 1972), according to bedcapacity: United States,l973-74

Cost per patient day

All

bed

capacities

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0

r

Lessthen $lO.OO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.0

$10.00-$14.99 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36.3

$15.00-$19.99 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

22.9

$20.00-$24.99 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . -

8.8

$25.000r more . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9.1

NOTES: Excludes homes that were in business less than2 years.

Figures may not add to totals due to rounding.

7

Less than 2549

25 beds beds

100.0 100.0

43.0 28.0

26.3 36.0

21.5 23.2

*

5.4

8.9 7.4

I

50-99

beds

100 beds

or more

100.0 I 100.0

!

1

18.4

42.3

20.5

10.5

8.3

11.0

34.6

27.0

15.3

12.1

12
Table9. Percent distribution of nursing homes which had physicians attending their own private patients by number of attending

physicians, according to badcapacity of home: Unitad States, 1973-74

Number of physicians attending their own private patients

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ? . . . . . . . . . . . . . . . . . .

None . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

l-2attending physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

s.~~~~ndingphysicians.... ......................................

6.10attendingphysicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11-15attending physicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18-20attending physicians.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

21-30attendingphysicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

31+Oattendingphysicians. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

500rmoreattending physicians. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

NOTE: Figures maynotadd totokdsd uetorounding.

100.O II 100.0

6.7 6.3

14.5 22.0

27.6 41.6

19.7 17.3

10.6 7.2

5.5 ●

8.2 2.8

5.2 *

2.0 *

_

50-99

beds

100.0

5.0

11.6

22.7

23.7

13.1

6.7

11.0

5.5

*

100 beds

or more

100.0

10.0

6.2

11.2

18.0

12.8

9.0

13.3

12.6

7.1

Table IO. Percent distribution of nursing homes which had physicians attending their own private patients by number of attending

physicians, according to certification status: Unitad States, 1973-74

Medicaidonlv I

Number of physicians attending their

own private patients

All

certification

Both

Medicare

and

Medicaidl

t

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0

c

100.0

None . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

l-2attendingphysicians . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.5attendingphysicians . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.10attendingphysiciens . . . . . . . . . . . . . . . . . . . . . . . . . . . .

11-15attendingphysicians . . . . . . . . . . . . . . . . . . . . . . . . . . .

160rmore attendingphysicians . . . . . . . . . . . . . . . . . . . . . . .

6.7

14.5

27.6

79.7

10.6

20.9

*

*

12.3

16.0

15.9

47.6

Total

100.0

5.8

15.7

31.3

23.3

10.3

13.5

I I

Skilled lnter- Not

nursing mediate certified

home2 care

facility

100.0

8.8

12.2

26.5

23.5

10.8

18.1

100.0

*

18.4

35.1

23.2

9.9

10.0

100.0

11.8

24.0

36.9

16.0

5.2

6.1

18percent of these homes were certified for Me~lcare onlY.

235 percent of these homes were certified as ~ SNH and ICF.

NOTE: Figures maynotadd tototakd uetorounding.

13
Table 11. Percent of nursing homes providing onsite professional rehabilitation services, by bed capacity, type of service, and number

of services: United States, 1973-74

Type of service and number of services

Physical therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...? . .

Occupational therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Recreational therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Speech and hearingtherapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Counseling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

3ormoresarvicas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Noservices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

All

bed

capacities

52.8

23.5

31.3

28.7

52.1

5.0

24.6

30.8

Less than

25 beds

32.7

11.1

23.4

16.5

32.6

●

14.3

48.6 t

25-49 50-99

beds beds

39.9 57.6

77.7 24.8

28.2 28.4

19.8 30.4

44.1 56.5

*

5.4

19.0 22.5

38.2 27.6

100 beds

or more

72.0

35.5

43.9

43.3

66.6

7.8

40.0

16.0

Table 12. Number ofnursing homes with waiting lists andpercent distribution of these homas, bynumber ofpersons onwaiting list and

bed capacity: United States, 1973-74

All

Number of persons on waiting list bed

Less than 25-49 50-99 100 beds

25 beds beds beds or more

capacities

Numberofhomeswith waitinglists . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,300 1,600 2,700 4,200 2,900

I

Percent distribution

All homaswith waitinglists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 100.0

Nobodyon weitingliet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16.7 13.8 14.8 17.4 18.8

l-lOpersonsonwaiting list..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54.7 76.3 62.4 50.0 42.3

11-50personson waitinglist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23.8 *

20.7 27.7 29.1

510rmora personsonwaiting list . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.8 * *

4.9 9.8

NOTE: Figures maynotadd tototals duetorormdkig.

Table 13. Parcent distribution of nursing homes with waiting lists by bed capacity, according to number of personson waiting list:

United States, 1973-74

Number of persons on waiting list AH Less than 2549 50-99 100 beds

homes 25 beds beds beds or more

All homeswith waitinglists. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 14.2 23.5 37.0 25.2

Nobodyon waitinglist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 11.8 20.9 38.7 28.5

l-lOpersOnsOn weitinglist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 19.8 26.8 33.9 19.5

ll-50personson waitinglist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 *

20.3 42.9 30.9

510rmore persons onweitinglist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 * *38.1 51.0

NOTE: Figures maynotadd tototals dueto rounding.

14
Table 14. Percent distribution of nursing homes by whether or not they conduct training programs forpeople noton their staff in

cooperation with educational institutions, according to bed capacity: United States, 1973-74

All

Training program status bed

Less than 50-99 100 beds

50 beds beds

capacities

or more

Total . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0

Conducttrainingprogram . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28.4 13.4 35.2 43.8

Do notconducttraining program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71.6 86.6 64.8 56.2

NOTE: Figures maynotadd tototals due to rounding.

Table 15. Percent distribution of nursing homes by whether or not they conduct training programs for people not on their staff in

cooperation with educational institutions, according tocertification status: United States, 1973-74

Training program status

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

Conducttrainingprogram . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Donotconducttrainingprogram . . . . . . . . . . . . . . . . . . . . . .

1~ percent of these homes were certified for ~. OnlY.

23s percent of these homes were certified as ~ SNH snd ICF.

NOTE: Figures maynotadd tototals due to rounding.

All Both

certifi- Medicare

cation and

statuses Medicaidl

Medicaid only I

=imc~

%lRi%lEit%

Table 16. Percent distribution of nursing homes by percent of rooms with 4 beds ormoreper room, according tonumberof roomsin

the home: United States, 1973-74

Percent of rooms with 4 beds or more

Numberofrooms in home

~

klmii Total . . . . . . . . . . . . . . . . . . . . . . . . .

Homeswith l-20rooms . . . . . . . . . . . . . . . . . . .

Homeswith 21-50rooms . . . . . . . . . . . . . . . . . .

Homeswith 51roomsormore . . . . . . . . . . . . . . . .

31 percent- 51 percent- 76 percent

50 percent 75 percent or more

6.4 2.6 3.1

11.9 4.3 5.0

4.0 *

2.7

* ● ●

NOTE: Figures maynotadd tototals due to rounding.

15
Table 17. Percent distribution of nursing homes by percent of rooms with 1 or2 beds perroomr according tonumber ofrooms in the

home: United States, 1973-74

I

Percent ofroomswithl or2 beds

Number of rooms in home

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

Homeswith l-20rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Homeswith 21-50rooms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Homeswith 51roomsormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .4

All 50 percant 51 percent- 76 percent

homes or less 75 parcent or more

100.0 20.3 15.6 64.1

100.0 32.4 21.0 46.5

100.0 16.3 14.4 69.3

100.0 8.8 9.6 81.6

NOTE: Figures maynotadd tototals due to rounding.

Table 18. Percent distribution of nursing homes by percant of rooms with 1 or 2 bads perroom, according to certification status:

United States, 1973-74

Percent of rooms with 1 or2 beds

All homea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

50percentorless . . . . . . . . . . . . . . . . . . . . . . . . . . ...’. . . .

51 percent-75percent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

76percentormore . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1~ percent of these homes were certified for ~ only235 percent of these homes were certified as ~ SNH and ICF.

NOTE: Figrsres maynotadd tototala due to rounding.

All

certification

statuse3

100.0

20.3

15.6

64.1

Medicaid only

Both 18 #

Medicare Skilled lnterand

Medicaidl Total nur:;$ “’::y

facility

100.0 I 100.011 100.0 I 100.0

Numberof homes . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Numberofbeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Numberofadmissions . . . . . . . . . . . . . . . . . . . . . . . . .

Numberofdischarges . . . . . . . . . . . . . . . . . . . . . . . . . .

Numberofdeaths . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Average dailycensus . . . . . . . . . . . . . . . . . . . . . . . . . .

Average bedside.......,.. . . . . . . . . . . . . . . . . . . .

15,700

1,174,800

1,110,900

1,077,600

327,400

1,007,900

75

Not

certified

100.0

16.4

15.1

68.3

Table 19. Selected characteristics ofnursing homes, bycetiification status: United States, l973-74

Medicaid only

Al I Both

Item certifi- Medicare Skilled lntercation and Total nursing mediate

statuses Medicaidl home2 care

facility

4.200

441,000

624,200

599,300

150,500

372,400

105

7,900

572,800

388,500

363,000

122,400

493,900

73

3,500

320,500

223,600

209,400

70,600

270,200

92

4,400

252,300

164,900

153,600

51,800

223,600

57

Not

certified

3,600

161,000

98,200

116,300

54,500

141,700

46

1s Percent of these homes were certified for Medicare OnlY.

235 percent of these homes \verecertified m~SNHand IcF.

NOTE: Figures maynotadd tototals due to rounding.,

16
APPENDIXES

I.

IL

IrL

Iv.

I.

II.

L

II.

III.

IV.

CONTENTS

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

Survey Design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

General Qualifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

RelfabflityofEstimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DefinitionsofCertainTermsUsedinThkReport . . . . . . . . . . . . . . . . . . . . . . . . .

QuestionnairesUsedinthel973-74NationalNumingHomeSurvey . . . . . . . . . . . . . . .

Criteria for Uassifying Nwting Homes According to Level of Nwting Cme . . . . . . . . . . . .

LIST OF APPENDIX FIGURES

Relative standard errors for estimated nmnher of admissions, discharges, beds, and establishmerits, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Relative standard error for estimated number of resident days . . . . . . . . . . . . . . . . . .

LIST OF APPENDIX TABLES

Distribution of homes in the 1973-74 National Nursing Home Survey universe and disposition of

sampk homes according to primary sampling strata (certification status and size of home):

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

Standard errors of percentages for establishments . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Standard errors ofpercentages for beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

18

18

21

21

27

29

70

22

23

19

24

25

Standard errors of percentages for admissions and dkcharges . . . . . . . . . . . . . . . . . . . 26

17

s
APPENDIX I

TECHNICAL NOTES ON METHODS

SURVEY DESIGN

General

From August 1973 to April 1974, the Division of

Health Resources Utilization Statistics (DHRUS) conduqted the National Nursing Home Survey (NNHS)-a

sample survey of nursing homes, their residents and

staff in the conterminous United States. The survey

was designed and developed by the DHRUS in conjunction with a group of experts in various fields encompassing the broad area of long-term care. 1 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 nuvsin.g care. (My homes

providing nursing care were included because detailed questions on facility services and resident health

status were relevant only to these facilities. These

homes included both nursing care homes and personal care with nursing homes, while personal care homes

and domiciliary care homes were excluded. Homes

were either freestanding establishments, or nursing

care units of hospitals, retirement centers, and similar

institutions. A definition of nursing care and detailed

criteria for classifying homes providing such care are

presented in appendix IV.

The survey universe consisted of two groups of

homes: those providing some level of nursing care as

classified in the 1971 hiaster Facility Inventory (hlFI)

and homes 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 MFI. The MF1 is a census of all inpatient

health facilities conducted every 2 years by mail by

the National Center for Health Statistics. A detailed

NOTE:The tistof referencesfollows the text.

description of how the MFI was developed, its content,

and procedures for updating and assessing its coverage

has been published. 2,3,4

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. (Homes opening in

early 1973 could not be included since data about them

were not yet available.) The homes which opened in

1972 comprised the second, and smaller (7 percent),

group of facilities in the universe. Although the universe included only homes providing nursing care, all

homes opened in 1972 were included because the level

of nursing care they provided was unknown prior to the

survey. Gnce the NNHS was conducted, facilities not

meeting the criteria were classified as out of scope

(see table I for details).

Although the NNHS was conducted in 1973-74, it

should be noted that estimates will not correspond

precisely to figures from the 1973 MFI census for

several reasons. In comparison to the MFI, the NNHS

universe excluded the following: 1) personal care homes

and domiciliary care homes; 2) homes which opened

in 1973; and 3) which, between 1971 and 1973, upgraded the level of care they provided, thereby meeting

the “nursing care” criteria when surveyed in the 1973

MFI. Data from the NNHS are also subject to sampling

variability, while data from the MFI are not, since the

MFI is a census.

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 IviFI were sorted into three

l.ypes of strata based on Medicare and h{edicaid certification: 1) Both Medicare and Medicaid and Medicare

only; 2) Medicaid only; and 3) Not Certified. Homes in

18
Table 1. DISTRIBUTIONOF HOMES IN THE 1973-74NATIONALNURSINGHOME SURVEYUNIVERSEAND DISPOSITION OF SAMPLE HOMESACCORDINGTU PRIMARYSAMPLING STRATA (CERTIFICATIONSTATUS AND SIZE OF

HOME): CONTEMINOUS UNITED STATES,1973-74

Certificationstatusand size

of borne

All types---------------------

Both Medicareand Medicaidand

Medicareonly------------------

Unknownbeds------------------------

Less than 25 beds-------------------

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

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

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

200-299beds------------------------

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

500 beds or more-----------:--------

Medicaidonly-------------------

Unknownbeds------------------------

Less than 15 beds-------------------

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

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

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

1oo-199beds------------------------

200-299beds------------------------

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

500 beds or more--------------------

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

Unknownbeds------------------------

Less then 15 beds-------------------

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

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

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

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

200-299beds------------------------

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

500 beds or more--------------------

Universe

(;&rn~nlg

17,685

4,099

143

538

1,713

1,385

224

68

20

7,473

25:

967

2,253

2,688

1,108

145

43

16

6,113

1,2+;

1,062

1,575

1,334

652

120

52

20

Numberof homes in sample

Total

homes

2,118

803

100

46

20

790

0

5

lx

293

241

52

::

28

20

out-ofscopeor

out of

business

In scope and

in business

Nonresponding

63

26

0

1

+

11

3

2

1

24

0

2

13

0

0

0

3

2

0

1

0

Responding

1,908

757

732

281

232

44

20

14

116

31

23

15

1

The universeconsistedof nursinghomes providingsome levelof nursingcare as classifiedin

the 1971MFI end hones opened for businessin 1972.

each of thesethreestratawere sortedintobedsize

grou~s,producing26primarystrataasshownintable1.

The nureinghomes intheuniversewere orderedby

typeofownership,geographicregion,State,andcounty.

The samplewas thenselectedsystematically aftera

random startwithineach primarystratum.Table1

showsthedistribution ofestablishments inthesampling

frameand thefinaldispositionofthesamplewithregardtoresponseand in-scopeetatus.The numberof

homes estimated bythesurvey (15,749) is lessthan the

NOTE:Thefistof referencesfollowsthe text.

universe figure (17,685)becausesome homes wentout

ofbueinessor outofecopebetweenthetimetheuniverse was “frozen”and the survey was conducted.

Differences ranging from 2,100-2,900 between survey

estimates and universe figures occurred inthe 1963,5

1964,6 and 19697 nursing home surveys for the same

reason.

The second-stage selection of residents snd employees was carried out by the interviewers atthe time

of their visite to the establishments in accordancewith

specific instructions given for each eample establishment. The sample frame for residents was the total

19
number of residents on the register of the establishment on the evening prior to the day of the survey.

Residents whowere physically absent from the facility

due to overnight leave orahospital visit buthad abed

maintained for them at the establishment were included

in th~ sample frame. An average of 10 residents were

in the sample per home.

The sampling frame for employees was tbe Staff

Control Record (see appendix III) on which the interviewer listed the namea of all staff (including those

employed by contract) and sampled professional, semiprofessional, and nursing staff. Those generally not

involved in direct patient care, such as office staff,

food service, housekeeping, and maintenance personnel

were excluded from the sample. The interviewer used

predesignated sampling instructions that appeared at the

head of each column of this form. An average of 14 staff

were in the sample per home.

Data Collection Procedures for 1973-74

National Nursing Home Survey

The 1973-74 NNHS utilized eight questionnaires

(see appendix 111for copies):

Administrator Letter and Worksheet

Facility Questionnaire

Expense Questionnaire

Resident Control Record

Resident Questionnaire

Staff Questionnaire— Parts I and II

Staff Control Record

Data was collected according to the following

procedure:

1. A letter was sent to the administrators of

sample homes informing them of the survey

and the fact that an interviewer would contact

them for an appointment. On the back of the

letter was a worksheet which the 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 admission and

discharges, inpatient days of care, etc.). Included with this introductory letter were letters

of endorsement from the American Nursing

Home Association and the American Association of Homes for the Aging urging the administrators to participate in the survey (see

appendix 111for copies).

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 followin~

procedures were followed: The Facility Questionnaire was completed by the interviewer

who interviewed the administrator or owner

of the home. After completing this form, the

interviewer secured the administrator’s permission to send the Expense Questionnaire to

the facility’s accountant. (If financial records

were not kept by an outside firm, the Expense

Questionnaire was filled 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 and requested the return

of the form.

The following table presents a summary of the data

collection pr~cedure~:

Quest ionnaire

Facili.t y

Expense

Resident

Staff

Respondent

Administrator

Facility’s

accountant

Member of nursing staff familiar with care

provided to the

resident / res ident’ s medical

records (10 sampled residents

per facility)

sampled staff

member (14 per

facility)

Interview

s ituat ion

Personal

interview

Self-enumerated

questionnaire

Personal

interview

Self-enumerated

questionnaire

20
GENERAL QUALIFICATIONS

Nonresponse and Imputation

of Missing L)ata

Response rates differed foreach type of question.

naire as indicated beIow:

Questionnaire Resfionse 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 home

to respond. Data wt?ke also adjusted for nonresponse

which resulted from failure to complete one of the

questionnaires (expense, resident, staff) or from failure to complete an item on a questionnaire. Those

items left unanswered on a partially completed questionnaire (facility, expense, resident, staff) were generally imputed by assigning a value from a responding

unit with major characteristics identical to those of

the nonresponding unit.

Rounding of Numbers

Estimates of homes, residents, resident days, and

beds 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 followups

for missing and inconsistent data, some manual editing

of the quewionnaires, extensive editing as conducted

by computer to assure that all reeponses were accurate,

consistent, logical, and complete. Once tbe data base

was edited, the computer was used to calculate and

assign weights, ratio adjustments, recodes, and other

related procedures necessary to produce national esti -

mates from the sample data.

Estimation Procedures

Statistics reported in this publication are derived

by a ratio estimating procedure. The purpose of ratio

estimation is to take into account all relevant information in the estimation process, thereby reducing

the variability of the estimate. The estimation of number of establishments and establishment data not related to size are inflated by the reciprocal of the probability of selecting the sample establishment and adjusted for the nonresponding establishments within

primary certification-size strata. Two ratio adjustments, one at each stage of selection, were also used

in the estimation process. The first-stage ratio adjustment (along with the above inflation factors) was

included in the estimation of establishment data related to size, resident data, and staff data for all primary certification- size strata from which a sample of

homes was drawn. The numerator was the total beds

according to the Master Facility Inventory data for

all homes in the stratum. The denominator was the

estimate of the total beds obtained through a simple

inflation of the Master Facility Inventory data for the

sample homes in the stratum. The effect of the firststage ratio adjustment was to bring the sample in

closer agreement with the known universe of beds.

The second-stage ratio adjustment was included in the

estimation of resident and staff data within establishments. The second-stage ratio adjustment is the product of two fractions: the first is the inverse of the

sampling fraction for residents (or staff) upon which

the selection is basec$ the second is the ratio of the

number of sample residents (or staff) in the establishment to the number of residents (or staff) for whom

questionnaires were completed within the home.

RELIABILITY OF ESTIMATES

As in any survey, the results are subject to reporting and processing errors and errors due to nonresponse. To the extent possible, these types of errors

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.

21
The relative standard error of an estimate is

the standard error of the estimate divided 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, curve B of figure I shows the relative

standard errors for the estimated number of

beds. For a relative standard error of 25 percent

or less, the minimum number of beds is 7,000.

Thus bed estimates must be 7,000 or larger in

order to meet the standards of reliability.

Similarly, in figure I the estimates of number of

homes must be 180 or larger in order to have a

relative standard error of 25 percent or less.

(The relative standard error for estimated

number of resident days is shown in figure II.)

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. Both values can be determined from the

curve in figure I. For example, table 19 shows

Iw

::

70

60

50

40

30

.5

.4

.3

.2

.1

that the total number of beds in all noncertified

homes was 161,000. The relative standard error

corresponding to this estimate on curve B is

approximately 4.8 percent. The stmdard error is

161,000 X 0.048 = 7,728.

The chances are about 68 out of 100 that an

estimate from the sample differs from the value

which would be obtained from a complete

census by less than the standard error. The

chances are about 95 out of 100 that the

difference is less than twice the standard error

and about 99 out of 100 that it is less than 2?42

times as large. For example, it was found that

about 5.20 percent of all certified homes had no

attending physician. The chances are 95 out of

100 that the true value is contained in the

interval 5.20 t 2,0 (0.70) (i.e., between 3.80 and

6.60), and 99 out of 100 for the interval

5.2 * 2.5 (0.70) (i.e., between 3.45 and 6.95).

Statistical tests to determine whether the

differences between selected characteristics in

the classification breakdowns are statistically

significant can be implemented by cornpming

5

t B: Beds

bents

A

2

100 1,000 10,000 100,000 1,000,000

SIZE OF ESTIMATE

3 45678Q

Figure [. Relative standard errors for estimated numbers of admissions, discharges, beds,ande~tabli~hments

22
30 \ I I I I I I I I

I I NI 1111

20

100

90

86

70

60

50

All

9

8

7

6

5

4

3

2

1

,6

.5

.4

.3

.2

.1J I I 11111]111111 Ill

A A a

23 456789 2 3 456789 2 3 456

1 10 10

SIZE OF ESTIMATE (in millions)

Figure 11. Relative standard arror for estimated number of resident days

the confidence intervals for the estimates in this interval does not overlap with

question. If there is no overlapping of the

confidence intervals, the estimates are considered statistically different. For example, the

percent of noncertified homes having no attending physician was 11.80, and the approximate

standard error of this is 1.79. The chances are 95

out of 100 (the 95-percent confidence interval)

that the true value being estimated is contained

in the interval between 8.22 and 15.38. Since

;:0

- 80

- 70

- 69

- 50

- 40

- 30

- 20

- 10

- 9

- 8

- 7

- 6

- 5

- 4

- 3

- 2

- 1

- .9

: .8

: .7

- ,6

- - .5

- .4

- .3

- .2

. J

789

10

the 95-

percent confidence interval of the certified

homes (3.45-6.95, as obtained above), the difference between the noncertified homes and the

certified homes that had no attending physician

is considered statistically significant in this

report.

Tables II, III, and IV give the standard errok

of percentages for establishments, beds, and

admissions and discharges.

23
Table 11. Standard errors of percentages for establishments

Base of estimated percent

(number Of establishments)

100 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

200 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

300 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

400 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

500 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

600 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

700 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

800 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

900 . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

20,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

Estimated percent

1 or 99 2 or 98 5 or 95 100r90 20 or 80 30 or 70 40 or 60 50

Standard error in percentage points

3.33

2.36

1.93

1.67

1.49

1.36

1.26

1.18

1.11

1.05

0.75

0.61

0.53

0.47

0.43

0.40

0.37

0.35

0.33

0.24

4.69

3.32

2.71

2.35

2.10

1.92

1.77

1.66

1.56

1.46

1.05

0.86

0.74

0.66

0.61

0.56

0.52

0.49

0.47

0.33

7.30

5.16

4.22

3.65

3.27

2.98

2.76

2.58

2.43

2.31

1.63

1.33

1.15

1.03

0.94

0.87

0.82

0.77

0.73

0.52

10.05

7.11

5.80

5.03

4.50

4.10

3.80

3.55

3.35

3.18

2.25

1.84

1.59

1.42

1.30

1.20

1.12

1.06

1.01

0.71

13.41

9.46

7.74

6.70

6.00

5.47

5.07

4.74

4.47

4.24

3.00

2.45

2.12

1.90

1.73

1.60

1.50

1.41

1.34

0.95

15.36

10.86

8.67

7.68

6.87

6.27

5.80

5.43

5.12

4.86

3.43

2.80

2.43

2.17

1.96

1.84

1.72

1.62

1.54

1.09

16.42

11.61

9.48

8.21

7.34

6.70

6.21

5.80

5.47

5.19

3.67

3.00

2.60

2.32

2.12

1.96

1.84

1.73

1.64

1.16

16.76

11.85

9.67

6.38

7.49

6.84

6.33

5.92

5.59

5.30

3.75

3.06

2.65

2.37

2.16

2.00

1.87

1.77

1.68

1.18

//hrstration of use of table //: Itwas notad in the text that 23 percent (3,600) of the estimated 15,700 nursing homes in the United

States were not certifiad for either Medicare or Medicaid. Linear interpolation between values shown in table II will vield an

approximate standard error Of 1.17 percent for an estimate of 23 percent with a base of 15,7oO.

24
Table I I 1. Standard errors of percentages for beds

Base of estimated percent

(numbar of beds)

7,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9,000 . . . . . . . . . . . . . . . . . . . . . . . . . . . .

10,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

20,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

30,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

40,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

50,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

60,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

70,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

80,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

90,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

100,000 . . ’ . . . . . . . . . . . . . . . . . . . . . . .

200,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

300,000, . . . . . . . . . . . . . . . . . . . . . . . . .

400,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

500,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

600,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

700,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

800,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

900,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

1,000,000 . . . . . . . . . . . . . . . . . . . . . . . . .

2,000,000 . . . . . . . . . . . . . . . . . . . . . . . . .

Estimated percent

1 or 99 2 or 98 5 or 95 100r90 20 or 80 30 or 70 40 or 60 50

2.46

2.30

2.17

2.06

1.46

1.19

1.03

0.92

0.84

0.78

0.73

0.69

0.65

0.46

0.38

0.33

0.29

0.27

0.25

0.23

0.22

0.21

0.15

3.47

3.24

3.06

2.90

2.05

1.67

1.45

1.30

1.18

1.10

1.02

0.97

0.92

0.65

0.53

0.46

0.41

0.37

0.35

0.32

0.31

0.29

0.20

Standard error in

5.39

5.05

4.76

4.51

3.19

2.61

2.26

2.02

1.84

1.71

1.60

1.50

1.43

1.01

0.82

0.71

0.64

0.58

0.54

0.50

0.48

0.45

0.32

7.43

6.95

6.55

6.21

4.39

3.59

3.11

2.79

2.54

2.35

2.20

2.07

1.96

1.39

1.13

0.98

0.88

0.80

0.74

0.69

0.65

0.62

0.44

:rcentage

9.90

9.26

8.73

8.28

5.86

4.78

4.14

3.70

3.38

3.13

2.93

2.76

2.62

1.85

1.51

1.31

1.17

1.07

0.99

0.93

0.87

0.83

0.59

ints

11.34

10.61

10.00

9.49

6.71

5.48

4.74

4.24

3.87

3.59

3.36

3.16

3.00

2.12

1.73

1.50

1.34

1.23

1.13

1.06

1.00

0.95

0.67

12.13

11.34

10.69

10.15

7.17

5.86

5.07

4.54

4.14

3.83

3.59

3.38

3.21

2.27

1.85

1.60

1.43

1.31

1.21

1.13

1.07

1.01

0.72

12.38

11.58

10.91

10.35

7.32

5.98

5.18

4.63

4.23

3.91

3.66

3.45

3.27

2.32

1.89

1.64

1.46

1.34

1.24

1.16

1.09

1.04

0.73

Illustration of use of tab/e ///: Table 19 shows that of the 1,174,800 total beds, 252,300 (21.5 nercent) ware in homes. certified as

interrnadiate cera facilites. Linear interpolation between values shown in table III will yield ‘an approximate standard arror of 0.81

percent (about 9,500 bads) for an estimate of 21.5 percent with a base of 1,174,800.

25
Table IV. Standard errors of percentages for admissions and discharges

Base of estimated percent

(number of admissions and discharges)

10,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

20,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

30,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

40,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

50,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

60,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

70,000. . . . . . . . . . . . . . . . . . . . . . . . . . .

80,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

90,000 . . . . . . . . . . . . . . . . . . . . . . . . . . .

100,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

200,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

300,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

400,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

500,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

600,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

700,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

800,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

800,000 . . . . . . . . . . . . . . . . . . . . . . . . . .

1,000,000 . . . . . . . . . . . . . . . . . . . . . . . . .

2,000,000 . . . . . . . . . . . . . . . . . . . . . . . . .

Estimatad percent

1 or 99 2 or 98 5 or 95 100r90 20 or 80 30 or 70 40 or 60 50

Standard error in percentage points

2.87

2.03

1.66

1.44

1.28

1.17

1.09

1.02

0.96

0.91

0.64

0.52

0.45

0.41

0.37

0.34

0.32

0.30

0.29

0.20

4.04

2.86

2.33

2.02

1.81

1.65

1.53

1.43

1.35

1.28

0.90

0.74

0.64

0.57

0.52

0.48

0.45

0.43

0.40

0.29

6.29

4.45

3.63

3.15

2.81

2.57

2.38

2.22

2.10

1.99

1.41

1.15

0.99

0.89

0.81

0.75

0.70

0.66

0.63

0.44

8.66

6,13

5.00

4.33

3.87

3.54

3.27

3.06

2.89

2.74

1.94

1.58

1.37

1.23

1.12

1.04

0.97

0.91

0.87

0.61

11.55

8.17

6.67

5.77

5.17

4.72

4.37

4.08

3.85

3.65

2.58

2.11

1.83

1.63

1.49

1.38

1.29

1.22

1.15

0.82

13.23

9.36

7.64

6.62

5.92

5.40

5.00

4.68

4.41

4.18

2.96

2.42

2.09

1.87

1.71

1.58

1.48

1.39

1.32

0.94

14.15

10.00

8.17

7.07

6.33

5.77

5.35

5.00

4.72

4.47

3.16

2.58

2.24

2.00

1.83

1.69

1.58

1.49

1.41

1.00

14.44

10,21

8.34

7.22

6.46

5.89

5.46

5.10

4.81

4.57

3.23

2.64

2.28

2.04

1.86

1.73

1.61

1.52

1.44

1.02

///ustratiofs of use of tab/e W: Table 19 shows that of the 1,110,900 admissions, 98,200 (8.8 percent) were in noncertified homes.

Linear interpolation between values shown in table IV will vield an armroximate standard error of 0.78 percent (about 8,700 admissions)

~r an estimate of 8.8 percent with a base of 1,110,900. “

26
APPENDIX II

DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT

Terms Relating to Facilities

or Residents

Nursing home. —This term refers to all institutions that were within the scope of the 1973-74 Nursing

Home Survey (see appendix IV).

Type of ownershi~--- Facilities are classified by

type of ownership as follows:

Propviekwy home. —A facility operated under

private commercial ownership.

Nonprofit home.— For the purposes of the report

this could be a nonproprietary or a government

home. A nonproprietary home is operated under

voluntary or nonprofit auspices, including both

church-related and other nonprofit homes. A government home is operated under Federal, State,

or local government auspices.

Resident.—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.

Charge. —The charge made by the establishment

itself. It does not include charges which are not part

of the bill rendered by the institution such as those

for services of physicians.

Bed.— One set up and regularly maintained for

patients or residents. Beds maintained for staff and

beds used exclusively for emergency services are

excluded.

Terms Relating to Employees

Employee. —This term refers to any person who

was on the staff of tbe facility or was employed under

contract. It includes any paid worker, proprietor, or

member of a religious order who contributes his

services.

Full- time. —Employees who worked 35 hours or

more in the week prior to the survey are designated

“full-time.”

Part- time. —Employees who worked less than 35

hours in the week prior to the survey are designated

“part-t ime.”

Full-time equicaknt. —For the purposes of the

report, 35 hours of “part-time’ r employees’ work per

week are counted as equivalent to one “full-time”

employee.

Geographic Terms

Classification of homes by geographic area is

provided by grouping the States into regions. These

regions correspond to those used by the U.S. Bureau

of the Census and are as follows:

Region Stutes Included

Northeast ------- Maine, New Hampshire, Vermont,

Massachusetts, Rhode Island,

Connecticut, New York, New Jersey,

Pennsylvania

North Central --- Michigan, Ohio, Illinois, Indiana,

Wisconsin, Minnesota, Iowa,

Missouri, North Dakota, South

Dakota, Nebraska, Kansas

South ----------- Delaware, Maryland, District of

Columbia, Virginia, West Virginia,

North Carolina, South Carolina,

Georgia, Florida, Kentucky,

Tennessee, Alabama, Mississippi,

Arkansas, Louisana, Oklahoma,

Texas

West ---------- Montana, Idaho, Wyoming, Colorado,

New Mexico, Arizona, Utah, Nevada,

Washington, Oregon, California,

Hawaii, Alaska

Coverage of Financial Data

The financial data collected were not designed nor

are they adequate to provide a direct comparison be27
tween costs and revenues of nursing home operations.

The resident charge and establishment cost data were

collected for different time periods. Resident charge

data were collected for the period August 1973-April

1974 by recording for the sampled residents the amount

charged for their care for the month prior to the survey. The cost data are generally kept by the facilities

on a calendar year basis and were collected for 1972,

the most recently completed year at the time of the

survey. Facilities which used only a fiscal year basis

of accounting were asked to report their cost data for

the most recently completed fiscal year.

The total charge data were collected only for those

sample residents who had been in the facility for at

least one full month and included all charges for lodging,

meals, nursing care, medical supplies, and special

services. The charge data are not equal to the facility

revenue for several reasons. In the instances where

charges were made but not collected, the facilit y’s

actual revenues from patient services rendered do not

equal charges for those services. A facility’s total

charges as collected also differ from its revenues in

that the charge data do not account for the amount of

contributions, grants, or subsidies received for general operating purposes from voluntary agencies,

foundations, governmental agencies, and similar groups.

Other sources of revenue which are not reflected ir

the charge data are income from investments (interest

and dividends), services not directly related to patient

care, and capital gains on the sale of equipment or

other tangible assets.

The cost data were collected according to the

following major components:

Labor costs — wages and fringe benefits for staff

members and contract employees.

Fixed costs—equipment, building and land rentals,

insurance, taxes, licenses, interest, financing and

depreciation charges, and amortization of leasehold improvements.

Opera ting costs — expenses for food, drugs, supplies, equipment, laundry, linen, utilities, buildings

and grounds maintenance, and contractual arrangements for laboratory, professional, and household

services.

Miscellaneous costs —dues, subscriptions, travel,

advertising, and other expenses,

Excluded from costs are any losses sustained in

the sale or disposition of fixed assets and other extraordinary losses or costs not related to the current

cost of providing health care. To the extent that homes

do not charge patients the full value of donated goods

and services which are used for patient care, revenues

from patient care will be smaller than they could be.

Hence, they are not comparable to the collected cost

data which include an estimate of the market value of

donated goods and services.

000

28
APPENDIX Ill

QUESTIONNAIRES USED IN THE

1973-74 NATIONAL NURSING HOME SURVEY

@

.,,M cur

(:{p“= DEPARTMENT OF HEALTH. EDUCATION, AND WELFARE

,*’ PUBLIC HEALTH SERVICE 0,s.

HEALTH RESOURCES ADMINISTRATION

ROCKVILLE, MARYLAND 20S52

NATIONAL CENTER 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 two summary reports from previous

surveys, which are illustrative of the kinds of data to be obtained

from this survey. These statistics will be used to meet the needs of

Congress, State legislatures, Federal, regional, and local health

planners, national health associations, and man y others who plan and

provide health services to the aged.

As you can see from these reports, it is not possible to identify any

particular facility. We wish to as sure you that any information which

permits the identification of the services provided by your facility,

or the residents and staff will be held strictly confidential. This

information will be used only by persons engaged i.n and for the purposes

of the survey, and will not be disclosed or released to others for any

purpose. Because the NCHS is committed to provide a factual basis for

planning national programs designed to advance the health of the American

people, limited basic information about your facility (such as name,

address, size, type, and ownership) will be made available upon request

to the NCHS.

Within about one week an interviewer will contact you for an appointment;

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

29
from your records. I have enclosed them so that you may do this at

your convenience prior to the interviewer’s visit.

This survey includes a small, carefully selected nationwide sample of

nursing homes and similar facilities. Because this ntirsing home 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,

Edward B. Perrin, Ph. D.

Acting Director

30
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 Month Year

● HOW MANY PERSONS WERE ADMITTED TO THIS FACILITY DURING 1972?

Admissions

● HOW MANY PERSONS WERE DISCHARGED FROM THIS FACILITY DURING 1972, EXCLUDING DEATHS?

Dlsahqat

● HOW MANY PERSONS DIED DURING 1972 WHILE RESIDENTS OR PATIENTS OF THIS FACILITY?

Daaths

● 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

s HOW MANY ROOMS FOR RESIDENTS DOES THIS FACILITY HAVE THAT CONTAIN:

a. 1 bad only Q None

b. 2 beds ❑ No”.

c, 3 beds ❑ None

d. 4 or more beds ❑ None

RETAIN THIS FORM AND DATA FOR THE INTERVIEWER TO COLLECT.

31
#$%&

American ~4 0 Nursing Home

‘G++! Association

1200 15th street, N.W./Washington, D.C. 20W5 Phone: (202) 833-205$)

Dear Administrator:

I am writing to urge your participation in the 1973 Nursing Home

Survey. The National Center for Health Statistics has invested

over a year in developing this study which will collect national

data on services, basic costs, staff, and residents in nursing

homes.

The support of our association and of all nursing home administrators is indispensable to the successful inauguration of this

research which will provide invaluable data for planning and

organizing health care of the aged, drafting health legislation,

and setting national policies and priorities to obtain quality

care for all nursing home residents.

I believe you will find the survey design maximizes the utility

of the data collected while it attempts to minimize the amount

of staff involvement. In addition, strict confidentiality

provisions are to be maintained. Only summary data will be

published and made available to health planners, researchers,

health professionals, and the public.

I am confident that the information derived will be well worth

the initial investment of your time and effort as it will ultimately result in increased quality of care for all nursing home

residents.

Again may I urge your cooperation with the Survey. Its success

will provide us in the nursing home field with much needed and,

hitherto, unavailable data in this rapidly expanding segment of

the health care industry.

Sincerely,

DON T. BARRY “

Association President

3TB:lb

32
AMERICAN ASSOCIATION OF HOMES FOR THE AGING

374 NaI!onal Press Budding 14th & F Streets, N.W,, Washington, D.C 20004

The national orgamzat,on of NONPROFIT HOMES Telephone (202) 347-2000

%iiiGk

Dear Administrator:

The National Center for Health Statistics has requested the

cooperation of AAHA homes in connection with its 1973 Nursing Home

Survey. Because I believe this survey will provide HEW with information which will enable the Department to improve national policy with

respect to long term care, I am writing to urge your participation.

The atudy will collect national data on services, costs, staff,

and residents in nursing homes. The data will then be used for planning and organizing health care of the aged, drafting health legislation, and setting national policies and priorities to obtain quality

care for all nursing home residents.

Strict confidentiality provisions are to be maintained by the

Center. Only sununarydata will be published and made available to

health planners, researchers, health professionals, and the public.

Although I recognize the amount of time which will be required

to complete the survey questionnaire is substantial, I believe the

information derived will be worth the investment of your time, as it

will ultimately be used in an effort to improve long term care. Also,

I believe it is tiportant to have the nonprofit point of view represented in public policy. Failure to participate on the part of nonprofit homes could result in the making of public policy without our

input.

I therefore again urge your cooperation with this Survey.

Sincerely,

%-

T

Eugene Hackler, President

American Association of Homes for the Aging

33
FACILITY QUESTIONNAIRE

1973 Nursing Home Survey

National Center for Health Statistics

~

Health Resources Administration

Rockville, Maryland

Name and address label

TELEPHONE NUMBER

Area Code Number

ccl-1 CC2 cdl-l CC12

CC24 CC27

SECTION A - FACILITY INFORMATION

1.a.

2a.

Is THE CORRECT

(name of facility on label)

Correct Name of Facility if Different from Above

NAME FOR YOUR FACILITY? /

34-1 ❑ yes

/“ ‘

[

Number Street P.O. BOX, Rout*,

-2 •1 IKI+ b. WHAT IS THE CORRECT NAME?

●tc,

Is THE CORRECT City or Town County

(addresc cm label)

MAILING ADDRESS FOR YOUR FACILITY?

A -

State

35-1 ❑ yes

Zip Code

-2 •1 rw -- b. WHAT IS THE ENTIRE CORRECT

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.)

36-1 ❑ a. Nursing home (includes Medicare certified Extended Care Facilities and Medicaid certif icd Skilled Nursing Homes)

-2 ❑ b. Intermediate care facility (includes Medicaid certifiwl Intwmedlate Care Facilities)

-3 •1 c. Convalescent or rest home

-4 ❑ d. Home for the aged

{

-5 •1 e. Extended care unit of a hospital

r

6nf. Nursing care unit of a retirement center

-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) only one box.)

3S,39 -23 ❑ e.

-24 ❑ b.

-25 ❑ C.

-~ ❑ d.

-21 ❑ e.

-22 ❑ f.

-11 ❑ g.

-12 ❑ h.

-13 ❑ i.

-14 ❑ j.

-15 ❑ k.

-16 ❑ 1.

-17 ❑ m.

-18 ❑ n.

-19 ❑ 0.

Form 73N HS-1

34

Individual

)

Partnership

I

/

4.b. IS THIS HOME A MEMBER OF A GROUP OF HOMES OPERATING

UNDER ONE GENERAL AUTHORITY OR GENERAL OWNERSHIP?

Corporation

40-1 ❑ yes

Church related

-2 ❑ nO

Nonprofit cor~ration

J

Other nonprofit ownership

State

Count y

City

Cit y~ount y

Hospital Oistricc

U.S. Public Health Sewice

Armed Forces

Veterans Administration

Other Federal Agency -- Specify 41-
5. DOES YOUR FACILITY ACCEPT: IMark (X) only onebox.)

44-1 ❑ Malesonly?

-2 ❑ Femalesonly?

‘3 ❑ Both malesandfemales?

6,a. DOES YOUR FACILITY ACCEPT PERSONS OF ALL AGES, INCLUDING INFANTS AND CHILDREN?

45-1 ❑ Yes (Skipto Question7]

~ b. WHAT IS THE MINIMUM AGE ACCEPTED? D No minim.m weor _ yrs.

CC46,4?

c. WHAT IS THE MAXIMUM AGE ACCEPTED? ❑ No rnaxinwmageor yrs.

CC4B,49

7. WHAT IS THE TOTAL NUMBER OF BEDS REGULARLY MAINTAINED FOR RESIDENTS? (INCLUDE ALL BEDS SETUP

AND STAFFED FOR USE WHETHER OR NOT THEY ARE IN USE BY RESIDENTS AT THE PRESENT TIME. DO=

INCLUDE BEDS USED BY STAFF OR OWNERS OR BEDS USED EXCLUSIVELY FOR EMERGENCY PURPOSES, SOLELY

DAY CARE, OR SOLELY NIGHT CARE.)

Total beds

CC50

6,a. WAS lncnt AN IIULKEFWE Uri utL, nt/’mE IN I I-It IUII+L Ivuwlt$tn UF L-Jtub Uunllvo t Ht IJWl YtAnf

.FO,rm - . . . ,.,------- - - .--,------- .., -,-,,------ ., .,, ,----- -- ---- -,, -,.,--,, - , . . . . .. . . .

54-2

.1

❑ No (Skipto Question9)

%

Yes

b. Increawof

CC55

c. Decreaseof

CC58

beds

beds

9a. 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) !&led ❑ Noneor

CC65

(2) Females? ❑ Noneor

c&9

CARD 2

ccl 1.2

10,a. IS THIS FACILITY PARTICIPATING IN THE MEDICARE (TITLE XVIII) PROGRAM?

(

b. WHAT IS THE PROVIDER NUMBER?

I

ccl 3

❑ No pmwder f?g,ven

12.1 ❑ Yes~ c. HOW MANY BEDS ARE CERTIFIEO FOR MEDICARE?

\

bads

CC19

d. HOW MANY OF THESE CERTIFIED BEDS WERE OCCUPIED BY MEDICARE

PATIENTS LAST NIGHT?

( DNOIWOrcc,, beds

‘2 ❑ No (Skip to Question1I )

Form 73N HS-1

35
11.a. IS THIS FACILITY PARTICIPATING IN THE MEDtCAID (TITLE XIX) PROGRAM?

/

❑ Yes ❑ No (Skip to Question 12)

29-1 -2

b.(1) DOES IT HAVE ANY SKILLED NURSING BEDS?

❑ No ❑ Yes— b.(2)

30-2 -1

/:

b.(3)

b.(4)

WHAT IS THE PROVIDER NUMBER?

CS31 ❑ No provider # given

HOW MANY BEDS ARE CERTIFIED AS SKILLED NURSING BEDS?

❑ Nom or beds

CC44

HOW MANY OF THESE CERTIFIED BEDS WERE

OCCUPIED BY MEDICAID PATIENTS LAST NIGHT?

❑ None or beds

CC46

C:(1) DOES IT HAVE ANY INTERMEDIATE CARE BEDS?

❑ No ❑ Ym~

52-2

c.(2) WHAT IS THE PROVIDER NUMBER?

-1

/1

CC53 ❑ No provider # given

c,(3) HOW MANY BEDS ARE CERTIFIED AS INTERMEDIATE CARE BEDS?

❑ None or beds

CC66

c.(4) HOW MANY OF THESE CERTIFIED BEDS WERE

OCCUPIED BY MEDICAID PATI ENTS LAST NIGHT?

❑ No”. or ==70 beds

SECTION B - CLASSIFICATION INFORMATION (CONFIDENTIAL)

ASSURANCE OF CONFIDENTIALITY - All information which would permit identification of the individual facility will be held in

strict confidence, will be used only by persons engaged in and for the purposes of the survey, and will not be disclosed or

released to others for any purposes.

12.a, WAS THIS BUILDING ORIGINALLY CONSTRUCTED FOR USE AS A NURSING HOME, REST HOME, CONVALESCENT

HOME, HOME FOR THE AGED?

CARD 3

ccl 1.3 ❑ Yes

r

❑ No

12-1 -2

(Skip to next page}

b, WHAT WAS THE ORIGINAL PURPOSE AND USE OF THIS BUILDING?

13-1 ❑

-2 •1

-3 •1

~cl

-5 •1

~cl

Private home (i.e., single family dwelling)

Duplex (2 to 4 units)

Apartment housa (5 or more units)

Hotal or motel

Hospital

Other (Spacify) 14-

(Mark (Xl only one b-ax.]

Form 73 NHS-1

36
Int*rvl*ww:

S- bmk of

Iattar to

●dmlnlttrator

for quamions

13 through 17.

THE FOLLOWING QUESTIONS ON ADMISSIONS AND DISCHARGES CONCERN CALENDAR YEAR 1972,

WHICH IS THE PERIOD OF JANUARY 1, 1972 THROUGH DECEMBER 31, 1972. IF YOUR ANSWERS TO

THESE QUESTIONS COVER A PERIOD OTHER THAN CALENDAR YEAR 1972, WHAT IS THIS OTHER TIME PERIOD~

From through

Month Year G Year

CC16,16 ccl 7,18 CC19,20 CC21,22

13. HOW MANY PERSONS WERE ADMITTED TO THIS FACILITY DURING 1972?

Admissions

ee23

14. HOW MANY PERSONS WERE DISCHARGED FROM THIS FACILITY DURING 1972, EXCLUDING DEATHS?

Dlecharges

0C27

15; HOW MANY PERSONS DIED DURING 1972 WHILE RESIDENTS OR PATIENTS OF THIS FACILITY?

Deaths

CC31

16. IN 1972, WHAT WERE THE TOTAL INPATIENT DAYS OF CARE PROVIDED? (THE SUM OF THE DAILY PATl ENT CENSUS

COUNT FROM 1/1/72 THROUGH 12/31 /72,)

Days a (mark (X) if estimated)

CC36 41-1

17. HOW MANY ROOMS FOR RESIDENTS DOES THIS FACILITY HAVE THAT CONTAIN:

a. ❑ None or 1 bad only

CC44

b. ❑ None or 2 beds

CC46

c. ❑ None or 3 beds

CC62

d, ❑ None or 4 or more beds

e&6

●16. 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.

Supervision over medications which may be self-administered

Medications snd treatments admlnlsterad in accordance with

physicians’ orders

Rub and massage

Help with tub bath or shower

Help with dressing

Help with correspondence or shopping

Help with walking or getting about

Help with sating

OR

60-1 ❑ Yes

61.1 ❑ Yes

62.1 ❑ Yes

63-1 0 Yes

64-1 ❑ Yes

65-1 ❑ Yes

66-1 ❑ Yes

67-1 D Yes

None of the above setvicesroutinely provided, room and 68-1 ❑ yes

board providad only

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

Form 73 NHS-1

37
●19. DURING THE PAST SEVEN DAYS, HOW MANY RESIDENTS RECEIVED EACH OF THE FOLLOWING SERVICES?

CARD 4

ccl 1-4

a. Nasal feeding

CC12

d. Catheterization

CC24

9. Oxygen therapy

CC36

j, Hypodermic injection

CC4S

b. B Iood pressure reading

CC16

e. Full bed-bath

cc28

h. Application of dressingor bandage CC40

k. Irrigation

CC62

c. Enema

f. 6owel or bladder

retraining

i. Tempxature-pulserespiration

1.IntravenousInjection

CC20

CC32

CC44

CC56

’20. DOES THIS FACILITY PROVIDE ANY OF THE FOLLOWING PROFESSIONAL REHABILITATION SERVICES ON THE

PREMISES? (THE THERAPISTS MUST BE LICENSED OR REGISTERED IN THEIR SPECIFIC PROFESSIONS.)

a. Physical therapy

b. Occupational therapy

c. Recreationaltherapy

d. Speech and hearing therapy

e. Counseling by social worker, psychologist, or mental health

worker

f. Other rehabilitation setvices (Specify)

w

60-1 ❑ Yas

61-1 ❑ Yes

62-1 ❑ Yes

63-1 ❑ Yes

64-1 ❑ Yes

65-1 ❑ Yes

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

21. DOES THIS FACILITY CONDUCT TRAINING PROGRAMS FOR PEOPLE NOT ON YOUR STAFF IN COOPERATION

WITH AN EDUCATIONAL INSTITUTION?

lJ Yes ~ No

67-1

22. WHAT ARE THE ACTUAL HOURS FOR EACH SHIFT? (Circle am or pm)

CARO 5

a. Oay shift from am

to

am

ccl 1-5 ccl 2 pm .x16 pm

b. Evening Shift from am to am ❑ No s“cll shift

CC20 pm CC24 pm

c. Night Shift from am to am D No such shift

CC26 pm CC32 pm

Form 73 NHS.I

38
23a. 1. FOR THE PAY SHIFT YESTERDAY, WAS THE PERSON IN CHARGE OF NURSING CARE (FOR THE ENTIRE

FACILITY): (Mark IX) Only One BOX)

WHAT IS THE LEVEL OF

SKILL OF THIS PERSON?

(Mark (X) Only One Box)

❑ 13egiatemx.1.IJrse

a.3. WHAT HOURS DID ~PERSON

WORK YESTERDAY? (Circle

am or pm.1

am am

from to —

CC41 pm CC46 m

❑ Licensed PracticalN.ma

❑ Nurse’sAide

❑ Otkr 40-

Specify Occupation

23,b. 1. FOR THE FV ENING SHIFT YESTEROAY, WAS THE PERSON IN CHARGE OF NURSING CARE (FOR THE ENTIRE

FACILITY): (Mark (X) Only One Box)

/

49-1 ON CALL -2

7

ON OUTY - that is awake, -3

9

NO SUCH SHIFT

dressed, and serving the o (Skip to Part 23.c.I

residents

I - b.2. WHAT IS THE LEVEL OF

SKI LLOFTHISPERSON?

(Mark (X) Only One Box)

60-1❑

-’ ❑

-3 •1

-40

Registered Nurse

Licensed Practical Nurse

Nurse’s Aide

Other

Specify Occupation

b.3.

from .

WHAT HOURS DIO THI PERSON

WORK YESTERDA + ? (Circle

am or pm.)

am am

to

CC52 pm CC66 pm

—5l23.c. 1. FOR THE NIGHT SHIFT YESTERDAY, WAS THE PERSON IN CHARGE OF NURSING CARE (FOR THE ENTIRE

FACILITY): (Mark (X) Only One Box)

w-f •l ON CALL -2 ❑ ON OUTY - that is awake, -3 ❑ NO SUCH SHIFT

/

L..’. dressed,and serving the

61-1

-2

-3

-4

h(Sk,p to Ouest,on 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.1

•1

•1

•1

•1

am am

Registered Nurse from to

cc63 pm &7 pm

Licensed Practical Nurss

Nurse’s Aide

Other 62-

Spaclfy 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 EMPLOYEO

UNDER CONTRACT.)

Physicians

CC71

Form 73 NHS-1

39
. ....

25a. WHAT TYPE OF STAFF MEMBER EXERCISES OAI LY, ON-DUTY SUPERVISION OVER ALL CLINICAL SERVICES

IN THIS FACILITY? (Mark (X) Only One Box.)

Administrator . . . . . . . . . 75-I @b. IS THE ADMINISTRATOR ALSO A:

. .

physician 76-1 ❑ Yes -2 •1 No

registered nurse 77-1 ❑ Yes -2 ❑ No

licena4 practical 78.1 ❑ Yes -2 ❑ No

nurse

Physician . . . . . . . . . ...75-2a

Ragisterad Nurse . . . . . . .

-3 •1

Other . . . . . . . . . . . . . . 4

7

Specify 78-

●26. DOES THIS FACILITY PROVIDE ANY OF THE FOLLOWING SERVICES TO PERSONS WHO ARE NOT RESIDENTS OF

THIS FACILITY?

a. Day care (services provided during tk day to persons who

CARO 6 do not sleep in the twine ovarnight. DaY care sewices can

CC1l.6 include nursing care, physical or occupational therapy,

recrmtioml activities, at least one full meal a day) . . . . . . 12-1 ❑ Yes -2 ❑ No

b. Meals either home delivered or in a group setting . . . . . . 13-1 ❑ Yes -2 ❑ No

c. Transportation andlor escort services. . . . . . . . . . . . . . 14-1 ❑ Yes -2 ❑ No

d. Homemaker or chore services . . . . . . . . . . . . . . . . 15-1 ❑ Yes -2 H No

e. Information andlor referral for health needs . . . . . . . . 16-1 ❑ Yes -2 ❑ No

f. Friecdly visiting . . . . . . . . . . . . . . . . . . . . . . . ...17-1 ❑ Yes -2 ❑ No

9. Daily telephone checking service . . . . . . . . . . . . . . . . 18-1 ❑ Yes -2 ❑ No

h. Arrangement or provision of recreational activities . . . . . . 19-1 ❑ Yes -2 ❑ No

i. Laundry swvice. . . . . . . . . . . . . . . . . . . . . . . ...20-1 l_J Yes -2 •1 No

i. Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...21-1

P

Yes -2 ❑ No

Specify 22-

27a. DOES THIS FACILITY KEEP A WAITING LIST OF PERSONS TO BE AOMITTED WHEN A BED BECOMES AVAILABLE?

/4?1 ‘es ❑ No (Skip to Question 28)

-2

b. HOW-MANY PEOPLE ARE ON THIS WAITING LIST?

❑ None or — w=ple

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?

a.

b.

c.

d,

e.

f.

9.

h.

i.

J.

Day care (awvices Wovided during the day to p.srsons who

do not sleep in ths home overnight. Day care services can

include nursing care, physical or occupational therapy,

recreational activities, at least one full meal a day). . . . . . 28-1 ❑

Meals either home delivered or in a group setting . , . . . .29-1 •1

Transportation and/or escort services , . . . . , . . . . . ...30-1 ❑

Homemaker w chore a?rvices . . . . . . . , . . . , . . . . 31-1 •1

Information amilor referral for health needs . . . . . . . . 32-1 •1

Friendly visiting . . . . . . . . . . . . . . . . . . . . . . .. 33.1 •1

Daily telephone checking service . . . . . . . . . . . . . . . . 34.1 •1

Arrangement or provision of recreational activities . . . . 35-1 •1

Laundry service . . . . . . . . . . . . . . . . . . . . . . . ...36-1

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...37-1

;

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

Yes

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

-2 ❑ No

Form 73 NHS-1

40
●28, DOES THIS FACILITY INCLUDE AS PART OF ITS BASIC CHARGE TO EACH RESIDENT THE CHARGES FOR:

Yes No

a, Phwician services . . . . . . . . . . . . . . . . . . . . . . . . 39-1 ❑ “2 ❑

b. Private duty nursing . . . . . . . . . . . . . . . . . . . ...40-1 •1 -2 •1

c, Other nursing service$ . . . . . . . . . . . . . . . . . . . ...41-1 ❑ -2 •1

d. Therapy, . . . . . . . . . . . . . . . . . . . . . . . . . . ...42-1 •1 “2 •1

e. Drugs . . . . . . . . . . . . . . . . . . . . . . . . . . . ...43-1 u “2 •1

f. Medic.alsupplies . . . . . . . . . . . . . . . . . . . . . ...44-1 •1 -2 •1

9. Specialdiet, . . . . . . . . . . . . . . . . . . . . . . . . ...45-1

h. Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46-1

; ;;

Specify - 47-

29. HASTHISNURSING HOMEBEENIN BUSINESSATTHISADDRESS FOR LESSTHAN TWOYEARS? (COUNT FROMTHE

TIMEITFIRSTOPENED ATTHISAODRESS ASANURSINGHOME EVENTHOUGHTHE OWNERSHIPORTHE SERVICES

OFFEREDMAYHAVE CHANGED.)

iYes

50-1

.,

Do Not Administer Expense Questionnaire

Form 73N HS-1

41
EXPENSE QUESTIONNAIRE

1973 Nursing Home Survey E!IE!l

Natmnal Center for Health Statlatics

Health Resources Administration

Rockville, Maryland

Dear Accountant:

The National Center for Health Statistics (NCHS) of the U. S. Public Health Service is conducting a

survey of all resident facilities providing nursing and personal care to obtain basic data on their operating

expenses, 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. These

statistics will be used to meet the needs of Congress, State legislatures, Federal, regional, and local

health planners, national health associations, and many others who plan and provide health services

to the aged.

This booklet contains the Expense Questionnaire, together with the account descriptions of the cost

categories included in the questionnaire. In addition, there is a full-time Certified Public Accountant

whose services are free of charge available via toll free telephone (800-638-0856) to answer your questions

about completing this questionnaire. However, we ask that you first attempt to complete the attached

questionnaire (which immediately follows in this booklet), using this instruction booklet. If you still have

questions, please use the free telephone contact (listed above) to acquire answers prior to completing

the questionnaire.

Please note at the bottom of this page that authorization is given for you to release the requested

information. We wish to assure you that any information which permits the identification of the

individual facility will be held in strict confidence, will be used only by persons engaged in and

for the purposes of the survey, and will not be disclosed or released to others for any purposes.

Please complete this questionnaire and return it in the enclosed postage-paid envelope within 5 working

days, Your cooperation in this survey will be greatly appreciated.

Sincerely yours,

Edward B. Perrin, Ph. D.

Acting Director

I hereby authorize of

(Accountant’s Name) (Accountant’s Address and Telephone)

{

❑ fiscal year

to Iist the ❑ 1972 Calendar year I

expenses in operating the

(Facility Name)

of

(Facility Address)

Date

(Signature) (Title)

Form 73N HS-2

42
INSTRUCTIONS FOR COMPLETING THE EXPENSE QUESTIONNAIRE

PLEASE READ THESE INSTRUCTIONS CAREFULLY BEFORE YOU BEGIN TO ANSWER

THE EXPENSE QUESTIONNAIRE WHICH IS ATTACHED TO THIS BOOKLET

The definitions in this manual highlight the substance of each cost grouping as well as

related groupings of expenses to be excluded from specific cost definitions.

Donated services, supplies, space, etc., are to be priced at their reasonable value and added to

the cost category to which applicable.

Where a home is an affiliate of another facility, such as a hospital, and the records of the home

are a part of the total accounting systamr allocation techniques may be required to identify certain of the

costs such as payroll, rent, supplies, and insurance. This is acceptable providing a sound basis is established

for the allocation,

While it is preferred’that the report be on the calendar year ending December 3?, 1972, you

may cover a different twelve-month period if you are on a fiscal year basis. The cost data, of course,

must be for the same time frame as the related statistical data included in other phases of this survey.

This is for the purpose of including all of the costs of delivering health care, disregarding whether the

services were paid for or (as in homes staffed by members of a religious order] donated.

Expenses may be reported on either a cash or accrua I basis; however, there must be a

consistency in the system applied throughout the entire period under report.

The cost categories in this questionnaire are aimed at the total cost of care for patients, and

are matched to statistical data being collected for para IIel purposes. Typical functions I cost information

(e.g., administrative, clerical, medical cost categories) will not providean appropriate framework for the

study and should consequently not be used.

—

The expense categories used in this questionnaire are also not inten~eci to be a recommended

cost structure for homes; they are tailored to a single specific use in the survey. It is recognized that

certain of the costs, such as supplies, foods, drugs, and equipment spec!fica IIy purchased for sate to

patients, may not, within the present expense structure of a nome, be recorded as expense. Again, this

survey is for the purpose of capturing all costs incident to providing health care In a nome and therefore

must include services and supplies dire=ly charged to patients.

In general, it is essential that all recorded expenses incurred by the ~ome be included in the

expense categories, as well as the value =donated items not recorded in the account structure. Excluded

from costs, however, are any lossessustained in the sale or disposition of fixed assets and other extraordinary lossesnot related to the current cost of providing heaIth care.

Form 73N HS-2

43
EXPENSE QUESTIONNAIRE ‘1 OMB # 068.s-72172

Expires 7-31-74

1973 Nursing Home Survay

Natmnal Center for Health Statistic

Health Resources Administration

Rockville, Maryland ccl -2

ASSURANCE OF CONFIDENTIALITY - All information which would permit identification

ESTABLISHMENT NO.

of the individual facility will be held in strict confidence, will ba usad only by persons engaged in

and for the purposes of the wwey, and will not be dicclosed or released to others for any purposas.

CC2

CARD 1

Cell-l

A. PLEASE LIST BELOW THE 1972 CALENDAR YEAR EXPENSES FOR OPERATING THE FACILITY, IF EXPENSES

ARE NOT FOR THE 1972 CALENDAR YEAR, SPECIFY PERIOD COVERED:

from to

month yaar month year

ccl 2 ccl 4 ccl 6 ccl 8

B. REFER TO THE ENCLOSED DEFINITIONS WHEN COMPLETING THIS FORM. FOR FURTHER CLARIFICATION

PLEASE CALL FREE OF CHARGE THE FOLLOWING PHONE NUMBER: 800-638-0856.

EXPENSE CATEGORY AMOUNT

1.

CARD 2

ccl 1-2

2.

3.

4.

5.

6.

7.

(See Note 1on next page) (If NONE, please enter “O”)

Payroll Expense (Do not include contracted sawices):

a, Wages and Salaries (gross amount including

employees’ F! CA, vacation and sick pay,

taxes, etc.):

(1) Nursing staff payroll expanse . . . . . . . . . . . .$

(include RNs, LPNs, Practical nurses, CC21

aides, orderlies, student nurses, and

other nursing staff)

(2) Physicians, other professionals and semiprofessionals payroll expencz . . . . . . . . . . . .$

CC31

(3) All other staff payroll expense . . . . . . . . ..$

(All employees not listed in (1) and (2) CC41

including salary or withdrawals for

self-emplowd proprietor+wner’)

SUBTOTAL (add lines a.(l), a.(2), and

a.(3) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

CC51

b. Fringe Benefits (state unemployment, . . . . . . . . . . . . . . . . . . . . ..$

group health and life insurance and all other .X61

payroll ard non-payroll benefits for all

employees on the staff)

TOTAL PAYROLL EXPENSE (add

subtotal lineand linel.b.), . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

CC71

Equipment Rent . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

CC21

Insurance linclude pro fessional-pubiic liability and . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$

other insurance) CC31

Taxasand licenses (include franchise tax) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

CC41

lnterestarclFinancingCharges... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

CC51

DepreciationCharges(8uildingsard Equipment) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

CC61

Rent on Building and Land.... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

CC71

—

● If self. employed proprietor-owner isnon-saler iad, please estimate salary.

Form 73 NHS-2

44
CARD 3

ccl 1-3

8.

9.

10.

11.

12,

13.

CARD 4

ccl 1-4

14.

15,

16.

Amortization of Leasehold improvements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

CC21

FoodandOtherDietaryltems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

(include non-contracted services only) CC31

DrugExpenses(mstofdrugseitherpurchasad . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

or obtained by contract, or purchased for patients CC41

and sold directly to them)

SuppliesandEquipment(c-astofsuppliesand . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

equipment either purchased or obtained by CC51

contract, or purchased for patients and sold

directly to them)

PurchasedMaintenanceofBuildings, Grounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

and Equipment Cffil

Laundryand LinenExpense(include non- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

mntracted serwces only) CC71

Purchased Department Functions:

a, Medical,therapy,educationallaboratory . . . . . . . . . . . . . . $

and other professional services obtained CC21

by contract.

b. Another contracted services(include house- . . . . . . . . . . . . . . .$

keeping, linen, food, or other services not CC31

obtained in-house)

TOTALPURCHASEDDEPARTMENTFUNC’TIONS (add lines . . . . . . . . . . . .$

14.a and 14.b) CC41

Utilities(telephone,gas,water,and electricity) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..$

Cc61

OtherandMiscellaneousExpense . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

(include dues. subscrlmions. travel, auto-

$

C&l

mobile, advertising, other services not

incl,.cled elsewhere, mediw land non.medmal

fees, unclassified). See Note 2 below.

TOTAL EXPENSES (addexpensecategoryhnaltems......... . . . . . . . . . . . . . . . . . . . . . . .

1 through 16)

$

CC71

Please check the add atIon of subcategories and tots I expenses.

Note 1. If your accounting system does not generate cost Items as catagorizad atmve, please use your best emmate

of allocatmn among the Ilne items.

Note 2, If Other and Miscellaneous Expense comprises 10 percent or more of the total expenses, please give datails below

of major amounts which constitute 20 percent or more of L!ne 16.

Description Amount

If your questions are not answered by the instructions, you may contact a certified public accountant free of charge at the

following toll-free number for answers:

(800) 638-0856

Thank YOU.

Form 73N HS-2

45
DEFINITIONS

1. PAYROLL EXPENSE

a. Wages and Salaries

Wages and salaries are generally defined asgross earnings paid an employee including payment for annual and sick

leave, overtime, bonuses and other remuneration of a payment nature received by the employee. The wages and salaries represent

theamount earned and reported tothelnternal Revenue Service onhisor her W-2statement. Self-employ edproprietors, while

not salaried as employees, are to be included in this definition either in the amount reported on the tax return as self-employed

salary, or as a reasonable amount, related to the technical or non-technical services provided.

Employee salaries and wages, by the above definition, exclude payments for professional or non-professional services

obtained under contract, or fees paid doctors onafee-for-service basis. Also excluded from Wages and Salaries are Fringe Benefits

as definedin 1 b(Payroll Expense -Fringe Benefits) below.

Non-funded employee benefits such as meals and living quarters, if provided an employee, and considered a part of the

gross salary received, are to be included in grosswages and salaries.

Wages and salaries are to be reported on the grossbasis, without deductions for FICA, Federal and State taxes, and other

deductions from an employee’s grosspay.

(1) Nursing and Staff Payroll Expense

Nursing staff payroll expense is defined as the total wage and salary compensation given those employees who

administer nursing care to patients.

This category includes registered nurses, licensed practical nurses, practical nurses, nurses’ aides, orderlies, and student

nurses.

(2) Physicians and Other Professionals Payroll Expense

Physicians and other professionals payroll expense is defined as wage and salary compensation given those professional

employees who provide direct health care to patients.

This category includes physicians, psychiatrists, dentists, optometrists, therapists, psychologists, podiatrists, audiologists, etc.

(3) All Other Staff Payroll Expense

AH other staff payroll expense is defined as wage and salary compensation given all employees not specifically

categorized in (1) or (2) above.

This category includes medical and dental technicians, social service workers, X-ray assistants, lab assistants, and

administrative personnel including aself-employed proprietor-owner.

Nursing staff, physicians and other professionals are excluded from this category.

Any employee who spends 75 percent or more of his time in any one of the three areas mentioned above should have

~ofthewage andsalary compensations charged tothat expense category. Further allocsiion is acceptable if it isa feature of

your accounting system.

b. Fringe Benefits

Fringe benefits areexpenses incurred by the home forthecurrent and future benefitof home employ ees. These

expenses, not added to the wages and salaries of the employees, include such items as group health, hospitalization, employer’s

portion of FICA, Federal and State Unemployment insurance, andlife insurance premiums (exclusive ofpremiums paid where

(a) the Home is the beneficiary or (b) on the life of the proprietor-owner).

Excludad from this cost category are payments for vacation, maternity and sick pay, terminal paymants, employee’s

share of FICWving facilities provided employ eeswhere such facilities preestablished forthebenefit ofttse home.

2. EQUIPMENT RENT

Equipment rent is defined as all costs incurred for the rental or leasing of equipment. Charges to this category

would include therental or leasing of furniture, typewriters, computers, X-ray machines orother forms of equipment. Exclude

from thiscategory all lea%-purchase agreements anddeferred payment plans onthe purchase of equipment. These latter tyr?

purchases will be treated through the Depreciation Cost Category (exPense category 6).

Form 73N HS-2

46
3. INSURANCE

Insurance is defined as the cost of premiums for policies necessary to the normal operation of nursing homes.

These charges include fidelity bonds, fire and extended coverage, malpractice, property and bodily injury liability, and

automobile insurance where transportation is included as a service of the facility.

Exclude insurance paid for the benefit of employees, such as employee life or group hospitalization, as well as key man

life insurance. Saedefinition ofexpensacatagoryl (b) fordistribution ofemployee benefit insurance paid. lfthe homa's

accounting system ison the accrual basis, exclude anyprepaid costs and inciude only thepremiums on the current year’s portion.

4. TAXES AND LICENSES

Taxes and licenses are defined as costs paid or due to Federal, state, county, and local governments for taxes levied or licenses

required.

This category includes licenses obtained for the right to do businessand taxes on real estate, personal property, excise and

business franchise taxes.

Amounts remitted to Federal, state, county, and local governments for income taxes withheld from wages and salaries must

ba excluded,

5. INTEREST AND FINANCING CHARGES

Interest and financing charges are defined as costs incurred as interest or finance charges on loans, notes, or other forms of

indebtedness.

These charges include amounts of interest on notes payable, mortgages payable or long-term purchase agreements. The

initial cost of financing or refinancing a loan, however, is to be excluded as an extraordinary cost not related to the normal cost

of providing health service. Also to beexcluded from this expense category areplacement fees onloans andcosts related to

penalty clauses on early retirement of mortgages or other loans.

Penalties paid to Faderal, state, county, or local govarnmants for impropar filing of tax or information returns should be

excluded.

6. DEPRtCIATION CHARGES

Depreciation is defined as the distribution of the cost of tangible capital assets, lesssalvage (if any), over the estimated

life of the asset.

Charges to this category should exclude amortization as defined in expense category 8.

Depreciation charges are to be Iimited to the straight4ine method rather than an amount that may be acceptable under the

Fadaral tax law (doubledeclining, sum-of-the years digits, one and one-half straight-line, etc.).

Tangible capital assets, currently being purchased under a lease-purchase agreement, are to be depreciated rather than treated

as a rental payment. Exclude from this category any equipment of a nominal amount expensed in Equipment (Cost category 11. ).

7. RENT ON BUILDING AND LAND

Rent on building and land is defined as all costs incurred for space occupied pursuant to leasesor rental agreements.

Included in this category is the cost of all buildings or real estate rented or leasad by the home.

Chargas to this category should exclude lease-purchase agreements and payments made on a mortgage covering the building

or land.

!.3 AMORTIZATION OF LEASEHOLD IMPROVEMENTS

Amortization of Ieasahold improvements is def inad as the writeoff of improvements to leased premises over the remaining

life of the lease or the useful life of the improver,:ant, whichaver is shorter.

Improvements to leased premises which have a remaining lease or useful life of one year or lessshould be expansed directly

when incurred.

Included in this catagory are improvements to leased premises such as wall partitions, permanent counters and cabinets,

tile floors and wall coverings, and plumbing fixtures.

Exclude from this category any improvements of a nominal amount charged to repairs and maintenance and included in

another cost category in this questionnaire.

Form 73NHS-2

47
9. FOOD AND DIETARY ITEMS

Dietary and food items purchased for preparation on the home’s premises are to be charged to this account.

Income received on the sale of meals to non-patients and staff (when charged) will be deducted from the recorded gross

cost of the food and dietary items.

Where food inventories are maintained, the cost of food consumed will be the basis for the recording of cost (invantory at

baginningof year plus purchases,less ending inventory.) Freight andsales taxes, whether included inthepurchase, orasaseParate

item (freight only), aretobe charged tothecost of food anddietary items, rather than to recharged to 'Taxes and Licenses”

(salestax) or “Other and Miscellaneous Expense” (freight).

This coat category excludes related food costs, such as food preparation (wages), cost of kitchen operation, menu preparation,

and paper supplies related to the serving of meals.

The cost of meals purchased fmm hospitals or other outside services is excluded from this cost category (see 14 (b), Contracted

Services - Food) whether or not under contract.

Food purchased (to beprepared bythe home) forsale tospecific patients isalsoto recharged tothis account.

10. DRUG EXPENSES

Drug expenses represent the cost (or value when donated) of drugs consumed out of inventory or purchased for patients

and resold to them. Drugs not under inventory control will be considered expensed when purchasad.

For purposes of this definition, drugs include both prescription type medicinas as well as non-prescription items such as

aspirin, laxatives, and vitamins. Excluded from this definition are such non-medicine items as cotton, bandages, syringes, and other

items which donotmeet thecommon definition ofdrugs, andarecategorized under supplies, item 11, below.

Recognizing that medical supplies may be co-mingled in the cost account with drug items, an allocation technique may be

adopted for the purposes of determining the separate cost of drug expenses.

The coat of drugs includes freight costs as well as salestaxes added to the purchase price of drugs.

Drug cost is not to be reduced by revenuas from patients whether sold out of the nursing home inventory or purchased

specifically for the=se.

11. SUPPLIES AND EQUIPMENT

a. Supplies

Includes the purchase or donatec tialue of all supplies exclusive of drug supplies (see 10.) and food and other dietary

itelns (see 9.)

Supplies include, but are not limited to, supplies used in food preparation and serving (dishes, kitchen ware, paper

supplies, etc.), office supplies, medical supphes, laundry, linen and blanket supplies, uniforms, the purchase of minor equipment

(staplers, ash trays, etc.) classified w supplies, and repair and maintenance supplies and parts (cleaning supplies, light bulbs, small

tools, etc.1.

Under normal cond!tinns, suppliv: of tha nature of those classified for inclusion in this cost category are not maintained

under inventory control excepl :I$J minimum level which may baused asa re-order point. The accounting system of the him, will

ciwtatewhethert hesecostsw:ll twdevalopect ona “deliverybasis’’oron “issuec!’’basls. Eitherm ethodwillb eacceptable.

In those instances wher? The nurs.ng homa is affiliated wirh another facility such as a hospital and there is no separation

c; accounting record- ~,1 ‘Wocatmn cost distribution method, consE.tent with scmndaccounting practices and principles, will be

acceptalz;e.

b. Equipment

Includes thepurchaseo! donat,.>r~ofirems class,f!edaseaurpment, but because of thenominal costornature of the

Items, they are not — capitalized.

Equipment in this grouping include, bui are no: hmltad 10, applc,o.’iate items of medical equipment, furniture and

fixtures of a nominal value not maintained under asset control, repair and maintenance equipment, kitchen equipment, and

administrative equipment.

Form 73NHS-2

48
Equipment purchased specifically for sale to a patient, regardless of the cost or nature of the purchase, is to be

included inthiscategory. Reasoning behind this decision isthattitle belongs tothepatient and, accordingly, thehome has no

basis for depreciating the equipment, Accordingly, alJequipment purchased for patients WIII be recorded in this cost category. The

revenues derived from the sale of theequipment tothe patients will not becredited asanoffset to the cost recorded in Supplies

and Equipment.

Exclude from this category any equipment which is being depreciated in cost category 6.

12. PURCHASED MAINTENANCE OF BUILDING, GROUNDS, AND EQUIPMENT

This cost grouping includes contract costs for elevator mamtenance, equipment appliance maintenance, ground maintenance,

contracts to maintain plumbing, electrical systems, and similar type service requirements. Excluded from this grouping are contracts

forsuch services astrash removal, cleaning services, andother housekeeping services. Thecost for these Iattercontracts istobe

recorded in 14 (b), Purchased Department Functions -- All Other Contracted Services.

Maintenance costs, not under contract, to be recorded in this cost category include the expense of plumbers, electricians,

ground maintenance, carpenters, genwal repairmen (appliance repairs, etc.), andsimilar non-contractual maintenance services.

13. LAUNDRY AND LINEN EXPENSE

This account relates to the cost of outside service only, rather than the cost of purchasing linens, towels, blankets, uniforms,

etc. This cost may or may not be under a service contract and may include the rental cost of the supplies provided under a contract.

Laundry and linen expense, as classified in this cost category, excludes services for this function provided by nursing home

staff, Personnel costs forthis service will be charged to 1.a.(3), Wages and Salaries -- All Other Staff payroll Expense.

Separate charges for laundry or linen lost or damaged by the nursing home under a service-rental agreement will be reflected

in this grouping.

14. PURCHASED DEPARTMENT FUNCTIONS

Purchased department functions are defined as those services which are obtained by the home through a contract with an

outside entity.

a. Medical, therapy, educational laboratory and other professional services obtained by contract

This category includes services contracted with physicians, therapists, laboratories, pharmacies, nurses, and other

professional service providers.

This category excludes all maintenance contract services and other non-professional contract services,

b. All Other Contracted Services

All Other Contracted Services include contracts for housekeeping, linen service, food and dietary service, ambulance

service and any other non-professional contract service not specifically mentioned above. I

This category excludes maintenance service contracts and professional contract services.

15. UTILITIES

Utilities are defined as charges for telephone and telegraph, gas, fuel, oil, water, and electricity.

Charges to this category should exclude any utility charges, such astelephone, that are reimbursed by patients or employees

or charges that are paid by the lessor under the lease agreement.

16. OTHER AND MISCELLANEOUS EXPENSES

This expense category is a catchall to record—all costs not classified in 1. through 15. above. Costs included in this grouping

are dues and subscriptions, printing costs, advertisements, travel costs, automobile expenses, non+lassified medical andnon.medical

fees (example - audit and legal fees), postage and casual labor not charged to other expense categories.

Form 73NHS-2

49
..

.

RESIDENT CONTROL RECORD

1973 Nurs!ngHomeSurvey

Natmnal Center for Health Statmtlcs

Health Resources Admmmratmn

Rockwlle, Maryland

Sheet_ _Sheets E&cl

ESTABLISHMENT NO.

TOTAL RESIDENTS IN HOME .cl.~

CC12-15 CC2 ccl 1-1

IN SAMPLE

CC16-19

RESIDENTS IN NURSING HOME

SAMPLE NAME OF RESIOENT 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 2B

04 29

05 30

06 31

07 32

08 33

09 34

10 35

11 36

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

Form 73 NHS.6 If More Lines Are Needed CONTINUE ON THE BACK

50
---

RESIDENT CONTROL RECORD

RESIDENTS IN NURSING HOME

SAMPLE NAME OF RESIDENT SAMPLE NAhlE OF RESIDENT

DESIGNATION DESIGNATION

LINE LINE

NO. NO.

Sw Sw

TE_ TE

a b c a b c

51 76

52 77

53 78

54 79

55 80

56 81

57 82

58 83

59 84

60 85

61 86

62 87

63 8a

64 89

65 80

66 91

67 92

68 93

69 94

70 95

71 96

72 97

73 98

74 99

75 00

Form 73NHS.6 If More Lines Ara Needed Usa A New RESIDENT CONTROL RECORD

And Renumber The Lines Beginning With ti 101

51
..

RESIDENT QUESTIONNAIRE EiF=l

1973 Nursing Home Survey

National Center for Health Statistics

Health Resources Administration

Rockville, Maryland

1-7

ASSURANCE OF CONFIDENTIALITY – All information which would permit identification

ESTABLISHMENT NO.

of the individual will be held in strict confiienca, will be used only by pemons engaged in and for

the purposes of the survey, and will not be disclosed or releasad to others for any purposes.

CC2

LINE NO.

ccl 1

ccl 4-1

1. WHAT IS - DATE OF BIRTH?

rlnn”rn

Month Day Year AW

CC1 5,16 17, 18 19-21 CC22-24

2. WHAT IS – SEX? ❑ Male ~ Female

25-1

3. WHAT IS – ETHNIC BACK- 261 ❑ Caucasion .2 ❑ Negro -3 ❑ Oriental

GROUND? (Mark (X) Only

one box) -4 H Spanish American -5 ❑ American Indian -S ❑ Other

4. WHAT IS – CURRENT MARITAL 27-1 ❑ Married -2 ~ Widowed

STATUS? (Mark (X) only

-3 ❑ Divorced

one box) -4 ❑ Separatd -5 ❑ Naver Married

5. WHAT WAS THE DATE OF – CURRENT ADMISSION TO THIS PLACE?

nun

Month Oay Year

CC28, 29 3D-31 32-34

6a. WHERE DID – LIVE AT THE TIME OF ADMISSION? (Mark (X) only one box)

(1) In a boarding home 35-1

(2) In another nursing home or related facility -2

(3) In a mental hospital or other Ions-term specialty hospital -3

(4) In a wneral or short-stay howital 4

(5) In a private apartment or house -5

(6) Other place, (Specify) -6

36-

(7) Oon’t know -7

❑

❑

❑

•1

)- ❑ Gb

cl”

•1

(1)

(2)

(3)

(4)

[5)

(6)

AT THE TIME OF ADMISSION

DID – LIVE WITH: (Mark (X)

all that apply)

Yat

Sp.ause? 37-1 ❑ -2

Children? 36-1 ❑ -2

Other relatives? 39-1 ❑ -2

Unrelated persons? 4@l ❑ -2

Lived alone? 41-1 ❑ .2

Oon’t know? 42-1 ❑

7. WHAT IS THE PRIMARY REASON FOR – AOMISSION TO THE HOME? (Enter “1” in box for primary reason; if secondary

reason given, enter “2”.)

43- ❑ Physical reasons (e.g., illness or need for treatments)

44 ❑ Social reasons (e.g., no family, or lack of family interest)

45- ❑ 6ehavioral reasons (e.g., disruptive behavior, mental detwi.amtio”)

4s- ❑ Economic reasons (e.g., no monay andlor resources)

Form i’3N HS-7

52
8. WHAT WAS THIS RESIDENT’S PRIMARY DIAGNOSIS: (Mark (X) only one box in etwh ml.mn)

a. AT ADMISSION? b. AT THE TIME OF–LAST EXAMINATION?

49,50 ❑ 001 51,52 ❑ bOl

•l a02 ❑ b02

❑ m ❑ bCO

•1 ?04 ❑ lbCW?

•1 .05 ❑ b05

•1 a= ❑ bffi

•1 ,07 ❑ b07

❑ 80s ❑ bOS

•1 @9 ❑ b09

❑ ,10 ❑ b10

•1 all ❑ bll

•1 ,12 ❑ b12

•1 a13 ❑ b13

•1 a14 ❑ b14

•1 .15 ❑ b15

❑ .16 ❑ b16

•1 a17 ❑ b17

❑ ,18 ❑ b18

•1 a19 ❑ b19

•1 a20 ❑ b20

•1 a21 ❑ b21

\

a22 ❑ b22

Spacify:

Senility, old aga, and other symptoms and illdefined cotiitions (e.g., coma, uramia)

Heart attcck (e.g., i.schemic heart disaass)

Stroke (e.g., cerebrovaasular diseases)

Hardening of arteries (e.g., arterioacleraais, disaasas of the arteries, areriolas, capillaries)

Other diseasas of the circulatory system (e.g., NOT heart attcck, stroke, or hardening of the arterias]

Accidents, poisonings, and violence (e.g., t%acture of hip, other broken bonas, burns, concussion)

Mental disorders (e.g., mental retardation, psychows, neumsas, mental ilhreas, emotionel problems)

Diseasas of the musculoskeletal system and connective tissue (e.g., arthritis, rheumatism, back pain)

Endacrine, nutritional, and metabolic diseases (e.g., goiter, diabates, gaut)

Diseases of the respiratory system (e.g., pneumonia, emphysema)

Neoplasms (e.g., cancer, tumors)

Diseaaas of the newaus system and wwa organs (e.g., Parkinson’s disease, glaucoma, cataracts,

blindness, multiple sclerosis, spastic paralysis, epilepsy)

Diseasas of the digestive system (e.g., cirrhosis of liver, ulcer, intestinal obstruction)

Infective and parasitic diseasas (e.g., T.B., @lie, syphilis)

Diseaees of the genitourinary system (e.g., nephrasis, chronic pelvic infection, hyperplaaia of proetate)

Diseass of the skin and subcutaneous tissue (e.g., cellulitis, abscess, chronic ulcer]

Diseacas of the blacd and blood-forming organs (e.g., anemia)

Conganitd anomalities (e.g., hydrocaphalus)

Complications of pregnancy, childbirth and the puerperium (e.g., infections,hemorrhaga, toxemias)

Cwtain causas of pi?rinatal morbidity and mortalitf (e.g., birth injury or immaturity of infant)

Don’t know

Othar (Specify) 54

53-

9. DOES - HAVE ANY OF THE FOLLOWING CONDITIONS OR IMPAIRMENTS? (Mark (X) all that apply)

CC55.85 -1 ❑ a. Senility (includes decline in intellect, memory, and judgement, loss of orientation, difficulty in spaaking; feebleness.)

-2 •1 b. Mental 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?

$Uf. Glaumma or cataracts

-7 ❑ 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, lag, fingw:, arm, or back

-0 •1 J

Heart trouble

OR

-auk Resident has none of the above conditions or impairments

❑ Yes ~ No

6E-1

Form 73NHS-7

53
10. DOES THIS RESIDENT REGULARLY USE ANY OF THE FOLLOWING AIDS?

CARD 2

14-2 a. Walker

No Yes

15-2 ❑ -1 ❑

b. Crutches 16-2 ❑ “1 •1

c. Braces 17-2 ❑ -1 •1

d. Wheelchair 18-2 ❑ -1 •1

e. Artificial Limb 19-2 ❑ -1 •1

f, Self-feeder 20-2 ❑ -’ •1

9. Any other aids (do not count glass= or hearing aids) 21-2 ❑ “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 hOME.1

a.

b.

c.

d.

e.

f.

Physical therapy

Recreational therapy

Occupational tharapy

NUMBER OF

TIMES

❑ Noneor I I

CC23

❑ Ncmeor I I

CC25

❑ None or

CC27

Speech therapy ❑ Nona or 1

CC29

Hearing therapy

Professional counseling by social

worker, psychologist or other

mental health worker

❑ None or J

CC31

❑ Nmefx I

CC33

12. DURING THE PAST 7 DAYS, WHICH OF THESE SERVICES DID–RECEIVE? (Mark (X) all that apply)

CC35.B2 -01 ❑ a.

-02 ❑ b.

.03 ❑ c.

-04 ❑ d.

-05 ❑ a.

-m ❑ f.

-07 •1 9.

.0s ❑ h.

-09 ❑ i.

-10 ❑ j.

-11 ❑ k.

-12 ❑ L

-13 ❑ In.

OR

-14 ❑ n.

Rub or macsage

Administration of treatmant by staff

Special diet

Application of starile dressings or bandagaa

Temperature-pulse-respiration

Ful I bed-bath

Enema

Catheterization

Blood pressure reading

Irrigation

Oxygen therapy

Intravenous injection

Hypodermic injection

None of the above services received

Form 73NHS-7

54
-+..

13, DURING THE PAST 7 DAYS, DID - RECEIVE ANY MEDICATIONS?

CARD 3

T

Q ‘“(sk~ ‘es

WHICH TYPES OF MEDICATIONS DID – RECEIVE? (Mark (X) All That Apply)

cclB.45 -01 ❑ a.

-02 ❑ b.

-03 ❑ c.

-04 H d.

-05 ❑ e.

-03 ❑ f.

-07 ❑ g.

-CE H h,

-09 ❑ i.

-lo ❑ j.

-11 ❑ k.

-12 ❑ L

-13 ❑ m.

-14 (J n.

-15 ❑ 0.

Tranquilizers (e.g., Thorazine, Mellaril)

Hypnotics - Sedatives (e.g., Nembutal, Seconal, Phenobarbital, Butisol, Placidyl, Chloral Hydrate)

Stool softeners (e.g., Peri-COlace)

Anti-Depressant (e.g., E Iavil)

Anti-Hypertensives (e.g,. Ismelin)

Diuretics (e.g., Diuril, Esidrex)

Analgesics (e.g., Aspirin, Darvon, Demerol, Percodan, Empirm with Codeine)

Diabetic agents (e.g., Orinase, Insu Iin)

Anti-inflammatory agents (e.g., Cortisone, Sodium Salicylate, Butazolidin, Indocin)

Anti-in fectives (i.e., antibiotics) .

Anti-Anginal drugs (e.g., Nitroglycerin, Peritrate)

Cardiac Glycosides (e.g., DigitalIs, Lanoxin)

Anti-Coagulants (e.g., O icumarol, Warfarinl

Vitamins or iron

Other types of medications not listed above

14. THE FOLLOWING ACTIVITIES FOR DAILY LIVING LIST VARIOUS LEVELS OF CARE THAT MAYBE NEEDED BY A

RESIDENT. PLEASE INDICATE THE ONE THAT BEST DESCRIBES THE LEVEL OF CARE NEEDED BY PRESIDENT.

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 (Xl Only One Box)

43-1❑

“2 •1

“3 •1

“4 ❑

-5 •1

Perform all four with no assistance?

Perform all four with no assistance, but needs help in getting andlor putting away equipment?

Perform three or four with no assistance, but requires help with a complete bath?

Require assistance with one or two of these hygiene activities?

Require assistance with all four of these hygiene activities?

b. CONCERNING DRESSING, DOES THIS RESIDENT:

(Mark (X) Only One BOX)

47-1 ❑ Get clothes from closetsand drawers and completely dresswithout assistance?

‘2 ❑ Get clothes frOm clo~ets and drawers and completely dress with some assistance (tying shoes, fasttming braces, CIosi”g buttons or

zippers in back of garments)?

‘3 ❑ Receive assistance in @tif19 clothes, or in drassing (do not count tying shoes, fastening braces, closing buttons or zippers i“ back

of garments as assistance)?

~ •l Stay panly or completely undressed?

c. CONCERNING FEEDING, DOES THIS RESIDENT:

(Mark (X) Only One Box)

4s-1 ❑

“2 •1

-3 ❑

-4 ❑

“5 •1

Feed self without assistance?

Feed self with minor assistance (cutting meat or buttering bread)?

Receive major assistance in feeding (do not count cutting meat or buttering bred)7

Require intravenous feeding?

Require tube faeding?

Form 73N HS-7

55
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 object of support), may

manage bedpan or commode ——at night?

-2 ❑ Receiving nurses’ e.$.sistancein 9oin9 to the toilet room (do not count use of cane, walker, or other object of SUPPOrt),

using bedpan or commode at night, or cleaning self or arranging clothes after elimination?

‘3 ❑ Unable to 90 to the toilet room for the elimination process?

e. CONCERNING MOVING IN AND OUT OF A BED OR CHAIR, IS THIS RESIDENT:

(Mark (X) Only One Box)

Receiving no assistance? 52-1 ❑

Walking with assistance of one person?

Walking with assistance of two persons?

UP in a chair with assistance once in 8 hours?

UP in a chair with assistance twice in 8 hours?

Bedfast with assistance in turning evary two hours?

B6flfast with assistance in turning every hour?

f. CONCERNING CONTINENCE, IS THIS RESIDENT:

In control of both bowals and bladder?

An ostomy patient?

In control of bladder only?

In control of bowels onl y?

Not in control of bowels or bladder?

-2 •1

-3 •1

)

-40

F

“5 •1 53-1

e.(1) DOES – HAVE

? ‘es ?

No

-6 ❑ BED SORES?

-7 ❑ (continue with part f.]

(Mark (X) Only One Box)

54-1 ❑

“2 •1

F

-3 •1

-4U f.(1) IS – RECEIVING BOWEL AND/OR

BLADDER RETRAINING?

-5 •1

55-1 ❑ Yes (Skip to Question 16a.)

-2

t

No

f.(2) WOULD RETRAINING GIVE THIS

RESIDENT CONTROL OVER

BOWELS AND/OR BLADDER?

❑ Y,, ~ No ~ Doubtful

56-1

15a. DOES THIS RESIDENT EXHIBIT ANY OF THE b. DOES THIS RESIDENT EXHIBIT THIS BEHAVIOR

FOLLOWING BEHAVIOR?

No

(1) Depressed 57-2 ❑ -1

(2) Agitated, nervous 59-2 ❑ -1

(3) Abusive, aggressive 61-2 ❑ -1

(4) Confused, senile 63-2 ❑ -1

(5) Disturbed sleep 65-2 ❑ .1

(6) Other problem behavior 67-2 ❑ -1

Form 73NHs-7

56

MORE OFTEN THAN ONCE A WEEK OR ONCE A WEEK

@ (Specify) 6BMore often than

once a week

58-1 ❑

601 ❑

62-1 ❑

64-1 ❑

66-1 ❑

_ 69.1 Q

Once a week

or less

-2 •1

“2 •1

.“20

-2 ❑

“2 •1

“2 •1
16a.

CARD 4

14.4

b.

c.

d.

DURING THIS RESIDENT’S STAY HERE, WHEN DID – LAST SEE A PHYSICIAN FOR TREATMENT, MEDICATION, OR FOR

AN EXAMINATION?

Month Day Year

001

OR ❑ Has Never Seen A Doctor While Here (Sk!p to

21-1 Question 17a.J

ccl 5,16 17,16 19,20

i

AT THAT TIME, DID - RECEIVE:

Yes No

(1) An examination? 22-1 ❑ -2 •1

(2) Treatment? 23-1 ❑ -2 •1

(3) Prescription? 24-1 ❑ -’7- •1

(4) Other? 25-1

%

“2 •1

Specify 26-

DID THE PHYSICIAN ATTEND THE RESIDENT: (Mark (X) Only One Box)

27-1 ❑ as a private physician?

‘2 ❑ fOr the =itwlf which furnishes the medical care?

‘3 ❑ temporarily as a replacement fOr the resident’s private physician who was” nable to attend the r~,dem?

-4 ❑ under some other arrangement? (Specify) 28-

DOES A PHYSICIAN EXAMINE THIS RESIDENT: (Mark (X) Only One Box)

29-1 ❑ only when called?

“2 ❑ i~e9ularlY, but without being calied?

-3

\

on a scheduled basis?

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 Q every three months

-5 ❑ once a year

-6 H other (Specify) 31-

17a. DOES – WEAR EYE GLASSE.$?

Yes

32-1 b

b. IS – SIGH+ WITH GLASSES: (Mark (X) Only One Box]

w-f ❑ not inwaked? (e.g.,canreadOrdinaw newsPaPer

print)

‘2 ❑ PnrtiatlY impaired? (e.g., can watch television 6 to

12 feet across the room)

‘3 ❑ severely imPairKf? (e.g., can recognize the features

of familiar persons if they are within 2 to 3 feet)

.4 ❑ completely lost? (e.g., blind)

No

9-2

r

c. IS - SIGHT: (Mark (X) Only One Box)

33-1 ❑ not impaired? (e.g., can read ordinary newwaper

print without glasses)

‘2 ❑ paRially impaird? (e.g., can watch televisions to

12 feet across the room)

‘3 ❑ smerelY imPaired? (e.g., can recognize the features

of familiar mrsons if thev are within 2 to 3 feet)

-4 ❑ completely lost? (e.g., blind)

18a. DOES – USE A HEARING AID?

Yes

%’ 34-1

‘b. IS - HEARING WITH A HEARING AID: c.

(Mark (X) Onlv One Box)

35.1 D

“2 •1

“3 •1

-4 •1

not imoaired? (ea.. can hear a teleDhOn% conversation

on an ordinary tel&hone)

partially impaird? (e.g., can hear most of the things

a person says)

swerely impaired? (e.g., can hear only a faw words a

person says or loud noises)

completely lost? (e.g., deaf)

No

%’ -2

IS –HEARING: (Mark (X) Only One Box)

35-f ❑

-2 •1

-3 ❑

-4 •1

not impaired? (e.g., can hear a telephone conversation

on an ordinary telephone)

partially impaired? (e.g., can hear most of the things

a permn says)

severely impaired? (e.g., can hear only a few words a

person SBYSor loud noises)

completely lost? (e.g., deaf)

Form 73NHS-7

57
19. IS – ABILITY TO SPEAK: (Mark (X) Only One Box)

38-1 ❑ not impaired? [e.g., ISable to be understock; can carrY On a nOrmal cOnver$atrOn)

-2 ❑ PartiallY Impaired? (e.g., is able to be understmd but has difficulty pronouncing some words)

‘3 ❑ S~erelY imwir~? (e.9., WnnOt carry on a normal Conversation; is understock only with difficulty)

.

-4 ❑ completely lost? (e.g., is mute)

20a. DOES THIS RESIDENT HAVE DENTURES?

•1 Yes7

~ NO (skip to Chestio” ZIa.)

39-1

b. DOES - USE THE DENTURES?

❑ Yes ~ No

4C-1

21a. DURING THE LAST MONTH, OID – LEAVE THE HOME FOR ANY RECREATIONAL OR LEISURE ACTIVITIES?

/9 ‘es

b. FOR WHICH OF THE FOLLOWING ACTIVITIES

DID – LEAVE THE HOME? (Mark (X) All That Apply)

CC42-52 -1 ❑

“2 •1

-3 •1

-4 •1

-5 •1

-6 ❑

-7 •1

-8 ❑

-9 •1

-0 •1

Get books, etc., from the library

Attend plays, movies, concerts, etc.

Attend arts and crafts classes outside the home

V!sit museums, parks, fairs, etc.

Go on shopping trips organized by the home

Go on independent shopping trips organizd

by the resident or visitors

Visit a beauty shop or barber shop

Visit community clubs (such as community ten.

ters, senior citizen clubs, sewice clubs, bridge

clubs, unions, etc.)

Attend religious services or other rellgious activities

Go for a walk

AN”

c. WHY DIDN’T – LEAVE THE HOME TO PARTICIPATE IN

ANY ACTIVITIES OURING THE LAST MONTH? (Mark (X)

All That Apply)

CC42.62 -1 ❑

-2 ❑

-3 •1

-4 El

-6 ❑

-60

-7 •1

-8 H

Resident was too ill or was not able to move

well enough to participate

Resident was not interested

Staff was unable to determine resident’s interests

at this point

Staff feels that the resident’s behavior

will not be toleratsd outside the home

No one was available to accompany the resident

Resident cannot afford these activities

Lsck of transportation

Other, (Specify) 53-

-& ❑ Other, (specify) 63-

22a. DURING THE PAST YEAR, HAS THIS RESIDENT BEEN ON ANY KIND OF LEAVE OVERNIGHT OR LONGER,

EXCLUDING LEAVE FOR MEDICAL REASONS?

Q “T g

No (Skip to Question 23%1 ❑ Don-t kmw (Skip to Q.estim 23a.)

-3

b. WHERE DID – USUALLY GO WHEN ON LEAVE? (Mark (X) Only One 80x)

66-1 ❑ To own home or apartment

-2 ❑ TO homeof family or relatives

‘3 ❑ TO home of unrelated friends

-4 ❑ To fc.sterhoma

.6 ❑ To boardinghouse w room

-8 ❑ TO another place, (Specify) 56-

-7 ❑ Don’t know

c, ABOUT HOW OFTEN DID THIS RESIDENT GOON LEAVE? (Mark (X) Only One Box)

67-1 •1

-2 ❑

-3 •1

-4 •1

-5 •1

-8 ❑

-7 ❑ Form 73NHs-7

Nearly every week

About once a month

About once every two months

Several times a year

About once a year or less

Other (Specify) 68.

Don’t know

58
23a. DOES – HAVE ANY VISITORS?

b. HOW FREQUENTLY DO VISITORS SEE THE RESIDENT? (Mark (X) Only One Box)

16-1 ❑ Nearly every week “5 ❑ Abaut Once a year or Iess

.2 ❑ About once a month -6 ❑ Other (Specify) 17-

“3 ❑ AbOut Once every two months -7 ❑ Oon’t know

.4 ❑ Several times a year

24. HOW MANY BEDS ARE IN – ROOM? (Mark (X) Only One Box)

18-1 ❑ Onebed (i.e., the resident’sown bed) -4 ❑ Four beds

.2 ❑ Two beds -6 ❑ Five or more beds

-3 ❑ Three bads

25a. HAS THIS RESIDENT LIVED IN THIS FACILITY FOR ONE FULL MONTH OR LONGER?

r-J Yes ❑ No

19-1 -2 ---l

Stop; goon to next

qu:stlonnaire.

b. LAST MONTH, WHAT WAS THE BASIC CHARGE FOR THIS RESIDENT’S LODGING, MEALS, AND NURSING CARE

NOT INCLUDING PRIVATE DUT-SING OR OTHER SPECIAL CHARGES?

❑ No charge isnmdeforcare (Skipm Question 26a.) $

●

CC20-25

c. LAST MONTH, WHAT WAS THE TOTAL CHARGE FOR THIS RESIDENT’S CARE, INCLUDING ALL CHARGES FOR

‘SPECIAL SERVICES, DRUGS, AN~CIAL MEDICAL SUPPLIES?

❑ No charge ism.?deforc.me (Skip to C1.es.tie” 26a.) $

●

CC26-31

(1) OID THIS AMOUNT INCLUDE SPECIAL CHARGES FOR

No Yes

(a) physician services? 32-2 ❑ -’ •1

(b) private duty nursing? 33-2 ❑ -’ •1

[c) therapy? 34-2 ❑ -1 •1

(d) drugs? 35-2 ❑ -1 •1

(e) special medical supplies? 36-2 ❑ -’ •1

(f) sp+cial diet? 37-2 ❑ “’ •1

(g) other?

P

38-2 ❑ -1

Specify -39

26a. WHAT WERE *THE SOURCES OF PAYMENT FOR THIS RESIDENT’S CARE LAST MONTH?

[Mark(Xl All That Apply)

CC40’48 ❑ (1) Own income or family ❑ (4) Other publicassista”m

support (private plans,

❑ (7) Initial fmymentor welfare Iife care

retirement funds, social

security, etc.) ❑ (5) Church 5UPPON ❑ (8)~fl::ge is made

❑ (2) Medicare(Title XVIII) ❑ (6) VA contract

❑ (3) Medicaid (Title XIX)

❑ (9) Other (Spemfy) ~ 49-

b. WHAT WAS THE PFUMARYSOURCE OF PAYMENTS FOR – CARE LAST MONTH?

(Mark (X) Only One Box.)

50-1 ❑

“2 •1

“3 •1

Own income or family 4 ❑ other Public assistance -7 •1

support (private plans, or welfare

retirement funds, social

swurity, etc.) -5 ❑ Church support .8 ~

Medicare (Title XVI 11) -6 ❑ VA contract

-9 •1

Medicaid (Title XIX)

I nitlal payrnem.

life care

No char~ is made

for care

Othar ISpscify) ~

51-

Form 73NHS.7

59
STAFF QUESTIONNAIRE - PART 1

1973 Nursing Home Survey

National Center for Health Statistics E!E@l

Health Resources Administration

Rockville, Maryland 26 ccl-4 36.-

!

ASSURANCE OF CON FIDENTIALITY– AII information A. ESTABLISHMENT NO. B. LINE NO.

which would permit identification of the individual wil I be held

In strict confidence, will be usedonly by personsengagedin and

for the purposes of the suwey, and wi II not be disclosed or released UIIIUEl QI

to others for any purposes. CC2

C. OCCUPATION (CODE D. IN CHARGE OF SHIFT?

FROM STAFF

CLASSIFICATION CARO)

;0;6

I

CC14-I CC15 CC17

The National Center for Health Statlstfcs of the Health Your answers will be gwen confidential treatment. The mformatton WIII be

Resources Admmmtrat!on ISconducting a natmnwlde used for statistical purposes only, and WIII be presented m such a manner that

survey m nursing homes. One of the purposes of the survey no mdwidual person or establwhment can be Identified. After completmg the

ISto oblzln certarn lnformatmn about the staff employed In these form please return it in the envelope prov!ded.

faclllt,es. We would appreciate your taking the brtef amount of

time necessary to complete thm quest mnna!re.

You may ask questmns of the intewiower or by calling S00.63S.0S56.

1. HOW LONG HAVE YOU WORKED AS A

a. IN THIS FACILITY?

mu

Years Months

CC20 CC22

b. IN OTHER NURSING HOMES,

HOMES FOR THE AGED, OR

SIMILAR FACILITIES? n n 0’ s%::~er ❑ Years Months

CC24 CC26

c. IN HOSPITALS?

m m “R ~:~~;:~:~:box ❑

Years Months in a hospmd.

CC2S CC30

2. WHAT IS YOUR OATE OF BIRTH? //

Month Day Year

CC32,33 CC34,35 CC36,37

3. HOW MANY HOURS PER WEEK DO YOU USUALLY WORK IN THIS FACILITY?

m hours

CC38

4. HOW MANY HOURS DID YOU WORK LAST WEEK IN THIS FACILITY?

Dhows 0’ ❑ none

CC40

5, BESIDES THE HOURS WORKED IN THIS FACILITY, HOW MANY ADDITIONAL HOURS DID YOU WORK IN YOUR

PROFESSION LAST WEEK?

n hews “R ❑ me

CC42

6. WHAT IS YOUR SALARY BEFORE DEDUCTIONS FOR THE WORK YOU PERFORM IN THIS FACILITY ONLY?

( Mark (X) Only One Box)

$ . per

I

52-1 ❑ week

CC44

i “2 •1 h“”’

OR “3 ❑ two weeks

❑ I donate my services -4C1 one month

CC51.1 -5 •1 other time period, specify 53-

Form.73NHS-4

60
7. IN ADDITION TO THIS SALARY, DO YOU RECEIVE:

(Mark the Yes or No Box for Each Line) Yes No

a. Paidvacatmn, paid hol!days, andlor paid sick leave> . . 54.1 ❑ “2 •1

b. Cash bonus? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,., 55.1 ❑ -2 •1

c, Pensmn plan in additmn to Social Security? 56-1 ❑ -2 c1

d. Health insurance? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57.1 n

-2 •1

e. L8felnsurance? . . . . . . . . . . . . . . . . . . . . . . . . . . . 5B.1 ❑ “2 •1

f. Release time for attending trairung instnutes7 ., 59.1 ❑ -2 •1

g, CIVIC or personal leave (such as leave for jury duty, mllltary

reserves, voting, funerals] ? . . . . . . . . . . . . . . . . . . . . 60.1 ❑ “2 •1

h. Room? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61-1 n

“2 •1

i. Meals? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62.1 D

-2 c1

j. Other? Specify _

64-

63-1 ❑ “2 c1

8. LAST WEEK IN THIS FACILITY, DID YOU PERFORM ANY OF THE FOLLOWING SERVICES:

[Mark the Yes or No Box for Each Line)

Yea No

a. Admmmtration of the facility? . . . . . . . . . 65-1 ❑ -2 c1

b. Nursing care? . . . . . . . . . . . . . . . . . 66-1 ❑ -2 c1

c. Medical anddenta! care? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67.1 ❑ -2 •1

d. Physical therapy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6B.1 ❑ “2 c1

e. Occupational therapy? . . . . . . . . . . . . . . . . . . . . . . . . . . 69.1 ❑ -2 •1

f. Recreational therapy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70.1 ❑ “2 c1

g. Speech and hearing therapy? . . . . . . . . . . . . . . . . . . . . . . . . . 71-1 ❑ -2 •1

h, Social work? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72-1 ❑ -2 •1

i, Clerical work? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73-1 ❑ -2 •1

j. Knchenldietarv work, grocery shopping? . . . . . . . . . . . . . . . . . . 74-1 ❑ -2 c1

k. Housekeeping services? . . . . . . . . . . . . . . . . . . . . . . . . . 75-1 u

“’2 •1

1. Other? Specify service _ 77 76-1 ❑ -2 c1

9, WHAT IS THE HIGHEST GRADE YOU Circle highest grade completed CARD2

COMPLETED IN SCHOOL? CC142

a. college . . . . . . . . . . . . . . . . 1 2 3 4 5 or more CC15

b. Nursing school (dtploma) 123 CC16

c. Junior college . . . . . . . . . . . 12 CC17

d. High school . . . . . . . . . . . 1234 CC18

e. Elementary school . . . . . . . 1234567B CC19

1Oa. WHICH OF THE FOLLOWING DEGREES

DO YOU HAVE? b. FOR EACH DEGREE THAT YOU c. IN WHAT YEAR DID YOU

(Mark all that apply, count

HAVE PLEASE ENTER YOUR s RECEIVE EACH OEGREE?

MAJOR FIELD OF STUDY

completed degrees only)

Associate degree or certificate 20-1 19

CC25,26 CC27,26

Bachelor’s degree 21.1 - 19

CC29,30 CC31,32

Master’s degree 22-1 •1

19

CC33,34 CC35,36

Doctorate [M. D., D. O., Ph. D., 23.1 19

etc. 1 CC37,38 CC39,40

If none of these, mark (X) box ~ a“dskiptoQ”estio” 11)

Form 73 NHS-4

61
11. HAVE YOU TAKEN ANY NON. OEGREETRAl NINGCOURSES lNTHE PAST YEAR? TRAIN INGCOURSESINCLUOE

CLASS SESSIONS AN DSEMINARS. DO NOT INCLUDE COURSES FOR DEGREE CREDIT.

42.1

7

Yes -2

QNo

(Skip to Questmn 12)

b. FOR EACH OF THE SUBJECT AREAS c. NUMBER OF

LISTED BELOW, INDICATE HOW MANY COURSES*

NON-DEGREE TRAINING COURSES* YOU TAKEN IN PAST

HAVE TAKEN WITHIN THE PAST YEAR. 12 MONTHS

a. Nursing care of the aged

orchron!cally ill I I

CC43.44

b. Medical or dental care of the

aged orchron!cally III I I

CC45,46

c, Mental or social problems of

the aged or chronically ill I I

CC47,48

d. Phys!cal therapy or

rehabilitation I I

CC49,50

e. Occupatmnal therapy

I

I ..61,52

f, Nutrition or food services I I

CC53,54

9. Nursing home admmistratmn CC55,56

h. Inserwce Education CC57,58

i. Medical records CC59,60

i. Actwity programs for the

aged orchron!cally III

{

CC61,62

k. SocIel serv#cesfor the aged

orchron!cally III CC63,64

I Pharmacology and care of

drugs

I I

CC65,66

m. Other course related to your work

Speclf y CC68,69

67-

4

“Tralnmg courses mcludeclass sessions and seminars Donotlnclude

courses for degree credit. I

PLEASE TURN THE PAGE FOR THE NEXT QUESTION.

Form 73 NHS.4

62
12. ARE YOU A PHYSICIAN (M.D. OR D.O.)?

.. Olves ❑ No(Pleasestop,thisisthelastqueNionwhichappliestoyou.

Thank you foryour cooperation. Please return the questionnaire

/ ‘2

in the enclosed postage paid envelope either to the intewiewer or to:

/

Applied Management Sciences

962 Wayne Avenue, Suite 701

Silver Spring, Maryland 20910)

b. DO YOU ATTEND YOUR OWN PRIVATE PATIENTS IN THIS HOME?

CAR03 15-1 ❑ Yes~b.1 HOW MANY OF YOUR OWN PRIVATE PATIENTS DO YOU ATTEND IN THIS FAClLlTY7_ patients

x CC16

f

c, ARE YOU NOW ATTENDING PATIENTS TEMPORARILY IN THIS

FACILITY TO COVER FOR THE PATlENT’S OWN PHYSICIAN? 19-1 ❑ Yes -2 ❑ No

d. DO YOU TAKE EMERGENCY CALLS FOR ANY PATl ENT IN THIS HOME? 20-1 ❑ Yes -2 ❑ No

e. DO YOU PROVIDE OTHER DIRECT PATIENT SERVICE IN BEHALF OF

THE HOME’S RESPONSIBILITY FOR SECURING SUCH COVERAGES

(e.9., ADMISSION EXAMS, PRONOUNCING DEATHS, SECURING

MEDICATION AND OIET ORDERS, ETC.)? 21-1 ❑ Yes -2 ❑ No

f. DO YOU PROVIDE INSERVICE TRAINING TO THE HOME’S PERSONNEL? 22-1 ❑ Yes -20 No .

9. FOR HOW MANY RESIDENTS IN THIS HOME 00 YOU PROVIDE MEDICAL CARE?

residents

CC23

Thank You for your cooperation. Please return the questmnnaire in the enclosed postage paid envelope

either to the interviewer or to:

Applied Management Scnences, Inc.

962 Wayne Avenue, Suite 701

Silver Spring, Maryland 20910

Form 73 NHs.4

63
STAFF QUESTIONNAIRE -- PART II

1973 Nursing Home Survey

National Center for Health Statistics

Health Resources Administration m

Rockville, Maryland

cc 1-5 ccl 1-1

T A. ESTABLISHMENT NO. B. LINE NO. c, occuASSURANCE OF CONFIDENTIALITY - All information

PATION

CODE

which would permit identification of the individual will be

held in strict confidence, will be usad only by persons engaged

CC2 CC12 CC15

in and for the purposes of the survey, and will not be disclosed or released to others for any purposes.

(

The National Center for Health Statistics of the Health

Resources Administration is conducting a nationwide

survey in nursing homes. One of the purposes of the survey

is to obtain certain information about the staff employed in these

facilities. We would appreciate your taking the brief amount of

time necessary to complete this questionnaire.

Your answers will ba given confidential treatment.

The information will be uead for statistical purposes

only, and will be presented in such a manner that

no individual pxson or establishment can be identified.

After completing the form please return it in the

envelope provided.

Thank you for your cooperation.

THE FOLLOWING STATEMENTS ARE ABOUT NURSING HOMES AND/OR HOMES FOR THE AGED. FOR EACH OF THE

STATEMENTS PRESENTED, MARK (X) THE RESPONSE CATEGORY WHICH MOST NEARLY REPRESENTS YOUR FEELING

MARK A BOX FOR EACH STATEMENT.

1. DEATHS IN HOMES FOR THE AGED OR NURSING HOMES SHOULD BE MADE AS INCONSPICUOUS AS POSSIBLE

AND ANY CONVERSATION ABOUT THEM AMONG RESIDENTS SHOULD BE DISCOURAGED.

‘B-lb -’h “’n “15 -5 b

Strongly agrae Agrae Don’t know Disagree Strongly disegree

2. RESIDENTS OF HOMES FOR THE AGED SHOULD BE ENCOURAGED TO ENGAGE IN VOLUNTARY ACTIVITIES,

E.G., RECEPTIONIST FOR THE HOME, FEEDING AND READING TO OTHER RESIDENTS.

“-16 “’b -’b “15 “’h

Strongly egree Agree Don’t know Disagres Strorgly disagree

3. THE FORMATION OF CLIQUES OR SMALL SOCIAL $GROUPS SHOULD BE DISCOURAGED IN ANY RESIDENTIAL

SITUATION.

“-’6 “’d -Sb “b “h

Strong Iy agree Agree Don’t know Disagres Strongly disagree

4. SYMPTOMS OF SENILITY ARE ESSENTIALLY PHYSIOLOGICAL AND IT IS LARGELY A WASTE OF VALUABLE STAFF

TIME TO ATTEMPT TO ALLEVIATE THEM WITH “SOCIAL THERAPY”.

21-1 b -2 d “’h “15 -Sh

Strongly sgree Agree Don’t know Disegres Strongly disagree

5. “VACATIONS” FOR RESIDENTS SHOULD BE DISCOURAGED SINCE THEY CAUSE SUCH PROBLEMS IN ADJUSTMENT

WHEN THE RESIDENTS RETURN TO INSTITUTIONAL LIVING.

A B c D E

22-1 ❑ -2 ❑ -3 ❑ 4 ❑ -5 ❑

Strongly agree Agree Don’t know D isagrw Strongly dieagree

6. RESIDENTS SHOULD AT ALL TIMES BE SUSCEPTIBLE TO OBSERVATION BY THE STAFF.

“-lb -Zb -’b “h “b

Strongly Wree Agres Don’t know Disagree Strongly disagree

Form 73N HS.5

64
7. RESIDENTS SHOULD BE DISCOURAGED FROM SHOWING AN INTEREST IN THE OPPOSITE SEX, FOR SUCH BEHAVIOR

IS INAPPROPRIATE AT THIS AGE.

“-’h “2 •1B “’h “b -’ h

StrongIy agree Agree Don’t know Dmagree Strongly disagree

8. IT ISA RESPONSIBILITY OF STAFF TO ENCOURAGE RESIOENTS OF HOMES FOR THE AGEO TO PARTICIPATE IN

COMMUNITY ACTIVITIES WHEREVER POSSIBLE, E.G., HOBBY FAIRS, VOTING, ETC.

“-’ii -*b -’6 “ii “b

Strongly agree Agree Don’t know Disagree Strongly dis~ree

9. OLD PEOPLE LIKE AND NEED SIMPLE, EASILY DIGESTED FOODS AND ARE NOT MUCH INTERESTED IN “FRILLS”.

28-’ 0 -’ii -’d “h -’d Strongly agree Agree Don’t know Disagree Strongly disagree

10. SOMETIMES RESIDENTS OF NURSING HOMES OR HOMES FOR THE AGED SHOULD BE CHALLENGED TO DO JUST

A LITTLE MORE THAN THEY HAVE BEEN DOING, EVEN AT SOME SMALL RISK, E.G., WALKING OUT-OF-DOORS.

“-’n -’h -d “b -5h

Strongly agree Agree Don’t know Disagree Strongly disagree

11. RULES FOR VISITING HOURS ARE NECESSARY SO THAT THE ROUTINE OF CARE WILL NOT BE INTERRUPTED.

‘“”’n-’ii -d “ii “’b

Strongly agree Agree Don’t know Disagree Strongly disagree

12. ONE OF THE MAJOR DIFFICULTIES THE STAFF RUNS INTO IN WORKING WITH AGROUPOF OLD PEOPLE IS THEIR

INSISTENCE THAT PERSONNEL STOP AND LISTEN TO THEIR PROBLEMS OF EVERYDAY LIVING.

31-1h -2 h -’h (1 -5d

Stronglyagree Agree Don’t know D#sagree Strongly disagree

13, WE CAN MAKE SOME IMPROVEMENT, BUT BY AND LARGE THE CONDITIONS OF NURSING HOMES ARE ABOUT AS

GOOD AS THEY CAN BE, CONSIDERING THE CONDITION OF THE RESIDENTS.

Strong Iy agree Agree Don’t know Disagree Strongly disagree

14. IT IS NECESSARY TO OISCOVER THE REASON FOR, NOT JUST TO CONTROL, DISRUPTIVE BEHAVIOR.

33-’h “2h -(I “b “b

Strongly agree Agree Don’t know Disagree Strongly disagree

15. AN EFFECTIVE WAY OF HANDLING PROBLEMS WHICH ARISE IN THE HOME IN THE COURSE OF DAILY LIVING

WOULO BE TO HAVE REGULAR MEETINGS WHERE THE RESIDENTS AIR THEIR GRIPES.

34-’b -2 ii -3h “6 -’h

StrongIy agree Agree Don’t know D#sagree Strongly d magree

Form 73 NHS.5

65
16. RESIDENTS IN HOMES NEED TO BE ENCOURAGED TO MAKE THEIR OWN DECISIONS FOR DAILY LIVING, RATHER

THAN BEING CONTROLLED BY ROUTINE.

A B c D E

“-’n -’cl -3CI “cl -’cl

Stronglyagree Agree Don’t know Disagree Strongly disagree

17. THE QUIET RESIDENT IS DEMONSTRATING A GOOD ADJUSTMENT TO THE HOME AND DOES NOT NEED AS MUCH

ATTENTION AS THE DEMANDING ONE.

A B c D E

..10 +-J -30 4D ~n

Strongly agree Agree Don’t know Disagree Strongly disagree

18. AS SOON AS A PERSON SHOWS SIGNS OF SENILITY HE SHOULD BE PLACED IN A HOME.

A B c D E

“-’cl “’n -’cl “cl -’n

Strongly agree Agree Don’t know Disagree Strongly disagree

19. WE SHOULD BE SYMPATHETIC WITH OLD PEOPLE, BUT WE CANNOT EXPECT TO UNDERSTAND THEIR ODD

BEHAVIOR.

A B c D E

40-1 •1 -2 ❑ -K1 40 “cl

Strongly agree Agree Don’t know Disegree Strongly disagree

20. OLD PEOPLE ARE FREQUENTLY KEPT IN NURSING HOMES ALTHOUGH THEY COULD GET ALONG WELL ENOUGH

IN THE COMMUNITY.

A B c D E

“1-’0 -’cl -’cl “cl-m Strongly agree Agree Don’t know Disagree Stronalv disaaree

Thank you for your cooperation. Please return the form in the enclosed poetage paid snvelopto

Applied Management Sciences

962 Wayne Avenue, Suite 701

Silver Spring, Maryland 20910

Form 73 NHS-5

66
STAFF CLASSIFICATION CARD

1973 Nursing Home Survey

National Center for Health Statistics

Health Resources Administration

Rockville, Maryland

I

OMB # 068-S-721 72

Expires 7.31-74 I

WHICH OF THE FOLLOWING JOB CATEGORIES BEST FITS THE JOB WHICH THIS EMPLOYEE DOES IN THIS FACILITY?

01,

02,

03,

C4.

05.

06.

07.

08.

09.

10.

11.

12.

13,

14,

15,

16,

17.

18.

19,

20.

21,

22.

23.

ADMINISTRATOR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PHYSICIAN (M. D. OR D.O.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DENTIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

PHARMACIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

REGISTERED OCCUPATIONALTHERAPIST . . . . . . . . . . . . . . . . . . . .

REGISTERED PHYSICALTHERAPIST . . . . . . . . . . . . . . . . . . . . . . . . . .

ACTIVITIES DIRECTOR .,,,..,. . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DIETITIAN OR NUTRITIONIST . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

REGISTERED MEDICAL RECORD ADMINISTRATOR . . . . . . . . . . . . . .

SOCIALWORKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

SPEECHPATHOLOGISTAND/OR AUDIOLOGIST . . . . . . . . . . . . . . . . . .

OTHER PROFESSIONAL OCCUPATIONS (INCLUDES INTERN,

RESIDENT, THERAPEUTIC RECREATOR) . . . . . . . . . . . . . . . . . . . . . .

OCCUPATIONTHERAPISTASSISTANT . . . . . . . . . . . . . . . . . . . . . . . .

PHYSICALTHERAPISTASSISTANT . . . . . . . . . . . . . . . . . . . . . . . . . .

SOCIALWORKERTECHNICIAN/ASSISTANT . . . . . . . . . . . . . . . . . . . .

OTHERMEOICAL RECORD ADMINISTRATORS ANDTECHNICIANS . . . .

GROUP A

Entar in Column i

of Staff Control Record

REGISTERED NURSE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LICENSED PRACTICALNURSEOR LICENSEO VOCATIONAL NURSE . . .

NURSE’SAIDE ANDORDERLY. , . . . . . . . . . . . . . . . . . . . . . . . . . . . .

CLERICAL, BOOKKEEPING,OR OTHER OFFICESTAFF . . . . . . . . . . . .

FOOD SERVICE PERSONNEL(COOK, KITCHEN HELP, ETC.) . . . . . . . .

HOUSEKEEPING AND MAINTENANCE PERSONNEL (MAID,

LAUNDRYMAN, MAINTENANCE MAN, ETC.) . . . . . . . . . . . . . . . . . . . .

JOBOTHERTHAN THOSE LISTED ABOVE (PLEASE SPECIFY JOB

TITLE ON THEINDIVIDUALLINE OF STAFF CONTROL RECORD) . . . .

GROUP B

Enter in Column j

of Staff Control Record

GROUP C

Enter in Column k

of Staff Control Record

GROUP D

Enter in Column I

of Staff Control Record

GROUP E

Enter in Column m

of Staff Control Record

67
STAFF CONTROL RECORD Shect_of_

1973 Nursl”g Honw SurW

Nat,c,ul Center for Health Statktia

m

Health Rcmu,ce Adm,nttirattom

Rcckv,l le. M,ryl,cd

A%URANCE OFCONFIDENTIALIW .Alli"fwm,t$m ti,tiwwMwm,, #d@n,,f,cItion

ccl 3 w

.1 the ,nd,”,du,l wall & held ,“ s,,,ct confidence. wlt be used 0“1” LV -%,rK4@ ESTABLISHMENT NO

,. and f., the IIU,WS of the mmey, and w,!] net te d,dad w released to .at&s

f., ,“” !nlr$a$es.

lNE

R,

3TAFF SEX ETHNIC BACKGROUND EWLOYER HOURS !WRKED OCCUPATION LIN1

N8

Llslw!o* lha”am,s of all non, mm,,,,-

r

,, ,.,, w . . ,“, ,?- E.,” Cc4 From S“lf C,,.,l~t.” Cd

whoa,. on,hes,aff of the ,.,1,,” ,,,”,M, .,

., ,,. ●mr,l.,ed under contract

.“.!.,” -.,.. . . . .

S-4,,?LE mmp.,nl . . .. . .“,! ~“ ,“,!W -... 0, 16 17 1, ,, m 2,

Include rn,mbers of rel,g,ou, .,,.,, w ,,- *.. . . - ~o”,A ~rwo ~

yoyanza;wy~;:c~%de IS who ,.,,,,” ~ ,,.!! .,- .,,

cm., c GrGW D a

Am code -.”. “,, .r -, .“9!.,”

LW;dslator and ,s,,,1,.1 ()

“M. M“. x .mr. ,“ sw— 3w_ W_ Sw_ ml.

m.”.e, ? w. , ,.,, Mll

!“,,,,, ‘E — ‘E— ::cT ::,r m ml

Exclude ,olunteers ,., h,..,, &$w :2. -mm -m , ~Lz

L,s1 wr$on, [n chars of a ,h,ft

,.m, ●“,QO, P#,m., P,,.”,

O“ the too ,hr,e ,,.,,

NO

,m.w.d %.,..+ T*. ‘&y.d %+..

cc,, ccl, =,, <c,, c,,,

,

I*) (b) b) w w 10 hl

II 13

M. ,“ N. ,. m, ,. N. ,“

CC14 ci15 CC16 CC17 -:!19 ~y,. 7 :,y 7 gy.~ ::ay~ ~,,

c.., c.,... !,, -

: ‘:’” ! “; j :: ‘y”’; “:”; ::::

-%2 A. & “!$,, &

<01 12 t 23456 12 12 x01

<02 12 123456 12 12 x02

{03 12 1 23456 12 12 X03

01 12 123456 12 12 01

02 12 123456 12 12 02

03 12 1 23456 12 12 03

04 12 123456 12 12 M

05 12 1234S6 12 12 M

w 12 1 23456 12 12 06

07 12 1 23456 12 12 01

m 12 123456 12 12 m

m 12 123456 12 12 m

10 12 123456 12 12 1:

11 12 1 23456 12 12 11

12 12 1 23456 12 12 12

13 12 1 23456 12 12 13

14 12 1 23456 12 12 14

15 12 123456 12 12 15

16 12 123456 12 12 16

17 12 1 23456 12 12 17

18 12 123456 12 12 18

19 12 123456 12 12 19

20 12 123456 12 12 m

21 12 123456 12 12 21

22 12 1 23466 12 12 22

23 12 1 23458 12 12 23

24 12 1 23466 12 12 24

25 12 1 23456 12 12 25

26 12 1234S6 12 12 26

27 12 123456 12 12 2?

28 12 123456 12 12 z

29 12 1 23456 12 12 2?

24 12 1 23456 12 12 x

31 12 1 23456 12 12 31

32 12 1 23456 12 12 3;

33 12 t 23456 12 12 3:

34 12 1 22456 12 12 M

35 12 I 23456 12 12 3!

36 12 1 23456 12 tz 24

37 12 123456 12 12 31

39 12 1 23456 12 12 3

39 12 123456 12 12 3

40 12 123456 12 12 M

41 12 1 23456 12 12 41

42 12 123456 12 12 G

43 12 1 23456 12 12 <

44 12 123456 12 12 41

45 12 123456 12 12 4!

46 12 123456 12 12 41

47 12 I 23456 12 12 G

46 12 1 23456 12 12 I

u

49 1? 123456 12 12 4s

50 i

I I

1211 23456112[1 2 I I I I I I I 50

IImare1,.,,.,,needed CO\ TI\LE O\ 6*C K CO”,*””, !m@ng pattern O\ U*C k

7...+.,

68

.
[NE

lR STAFF SEX ETHNIC SACKG ROUND EMPLOYER HOURS $%ORKED OCCUPATION

w,t be!.. m n.nw 01 m ermns :::::,@h...

P

,,. . 0.. ,. , . . .. , . . ,,!!,r c@, From $.,,,! .(,’,,( .,, .“ c,!.

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nr,IJ”Iz,t,um md orders who

dmdfe fhc,r SWV8CO$ Arm code . . . . . . , ,5.< -... -“ .,”

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LIST.

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on the (m thr,, 1,”,$ U..,, s.”we ,,.-,.. >.”s!.

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I*1 [bl [c) [d) (*1 [f) [g) I thl

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,“.. . . .

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h, ($J [!1

12 123456 12 12 L..W,, ..: n . ..X ?2 . ..= 27 c, m%

~,1 12 1 23456 12 12 1 I

61 12 123456 12 12

1

63 12 1 23456 12 12 I

!,,! — 12 123456 12 12 t

,,,,

I

12 I 23456 12 12

!,,, 12 1 23456 12 12

!,? 12 1 23456 12 12 I

c,“

1

12 123456 12 12

E 12 1 23456 12 12

143 12 123456 12 12

[,1 12 I 23456 12 12

1.2 12 1 23456 12 12

,,J 12 1 23456 12 12

!4 12 1 23456 12 12

,7 12 123456 12 12

— — ~ .

j. 12 123456 12 12

——

;7 12 123456 12 12

_-.. –_

I

!i+ 12 123456 12 12

‘I+ 12 123456 12 12

% 12 1 23456 12 12

11 12 123456 12 12

72 12 I 23456 12 12

73 12 123456 12 12

14 12 1 23456 12 12

76 12 1 23456 12 12

W 12 1 23456 12 12

17 12 123456 12 12

78 12 1 23456 12 12

.+-—

19 12 123456 12 12 ]

20 12 123456 12 12

31 12 1 23456 12 12 I

32 12 1 23456 12 12

—

33 12 123456 12 12

w 12 123456 12 12

36 12 1 23456 12 12

36 12 123456 12 12

5 — 12 123456 12 12

18 12 1 23456 12 12

m 12 123456 12 12

10 12 123456 12 12

31 12 1 23456 12 12

)2 12 123456 12 12

33 12 1 23456 12 12

14 12 1 23456 12 12

15 12 1 23456 12 12

3G 12 123456 ?2 12

37 12 1 23456 12 12

?8 12 123456 12 12

D 12 1 23456 12 12

N 12 1 23456 12 12

If mm hm are needed USE A NEW 3HEET md

renumber the 10”cs bmmnw wrth !4 101 and conhnuc %UWII,U P,l!em

F.rm 73NHS-3

69
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

Survey 8 conducted by the National Center for Health

Statistics.

Definitions for these two cla~ses of nursing homes

were as follows:

Ntmsin.g Care Home

Fifty percent or more of the residefns 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.)

AI 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 one full-time RN or LPN was employed.

or

Some of the residents received nursing care during

the week prior to the survey.

No full-time RN or LPN was employed.

Tbe 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).

000

m * U.S.GOVERNMENTPRINTINGOFFICE 1977– 260-937:25
——

Series 1.

Series 2.

Series 3.

Seties 4.

Series 10.

Series 11.

VITAL AND HEALTH STATISTICS PUBLICATIONS SERIES

Formerly Public Health Service Publication No. 1000

Programs and Collection Rocedures. –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 Studiek –Reports presenting analytical or interpretive studies based on vital and health

statistics, carrying the analysis further than the expository types of reports in the other series.

Documents and Committee Reports. –Final reports of major committees concerned with vital and

health statistics, and documents such as recommended model vital registration laws and revised bh%

and death certitlcates.

Data ji-om the Health Interview Survey. –Statistics on illness; accidental injuries; disability; use of

hospital, medical, dental, and other services; and other health-related topics, based on data collected in

a continuing national household interview survey.

Data from the Health Examination Survey .–Data from dkect examination. testing. and measurement

of national samples of the civilian, noninkitutionalized population provide” the b~is for two types of

reports: (1) estimates of the medically defined prevalence of specific diseases in the United States and

the distributions of the population with respect to physical, physiological, and psychological characteristics; and (2) analysis of relationships among the various measurements without reference to an

explicit finite universe of persons.

Series 12. Data f+om the Institutionalized Population Surveys. –Discontinued effective 1975. Future reports from

these surveys will be in Series 13.

Series 13. Data on Health Resources Utilization. –Statistics on the utilization of health manpower and facilities

providing long-term care, ambulatory care, hospital care, and family planning services.

Series 14. Data on Health Resources: Manpower and Fizcilities. -Statistics on the numbers, geographic distrib-

~ ution, and characteristics of health resources including physicians, dentists, nurses, other health occupations, hospitals, nursing homes, and outpatient facilities.

Series 20. Data on Mortality. –Various statistics on mortality other than as included in regular annual or monthly

reports. Special analyses by cause of death, age, and other demographic variables; geographic and time

series analyses; and statistics on characteristics of deaths not available from the vital records, based on

sample surveys of those records.

Series 21. 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.

Series 22. 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.

Series 23. Data from the National Survey of Family Growth. –Statistics on fertility, family formation and dissolution, family planning, and related maternal and infant health topics derived from a biennial survey of

a nationwide probabilityy sample of ever-married women 1544 years of age.

For a list of titles of reports published in these series, write to: Scientific and Technical Information Branch

National Center for Health Statistics

Public Health Service, HRA

Hyattsville, Md. 20782