Data from the

NATIONAL HEALTH SURVEY

Employeesin NursingHomes

in theUnitedStates:

1977 NationalNursing Home Survey

Statistics on nursing home employees including hourly wages, employment experience, education, age, sex, and race or ethnicity

according to certification, ownership, bed size, and regional location of the homes. Based on data collected in the 1977 National

Nursing Home Survey.

DHHS Publication No. (PHS) 81-1820

Series 14

Number 25

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Public Health Service

Office of Health Research, Statistics, and Technology

National Center for Health Statistics

Hyattsville, Md. February 1981
r

Library of Congress Cataloging in Publication Data

Sirrocco, Alvin.

Employees in nursing homes in the United States, 1977.

(Vital and health statistics : Series 14, Data from the National Health Survey ; no. 25)

(DHHS publication ; no. (PHS) 81-1820)

Includes bibliographical references.

Supt. of Dots. no.: HE 20.6209:14/25

1. Nursing homes–United States–Employees–Statistics. I. Title. II. Series: United

States. National Center for Health Statistics. Vital and health statistics : Series 14, Data

from the National Health Survey, Data on health resources, manpower, and facilities ; no.

25. III. Series: United States. Dept. of Health and Human Services. DHHS publication ;

no. (PHS) 81-1820. [DNLM: 1. Nursing homes–United States–St atistics. 2. Personnel,

Hospit&United States–Statistics. W2 A N148vn no. 25]

RA997.S56 331.7’6136216’0973 80-607872

ISBN 0-8406 -0213-8

For sale by the Superintendent of Documents, U.S. Government Printing office, Washington, D.(!. MM02
NATIONAL CENTER FOR HEALTH STATISTICS

DOROTHY P. RICE, Director

ROBERT A. ISRAEL, Deputy Director

JACOB J. FELDMAN, Ph. D., Acting Associate Directorfor Ana(vsis and Epidemiology

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

GARRIE J. LOSEE, Acting Associate Directorfor Data Processing and Services

ALVAN O. ZARATE, Ph. D., Assistant Director for International Statistics

E. EARL BRYANT, Acting Associate Director for Interview and Examination Statistics

ROBERT C. HUBER, Acting Associate Director for Management

MONROE G. SIRKEN, Ph. D., Acting Associate Director for Research and Methodolo@’

PETER L. HURLEY, Acting Associate Directorfor Vital and Health CareStatistics

ALICE HAYWOOD, Informatiorz Officer

DIVISION OF HEALTH CARE STATISTICS

W. EDWARD BACON, Ph.D., Acting Director

JAMES E. DeLOZIER, Chie~ Ambulatory CareStatistics Branch

EVELYN MATHIS, Acting Chie~ Long-Term CareStatistics Branch

JOSEPH P. BARBANO, Chiex Health Professions Statistics Branch

W. EDWARD BACON, Ph .D., Acting Chie~ Hospital CareStatistics Branch

MANOOCHEHR K. NOZARY, Chief Technical Services Branch

STEWART C. RICE, ChieL Family Planning Statistics Branch

Vital and Health Statistics-Series 14-No. 25

DHHS Publication No. (PHS) 81-1820

Libra~y of CongressCatalog CardNumber 80-60787.2
CONTENTS

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

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

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

Qualifications of the Data .................................................................................................................

Facility Data ..........................................................................................................................................

Changes from the 1973-74 National Nursing Home Survey ...............................................................

Staff Data ........................................................................................................................................ .......

Total Staff ........................................................................................................................................

Administrative and Medical Staff ......................................................................................................

Nursing Staff .....................................................................................................................................

Therapeutic Staff ..............................................................................................................................

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

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

Appendixes

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

II. Definition of Certain Terns Used in~is Report ......................................................................

III. Survey Instruments Used in the Facility and Staff Portion of the 1977 National Nursing

A.

B.

c.

D.

E.

F.

Home Survey ............................................................................................................................

LIST OF TEXT TABLES

Average bed capacity and occupancy rate of nursing homes, by selected nursing home characteristics: United States, 1977 ..............................................................................................................

Median duration of resident’s stay in nursing homes and number and rate of discharges per 100

beds, by selected nursing home characteristics: United States, 1977 ..............................................

Number of nursing homes, beds, and residents, by selected nursing home characteristics:

United States, 1973-74 and 1977 .............................................. ...... .............................................

Number of full-time and part-time administrative and medical employees in nursing homes, by

occupational categories: United States, 1977 .................................................................................

Numbwof full-time and part-time therapeutic employees in nursing homes, by occupational categories: United States, 1977 .............................................................. ..............................................

Number of full-time and part-time therapeutic employees in nursing homes, by selected employee

characteristics: United States, 1977 ...............................................................................................

1

1

1

1

2

2

4

4

4

5

6

8

10

11

26

36

41

2

3

5

6

8

8

...

Ill
SYMBOLS

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

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

Quantity zero -------------------------------- -

Quantity more than O but less than 0.05 ----- 0.0

Figure does not meet standards of

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

iv
EMPLOYEES IN NURSING HOMES IN THE UNITED STATES:

1977 NATIONAL NURSING HOME SURVEY

AlSirrocco, Division of Health Care Statistics

INTRODUCTION

Scope of Report

Between May and December 1977, the National Center for Health Statistics, through the

Division of Health Resources Utilization Statistics, conducted a nationwide sample survey of

nursing homes, their residents, discharges, and

staff within the conterminous United States.

This survey, the 1977 National Nursing Home

Survey, included all types of nursing homes

regardless of their intensity of service or their

participation in Medicare or Medicaid programs.

This report concentrates on the characteristics and distribution of nursing home employees,

with secondary emphasis given to characteristics

and distribution of the nursing homes themselves. The presentation includes data on employees’ age, sex, race or ethnicity, education,

work experience, and salaries. Also presented

are such facility items as certification, ownership, region, number of beds, number of residents, occupancy rates, and staff ratios.

The text of this report is limited to selected

findings from the employee and facility data.

The tables, on the other hand, present a more

comprehensive look at the whole spectrum of

employee data gathered in the survey.

Background

Since 1963 the National Center for Health

Statistics has employed two types of surveys to

gather nursing home data: universe surveys and

sample surveys.

During universe surveys a mailout questionnaire is used to elicit basic information on characteristics of all known nursing homes in the

United States. A series of universe surveys,

called Master Facility Inventory Surveys, has

been conducted (1963,1 1967,2 1969? 1971!

1973,5 and 19766 ). A special ad hoc universe

survey, conducted in 1968,7 obtained more detailed information than did the national surveys.

However, the 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

mailings. This technique has been used a number

of times by the National Center for Health Statistics to collect nursing home data (1963,8

1964,9 and 196910 ). The universe used to draw

the samples for these surveys has in each case

been the most recent national Master Facility

Inventory listing, updated with newly opened

nursing homes.

An expanded sample survey was conducted

in 1973-74,11 for which separate questionnaires

were designed to incorporate facility, resident,

employee, and expense data. The 1973-74 survey was the first National Nursing Home Survey.

This report deals with the most recent in this

line of surveys, the 1977 National Nursing Home

Survey.

Qualifications of the Data

A basic knowledge of the survey design is essential to interpret the data in this report (see

1
appendix I for details). The survey design was a

stratified two-stage probability sample. The first

stage was a selection of facilities, and the second

stage was a selection of staff (as well as residents

and discharges) from the sampled facilities (see

appendix II for definitions of these terms). Data

on facility characteristics were obtained by interviews with the administrators, based on a Facilit y Questionnaire. Staff data were obtained by

leaving a Staff Questionnaire for the sampled

staff person to complete and return by mail. The

questionnaires are shown in appendix III. Only

those employees providing direct health-related

services to residents were eligible for sampling.

The response rates for facility and staff data

were 95 and 81 percent, respectively. Statistics

presented in this report were adjusted for facility and staff nonresponse (i.e., failure to complete the Facility or Staff Questionnaires).

Those items left unanswered on a partially completed questionnaire were generally imputed by

assigning a value from a responding unit that had

major characteristics identical to those of the

nonresponding unit.

Trend comparisons will inevitably be made

between findings from the 1973-74 surveyl z

and the 1977 survey. Before making trend comparisons, the following qualifications should be

noted:

●

●

The 1977 survey included all types of

nursing homes; the 1973-74 survey excluded those nursing homes providing personal care (without nursing) or domiciliary care.

The procedures used to estimate the

numb& of employees differed slightly

from those used in the previous survey;

the 1977 estimates are based on a sample

of employees from each sample facility,

while the 1973-74 estimates are based on

all staff in each sample facility.

FACILITY DATA

Utilization

The 1977 survey identified approximately

18,900 nursing homes and 1,40~,~00 nursing

2

home beds. Table 1 gives the number and percent distribution of homes, beds, and residents,

by ownership, certification, bed size, and geographic region. The reader may find it useful tqz

refer to this table when studying the staff data.

The average nursing home capacity was 74

beds. Table A shows how this average changes

according to various characteristics of the home,

For instance, government-owned nursing homes

had an average capacity of 136 beds, while those

under proprietary ownership had 67 beds.

Homes certified as both skilled and intermediate

had an average of 119 beds, while noncertified

homes had an average of 35 beds. Homes in the

West Region had an average of 53 beds, while

the other three regions were in the 78- to 82-bed

range.

Table A. Average bed capacity and occupancy rate of nurs.

ing homes, by selected nursing home characteristics:

United Statesr 1977

Nursing home characteristic

All nursing homes ...................

Ownership

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

Voluntary nonprofit .........................

Government ......................................

Certification

Skilled nursing facility only ..............

Skilled nursing facility and intermediate care facility .......................

Intermediate care facility only ..........

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

Bed size

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

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

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

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

Location

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

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

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

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

Averaga

bed

capacity

Number

74

67

87

136

82

119

65

35

23

72

130

264

81

82

78

53

rata

Percent

89

90

87

87

92

89

87

89

93

90

88

87

91

E

87
The average occupancy rate for nursing

homes was 89 percent, but this average did not

fluctuate by characteristics of the home as did

average bed capacity.

The turnover rate (discharges per bed) in

nursing homes was about 80 discharges for every

100 beds, and the median duration of a resident’s stay was 75 days. Table B indicates that,

within each of the nursing home characteristics

presented, substantial variations occur with the

latter statistic.

Residents in nonprofit nursing homes stayed

an average of 50 days, compared with stays of

80 days or more in homes under other types of

ownership. Homes providing skilled nursing care

(with or without intermediate care) had substantially shorter lengths of stay than either intermediate care or noncertified homes. This can be

accounted for by the Social Security Administration’s regulations concerning reimbursement

in skilled nursing facilities, which limit the number of days for which a person’s expenses are

paid. Also skilled nursing care is oriented to rehabilitation rather than to maintenance.] 3

The average length of a resident’s stay also

appeared to be influenced by the nursing homes’

bed size and regional location. The small homes

(less than 50 beds) had an average stay of 47

days, while the large homes (200 beds or more)

had an average of 103 days. A 39-day average

was reported in the West Region, while the three

other regions ranged between 78 and 99 days. It

should be noted, however, that the West Region

characteristically had smaller homes, which

would account for some of the regional

difference.

The turnover rate is a relative measure of

patient flow through the nursing home system.

Table B, Median duration of resident’s stay in nursing homes and number and rate of discharges per 100 beds,. bv. selected nursing home

characteristics: United States, 1977

Nursing home characteristic

All nursing homes........................................................................................................

Ownership

Proprietary ..mm.........................................................................................................................

Voluntary nonprofit ..............................................................................................................

Government ...........................................................................................................................

Certification

Skilled nursing facility only ...................................................................................................

Skilled nursing facility and intermediate care facility .............................................................

Intarmadiate care facility only ...............................................................................................

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

Bed size

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

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

100.199 bads .........................................................................................................................

200 bads or more ...................................................................................................................

Location

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

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

‘ South ................................................................................................................................ .....

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

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

Median

duration of

resident’s stay

in days

75

80

50

84

38

82

176

111

47

81

66

103

78

99

95

39

Discharges

Number I

Rate per

100 beds

1,117,500 80.4

803,100

225,100

89,200

379,000

448,400

210,400

79,600

150,000

323,800

479,500

164,200

247,100

336,600

270,900

262,800

83.3

77.1

66.5

129.8

82.5

54.4

47.4

81.6

78.0

89.1

64.9

79.4

70.1

72.1

118.2
For this report, turnover rate was calculated

using the number of discharges per 100 beds instead of admissions per 100 beds (as was used in

the 1973-74 National Nursing Home Survey reports). This was done because methodological

differences in collecting admission data and discharge data during the 1977 survey made the

discharge data a better measure of turnover.

As noted in a previous report,l 3 nursing

home utilization patterns are particularly influenced by certification status, with a higher turnover rate expected for skilled nursing facilities

than for intermediate care facilities. The results

from this survey tended to bear this out. The

turnover rates for calendar year 1976 showed

skilled nursing facilities had 129.8 discharges per

100 beds, combined skilled nursing and intermediate care facilities had 82.5 discharges per

100 beds, intermediate care facilities had 54.4

discharges per 100 beds, and noncertified homes

had 47.4 discharges per 100 beds.

The 1,303,100 residents residing in nursing

homes at the time of the 1977 survey were attended to by 647,700 full-time equivalent employees,a a rate of approximately 50 employees

per 100 residents. Most of these employees were

in the nursing field (577,000) with the majority

being nurse’s aides (424,900). The corresponding full-time equivalent staff per resident rates

were 33 nurse’s aides, 5 registered nurses, and 7

licensed practical nurses per 100 residents,

respectively.

While employee per resident rates are useful

in measuring the coverage allocated to residents

at the time of the survey, perhaps a more reliable measure is employees per beds, since beds

are static elements. Another advantage of using

employees per beds is that the resulting rate

gives the home’s coverage at capacity level. Table 2 presents these rates by various characteristics of the nursing home.

Changes from the 1973-74 National

Nursing Home Survey

The qualifications mentioned earlier should

be duly noted before any conclusions are drawn

aA full-time equivalent employee = full-time employees + part-time employee hours/35 hours.

regarding the changes that occurred between the

1973-74 and the 1977 surveys.

Since the eligibility criteria were different

for the two surveys, trend comparisons are not

recommended. The 15,700 homes reported in

the 1973-74 survey represented only those

homes that provided nursing services. The

18,900 homes reported in the 1977 survey included personal care and other such homes that

did not provide nursing services. Table C gives

breakdowns of the nursing homes, beds, and

residents for each of the two surveys (for purposes of information only).

The occupancy rates for the two surveys

were very similar. Based on the number of residents at the time of the survey, the occupancy

rates were 93 percent in 1977 and 92 percent in

1973-74. Using the average daily census for the

calculations, the rates were 89 percent in 1977

and 88 percent in 1973-74.

The 20-percent difference in homes and beds

will be important to remember when examining

the employee data that follow.

STAFF DATA

Total Staff

An estimated 509,900 full-time and 268,800

part-time employees provided direct or healthrelated services to nursing home residents in

1977. Clerical, food service, housekeeping,

maintenance, and other employees who did not

perform nursing, administrative, medical, or

therapeutic functions were not surveyed. However, a count of e,xcluded employees, when

added to the cited figures, results in an overall

estimate of 1,183,900 total employees.

Clerical- and maintenance-type employees

will not be included in this report. Any reference to total employees will refer to the

509,900 full-time and 268,800 part-time employees who provided direct or health-related

services.

The sections that follow divide the employees into three major staff groups: administrative

and medical, nursing, and therapeutic. Highlights

are presented for each group. The remainder of

this section presents basic items of information

concerning total employees in general.

4
Table C. Number of nursing homes, beds, and residents, by selected nursing home characteristics: United States, 1973-74 and 1977

Nursing home characteristic

All nursing homes .................................................

Ownership

Proprietary ....,,..,,..,,,,.,, ........................................................

Voluntary nonprofit and government ...................................

Certification

Skilled nursing facility only ..................................................

Skilled nursing facility and intermediate cara facility ...........

Intermediate cara facility only ..............................................

Not certified ....................................................0...... ..............

Bed size

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

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

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

200 bads or mora ..................................................................

Location

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

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

south ....................................................................................

West.....................................................................m................

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

Nursing homes

1973-74

15,700

11,900

3,900

7,700 i

4,400

3,600

6,400

5,500

3,200

600

3,100

5,600

4,100

2,900

Of the 509,900 full-time employees, 24,600

(5 percent) worked under contract with the

nursing homes. Of the 268,800 part-time employees, 65,600 (24 percent) were likewise under

contract.

Only 43,500 (8.5 percent) of the full-time

employees were males. Part-time employees

were also predominantly females, with males

occupying only 17.5 percent of these positions.

The average hourly wage of a full-time employee was $3.64. Table 3 indicates that male

employees received an average of $5.14 per

hour, while female employees received $3.50 per

hour. Part-time employees earned $6.31 per

hour, with males receiving $15.07 and females

$4.73 per hour. The differences between fulltime and part-time hourly wages occurred primarily in the non-nursing staff. This group

(which excludes registered nurses, licensed practical nurses, and nurse’s aides) showed average

hourly wages of $7.48 for full-time and .$13 .90

for part-time employees,

1977

18,900

14,500

4,400

3,60C

4,60C

6,000

4,700

8,000

5,800

4,200

900

3,900

5,900

4,900

4,200

Bads

1973-74

1,174,800

830,700

344,300

761,500

252,300

161,000

179,400

392,800

414,500

188,100

250,800

407,200

302,900

214,000

1977

1,402,40C

971,200

43I ,300

294,000

549,400

391,600

167,400

182,900

417,800

546,400

255,400

314,900

483,900

381,500

222,100

Residants

1973-74 I 1977

1,075,800I 1,303,100

756,200 888,800

319,700 414,300

; 699,400 269,600

527.800

236,700 368;200

139,800 137,500

162,600 167,900

367,700 397,000

386,100 505,200

159,300 233,000

236,100 292,100

368,700 449,400

278,200 364,700

192,800 207,000

The average number of years of current employment Wm- 3.5 for full-time and 3.4 for parttime employees. The average total work experience was 6.5 and 7.7 years for full-time and

part-time employees, respectively. Total work

experience refers to the length of time that employees have worked in their current occupation.

Administrative and Medical Staff

Administrative and medical staff categories

are listed in table D, along with the number of

full-time and part-time employees estimated to

be in each category. The total number working

full-time in nursing homes was approximately

33,700, of which 22,700 were administrators

(including assistant administrators). Since each

of the other categories had less than 3,000 employees, they will not be discussed here.

The distribution of the part-time employees

was quite different, however. Of the 53,000

5
Table D. Number of full-time and part-time administrative and

medical employees in nursing homes, by occupational

categories: United States, 1977

Occupational category

Total administrative and

madical employees ................

Administrator or assistant

administrator ...................................

Physician ............................................

Dentist ................................................

Pharmacist ..........................................

Dietitian or nutritionist ......................

Registered medical record

administrator ..................................

Other medical record administrator

and technician ..................................

Other professional occupation ............

Administrative and

medical employees

33,700

22,700

800

*

800

2,900

600

2,700

2,900

53,000

-

2,900

13,900

3,300

11,100

10,300

4,400

1,400

5,800

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

total part-time staff, only 2,900 were administrators. Most were physicians (13,900), pharmacists (11,1 00), and dietitians or nutritionists

(10,300).

As a group the full-time administrators had

the following characteristics:

●

●

●

●

●

●

●

Slightly more women than men.

Most were white (96 percent).

An average age of 45 years.

An average hourly wage of $7.47.

Only 7 percent completed less than 12

years of education, while 70 percent completed more than 12 years of education.

An average current employment of 6.6

years.

An average total work experience of 10.5

years as ;ursing home or-hospital administrators.

A comparison between the male and female

full-time administrators revealed that the average

hourly wage for males was $8.83, while females

earned $6.23 an hour (not statistically significant). Approximately 41 percent of the males

and 43 percent of the females had no prior

experience as a nursing home or hospital administrator. The average total work experience was

8.9 years for males and 11.7 years for females

(table 4). While 55.1 percent of the male administrators had 16 or more years of education,

only 19.8 percent of the females had as many

years of education.

For the part-time administrative and medical

staff, only physicians, pharmacists, and dietitians or nutritionists will be mentioned here.

Of the 13,900 part-time physicians, 10,000

were working under contract rather than on

staff. Their average age was 50 years, they received an average hourly wage of $24.00, 13,400

were males, and 90 percent were white physicians (with Asian the next largest racial group of

5 percent). Their average total work experience

was 13.9 years, of which 6.2 years was current

employment (table 5).

Of the 11,100 part-time pharmacists, 9,800

worked under contract. They had an averageage

of 40 years, an average hourly wage of $10.23,

10,000 were males, and 96 percent were white

pharmacists. Their average total work experience

was 8.0 years, of which 4.6 was current employment. The majority (7,300) had 17 years or

more of education, while 3,500 (virtually all the

rest) had 16 years of education (table 5).

Of the 10,300 part-time dietitians or nutritionists, 9,100 worked under contract. They had

an average age of 42 years, an average hourly

wage of $10.43, 10,100 were females, and 95

percent were white dietitians or nutritionists.

Their average total work experience was 10.9

years, of which 3.6 was current employment. An

estimated 8,000 had 17 years or more of education, while an additional 2,000 had 16 years of

education (table 5).

Nursing Staff

For purposes of this report the nursing staff

will be divided into three categories: registered

nurses, licensed practical or vocational nurses,

and nurse’s aides (and orderlies).

Re.g>tered nurses.–An estimated 43,800

full-time and 40,700 part-time registered nurses

were employed in the nursing homes covered by

the 1977 survey (table 3). Overall, the group had

the following characteristics:

6
●

●

●

●

●

●

●

Only 1,200 full-time and 2,100 part-time

employees worked ‘under contract

(table 6).

More than 98 percent were women.

Ninety-two percent were white; 4 percent

were black (table 6).

Average age was 43 years.

Average hourly wages were .$5.59 for

full-time and $5.32 for part-time work.

Ninety-eight percent completed 13 years

or more of education.

The average total work experience of fulltime regis~ered nurses wa~ 11,4 years, of

which 4.0 was current employment.

Table 7 gives registered nurses’ average

hourly wages distributed by various characteristics of the nursing homes. The table shows that

for both full-time and part-time employees the

average hourly wages do not vary significantly

regardless of the characteristic of the home.

Table 8 presents registered nurses’ current

and total work experience by various characteristics of the home. It should be carefully noted,

however, that the ownership, bed size, and certification of the homes represented the status of

the home at the time of the survey. There might

well have been a change in one or all of these

characteristics during the time period that the

nurses were employed.

In general, full-time registered nurses working in noncertified homes had longer current

employments (6.6 years) than those working in

skilled nursing facilities (3.7 years), or intermediate care facilities (3.3 years), or combination

skilled nursing and intermediate care facilities

(4.0 years). The same was true for registered

nurses with total experience. Those in noncertified homes averaged 17.2 years of total experience, compared with 11.2 years for those in

skilled nursing facilities, 10.5 years in intermediate care facilities, and 10.9 years for combined

skilled nursing and intermediate care facilities.

The size of the home appeared to have no

effect on the length of current employment or

total years of experience that registered nurses

were employed. They work in small homes (less

than 50 beds) for just as long a time as they

work in large homes (200 beds or more).

According to table 9, the length of time fulltime registered nurses worked in the home had

no effect on the types of services they were required to perform.

Licensed practical nurses.–An estimated

65,900 full-time and 31,600 part-time licensed

practical nurses were employed in nursing homes

in 1977. As a whole, the group had the following characteristics:

●

●

●

●

●

●

●

Only 900 full-time and 1,000 part-time

employees worked under contract.

Almost 98 percent were women.

About 80 percent were white and 16 percent were black.

Average age was 40 years.

Average hourly wages were $4.04 for full- r

time and $4.02 for part-time work.

About 75 percent completed 13 years or

more of education; 29 percent completed

14 years or more.

The average total work experience of

tensed pr~ctical nurses wa~ 9.0 years,

which 3.9 was current employment.

Table 7 indicates that the variation in

liOf .

licensed practical nurses’ salaries for various nursing home characteristics is greater than for registered nurses’ salaries. The variations were not

found to be significantly different, however.

Full-time licensed practical nurses in noncertified homes had longer current employments

(7.2 years) than those working in skilled nursing

facilities (3.9 years), intermediate care facilities

(3.8 years), and combination skilled nursing and

intermediate care facilities (3.5 years).

Nurse’s aides.–An estimated 345,000 fulltime and 117,900 part-time nurse’s aides were

employed in nursing homes in 1977. As a

whole, the group had the following characteristics:

. Approximately 19,000 full-time and

6,300 part-time nurse’s aides worked under contract.
●

●

●

●

●

●

About 93 percent were women.

Almost 75 percent were white; about 21

percent were black.

Average age was 34 years.

Average hourly wages were $2.76 for fulltime and $2.78 for part-time work.

About 33 percent completed less than 12

years of education, and 44 percent completed exactly 12 years of education.

The average total work expedience of fulltime nurse’s aides was 5.2-years, of which

3.2 was current employment.

Table 7 indicates no significant variation in

nurse’s aides’ hourly wages due to nursing home

characteristics.

Full-time nurse’s aides working in noncertified homes had longer current employments (4.9

years) than those working in skilled nursing

facilities (2.9 years), intermediate care facilities

(3.0 years), and combination skilled nursing and

intermediate care facilities (3.2 years) (table 8).

No significant difference appeared for prior experience regardless of type of certification.

Therapeutic Staff

The types of nursing home employees included in this group are shown in table E, along

Table E. Number of full-time and part-time therapeutic employees in nursing homes, by occupational categories:

United States, 1977

I Therapeutic

Occupational category employees

1

Full-time Part-time

Total therapeutic employees .... 21,600 I 25,600

I

Registered occupational therapist .......

Registered physical therapist ..............

Activities director ...............................

Social worker ......................................

Speech pathologist, audiologist ...........

Occupational therapist assistant..., ......

Physical therapist assistant ..................

Social worker technician, assistant ...... 1

1,000

1,100

10,200

3,100

●

1,700

3,300

900

3,000

6,400

4,500

5,700

2,600

1,100

1,500

700

with the number of full-time and part-time employees estimated to be in each category. The

data for the therapeutic staff revealed the following characteristics of the 21,600 full-time

and 25,600 part-time employees (table F):

●

●

●

●

About 1,500 full-time and 16,300 parttime employees worked under contract.

Approximately 78 percent were women.

Nearly 94 percent were white.

Average age was 37 years.

Table F. Number of full-time and part-time therapeutic employees in nursing homes, by selected employee characteristics: United States, 1977

Employee characteristic

Total therapeutic employees.,..

Race or ethnicity

White (not Hispanic) ...........................

Black (not Hispanic) ...........................

Hispanic ..............................................

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

Sex —

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

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

Employment arrangement

Contract .............................................

On staff ..............................................

Education

Less than 12 years ..............................

12 years ..............................................

13-14 years .........................................

15-16 years .........................................

17 years or more .................................

Years of employment

Current employment ..........................

Total employ merit .............................

Average age .........................................

Therapeutic

employees

Full-time Pert-time

Number

21.600

19,700

1,500

●

●

2,300

19,200

1,500

20,000

1,400

5,400

4,400

6,500

3,800

25,600

24,500

700

●

●

8,100

17,500

16,300

9,200

400

1,800

2,100

7,200

14,100

Average in yaars

x

NOTE: Figures may not add to totals due to rounding. NOTE: Figures may not add to totals due to rounding.
. Average hourly wages were $7.93 for fulltime and $12.09 for part-time work.

. Almost 48 percent of the full-time and

over 83 percent of the part-time employees completed more than 14 years of education.

. The total work experience of part-time

therapeutic staff was 7.6 years, compared

with 4.8 years for the full-time staff.

Table 10, which shows the number of fulltime equivalent therapeutic employees per 1,000

beds, indicates what types of homes are most

likely and least likely to employ therapeutic

staff.

Tables 11 and 12 give additional information

on full-time and part-time therapeutic staff (as

well as all other types of employees) by various

characteristics of the home.

000

9
REFERENCES

lNational 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.

2National Center for Health Statistics: Inpatient

health facilities as reported from the 1967 MFI Survey,

by A. Sirrocco, Vital and Health Statistics. Series 14-No.

4. DHEW Pub. No. (HSM) 72-I 065. Health Services and

Mental Health Administration. Washington, U.S. Government Printing Office, June 1972.

3National Center for Health Statistics: Inpatient

health facilities as reported from the 1969 MFI Survey,

by A. Sirrocco. Vital and Health Statistics. Series 14-No.

6. DHEW Pub. No. (HSM) 73-1801. Health Services and

Mental Health Administration. Washington. U.S. Government Printing Office, Dec. 1972.

4NationaJ Center for Health Statistics: Inpatient

health facilities as reported from the 1971 MFI Survey,

by A. Sirrocco. Vital and Health Statistics. Series 14-No.

12. DHEW Pub. No. (HSM) 74-1807. Health Services

and Mental Health Administration. Washington. U.S.

Government Printing Office, Mar. 1974.

5National Center for Health Statistics: Inpatient

health facilities as reported from the 1973 MFI Survey,

by A. Sirrocco. Vital and Health Statz&ics. 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: Inpatient

health facilities as reported from the 1976 M FI Survey,

by J. F. Sutton and A. Sirrocco. Vital and Health Statistics. Series 14-No. 23. DHEW Pub. No. (PHS) 80-1818.

Public Health Service. Washington. U.S. Government

Printing Office, Jan. 1980.

7National Center for Health Statistics: Employees in

nursing homes, United States, April-September 1968, by

J. F. Van Nostrand. Vital and Health Statistics. Series

12-No. 15. DHEW Pub. No. (HSM) 73-1700. Health

Services and Mental Health Administration. Washington.

U.S. Government Printing Office, Oct. 1972.

8 Nation~ Center for Health Statistics: Institutions

for the aged and chronically ill, United States, AprilJune 1963, by E. E. Bryant. Vital and Health Statistics.

PHS Pub. No. 1000-Series 12-No. 1. Public Health Service. Washington. U.S. Government Printing Office, July

1965.

9National Center for Health Statistics: Employees in

nursing and personal care homes: Number, work experience, special training, and wages, United States, MayJune 1964, by C. A. Taube and E. E. Bryant. Vital and

Health Statistics. PHS Pub. No. 1000-Series 12-No. 6.

Public Health Service. Washington. U.S. Government

Printing Office, Jan. 1967.

1‘National Center for Health Statistics: Administrators of nursing and personal care homes: Education and

training, United States, June-August 1969, by B. G.

Brown. Vital and Health Statistics. Series 12-No, 18.

DHEW Pub. No. (HSM) 73-1703. Health Services and

Mental Health Administration. Washington. U.S. Government Printing Office, Feb. 1973.

11 National Center for Health Statistics: Selected operating and financial characteristics of nursing homes,

United States: 1973-74 National Nursing Home Survey,

by M, R. Meiners. 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.

12National Center for Health Statistics: Employees in

nursing homes in the United States: 1973-74 National

Nursing Home Survey, by A. Sirrocco. Vital and Health

Statistics. Series 14-No. 20. DHEW Pub. No, (PHS) 79-

1815. Public Health Service. Washington. U.S. GovernmentPrinting Office, Feb. 1979.

13National Center for Health Statistics: An overview

of nursing home characteristics: Provisional data from

the 1977 National Nursing Home Survey, by M. Meiners.

Advance Data From Vital and Health Statistics, No. 35.

DHEW Pub. No. (PHS) 78-1250. Public Health Service.

Hyattsville, Md., Sept. 6, 1978.

14National Center for Health Statistics: Design and

methodology of the 1967 Master Facility Inventory Survey. Vital and Health Statistics. PHS Pub. No. 1000-

Senes l-No. 9. Public Health Service. Washington. U.S.

Government Printing Office, Jan. 1971.

15National Center for Health Statktics: The agency

reporting system $or maintaining the National Inventory

of Hospitals ~d’’hstitutions. Vita/ and Health sta~i~tic~.

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

1968.

16Nat.ions Center for Health Statistics: Nursing home

costs—1 972, United States. National Nursing Home Survey, by M. Meiners. Vital and Health Statistics, Series

13-No. 38. DHEW Pub. No. (PHS) 79-1789. Public

Health Service. Washington. U.S. Government Printing

Office, Nov. 1978.

10
1.

2.

3.

4.

5.

6,

7.

8.

9.

10,

11.

12,

LIST OF

Number and percent distribution of nursing

United States, 1977 ...............................................

DETAILED TABLES

homes, beds, and residents, by selected nursing home characteristics:

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

Number and rate per 100 beds of nursing home full-time equivalent employees, by occupational categories and selected

nursing home characteristics: United States, 1977 ........................................................................................ ............................

Number, average hourly wage, and average years of experience in occupation of full-time and part-time nursing home employees, by sex and occupational categories: United States, 1977 ............................................................................................

Number of full-time nursing home administrators by years of education, average years of employment experience, number

and percent with no prior experience, and by sex: United States, 1977 ....................................................................................

Number of selected part-time nursing home employees by years of education, average years of employment experience, number and percent with no prior experience, and by occupational categories: United States, 1977 ..............................................

Number of full-time and part-time nursing home employees, by occupational categories and selected employee characteristics: United States, 1977 ..................................... .................... ...........................................................................................

Averaga hourly wage of full-time and part-time nursing home employees, by occupational categories and selected nursing

home characteristics: United States, 1977 .......... ....................................................................... ...............................................

Number of years of employment experience of nursing home full-time nursing staff employees, by occupational categories

and selected nursing home characteristics: United States, 1977 ................................................................................................

Number of years of employment experience of nursing home full-time registered nurses, and numbar performing selected

services, by type of service performed: United States, 1977 .....................................................................................................

Number and rata per 1,000 beds of nursing home full-time equivalent therapeutic employees, by occupational categories and

selected nursing home characteristics: United States, 1977 .......................................................................................................

Number of full-time nursing home employees, by occupational categories and selected nursing home characteristics:

United States, 1977 ....................................................................................................................... ............. ........... ...................

Number of part-time nursing home employees, by occupational categories and selected nursing home characteristics:

United States, 1977 ............................... ....................................................................................................................................

12

13

14

15

16

17

18

19

20

.

21

23

24

11
Table 1. Number and parcent distribution of nursing homes, beds, and residents, by selected nursing home characteristics:

United States, 1977

Nursing home characteristic

All nursing homes . . . . . . . . . . . . . . . . . . . . . . . . .

gwnershiQ

Proprietay . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Voluntary nonprofit. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Wf cat

1

ifi ion

Skilled nursing facility only . . . . . . . . . . . . . . . . . . . . . . .

Medicare and Medicaid . . . . . . . . . . . . . . . . . . . . . . . .

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

Madicaid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Skilled nursing facility and

intermediate care facility . . . . . . . . . . . . . . . . . . . . . . . . .

Medicare SNF and

Medicaid SNF and ICE., . . . . . . . . . . . . . . . . . . . . .

Medicaid SNF and ICF . . . . . . . . . . . . . . . . . . . . . . . . .

Madicare SNF and Madicaid ICF . . . . . . . . . . . . .

Intarmedlate care facility only . . . . . . . . . . . . . . . . . . . .

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

BSsU?J2

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

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

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

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

lQ@Qo

Geographic region

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

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

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

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

Standard Federal administrative region

Region l. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Region 11. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Region Ill . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Region IV . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Region V. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Region VI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Region Wt. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Region VIII . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Region IX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Region X. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Twre of facility

Nursing care . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . .

All other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Nursing

Numbar

18,900

14,500

3,400

1,000

3,600

2,100

700

800

4,600

2,300

2,100

200

6,000

4,700

8,000

5,800

4,200

900

3,900

5,900

4,900

4,200

1,700

1,500

1,400

2,400

4,000

1,800

1,700

700

3.200

“500

12,300

6,600

100.0 1,402,400

76.8

17.7

5.5

19.2

11.3

3.7

4.2

24.2

12.3

10.8

3;::

25.0

42.3

30.8

22.3

4.6

20.5

31.1

26.0

22.4

9.1

7.8

7.3

12.9

20.9

9.7

9.2

3.7

16.8

2.7

971,200

295,600

135,700

294,000

204,500

27,000

62,600

549,400

319,500

218,700

11,300

391,600

167,400

162,900

417,600

546,400

255,400

314,900

483,900

381,500

222,100

98,900

145,600

115,000

177,600

345,900

162,300

122,800

54,900

134,900

44,600

100.0I 1,303,100 I 100.0

1 I

69.3

21.1

9.7

21.0

14.6

1.9

4.5

39.2

22.8

15.8

27:;

11.9

13.0

29.8

39.0

18.2

22.5

34.5

27.2

15.8

868,800

261,800

132,500

269,600

190,300

17,600

61,500

527,800

303,700

213,800

10,300

368,200

137,500

187,900

397,000

505.200

292,100

449,400

354,700

207,000

7.1 85,600

10.4 138,300

6.2 107,800

12.7 175,300

24.7 318,200

11.6 142,700

115,800

E 50,900

9.6 124,000

3.2 44,600

78.8 1,113,300

21.2 189,800

68.2

21.6

10.2

20.7

14,8

1.4

4.7

40.5

23.3

16.4

28:;

10.6

12.9

30.5

38.8

17.9

22.4

34.5

27.2

15.9

6.6

10.6

6.3

13.4

24.4

11.0

8.9

3.9

9.5

3.4

85.4

14.6

lSNF = stdlled nursing facility; ICF = intermediate care faciMy.

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

12
Table 2. Number and rate per 100 beds of nursing home full-time equivalent employees, by occupational categories and selected nursing home characteristics: United States,

‘r

Nursing home characteristic

All employees . . . . . . . .

QMo.m!m

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

Voluntary nonprofit . . . . . . . . . . . .

Government . . . . . . . . . . . . . . . . . . . .

Certification

Skilled nursing facility only..

Skilled nursing facility and

intermediate care facility ...,

Intermediate care

facility only . . . . . . . . . . . . . . . . .

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

E!.eQ@

Less than50 beds . . . . . . . . . . .

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

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

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

Location

Geographic region:

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

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

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

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

Standard Federal

administrative region:

Region I. . . . . . . . . . . . . . . .

Region H. . . . . . . . . . . . . . . . . . . .

Region Ill . . . . . . . . . . . . . . . . . .

Region IV . . . . . . . . . . . . . . . . . . .

Region V . . . . . . . . . . . . . . . . . .

Region VI . . . . . . . . . . . . . . . . . . .

Region V1l . . . . . . . . . . . . . . . . . .

Region VIII . . . . . . . . . . . . . . . . . .

Region IX . . . . . . . . . . . . . . . . . . .

Region X . . . . . . . . . . . . . . . . . . . .

Tvoe of facility

Nursing care . . . . . . . . . . . . . . . . . . .

All other . . . . . . . . . . . . . . . . . . .. . . .

All full-time

equivalent

employees

I

I

421,500

158,700

67,500

154,900

284,600

159,200

48,900

83,400

203,400

254,900

106,000

162,000

226,700

162,600

96,300

45,200

73,000

63,600

92,900

167,800

50,900

51,700

21,500

60,600

20,200

HEl43.4

53.7

49.7

52.7

51.8

40.7

29.2

45.6

46.7

46.6

41.5

51.4

46.6

42.6

43.4

45.6

50.2

55.3

52.3

46.5

31.4

42.1

39.2

45.0

45.2

53.6

18.5

1977

=1=1 Administrative,

medical, and

therapeutic

Number Rate per

100 beds

70.600 I 5.0

,

44,500

19,200

6,900

17,200

26,700

16,200

8,500

15,200

22,500

22,900

10,000

19,400

22,900

16,000

12,400

5,100

9,300

6,700

6,900

16,300

5,500

5,600

2,600

6,300

2,100

61,300

9,400

4.6

6.5

5.1

5.9

4.9

4.7

5.1

8.3

5.4

4.2

3.9

8.1

4.7

4.2

5.6

5.1

6.4

5.’t?

::;

3.4

4.C

5.1

6.1

4.e

5.?

3.2

Occuoationa[ cateoow of emolovee

T(

Number

577.000

376,900

139,600

60,500

137,700

257,900

141,000

40,400

66,200

160,900

232,000

95,900

142,700

203,800

146,600

63,900

40,200

63,700

56,600

84,000

151,500

45,400

46,100

16,700

52,500

16,000

531,200

45,600

Nursirm.=

11 Registered nurse Licensed practical nurse Nurse’s aide

Rate per Number Rate per Number Rate per

100 beds Number Rate per

100 beds 100 beds 100 beds

1 [

+

41.1 66,900 4.6 85,100 6.1 424,900 30.3

36.8

47.2

44.6

46.6

46.9

36.0

24.1

37.3

43.3

42.5

37.6

45.3

42.1

36.4

37.6

40.6

43.6

49.4

47.3

43.8

28.0

37.6

34.1

36.9

40.4

46.1

15.4

40,300

18,800

7,800

20,900

32,100

9,300

4,600

7,900

19,900

25,700

13,400

24,800

20,200

11,100

10,800

7,100

11,000

8,600

6,700

16,100

2,500

3,300

2,600

6,500

2,200

2E?L

4.2

6.4

5.8

7.1

5.9

2.4

2.8

4.3

4.6

4.7

5.3

7.9

4.2

2.9

4.9

7.2

7.6

7.6

3.8

4.6

1.5

2.6

5.2

4.6

4.9

5.6

1.7

55,300

19,500

10,300

19,500

35,600

24,600

4,900

12,000

25,100

33,400

14,600

20,300

26,700

27,000

11,100

5,200

9,600

6,100

13,700

19,700

10,800

6.500

2;000

7,200

2,300

J- 79,900

5,200

5.7 261,300

6.6 101,300

7.6 42,400

6.6 97,300

6.5 190,000

6.3 106,600

3.0 30,600

6.6 46,300

6.0 135,600

6.1 172,900

5.7 67,900

6.4 97,600

5.5 156,900

106,500

HI 62,000

5.2

6.6

7.1

7.7

5.7

6.7

U

5.3

5.2

27,900

43,100

39,900

63,600

115,700

32,100

36.300

13;900

36,600

13,500

7.2 369,500

1.8 35.400

29.0

34.3

31.2

33.1

34.8

27.3

18.4

26.4

32.5

31.6

26.6

31.0

32.4

26.4

27.9

26.2

29.6

34.7

35.8

33.5

19.6

29.6

25.3

26.6

30.3

35.2

11.9

135 hoursof part-time employees’work iscmisideredequivaIenttO 1 full.time empI.ayee. Part-timeemplOyeeswereconvertedtOfull-time equivalentemployeesby dividing thenumber ofhm!rs winked perweek

bv 35.

%cludes only employees providins direct health-related services to residents.

NOTE: Figuresmay not addto tc.talsdue to rounding.

cd
.

Table3. Number, average hourly wage, andaverage years ofexperience inoccupation of full-time andpart-time nursing home amployeas, bysexand occupational categories:

United States, 1977

occupational category

All employees 2. . . . . . . . . . . .

Administrative and medii

m

Administrator, assistant

administrator. . . . . . . . . . . . . . . . . . . . . .

Physician. . . . . . . . . . . . . . . . . . . . . . . . ..

Dentist. .. . . . . . . . . . . . . . . . . . . . . . . . . . . .

Pharmacist . . . . . . . . . . . . . . . . . . . . . . . ..

Oietifian or nutritionist. . . . . . . . . . . . .

Registered medical record

administrator. . . . . . . . . . . . . . . . . . . . ..

Other madical record

administrator and technician. . . . .

Other professional

occupations. . . . . . . . . . . . . . . . . . . . .

Theramutic staff

Registered occupational

therapist. . . . . . . . . . . . . . . . . . . . . . . . .. .

Registered physical therapist . . . ..

Activities director . . . . . . . . . . . . . . . . . .

Social worker . . . . . . . . . . . . . . . . . . . . . .

Speech pathologist, audiologist...

occupational therapist

assistant . . . . . . . . . . . . . . . . . . . . . . . . . .

Physical therapist assistant . . . . . . .

Social worker technician,

assistant . . . . . . . . . . . . . . . . . . . . . . . . . .

We ino etaff

Regiatared nurse.. . . . . . . . . . . . . . . . .

Ucensad ~actical nurse . . . . . . . .. .

Nurse’s aida . . . . . . . . . . . . . . . . . . . . . . .

Full-time employees

Number Average

Both

saxes

Male Female ~:~ ~

I

09,90+3 43,500 466,50a 3.64

22,700 10,600 12,100

800 &lo ●

. .

800 600 ●

2,900 “ 2,600

600 ● 550

2,700 “ 2,60a

2,9(M 700 2,200

1,000 “ 600

1,100 ● 800

10,200 700 9,600

3,100 “ 2,700

● ● ,

1,700 ‘ 1,600

3,300 500 2,8W

600 “ 800

43,800 1,000 42,900

65,600 1,500 64,400

!45,000 25,400 319,600

7.47

.

.

.

7.64

.

3.9s

4.7:

12.42

5.5!

4.44

5.5!

4.W

2.7(

hourly wagel

Mala Female :;:f

5.14 3.50 8.5

8.83 6.23

. .

.

. .

.

7.76

● .

. ●

. .

. ●

. .

.

12.59

.

5.52

. ●

. .

●

4.41

● .

●

5.56

.

4.04

3.08 2.74 #

10.4

.

.

.

8.1

.

.

7.2

.

.

4.1

2.9

●

●

6.2

.

11.4

9.0

5.2

Years

Kperienl

Male

7.s

9.C

6.4

*

.

.

.

.

.

.

7.3

‘emale

6.4

11.7

7.$

4.1

6.C

.

11.4

6.9

5.1

Part-time employees

T

Both

eexea Male Female

‘66,600 47,000221,600

2,900 1,200 1,70C

13,900 13,4cm “

3,300 3,300 “

11,100 10,000 I,loc

10,300 “ 1O,I(X

4,400 “ 4,20C

1,400 ‘ 1,30C

5,800 4,200 1,60C

3,000 ● 2,80C

6,400 3,600 2,70C

4,500 “ 4,40C

5,700 2,000 3,70C

2,600 1,200 1,40C

1,100 “ 1,Ooc

1,500 600 60C

700 ● 60C

40,700 “ 40,20C

31,600 600 30,60C

17,900 5,200 112,80C

Average hourly wage 1

Yeare

of axpedence

Both

sexas

Male Female ::a Male Famale

6.31 15.07 4.73 7.7 10.3 7.1

16.81 32.17 “ 10.5 “

24.00 23.97 “ 14.0 14.2

17.40 17.36 “ 9.5 9.5

10.23 10.27 “ 6.1 8.3

10.43 “ 10.39 10.9 “

11.07 ● 11.15 13.7 “

● . . . .

11.63 14.20 ● 11.1 13.7

12.98 “ 13.06 6.0 ‘

12.10 12.94 10.89 11.0 12.2

13.08 ● 13.08 4.2 “

13.09 14.99 12.11 7.7 ●

13.66 “ 13.46 “ “

. . ● . .

. . . . .

. . ● . ●

5.32 “ 5.31 10.7 ‘

4.02 “ 4.02 9.0 “ 9.1

2.78 “2.72 2.78 4.7 “ 4.8

●

●

●

✎

10.9

13.8

●

.

7.7

9.3

4.0

7.1

.

●

.

●

10.7

lCalculations of the average hourly wase include only staff who reported a salary. 1 percent of the fult-time employees and 4 percent of the part-time employees donated their services.

21ncludes only employees providing direct heafth.related services to residents.

Slncludes medical doctors and doctors of osteopathy.

41ncludes psychologist, X-ray technician, and others.

NOTE: Figures may not add to totals due to rounding.
Table 4. Number of full-time nursing home administrators by years of education, average years of employment experience, number and

pe;cent with no prior experience, and by sex: United States, 1977

Education and employment experience

.-

All full-time administrators .......................................................................................................

Years of education

Lessthan 12 years ....................................................................................................................................

12 years ....................................................................................................................................................

13 years ...................m........m.......................................................................................................................

14 years ....................................................................................................................................................

15 years .....mm..m. ........................................................................................................................................

16 years ....................................................................................................................................................

17 years or more .......................................................................................................................................

Employment experience

Prior experience ........................................................................................................................................

Current employment ................................................................................................................................

No prior experience ..................................................................................................................................

Full-time administrators

Total Male Female

Number

-11-

22,700 10,600

1,500 *

5,200 1,700

2,200 700

3,400 1,300

2,200 700

3,400 2,200

4,800 3,600

12,100

1,100

3,500

1,400

2,100

1,500

1,200

1,200

Average in years

AM

Number

9,500 [1 4,300

Percent

~

5,200

43.0

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

15
Table 5. Number of selected part-time nursing home employees by years of education, average years of employment experience,

number and percent with no prior experience, and by occupational categories: United States, 1977

Education and employment experience

All selected part-time employees ............................................................................

Years of education

Less than 16 years ..................................................................................................................

16 years ..................................................................................................................................

17 years or more .....................................................................................................................

Employment experience

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

Prior experience ......................................................................................................................

Current employment ..............................................................................................................

No prior experience ................................................................................................................

NO prior experience ................................................................................................................

lIncludes medical doctors and doctors of osteopathy.

Occupational category

=

Number

T

13,900 11,100

* ●

●

3,500

13,600 7,300

Average in yea

10,300

●

2,000

8,000

13.9 !8.0 I 10.9

7.7 3.4 7.3

6.2 4.6 3.6

Number

4,800 I 4,300 1 1,200

Percent

34.5 I 38.7 ] 11.6

16
Table 6. Number of full-time and pert-time nursing home employees, by occupational categories and selected employee characteristics: United States, 1977

Employee characteristic

Race or et n CIIY

hi.

White (not Hispa;c) . . . . . . . . . . . . . . .

Black (not Hispanic) . . . . . . . . . . . . . . .

Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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

%

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

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

&

Under 35 years . . . . . . . . . . . . . . . . . . . .

35-44 years . . . . . . . . . . . . . . . . . . . . . . . .

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

55 years and oar . . . . . . . . . . . . . . . .

Years of educ ~

Less than 12 years . . . . . . . . . . . . . . . .

12 years . . . . . . . . . . . . . . . . . . . . . . . . . . . .

13-14 years . . . . . . . . . . . . . . . . . . . . . . . .

15-16 years . . . . . . . . . . . . . . . . . . . . . . . .

17 years or more . . . . . . . . . . . . . . . . . .

Years of current emdovmen~

Less than 2 years . . . . . . . . . . . . . . . . .

2-4 years . . . . . . .. . . . . . . . . . . . . . . . . . . .

5-9 years . . . . . . . . . . . . . . . . . . . . . . . . . . .

10-14 years . . . . . . . . . . . . . . . . . . . . . . . .

15 years or more . . . . . . . . . . . . . . . . . .

Years of total ewefience

Less than 5 years . . . . . . . . . . . . . . . . .

5-9 years . . . . . . . . . . . . . . . . . . . . . . . . . . .

10-14 years . . . . . . . . . . . . . . . . . . . . . . . .

15 yeara or more . . . . . . . . . . . . . . . . . .

E!Qoe&12

Paid vacation, sick leave . . . . . . . . .

Other leave . . . . . . . . . . . . . . . . . . . . . . . .

Pension . . . . . . . . . . . . . . . . . . . . . . . . . . . .,

Health, life insurance . . . . . . . . . . . . . .

Direct medical benefits . . . . . . . . . . . .

Meal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fmolovment arranaem ent

Contract . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

On staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Full-tiIsw ernplayaeal Pert-time enmbwas 1

occupational category

Total

Occupatk

M=atide, Registered Licensed Nurse’s Total Adlcl~few&

pfacticel

thefap&Jtic nurse nurse aide thar&udic

390,900

94,600

7,200

17,300

43,500

466,500

248,700

97,500

67,200

76,500

127,700

174,000

121,200

66,100

2’t,000

260,900

127,000

76,300

29,200

14,500

265,000

112,400

55,200

57,400

426,200

313,600

102,000

252,700

90,100

115,200

24,600

485,400

50,700

2,700

700

1,100

15,600

39,600

20,600

11,400

12,600

10,600

3:900

13,400

12,300

14,100

11,600

21,900

15,400

10,800

4,200

3,000

27,600

13,500

6,100

6,000

46,200

43,900

13,200

33,100

10,600

19,200

a

Number

1,900

1,000

42,900

12,900

8,900

12,100

9,900

●

900

6,100

31,800

5,000

20,100

12,100

7,200

3,000

1,500

15,000

9,300

6,100

13,400

39,300

32,600

11,200

27,200

8,100

11,900

39,400 51,800 248,900 237,200

2,200 11,600 77,900 24,500

●

900 5,300 *

1,400 12,800

1,500

64,400

25,600

15,800

13,500

11,000

6,200

10,900

43,700

4,700

.

30,600

17,700

11,000

3,900

2,400

24,300

19,000

10,300

12,400

56,600

41,600

12,600

35,400

10,900

16,600

25,400

319,600

189,600

61,400

49,000

45,100

117,400

146,900

59,100

15,500

4,000

188,100

61,800

49,300

16,200

7,600

218,000

70,500

32,800

23,700

261,900

195,500

65,000

157,100

60,500

67,300

1,200 900 19,000 65,600

42,600 65,000 326,000 203,200

llncludes onlyemployees providing direct health-related services to residents.

2Figures do, @ add to totals because multiple responses were permitted.

31ncludes CIVICand personal leave (jury duty, reserves, voting, funerals) and release time for atte”d[”g training i“stjtutes.

5,000

47,000

221,800

117,200

52,800

46,300

50,500

40,900

62,400

52,000

57,600

56,000

134,900

73,700

37,800

15,800

6,700

135,600

57,700

34,400

41,000

123,600

94,300

20,600

52,000

17,100

48,100

. . . . . . _._,..—

onal ceteaofv

d ] ~-e-!~ Nuree’s

I I

-.s

aide

----- ..-.

74,400

1,900

●

2,000

40,600

38,100

23,91X

17,300

21,400

16,100

1,500

3,600

5,400

17,600

50,500

31,700

24,500

12,400

6,000

4,000

29,600

19,800

11,700

17,400

12,300

14,400

3,700

8,200

3,100

10,400

38,400

1,300

●

800

●

40,200

11,000

f 2,500

9,100

6,100

●

900

4,200

31,900

3,600

19,000

12,500

7,000

1,400

600

13,100

11,200

6,400

10,000

23,100

17,900

4,300

9,600

3,200

10.300

26,500

4,100

.

500

600

30,600

14,400

6,300

5,000

5,600

2,600

4,600

20,900

3,100

●

15,000

9,700

4,400

1,700

800

11,700

9,300

5,000

5,600

17,600

14,100

2,500

7,400

2,100

7,200

dfi98,000

17,200

.

.

5,200

112,800

67,900

16,700

12,800

20,600

36,600

53,300

21,500

5,000

●

69,200

27,000

13,900

8,700

●

61,300

17,400

11,300

6,000

70,300

47,600

10,000

26,800

8,600

20,200

6,300

111,600

NOTE: Figuresmay not add to totals due to rounding.
Table 7. Average hourly wage of full-time and part-time nursing home employees, by occupational categories and selected nursing home characteristics: United States, 1977

Nursinghome characteristic

All employees 2. . . . . . . . . .

~ropnetav.=

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

Voluntary nonprofit . . . .. .. . . . . . . .

Government. . . . . . . . . . . . .. .. . . . . . .

Cal ification

Skilled nursing facility only. . . . . .

Skilled nursing facility and

intermediate care facility. . . . . . .

Intermediate care facility only..

Non certified. . . . . . . . . . . . ... . . . . . . .

~e5~than~w. .,,..,

......

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

100-199 Lx?ds. . . . . . . . . . .. . . . . . . . .

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

lQxdk2Q

Geographic regior-c

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

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

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

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

Standard Fedaral

administrative region

Region I... . . . . . . . . . . . .. .. . . . . . . .

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

Ragion III . . . . . . . . . . . . . .. . . . . . . .

Region IV. . . . . . . . . . . . .. . . . . . . . .

Ragion V . . . . . . . . . . . .. . . . . . . . . .

Region W.. . . . . . . . . . .. . .. . . . . . .

Region WI. . . . . . . . . . . .. .. . . . . . .

Ragion VIH . . . . . . . . . . .. . . . . . . . .

Region IX. . . . . . . . . . . . .. . . . . . . . .

Region X . . . . . . . . . . . .. . .. . . . . . .

Tvoa of facili

Nursing care . . . . . . . . ..! .. . . . . . . .

All other. . . . . . . . . . . . . . . . . . .. . . . . . .

lCaIculations

their services.

of the average

Full-timeemployees Pert-timeem@yeaa

Occupationalcategory occupa6clnalCatagxy

Total A~;dmat~ Nursing Administrative, Nursing

Licensed Total

therap3Ltic Total Registered Nurse’s rnadiil,and

nurse practiil therapeutic Tofel Re@atered = Nurse’s

nurse aide nurse nurse

Me

7

$3.64

3.47

3.95

3.97

3.87

3.63

3.42

3.70

4.01

9.44

3.45

4.19

4.18

3.46

3.37

3.69

3.69

4.67

3.95 ~

3.22

3.54

3.30

3.19

3.36

3.66

3.42

3.64

3.67

hourly

7.20

8.25

7.03

6.93

7.57

8.23

6.71

6.46

7.19

6.95

7.77

7.37

7.36

6.17

6.65

6.78

7.73

9.70

7.51

7.52

6.51

7.00

.

6.95

.

5.59

5.04

5.51

5.14

5.39

5.48

6.22

5.80

5.45

5.34

5.72

5.49

6.22

5.37

5.14

5.61

5.66

4.63

.

6.01

●

Averaga hourly wagel

S7.46 I $3.22 $5.59 S4.04 I $2.76 $6.31

I

I

3.08 5.49 2.64 6.49

3.37 5.54 2.91 5.62

3.66 6.07 3.15 7.00

3.54 5.90 3.00

3.26 2.80

2.87 2.50

3.07 2.66

3.02 2.54

3.02 2.60

3.15 2.74

3.83 3.26

3.76 3.22

3.05 2.66

2.91 2.49

3.33 2.82

3.32 2.77

4.21 3.64

3.34 2.90

2.82 2.45

3.14 2.72

2.95 2.44

2.79 2.49

3.03 2.54

3.47 2.95

3.04 2.83

7.59 3.23 5.57 2.77 6.22

6.76 3.09 5.91 4.22 I 2.65 7.16

4.01

4.07

4.13

4,36

4.06

3.76

3.90

3.86

3.86

3.97

4.55

4.49

3.95

3.71

4.30

4.31

4.91

3.95

3.59

4.13

3.62

3.50

●

4.52

.

4.03

6.59

6.16

6.03

7.13

6.88

6.26

6.10

6.18

6.22

5.47

6.24

8.46

5.54

6.66

6.35

6.48

5.58

6.30

5.09

6.27

9.33

7.73

14.08

12.93

14.78

13.41

14.01

12.96

18.59

14.02

13.34

14.03

15.54

13.78

12.94

12.84

18.36

12.89

15.58

12.95

12.46

13.30

13.52

11.86

13.50

17.49

15.39

$13.801 $3.53 S5.32 S4.02 S2.78

3.60 5.31 4.05

3.55 5.33 3.92

3.79 5.42 4.03

3.80

3.61

3.15

3.31

3.48

3.37

3.52

4.01

3.86

3.37

3.20

3.62

3.68

4.18

3.65

3.16

3.50

3.18

$%

3.87

3.40

13.68 3.53 5.30

1608 3.49 5.52

5.52

5.22

5.28

5.21

5.64

5.07

5.23

5.83

5.33

5.17

5.22

5.69

5.36

5.67

5.00

5.02

5.25

.

.

.

6.15

.

4.20

4.10

3.84

.

3.84

3.77

4.12

4.62

4.16

4.09

3.71

4.12

4.09

.

3.84

3.59

4.24

3.81

.

.

.

.

2.74

2.84

3.08

2.63

2.90

2.56

2.67

2.82

2.67

2.78

3.25

3.04

2.72

2.61

2.88

2.78

3.41

2.65

2.48

2.79

2.73

2.47

.

2.74

.

—

wage include only staff who reported a salary. 1 percent of the full-time employees and 4 percent of the part-time employees donated

21nc]ude5 only employees providing direct health-related services to residents.
Table8. Num&rof years ofamployment experience ofnursing home full-time nursing staff employees, woccupetional categories and

selected nursing home characteristicx United States, 1977

Nursing home characteristic

All nursing homes ...............

Ownership

ProprietaW ......m..........m........................

Voluntary nonprofit ...........................

Government ........................................

Certification

Skilled nursing facility only ................

Skilled nursing facility and intermediate care facility .........................

Intermediate care facility only ............

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

Bed siza

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

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

100.199 beds ......................................

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

Location

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

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

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

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

Employment experience and occupational category

Total experience

I i

11.4

11.1

11.5

12.7

11,2

10.9

10.5

17.2

11.6

12.1

10.7

11.6

11.3

11.0

12.1

11.4

9.0

8.9

9.1

8.8

9.3

8.6

8.9

11.1

10.2

9.5

8.3

8.8

9.5

9.1

8.3

9.4

5.2

4.7

6.2

6.5

4.9

5.2

5.1

6.8

6.2

5.0

5.0

- 5.7

5.4

4.7

5,6

5.6

Prior experience

I

Current employment

Regis- Licensed Nurse’s Regis- Licensed Nurse’s

tered practical tered aide practical aide

nurse nurse nurse nurse

Number of years

7.4

7.7

7.1

7.0

7.5

6.9

7.2

10.6

7.6

7.8

7.2

7.1

6.9

7.0

8.3

8.0

5.1

5.3

5.0

3.8

5.4

5.1

5.1

3.9

4.9

5.7

4.9

4.6

4.6

5.0

5.0

6.1

2.0

1.9

2.4

2.4

2.0

2.0

2.1

1.9

2.2

1.9

2.2

1.9

1.8

1.7

2.1

3.1

T

4.0 3.9

3.4 3.6

4.4 4.1

5.7 5.0

3.7 3.9

4.0 3.5

3.3 3.8

6.6 7.2

4.0 5.3

4.3 3.8

3.5 3.4

4.5 4.2

4.4 4.9

4.0 4.1

3.8 3.3

3.4 3.3

3.2

2.8

3.8

4.1

2.9

3.2

3.0

4.9

4.0

3.1

2.8

3.8

3.6

3.0

3.5

2.5

19
Table 9. Number of years of employment experience of nursing home full-tima registerad nurses, and number ~arforming selected

“services,by typa of service performed: United S{ates, 1977

Type of service performed

All full-time registered nur~s .........................................................

Administration of the facili~ .........................................................................

Screening persons for admission .....................................................................

Nursing care ...................................................................................................

Madical and dental care ..................................................................................

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

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

Recreational tharapy ......................................................................................

Speech and hearing tharapy ............................................................................

Social work, counseling..................................................................................

Training of staff ....................................................................... ......................

Supervision of staff ........................................................................................

Clerical work, medical, and social recordkeeping ............................................

Kitchen/dietary work, grocary shopping ........................................................

Housekeeping sarvices, maintenance, care of grounds.....................................

Employment experience

Total Prior Current

experience experience employment

11.4

12.3

12.5

11.4

10.8

10.4

11.5

11.8

10.8

11.7

11.7

11.5

11.2

10.9

11.6

Numbw of years

7.4

7.6

8.1

7.4

7.0

6.7

7.4

29

7.7

7.7

7.5

7.4

7.5

7.5

4.0

4.7

4.4

4.0

3.8

3.7

4.1

3.9

3.9

4.0

4.0

4.0

3.8

3.4

4.1

Number

performing

sarvical

43,800

9,800

13,000

41,500

13,700

10,100

5,500

8,800

3,400

9,600

33,600

39,300

25,700

1,600

2,000

1Figures do not add to total because multiple responses were permitted.

.

20
Table 10. Number and rate per 1,000 beds of nursing home full-time equivalent therapeutic employees, by occupational categories and

salected nursing home characteristics: United States, 1977

All full-tima equivalent therapeutic

employees

Registered occupational theravist

Occupational cateqow

Registered physical therapist

Activities

director Social worker

Nursing home characteristic

=?=

Rate per

Number 1,000

beds

Rate per

1,000

beds

Rata per

1,000

beds

Rate par

1,000

bads

Rate par

1,000

beds

Number Number Number

All employees . .............

Ownership

Proprietary s,, ,., ,,,, ,.., . . . . . . . . .,., ,,,..., ,..

Voluntary nonprofit ......................

Gowrnment ..................................

Certification

Skillad nursing facility only..,,, ......

Skilled nursing facility and intermediate care facility ...................

Intarmadiata care facility only ......

Not certif ied..................................

Bed size

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

50-99 baas.....................................

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

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

Location

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

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

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

wan ..............................................

Seefootnotesat end of table.

28,600 20.4 1,500 1.1 2,700 1.9 12,600 9.0

17,000

T

8,400

3,200

6,700

13,000

7,300

1,400

3,800

9,100

10,800

5,000

8,000

10,600

6,100

3.900

17.5

28.4

23.6

22.8

23.7

18.6

8.4

20.8

21.8

19.8

19.6

25.4

21.9

16.0

17.6

800

600

●

●

900

●

●

●

500

●

500

600

600

●

●

0.8

2.0

●

,

1.6

*

●

●

1.2

*

2.0

1.9

1.2

●

●

1,700

700

●

1,000

1,300

●

●

●

800

1,200

500

1,200

800

●

*

1.8

2.4

●

3.4

2.4

●

●

●

1.9

2.2

2.0

3.8

1.7

●

●

8,900

3,100

700

2,700

4,600

4,600

700

2,500

4,500

4,300

1,300

2,600

4,800

3,100

2,000

9.2

10.5

5.2

9.2

8.4

11.7

4.2

13.7

10.8

7.9

5.1

8.9

9.9

8.1

9.0

1,800 1.9

1,500 5.1

600 4.4

800 2.7

2,000 3.6

1,100 2.8

● ●

● ●

1,100 2.6

1,500 2.7

900 3.5

1,300 4.1

1,200 2.5

1,100 2.9

* ●

21
Table 10. Number and rate per 1,000 beds of nursing home full-time equivalent therapeutic employees, by occupational categories and

selected nursing home characteristics: United States, 1977–Con.

Nursing home characteristic

All employees2 ..................................................

Ownarship

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

Voluntary nonprofit ............................... ...........................

Government .......................................................................

Certification

Skilled nursing facility only ...............................................

Skilled nursing facility and inter-

. mediate care facnlny ........................................................

Intermediate care facility only ...........................................

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

Bed size

l-assthan 50 &ds ...............................................................

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

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

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

Location

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

North &ntral .....................................................................

South .........................................................................c.......

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

Speech pathologist

or audiologist

Number

600

,

●

●

●

+

●

●

●

●

●

●

●

●

●

●

Rate per

1,000

beds

0.4

●

●

●

●

●

●

●

●

●

●

●

,

●

●

●

Occupational category

Occupational

therapist assistant

Number

2,200

1,000

700

500

●

1,400

●

●

●

700

900

600

500

1,300

*

●

Rate per

1,000

beds

1.6

1.0

2.4

3.7

●

2.5

●

●

●

1.7

1.6

2.3

1.6

2.7

●

●

Physical

therapist assistant

3,900

1,700

1,300

800

1,000

1,800

700

●

●

1,000

1,900

800

1,100

1,300

1,000

500

Rate par

1,000

beds

2.8

1.8

4.4

5.9

3.4

3.3

1.8

2.4

●

2.4

3,5

3.1

3.5

2.7

2,6

2.3

Socialworker

technician

or assistant

Numbar

1,200

700

●

,

●

700

●

●

●

●

500

●

●

●

●

●

Rate par

1,000

bads

0.9

0.7

Ii

●

●

1.3

●

●

●

0.;

●

●

●

●

●

13s hours or part-time employees’ work is considered equivalent to 1 run-time employee. Part-time emptoyees were ccmvwted to futl. time equivalent employees

by dividing the number of hours worked oer week bv 3s.

%ciudes only employees providins. direct heaitb-relsted services to residents.

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

22
Table 11. Number of full-time nursing home employees, by occupational categories and selected nursing home characteristics: United States, 1977

Nursing home characteristic

All

nursing

homes

Ownershio I Certification 1 Bed size

+

100 bads Northor more east

293,400 120,500

Location

I I

Occupational category

SNF

and

ICF

224.300

Not

certified

3B,400

—

5,300

●

●

●

●

●

●

●

●

●

500

.

●

●

●

.

3,100

3,600

24,600

ICF

only

126,900

—

6,700

●

.

●

900

●

500

600

.

●

3,6oO

800

●

●

500

.

6,700

19,700

B6,200

Lass than

50 bads

50-99

beds

North

Central I

South I

Proprietary West

All employees . .....................

Administrative and medical staff

Administrator, assistant

administrator ................ ..... .................

Physician3 .............................................

Oentist ..... ..... .........................................

Pharmacist ..................... ........................

Oietitian or nutritionist ......... ................

Registered medical record

.

admmmrator .............. ........................

Other medical record administrator

and technician .... .................................

Other professional occupations . ...........

Therapeutic staff

Registered occupational therapist ..........

Registered physical therapist .................

Activities director ............ ......................

Social worker ....... ............. .... .................

Speech pathologist, audicdogist ..............

Occupational therapist assistant .............

Physical therapist assistant ... ................. .

Social worker technician, assistant .........

Nursing staff

Registered nurze ............... .....................

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

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

509,900 329,400 59,700 156,900 T

173,900 137,600 76,000

7,200 5,300 4,700

● ● ●

●

●

900

6,BO0 4,300

600 ●

. ●

22,700

800

●

BOO

2,900

600

2,700

2,9oO

1,000

1,100

10,200

3,100

.

1,700

3,300

900

43,600

65,900

345,000

15,900

●

.

●

1,900

.

1,s00

1,300

●

700

7,200

1,300

●

700

1,300

●

25,100

42,500

227,700

6,400

600

●

●

900

●

1,200

900

600

600

3,900

1,700

●

1,000

1,600

600

20,600

27,900

154,700

8,3oo

●

.

●

●

●

.

●

●

●

1,800

●

.

●

.

.

4,6oO

B,200

35,100

7,500

●

●

●

1,000

●

BOO

1,000

.

●

3,600

600

.

●

800

.

12,000

19,600

108,100

6,900

500

●

600

1,500

600

1,700

1,700

500

900

4,900

2,000

●

1,300

2,400

700

27,200

38,100

201,700

5,500

●

●

●

500

●

700

1,200

●

600

2,300

1,000

●

.

1,000

●

14,BO0

15,000

75,700

●

●

900

●

600

●

●

.

2,500

1,000

●

“

900

.

.

.

600

600 ●

1,000 900

●

I

● ●

● I

●

BOO 700

1,700 1,200

700

“

1,200

●

,*

3,900

900

●

/’

500 .

● ●

●

●

1,600

.

3,100 2,300

1,800 600

. ●

1,1001 ‘ 1,000

1,100

●

2,000 800

● ●

&_E!!!@ 18,700 13,300

23,400 14,700

.117,300 79,500

I

lSNF = skilled nursing facility; ICF = intermediate care facility.

Zlncludes only employees providing direct health-related services to residents.

31ncludes medical doctors and doctors of osteopathy.

41ncludes psychologist, X-ray technician, and others.

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

N

cd
hl

.P

Table 12. Number of part-time nursing home employees, by occupational categories and selected nursing home characteristics: United States, 1977

Nursing home characteristic

All Location

nursing

homes

Ownership Bed size

Occupational cetegow J= Government

and

nonprofit

83,600

●

3,900

900

2,900

2,600

1,000

●

2,400

900

1,70D

1,300

1,400

700

●

*

*

13,400

10,600

38,100

SNF

and

ICF

115,600

500

6,600

1,600

3,600

3,500

2,100

600

2,100

1,500

2,600

1,200

2,100

1,100

●

600

●

19,200

12,700

53,000

SNF

only

68,000

600

3,300

1,300

2,700

2,300

1,600

●

1,800

900

1,800

1,000

1,600

800

●

●

●

12,900

7,900

26,200

I CF

only

&J7&o

700

2,600

●

4,300

4,000

●

●

1,100

600

1,700

2,000

1,700

500

●

500

●

5,600

8,700

29,100

Not Less than

50 beds

50800

-

1,800

2,400

●

2,700

2,200

1,000

●

1,400

600

1,500

1,400

1,200

●

●

●

●

6,800

6,800

19,500

50-99

beds

100 beds

or more

NortheastNorth

CXmtral

Proprietary

ZlJ50J

1,20C

1,40C

●

.

●

●

●

80C

.

●

●

,

●

,

●

,

2,90C

2,30C

9,60C

Allemplrsyees2 .....................

Administrative and medical staff

Administrator, assistant

administrator ........ ... ...................... ....

Physician3 ............... ...... ................... ....

Dentist ... .................... .... ....... ................

Pharmacist .................. ....................... .. .

Dietitian .x nutritionist .......... ...... ........

Registered medical rdcmd

administrator ....... ...... .................... ....

Other medical record administrator

and technician ....... ..... .................... ....

Other professional occupations . .. ........

Therapeutic staff

Registered occupational therapist .........

Registered physical therapist ......... ..... ..

Activities director .... .... .........................

Sacia[ worker ............ ... ......... ................

Speech pathologist, audiologist ......... ....

Occupational therapist assistant ........... .

Physical therapist assistant ............ ........

social worker technician, assistant .... ... .

Nursing staff

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

Licensed practical nudge .. ... .................. .

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

268,80C

-

2,90C

13,90C

3,30C

Il,loc

10,30C

4,40C

1 ,40C

5,80C

3,00C

6,40C

4,50C

5,70C

2,60C

1,10(

1,50C

70C

40,70C

31 ,60C

117,90C

165,200 —

2,500

10,000

2,400

8,100

7,800

3,400

1,200

3,500

2,200

4,700

3,200

4,300

1,900

600

1,Oocr

●

27,300

20,800

79,600

91JKJJ)

800

4,400

1,300

4,300

4,600

1,700

500

2,300

1,200

2,300

1,800

2,000

800

600

700

●

13,800

9,300

39,000

126600

-

●

7,000

1,800

4,100

3,600

1,700

700

2,200

1,200

2,600

1,300

2,500

1,400

●

700

●

20,100

15,500

59.400

*

●

4,200

1,000

2,100

2,000

800

●

2,200

900

2,100

800

1,600

1,000

●

●

●

17,100

8,400

33,100

94Jy3

700

3,500

500

3,000

3,100

800

●

1,500

1.400

2,200

1,500

2,100

800

700

600

●

12,600

11,500

47,100

800 1,000

2,900

1,000

2,500

2,300

3,200

800

3,500

3,000

1,500 1,300

500

1,000

●

1,100

●

600

900 1,200

1,300 900

1,100 900

● ●

●1 ●

●1 ●

● ●

4,700 6,300

7,800 3,800

22,400 15,300

%NF = skiifed nursing facicity; ICF = Catennediate care faciCity.

%cludss OIICYemployws providing dwct hesfth-rehted services to residents.

31ncludc5 medicsf doctors and doctors of osteopathy.

41ssclude4 psychologist, X-ray tedmicis% snd others.

NOTE F-s may not add to totah due to roundins.
*

APPENDIXES

CONTENTS

I. Technical Notes on Me&ods ..........................................................................................................

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

Sampling Frame ...................................................................................................................

Sampling Design ..................................................................................................................

Data Collection Procedures for the 19?7 National Nursing Home Survey ............................

General QualMcations ..............................................................................................................-

Nonresponse and Imputation of Missing Data ......................................................................

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

Data Processing ....................................................................................................................

Estimation Procedures .........................................................................................................

Reliability of Estimates .............................................................................................................

II. Definition of Certain Terms Used in This Report ...........................................................................

Terms Relating to FaciMes ......................................................................................................

Terms Relating to Staff .............................................................................................................

III. Survey Instruments Used in the Facility and Staff Portion of the 1977 National Nursing Home

Suwey ............................................................................................................................................

I.

I.

II.

111.

IV.

v.

VI.

VII.

VIII.

Facility Questionnaire ...............................................................................................................

Facility Worksheet ....................................................................................................................

Staff Classification Card ............................................................................................................

Staff Sampling List ...................................................................................................................

Letter to Staff Member .............................................................................................................

Staff Questionnaire ...................................................................................................................

APPENDIX FIGURE

Relative standard errors for estimated numbers of facilities, employees, residents, and beds .......

LIST OF APPENDIX TABLES

Number of facilities in the 1977 National Nursing Home Survey universe and sample, by disposition and sampling strata: Contertninous United States, 1977 ....................................................

Summary of data collection procedures .......................................................................................

Standard errors of percentages for homes ....................................................................................

Standard errors of percentages for total employees and nurse’s aides ..........................................

Standard errors of percentages for administrative, medical, and therapeutic staffi registered

nurses; and licensed practlcaf nurses ............................................................................................

Standard errors for average hourly wages for total staff and nurse’s aides ...................................-

Standard errors for average hourly wages for a~lnistrative, medical, and therapeutic staf~

registered nurses; and hcensed practlcaf nurses ............................................................................

Standard errors of percentages for beds .......................................................................................

26

26

26

27

29

30

30

30

31

31

31

36

36

39

41

41

53

54

55

59

60

32

28

30

33

33

34

34

35

35

25
APPENDIX I

TECHNICAL NOTES ON METHODS

SURVEY DESIGN

From May 1977 through December 1977,

the Division of Health Resources Utilization

Statistics (DHRUS) conducted the 1977 National Nursing Home Survey (NNHS)–a sample

survey of nursing homes, their residents, discharges, and staff in the conterminous United

States. The survey was designed and developed

by DHRUS in conjunction with a group of experts in various fields encompassing the broad

area of long-term care. The NNHS was the second of a series of surveys designed to satisfy

the diverse data needs of those who establish

standards for, plan, provide, and assess longterm care services. The first survey was conducted from August 1973 through April 1974.

Sampling Frame

The 1977 NNHS covered all types of nursing

homes including nursing care homes, personal

care homes with nursing, personal care homes,

and domiciliary care homes. Places that provided room and board only were excluded.

Facilities were either freestanding establishments or nursing care units of hospitals, retirement centers, or similar institutions where the

unit maintained financial and resident records

separate from those of the larger institutions.

The universe for the 1977 NNHS consisted

of two groups of homes: those classified as nursing homes in the 1973 Master Facility Inventory

(MFI)5 and nursing homes opening for business

since 1973. The major group (92 percent) was

composed of all nursing homes as classified in

NOTE: A list of references follows the tekt.

the 1973 MFI. The MFI is a census of all inpatient health facilities conducted every 2-3 years

by mail by the National Center for Health Statistics. A detailed description of how the MFI

was developed, its contents, and procedures for

updating and assessing its coverage has been

published.1~ lAY15

In order for data collection to begin in May

of 1977, the sampling frame was “frozen” in

December of 1976 so that the sample would

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 that opened for business after the 1973

MFI was conducted were also included in the

universe. (Nursing homes that opened after

December 1976 could not be included since data

about them were not yet available.) The nursing

homes that opened after the 1973 MF1 but before December 1976 comprised the second and

smaller (8 percent) bywup of facilities in the

universe. Information about this second group

of facilities was limited compared with the first

group which was listed in the 1973 MFI.

Estimates from the 1977 NNHS will not correspond precisely to fi<gurcs from the 1976 MFI

census for several reasons. In addition to the

differences in time period, the surveys used different data collection mechanisms. The MF1 is

a mail survey but the NNIIS is conducted by

personal interview. Thus the NNIIS nlcthodology permitted more detailed identification and

exclusion of facilities that were out of scope.

Because the NNHS is a sample survey, its data

are subject to sampling variability; bccausc the

MFI is a census, its data arc not. In general,

however, the data from the two sources arc

compatible.

26
Sampling Design

The sampling was basically a stratified twostage probability design. The first stage was a

selection of facilities and the second stage was a

selection of each of the following: residents, persons discharged in 1976, and employees from

the sample facilities. In preparation of the firststage sample selection, two different procedures

were used: one for facilities listed in the MFI

with known bed size and another for newly

opened facilities whose bed s?~e and service type

were unknown. The procedure for facilities in

the MFI with known bed, size consisted of sorting these facilities into two types of service

strata: (1) nursing care homes and (2) facilities

providing all other types of service (including

personal care homes with nursing, personal care

homes, domiciliary care ‘homes, and facilities

with unknown service type). Nursing homes in

each of these two service strata were then sorted

into bed-size groups, producing the first 16 primary strata shown in table I. Within each primtiry stratum, nursing homes were ordered by

typc of ownership, geographic region, State, and

county. The sample within the first 16 strata

was then selected systematically after a random

start within each primary stratum. The procedure for newly opened facilities whose size and

m-vice type were unknown was a doublesampling schcmc. In the first Step,a rand~m subset of one-third of these facilities (587 nursing

homes) was selected, and bed-size information

was dctcrmincd for thcm by telephone contact.

~~sing the newly gathered information on bed

size, this subset of facilities was then sorted

into bed-size groups producing the last 8 strata

shown in table I. Within each of these bed-size

strata, nursing homes were ordered by geographic region, State, and ZIP code. (Although

the first group of facilities from the MFI was

ordered by type of ownership and county, this

subset was not arranged the same way because

information on these variables was not available.) In the second step, the final sample

within the last 8 strata was then selcctcd systematically after a random start within each primary stmturn. ‘rablc I shows the entire distribution of facilities in the sampling fmrne and the

final disposition of the sample with regard to

response and inscope status.

The number of nursing homes estimated by

the survey (18,900) is less than the universe

figure (23,1 05), as well as the number of nursing

homes in the 1976 MFI (20,185), for several

reasons. Some facilities went out of business or

became ineligible for the scope of the survey

between the time the universe was frozen and

the survey was conducted. A facility was considered out of scope if it did not provide nursing, personal or domiciliary care services (e.g.,

facilities providing only room and board) or if

it were a nursing care unit or wing of a hospital,

retirement center, or similar institution without

separate financial and resident records for that

unit. The NNHS methodology included a

thorough procedure for identifying out-of-scope

facilities. For these same reasons, the 1973-74

NNHS estimate differed from the universe figure

by 1,900.16 Jn addition, the large number of

newly opened facilities in the sampling frame,

for which limited information on services provided was available, resul~ed in a larger proportion of facilities (10 percent) later identified as

out of scope in comparison with the 1973-74

NNHS (7 percent).

The second-stage sampling of residents, discharges in 1976, and employees was carried out

by the interviewers at the time of their visits to

the facilities in accordance with specific instructions given for each sample facility. The sample

frame for residents was the total number of residents on the register of the facility on the

evening prior to the day of the survey. Residents

who were physically absent from the facility due

to overnight leave or a hospital visit but had a

bed maintained for them at the facility were included in the sample frame. An average of five

residents per facility were in the sample.

The sample frame for discharges was the

total number of persons discharged alive or dead

during calendar year 1976. Persons who were

discharged more than once during 1976 Were

listed for each discharge. It is possible that a current resident was included in the discharge sampling frame if he or she were discharged during

1976. An average of four discharges per facility

were in the sample.

The sampling frame for employees was the

Staff Sampling List (see appendix III) on which

the interviewer listed the names of all staff providing direct or health-related services (including

27
Table 1. Number of facilities in the 1977 National Nursing Home Survey universe and sample, by disposition and sampling strata:

Conterminous United Statas, 1977

Sampling strata

All types of service ......................................................

Nursing care ...... .................. ........................................ ......

Less than 15 beds ....... .................................................................

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

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

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

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

200-289 beds .............. ................ .................................................

300-599 beds ...............................................................................

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

All other types of service2 ................................................

Less than 15 beds ........... .............................................................

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

2549 beds ...................................................................................

50-88 beds ..................................... .............................. ................

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

200-289 beds ...............................................................................

300-599 bds ............... .................... ............................................

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

Unknown type of service ................................. .................

Bed size known3 ..........................................................................

Less than 15 beds ........ .................................... .................... ........

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

2549 beds ...... .............................................................................

50-88 hds ...................................................................................

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

200-289 beds ................................................................... ............

300-599 beds .. .................................. ...........................................

600 beds ......................................................................................

Bed size unknown ........................................................................

Sample

Universe

(Sa-nmp:p Out of scope In scope and in business

All

facilities

or out of

business Non- Responding

responding

23,105

13,230

676

1,195

3,168

4,775

2,864

402

133

17

8,116

3,431

1,166

1,108

1,202

913

173

92

31

1,759

587

107

96

128

113

122

16

5

0

1,172

1,698

1,282

11

30

158

398

477

134

67

17

318

35

17

34

60

91

34

31

16

. . .

88

3

4

12

16

40

8

5

0

. . .

Number of facilities

166

95

3

8

25

17

18

6

12

6

57

13

5

11

5

11

4

4

4

. . .

14

1

3

6

1

2

0

1

0

. . .

81

68

0

1

6

17

32

6

6

0

8

0

0

0

1

3

2

1

1

. . .

5

0

1

0

1

2

1

0

0

. . .

1,451

1,129

8

21

127

364

427

122

49

11

253

22

12

23

54

77

28

26

11

. . .

69

2

0

6

14

36

7

4

0

. . .

lThe “niver~e ~~nsiated of the nursing homes as classiflled in the 1973 Master Facility Inventory and facilities opened for business

from 1973 to 1976.

Zlnchzdes personal care homes (with or without nursing), domiciliary care homes,anclfacitideswitlrurrlmrswsservicetYPe.

31n order to improve estimates of the 1,759 facilities for which both service type and bed size were unknown. bed sizes were

determined for a one-third sample (587 facilities). These facilities were then stratified by bed size before sample selection.

contract personnel employed last month) and

sampled contract, administrative, medical, therapeutic, 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 10 staff per

facility were in the sample.

In order to reduce respondent burden, restrictions were placed on the number of residents, discharges, and staff sampled in each

facility. Sampling rates were predesignated by

the size classification of the facility but sampling

rates were altered when necessary to assure that

28
the samples did not exceed the specified maximum of 8 for residents, 8 for discharges, and 23

for employees.

Data Collection Proceduresfor the 1977

National Nursing Home Suwey

The 1977 NNHS utilized the following questionnaires (see appendix III for facsimiles of

several of the questionnaires):

Facility Questionnaire

Expense Questionnaire and Definition Booklet

Staff Sampling List

Staff Questionnaire

Current Resident Sampling List

Current Resident Questionnaire

Discharged Resident Sampling List

Discharged Resident Questionnaire

Data were collected according to the following procedures:

1.

2.

3.

A Ictter was sent to the administrator of

sample facilities informing him of the

survey and the fact that an interviewer

would contact him for an appointment.

Included with this introductory letter

were letters of endorsement from the

American Association of Homes for the

Aging, the American College of Nursing

Home Administrators, the American

Health Care Association, and the National Council of Health Care Services

urging the administrator to participate in

the survey. A summary report from the

previous survey in 1973-74 was also enclosed to illustrate the kind and use of

data obtained from the survey.

Several days to 1 week after the letters

had been mailed, the interviewer telephoned the sample facility and made an

appointment with the administrator.

At the time of the appointment the

Facility Questionnaire was completed by

the interviewer who questioned the administrator or owner of the nursing

home. After completing this form, the

interviewer secured the administrator’s

authorization for completion of the

,Expense Questionnaire. Possible respondents to the Expense Questionnaire

include accountants, administrators of

the facilities, and other knowledgeable

staff members. Results from the survey

indicate that the respondents were

evenly divided into two groups: (1) accountants located outside the facility

and (2) administrators and other staff

members, such as bookkeepers, based in

the facility. Where data in p~epared financial statements were comparable to

data requested in the Expense Questionnaire, the respondent provided the facility’s financial statement to a specially

trained NNHS accountant who abstracted data to complete the Expense

Questionnaire. This occurred in onethird of the cases. The interviewer completed the Staff Sampling List (a list of

all currently employed staff who provided direct or health-related services),

selected the sample of staff from it, and

prepared Staff Questionnaires. These

were left for each sample staff person to

complete, seal in an addressed and

franked envelope, and return either to

the interviewer or by mail. The interviewer completed the Current Resident

Sampling List (a list of all residents currently in the facility), selected the sample of residents from it, and completed

a Resident Questionnaire for each sample resident by interviewing the member

of the nursing staff most familiar with

care provided to that resident. The nurse

referred to the resident’s medical record

when responding. No resident was interviewed directly. The interviewer then

completed the Discharged Resident Sampling List (a list of all persons discharged

alive or dead in 1976), selected a sample

of discharges from it, and completed a

Discharged Resident Questionnaire for

each sample person by interviewing a

member of the nursing staff who re29
ferred to medical records. In larger facilities, a team of two or three interviewers

conducted the survey in order to reduce

the length of time required in the facility.

Followup on the Staff Questionnaire

was initiated 2 weeks after the date of

interview. Followup on the Expense

Questionnaire was initiated 3 weeks after

the date of interview.

Table II presents a summary of the data collection procedures.

GENERAL QUALIFICATIONS

Nonresponse and Imputation of

Missing Data

Response rates differed for each type of

questionnaire:

Response

rate

Questionnaire (percent)

Facility 95

Expense 85

Current Resident 99

Discharged Resident 97

Staff 81

Generally, response rates were higher for

questionnaires administered in a personal interview situation (Facility, Current Resident, and

Discharged Resident) as compared with those

that were self-enumerated (Expense and Staff).

Statistics presented in this report were adjusted

for fa.dure of a facility to respond (i.e., to complete the Facility Questionnaire) and for failure

to complete any of the other questionnaires

(Expense, Current Resident, Discharged Resident, or Staff). Those items left ummswcred on

a P~ti~lY comPleted questionn~rc (F=ilitYJ

Expense, Current Resident, Discharged 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 facilities, residents, discharges,

and employees have been rounded to the nearest

hundred. Estimates of total costs and revenues

were rounded to the nearest million. For this

reason, detailed figures within tables do not

always add to totals. Percents were calculated on

the original, unrounded figures and will not

necessarily agree precisely with percents that

might be calculated from rounded data.

Table Il. Summary of data collection procedures

Questionnaire

Facility Questionnaire ...........................................................

Expense Questionnaire ..........................................................

Staff Sampling List ................................................. ...............

Staff Questionnaire ................................ ................................

Current Resident Sampling List .............................................

Current Resident Qu&tionnaire .............................................

Discharged Resident Sampling List ........................................

Discharged Resident Qu=tionnaire ......... ........ .......................

30

Respondent

Interviewer with administrator

Administrator, owner, accountant

or bookkeeper

Interviewer with staff members

Sampled staff members

Interviewer with staff member who

refers to Current Resident Census

Interviewer with nurse who

refers to medical record

Intewiewer with staff member who

refers to discharge records from

1976

Interviewer with nurse who

refers to medical record

Interview situation

Intarview

Self-enumerated

Informal interview or copied from

records

Self-enumerated

Informal interview or copied from

records

Interview

Informal interview or copied from

records

Interview
Data Processing

A series of checks were performed during

the course of the survey. This included field folIowups for missing and inconsistent data, some

manual editing of the questionnaires, and extensive editing as conducted by computer to

assure that all responses were accurate, consistent, logical, and complete. Once the data base

was edited, the computer was used to calculate

and assign weights, ratio adjustments, recodes,

and other related procedures necessary to produce national estimates from the sample data.

Estimation Procedures

Statistics reported in this publication are derived by. a ratio estimating procedure. The purpose of ratio estimation is to take into account

all relevant information in the estimation process, thereby reducing the variability of the estimate. The estimation of number of facilities and

f~cility data not related to size are inflated

by the reciprocal of the probability of selecting

the sample facilities and adjusted for the nonresponding facilities within primary type of

service-size strata. Two ratio adjustments, one

at each stage of sample selection, were also used

in the estimation process. The first-stage ratio

adjustment (along with the preceding inflation

factors) was included in the estimation of facility data related to size, and of all resident, discharge, and staff data for all primary types of

service-size strata.b The numerator was the total

beds according to the MFI data for all facilities

in the stratum. The denominator was the estimate of the total beds obtained through a simple

inflation of the MFI data for the sample facilities in the stratum. The effect of the first-stage

ratio adjustment was to bring the sample in

closer agreement with the known universe of

beds. The second-stage ratio adjustment was

included in the estimation of all resident, discharge, and staff data. It is the product of two

fractions: the first is the inverse of the sampling

fraction for residents (discharges or staff) upon

which the selection is based; the second is the

b For nursing homes with unknown bed size and

service type, the first-stage ratio adjustment was not included in the estimation of facility, resident, discharge,

and staff data.

ratio of the number of sample residents (discharges or staff) in the facility to the number

of residents (discharges or staff) for whom questionnaires were completed within the facility.

RELIABILITY OF ESTIMATES

As in any survey, the results are subject to

both sampling and nonsampling errors. Nonsarnpling errors include errors due to response

bias, questionnaire and item nonresponse, and

processing errors. To the extent possibIe, the

latter types of errors were kept to a minimum

by methods budt into survey procedures such as

standardized interviewer training, observation of

interviewers and field followups for missing and

inconsistent data, manual and computer editing,

100-percent verification of all keypunching, and

other quality checks. Because surv~y results are

subject to both sampling and nonsarnpling

errors, the total error is larger than errors due to

sampling variabilityy alone.

Because 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. Provisional estimates of the standard

errors are presented in this report because final

estimates are not yet available.

The chances are about 68 out of 100 that an

estimate from the sample differs from the value

that would be obtained from a complete census

by less than the standard error. The chances are

about 95 out of 100 that the difference is less

than twice the standard error and about 99 out

of 100 that it is less than 2Y2 times as large.

The relative standard error of an estimate is

the standard error of the estimate divided by the

estimate itself and is expressed as a percent of

the estimate. Relative standard errors for estimated numbers of beds; residents; total staff and

31
nurse’s aides; administrative, medical, and therapeutic staff, registered nurses, and licensed

practical nurses; and facilities are shown in figure 1. In this report, estimates that have a relative standard error more than 30 percent of the

estimate itself are considered “unreliable .“ For

example, curve D of figure I shows the relative

standard errors of estimated number of residents. For a relative standard error of 30 percent

or less, the minimum number of residents is

3,500. Thus resident estimates smaller than

3,500 are considered “unreliable” and are replaced with an asterisk.

Because of the relationship between the relative standard error and the estimate, the standard error of an estimate can be obtained by

multiplying the estimate by its relative standard

error. Thus for example, in curve E of figure I,

an estimate of 10,000 beds has a relative standard error of 30 percent. Its standard error is

0.30 x 10,000 = 3,000.

Standm-d errors for homes, employees, average hourly wages, and beds are presented in

tables 111through VIII.

A 2 3 456789A 23 4 56789A 23 4 56789A 2 3 456789A 2

100

3 4 56789A

1 ,Iloo 10,000 Ioo,ooo 1,000,000 10,000,000

SIZE OF ESTIMATE

Figure 1. Relative standard errors for estimated numbers of facilities, employees, rasidents, and beds

32
%

Table I I 1. Standard errors of percentages for homes

Baseof percent (homes)

3oo .. .. ... ... ... ... .. ... ... .. .. .. .. .. .... ... ... .. ... .. ... .. ... .. .... .. ... .. .... . .... .. ... ... ... .. ... .. ... .. .... .. .... . ... ..

4oo ... ... ... .... .. ... ... .. .... ... .. ... ... .. .. ... .... ... ... .. ... . .... ... ... .. .. ... .. ... ... ... ... . .... .. .... . ... ... ... .. ... ..

5oo .. .. ... ... .. .... .. .. .. . ... ... .. .... ... .. .. ... ... ... ... ... .. .. .... .. ... .. .... .. .. ... ... .. .... ... .. ... ... .. ... .. ... ... ... .

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

7oo .. .. .... . ... ... ... .. ... ..... .. ... .. ... .. .... .. ... ... .. .. .... .. ... ... ... .. .. ... ... .. .... ... .. ... .. ... ... .. ... ... .. ... ... .

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

900 ..,.,,.,,.,,.,..,., .. ... ... ... .. ... ... ... ... .. .... .. ... .. ... ... ... .. .... .. .. ... ... .. ... ... .. ... ... .. .... .. .. ... ... .. .. ..

l.ooo ... ... ... ... ... ... ... .. .... .. ... ... ... ... ... .... .. .. .... . .. ... ... ... ... .. ... ... .. .... .. ... .. ... ... .. .. .... .. ... .. ... .

2.000 . ... ... .. ... ... .. .... ... ... ... .. .... .. ... .. .... .. ... ... .. ... .. ... .. .... .. ... ... .. ... ... .. .... .. ... .. .... . .... .. ... ...

3.000 ... .. .. ... ... .. ... ... ... ... ... .. .... ... ... .. .. ... ... .. ... ... ... ... .. .. ... .. ... ... .. ... ... .... .. ... .. ... .. .... .. .. ... .

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

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

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

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

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

9.000 ... .. ... .. .... . ..... . .... .. ... .. .... .. ... ... ... ... .. ... .. .. .... .. ... ... .. .... .. ... .. ... ... ... .. .... . .... .. ... .. ... ...

10,000 ,.. ,., ,., !.,0,.,.,. ... ... ... .. .... .. ... ... .. ... ... ... .. . .... ... ... .. ... ... .. .. .... .. .... .. ... ... .. .. .... .. ... ... .. .

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

Estimated percent

1 or 99 100r90 20 or 80 40 or 60 50

Standard error in percentage points

2.54

2.20

1.97

1.80

1.67

1.56

1.47

1.39

0.99

0.80

0.70

0.62

0.57

0.53

0.49

0.46

0.44

0.31

7.67

6.65

5.94

5.43

5.02

4.70

4.43

4.20

2.97

2.43

2.10

1.88

1.72

1.59

1.49

1.40

1.33

0.94

Table IV. Standard errors of percentages for total employees and nurse’s aides

10.23

8.86

7.93

7.23

6.70

6.27

5.91

5.60

3.96

3.24

2.80

2.51

2.29

2.12

1.98

1.87

1.77 ;

1.25 I

Baseof percent (total staff)

3.000 ... .. .... .. ... .. .... .. .. ... .... . .... .. .. .. ... ... ... .. ... .. ... .. ... ... .. .. .... .. .. ... .. ... ... ... .. ... .. .. ... .. .. ... ...

4.000 .. ... ... .. ..... . .... .. ... .. ... .. .... .. ... .. ... .. .... . ... ... ... .. ... .. .. ... ... .. ... .. ... .. ... ... .. ... ... .. .. .. .. ... ...

5.000 .... .. .. ... ... .. .... ... .. ... ... .. ... .. ... ... .. ... ... .. ... .. ... .. ... .. ... .. ... ... ... .. ... .. ... .. .. ... .... . ... ... . ... ..

6.000 . .... .. .. ... ... ... .. .. .... .. ... . .... .. ... .. .... .. ... .. .. .... .. .. ... .. ... .. .. .... .. .. ... .. .... .. .. ... .. .. ... .... . ... ..

7.000 ..... .. .. ... ... ... ... .. ... .. ... .. ... .... . .... .. .. ... .. .. . ... .. ... .. .. ... .. .... .. ... .. ... .. ... .. ... .. .... .. .. ... . .... .

8,000 ,..,,.,..,.,,,,.,0. ... ... .. . . . .... .. .. .... .. ... ... .. .. ... ... .. ... .. .. ... .. ... ... .. ... .. ... .. .. ... .. .... .. ... .. .. ... .

9.000 .... .. .... .. ... .. ... .. ... ... ... .. ... .. ... .. ... .. .... .. .. .. .... . ... ... ... .. ... . .... .. .. .... .. .. .. .... .. .. .. .... .. .. .. .

lo.ooo ...................................................................................................................

20.000 .. .. .. .. .. .. ...m.. .. ... ... .. .. .... .. .. .. .. .. ... .. ... .... .. ... ... ... .. .. ... .. .... .. .. ... ... .. .. ... ... ... . .... .. ... . .

30.000 ... .. ... .. ... .. .... . ... ... ... ... ... .. .. ... .. .... .. .. .. . ... .. ... ... ... ... .. .. .. .... ... .. ... ... ... .. .. ... ... .. .. ... ..

40.000 ... ... .. .. .... .. .. .... ... .. .. ... .. ... ... .. ... .. ... .... .. .. ... ... .. ... .. .... ... .. ... ... .. .. .. ... ... .. .. . ... .. .. ... ..

50.000 .. .. .. ... .. ... ... .. ... ... ... .. ... .. .. ... ... ... ... .. ... ... .. .. .... .. ... ... .. .. .... ... .. .. .. ... ... .. ... .. ... .. .. ... ..

60.000 .... .. .. .... .. ... ... .. ... ... .. ... ... .. .. ... .. .... ... .. .. .... .. .. ... ... .. ... ... .. .. .... .. .... .. .. .. ... ... .. .. .. .. . ..

70.000 .. .. ... .. .. .... .. ... .. .... .. .. .. .... .. ... ... .. ... .. ... .. .... .. ... .. ... .. .... .. .. ... ... .. ... .. ... ... .. ... ... .. . .... .

80;OO0 .. .. .. .. .. .. .. .... ... .. ... .. ... ... .. .. ... ... ... ... .. .. ... ... ... .. ... .. .. .... .. ... ... .. .. ... ... .. ... ... .. .. ... ... . ..

90.000 .. ... ... .. ... .. ... ... ... .. ... .. ... ... .. .. .... .. ... ... .. .... .. . .... .... . ... .. ... ... .. ... .. ... .. .... . ... ... ... . ... .. .

loo.ooo .................................................................................................................

2oo.ooo ... ... .. .... . ... ... ... .. ... .. ... .. ... ... ... .. ... ... .. ... ... .. ... ... .. ... .. .... .. .. ... ... .. .. ... ... .. ... ... . ... .. .

3oo.ooo .... ... .. .. .. .... .. ... . .... ... ... .. .. .. .... .. ... ... .. ... .. ... ... ... .. ... ... .. ... . .. .. .. ... .. .... .. .. ... ... . .... ..

4oo.ooo . ...m. .... .. ... .. ... .. .. ... ... .. ... ... .. ... ... .. ... ... ... .. .. .... .. ... ... .. ... .. ... .. ... . .. ... .. ... .. .. ... . .... ..

5oo.ooo . .... .. ... .. ... .. ... ... ..m..m.. .. .. ...m. ... ...m.m. ... .... .. .. ... ... .. .... .. .... . ... .. .... . ... ... ... .. .. .. ... ... ..

600.000 .. ... ... .. ... ... .. .. ... ... .. ... .. ... .. ... ... .. .... .. .. ... .. ... ... ... ... ... .. .. .. ... ... ... .. .... . ... .. ... ... .. ... .

778.000 .. ... .. .... .. ... ... .. .. .. ... .... .. .. ... .. ... ... .. ... .. ... ... ... . ... ... .... .. ... .. ... .. ... .. ... .. ... .. ... ... .. ... .

12.53

10.85

9.71

8.86

8.20

7.67

7.23

6.86

4.85

3.96

3.43

3.07

2.80

2.59

2.43

2.29

2.17

1.53

12.79

11.08

9.91

9.04

8.37

7.83

7.38

7.00

4.95

4.04

3.50

3.13

2.86

2.65

2.48

2.33

2.22

1.57

Estimated percent

1 or 99 100r90 20 or 80 40 or 60 50

Standard error in percentage points

2.82

2.44

2.18

1.99

1.85

1.73

1.63

1.54

1.09

0.89

0.77

0.69

0.63

0.58

0.55

0.51

0.49

0.35

0.28

0.24

0.22

0.20

0.18

8.50

7.36

6.59

6.01

5.57

5.21

4.91

4.66

3.29

2.69

2.33

2.08

1.90

1.76

1.65

1.55

1.47

1.04

0.85

0.74

0.66

0.60

0.53

11.34

9.82

8.78

8.02

7.42

6.94

6.55

6.21

4.39

3.59

3.11

2.78

2.54

2.35

2.20

2.07

1.96

1.39

1.13

0.98

0.88

0.80

0.70

13.89

12.03

10.76

9.82

9.09

8.50

8.02

7.61

5.38

4.39

3.80

3.40

3.11

2.87

2.69

2.54

2.41

1.70

1.39

1.20

1.08

0.98

0.86

14.17

12.27

10.98

10.02

9.28

8.68

8.78

7.76

5.49

4.48

3.88

3.47

3.17

2.93

2.74

2.59

2.45

1.74

1.42

1.23

1.10

1.00

0.88

33
P

Table V. Standard errors of percentages for administrative, medical, and therapeutic staff; registered nurses; and licensed practical

nurses

Base of percent (professional staff)

550 ........................................................................................................................

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

l.ooo ... .. .... .. .. .. .. ... ... .. ... ... .. .. ... . ... .. ... ... .. .. ... .. .. .. .. .... ... . .... . ... ... . ... ... ... .. ... .. .. .... .. .. .. ... .

2.000 ... .. .. .. .. .... .. .. ... ... .. ... . .... .. .. ... . ... .. ... .. ... .. .. ... ... . .. .... .. ... .. ... .. .. ... .. ... ... .. ... .. .. ... ... .. ..

3.000 .. ... .. ... .. .. .. .... .. .. ... .. .. .. ... .. ... .. .. ... ... . ... ... .. ... . .... .. ... .. .. ... .. ... .. ... .. ... ... .. ... .. .. .. .. .... . .

4.000 .... . .... .. .. ... ... .. .. .. .... .. .. ... .. .. ... . .... .. .. ... .. . ... ... ... .. .. ... .. .. ... ... . .... ... .. .. ... .. ... .. ... .. .... ..

5.000 .... . ... .. .. ... .. ... .. ... .. ... .. ... .. ... .. .. .. .. ... .. ... .. .. ... .. ... . .... .. ... .. ... .. ... .. ... ... .. .. ... .. .. .. ... .... .

6.000 ... .. .. .. .. ... .. ... .... .. .. .. ... .. .. .. .... . ... .. ... .. .. ... ... . ... ... .. ... .. .. ... ... . ... .. .... .. .. ... ... . ... ... ... .. ..

7.000 .... .. .. ... .. ... ... .. .. .. ... ... .. ... .. ... .. .. ... .. .. .. ... .. .. .. ... ... ... . ... ... .. .. ... ... .. ... .. ... .. .. .. .... ... ... . .

8.000 ... .. .... .. .. ... .. ... .. .. .... . .. .... .. .. .. ... . ... ... .. ... .. .. .. ... .. .. ... ... .. ... .. .. ... .. ... .. ... .. ... .. .... . .... .. .

9.000 ... .. ... ... .. .. . .... ... .. .. ... .. ... . ... ... .. .. ... .. .. ... . ... ... .. .. ... .. ... .. ... .. ... .. .. ... .. .. .... .. ... ... .. .. ... ..

lo.ooo .. .. .... .. .. ... ... .. . ... ... ... .. .. .. .. .. ... ... ... .. .. .. .. ... .. ... .. ... .. ... .. ... .. .. ... ... .. .. ... .. .. ... .. ... ... .. .

20.000 .. .. .. ... ... .. ... ... .. .. .. ... .. ... .. .. .. ... .. .. .... . ... .. ... .. .. .. ... ... .. .. .. ... .. ... .. ... ... ... . ... .. ... .. ... .. ..

30.000 .. .. ... .. .. ... .. .. .... . ... .. .. ... .. .. ... .. ... . ... .. .... . ... ... . ... ... .. .. ... ... .. .. .... . ... .. ... .. ... .. ... .. ... .. ..

40.000 ... ... .. .. ... .. ... .. ... .. ... .. .. .. .. ... .. .. ... ... .. ... .. .. .. ... .. ... .. ... ... .. ... . .... .. .. ... ... . .. ... .. ... .... .. ..

50.000 ... ... . ... .. .. .... .. .. .. ... . .... .. .. ... .. . .. . ... ... ... .. .. .. .. ... .. ... .. ... ... .. ... .. .. .. .... .. .. ... .. .. .... . .... ..

60.000 .. .. ... .. .. ... .. ... ... .. .. .. ... .. .. ... .. ... .. ... .. .. ... . .... .. ... .. ... .. .. ... .. ... .. ... .. ... .. ... .. ... .. .. ... ... .. .

70.000 .... .. .. .... . .. ... .. .. ... ... .. .. .. ... ... .. .. .. ... ... .. .. ... .. .. ... .. .... .. .. .. ... .. ... ... .. .. ... .. ... .. ... .. ... ... .

80.000 ... .. ... .. ... .. ... .. .. ... . .... .. ... ... .. . ... .. ... .. ... .. .. ... .. .. ... .. ... .. .. ... .. ... .. ... ... .. ... . ... .. ... .. .... . .

90.000 ... .. ... .. .. .. ... ... ... .. .. .. .. ... .. ... .. ... .. ... .. .. .. .. ... .. ... .. ... .. .. ... ... .. .. ... ... .. .. ... .. ... .. .. ... ... .. .

loorooo .. .. ... ... . ... ... .. ... .... .. . ... .. ... .. .. ... ... .. .. .. ... .. .. ... .. ... .. .. .. .. .... . ... .... .. .. ... . ... .. ... .. ... ... .

2oo.ooo .. .. .. ... ... .. .. .. .... .. ... . .... .. .. .. ... .. ... .. ... .. .. .. ... .. .. ... ... ... . .. ... .. ... .. .... .. ... .. .. .. ... .. ... ... .

315rooo . ... ... .. ... . ... ... .. ... .. .. ... .. ... ... .. .. .. ... .. ... .. .. ... .. .. ... .. .. .. ... .. ... ... .. . .. .. .. ... .. ... . ... ... .. ...

Estimated percent

1 or 99 100r90 20 or 80 40 or 60 50

3.05

2.53

2.26

1.60

1.31

1.13

1.01

0.92

0.86

0.80

0.75

0.72

0.51

0.41

0.36

0.32

0.29

0.27

0.25

0.24

0.23

0.16

0.13

Standard error in percentage points

9.20

7.63

6.82

4.82

3.94

3.41

3.05

2.79

2.58

2.41

2.27

2.16

1.53

1.25

1.08

0.96

0.88

0.82

0.76

0.72

0.68

0.48

0.38

12.27

10,17

9.10

6.43

5,25

4.55

4.07

3,71

3.44

3.22

3.03

2.88

2.03

1.66

1.44

1.29

1.17

1.09

1.02

0.96

0.91

0.64

0.51

Table VI. Standard errors for average hourly wages for total staff and nurse’s aides

Base of ratio (total staff)

4.000 .... ... .. ... .. .. .... .. . .... .. ... .. .. ... ... .. .. .. ... ... .. .. .. ... ... .. .. ... .. .. .. ....

5.000 ... .. ... ... ... . .. .. .. ... .. .. ... ... .. .. .... . ... . ... ... ... . ... ... .. .. ... ... .. . ... ... .

6.000 ... .. ... ... . ... ... ... .. .. .. .. .. .. ... ... ... . ... .. .. ... . ... ... .. . .... .. .. ... .. ... .. ..

7.000 .. .... .. ... ... . ... ... . .... .. ... .. .. ... ... . ... .. ... .. .. ... ... .. .. ... ... ... . .. ... . ...

8.000 .. .... . .... ... . ... ... .. .. ... .. ... ... .. ... .. ... .... .. ... .. ... .. ... . ... ... .. .. ... .. ..

9.000 .. ... .. ... .. ... .. ... .. ... .. ... .. .. ... .... .. ... . .. ... .. ... ... .. .. ... .. .. ... .. ... . ...

lo.ooo .. .. ... .. .... . ... .. ... ... ... . ... .. ... ... . .... . .... .. .. .. ... .. ... .. .. .... .. .. .. ...

20.000 ... . ... ... ... . ... ... .. .. ... ... .. ... .. ... .. .. .. .... . ... ... .. .. .. ... .. ... .. ... ... ..

30.000 . .... .. .. .. ... ... .. .. ... ... .. ... .. ... ... . ... .. ... .. .. ... .... .. . ... .. .. ... ... .. ...

40.000 ... .... .. .. .. ... ... .. ... ... .. ... .. ... .. ... .. .. ... .. ... .. .. .. .. ... ... ... .. .. .. ... .

50.000 .... .. ... . ... ... .. ... ... .. .. .. .... ... .. .. ... . .... .. .. ... .. .. ... .. .. ... ... ... . ... .

60.000 .. ... ... .. ... .. ... ... ... .. ... . ... ... .. ... ... .. .. .. ... .. ... .. .. ... .. ... .. .. ... .. ..

70.000 .. .... .. .. ... ... .. .. ... ... .. .. ... .. ... .. ... .. ... .. .. ... .. .. ... ... .. ... .. .. .. ... ..

80.000 .. .. ... ... .. .. ... ... .. ... .. ... ... .. .. ... .. ... .. ... .. .. .. ... .. .. ... .... . .. ... .. ...

90.000 . ... .. .. . .. ... ... .. ... ... . .. . ... .. ... ... .. ... . .... . ... .. .. ... ... .. .. ... .. .... . ...

loo.ooo . ... ... . .... .. ... ... .. .. .. ... ... . .... . ... .. . .. .... .. .. ... .. .. ... ... .. .. ... . .. ..

2oo.ooo . .. ... ... .. ... .. ... ... . ... ... ... .. ... .. .. .. ... ... .. .. .. ... ... .. ... .. ... .. .. ... .

3oo#wo ... ... .. .. .. .... ... .. .. ... .. .. ... ... ... ... . ... .. .. ... .. ... .. ... . ... ... .. ... ... .

4oo.ooo . .. . ... ... .. ... .. ... ... ... .. ... . ... ... .. ... .. .. ... .. .. ... .. .... . ... .. ... ... .. ..

5oo.ooo . .. .. .. .. ... ... .. .. .... .. .. .... . ... .. .. .... . ... .. ... ... . ... ... .. .. ... ... .. .. ...

600.000 . ... ... . ... .. .. .. .. .... .. .. .. .. .... .. .. .. ... ... .. .. ... ... .. ... .. .. ... .. ... .. ...

77 B.OOO ... .... .. .. ... ... .. ... .. ... .. .. ... .. ... ... .. ... .. .. .. .. ... .. .... .. .. ... .. .. .. ..

15.02

12.46

11.14

7.88

6.43

6.57

4.98

4.55

4.21

3.94

3.71

3.52

2.49

2.03

1.76

1.58

1.44

1.33

1.25

1.17

1.11

0.79

0.63

15.33

12.71

11,37

8.04

6.57

5.69

5,09

4.64

4.30

4.02

3.79

3.60

2,54

2.08

1.80

1.61

1.47

1.36

1.27

1.20

1.14

0.80

0.54

Average hourly wage

$2.00 $2.50 $3.00 $3.50 $4.00 $5.00 $10.00 $15.00

Standard error in dollars

*0.77

‘0.69

*0.63

0.58

0.55

0.51

0.49

0.34

0.28

0.24

0.22

0.20

0.18

0.17

0.16

0.15

0.10

0.08

0.07

0.06

0.05

0.04

*0.91

*0.81

0.74

0.68

0.64

0.60

0.57

0.40

0.33

0.28

0.25

0.23

0.21

0.20

0.18

0.17

0.12

0.09

0.08

0.06

0.06

0.04

“1.04

‘0.93

0.85

0.78

0.73

0.69

0.65

0.46

0.37

0.32

0.29

0.26

0.24

0.22

0.21

0.20

0.13

0.10

0.09

0.07

0.06

0.05

*1.17

1.04

0.95

0.88

0.82

0.7B

0.74

0.52

0.42

0.36

0.32

0.29

0.27

0.25

0.24

0.22

0.15

0.12

0.09

0.08

0.07

0.05

●1.29

1.16

1.06

0.98

0.91

0.86

0.82

0.57

0.47

0.40

0.36

0.33

0.30

0.28

0.26

0.25

0.17

0.13

0.10

0.09

0.07

0.05

●1.55

1.38

1.26

1.17

1.09

1.03

0.98

0.69

0.56

0.48

0.43

0.39

0.36

0.33

0.31

0.29

0.20

0.15

0.12

0.10

0.08

. . .

2.79

2,49

2.27

2.10

1.97

1.85

1.76

1.23

1.00

0.86

0.77

0.69

0.64

0.59

0.56

0.52

0,34

0.26

. . .

. . .

. . .

. . .

4,02

3.59

3.28

3.03

2.B3

2.67

2.53

1,7B

1.44

1.24

1.10

1.00

0.92

0.85

0.80

0.75

0.49

. . .

. . .

. . .

. . .

. . .

*Figure does not meet standards of reliability.

34
Table VI 1, Standard errors for average hourly wages for administrative, medical, and therapeutic staff; registered nurses; and licensed

Baseof ratio (employaas)

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

1.ooo...............................................................................

2.000 ...............................................................................

3.000i ..............................................................................

4.000 ..............................................................................#

5.000 ...............................................................................

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

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

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

9.000 ...............................................................................

lo.ooo .............................................................................

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

30.000..o ..........................................................................

40.000 .............................................................................

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

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

70.000 .............................................................................

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

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

loo,ooo,,,.,,,,,,,,.,.,,.,.,,,,o..,,,,,,.,.,..,.,.,.,,,.....,......,.,,.,.........

2oo.ooo ...........................................................................

315,000 ...........................................................................

* k’igrrre does not meet standards Of reliability.

practical nurses

Average hourly wage

$2.00 $4.00 $6.00 $8.00 $10.00 $1 5.0(

Standard error in dollars

●1.02

*0.91

“0.65

0.53

0.46

0.41

0.38

0.35

0.33

0.31

0.30

0.22

0.18

0.16

0.15

0.14

0.14

0.13

0.13

0.12

0.10

0.10

*1.61

*1 .44

1.03

0.84

0.74

0.66

0.61

0.57

0.53

0.50

0.48

0.36

0.31

0.28

0.26

0.25

0.24

0.23

0.22

0.22

0<19

0.18

●2.1 i

*1.94

1.3E

1.14

0.99

0.89

0.82

0.77

0.72

0.69

0.66

0.49

0.43

0.39

0.37

0.35

0.34

0.33

0.32

0.31

0.28

0.27

●2.70

*2.42

1.73

1.42

1.24

1<12

1.03

0.96

0.91

0.86

0.83

0.63

0.55

0.50

0.47

0.45

0.43

0.42

0.41

0.40

0.37

0.35

Table VI [1. Standard errors of percentages for beds

*3.24

2.90

2.07

1.71

1.49

1.35

1.24

1.16

1.09

1.04

1.00

0.76

0.66

0.61

0.57

0.55

0.53

0.52

0.51

0.50

0.45

0.44

Baseof percent (beds)

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

20.000 ...................................................................................................................

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

40.000 ................................................................................................................a..

50.000 .............................................................................................o..o.........o.4.t....

60.000 .........................................................................................o..o.o..........o.........

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

80.000 .........................................................................o............o..........................+.

90.000 ..............................................................................................................3..<.

loo.ooo ............i...........................................................................................o.ct.....

2oo.ooo ..........m..............................................................................................o.......

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

4oo.ooo .................................................................................................................

5oo.ooo ............................................................................................................#....

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

7oo#ooo.....................................................................................................o...........

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

9oo.ooo .................................................................................................................

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

1,400,000 ..............................................................................................................

*4.5!

4.OE

2.91

2.41

2.11

1.9C

1.76

1.64

1.55

1.48

1.41

1.09

0.96

0.88

0.84

0.80

0.78

0.76

0.74

0.73

0.67

0.65

5.85

5.24

3.75

3.10

2.71

2.46

2.27

2.12

2.00

1.91

1.83

1.42

1.25

1.15

1.10

1.05

1.02

1.00

0.98

0.96

0.89

0.86

6.89

6.17

4.42

3.65

3.20

2.90

2.67

2.50

2.37

2.25

2.16

1.68

1.48

1.37

1.30

1.25

1.22

1.19

1.17

1.15

1.07

. . .

Estimated percent

1 or 99 100r90 20 or 80 40 or 60 50

Standard error in percentage points

2.94

2.08

1.69

1.47

1.31

1.20

1.11

1.04

0.98

0.93

0.66

0.54

0.46

0.42

0.38

0.35

0.33

0.31

0.29

0.25

8.85

6.26

5.11

4.43

3.96

3.61

3.35

3.13

2.95

2.80

1.98

1.62

1.40

1.25

1.14

1.06

0.99

0.93

0.89

0.75

11.80

8.35

6.81

5.90

5.2B

4.82

4.46

4.17

3.93

3.73

2.64

2.15

1.87

1.67

1.52

1.41

1.32

1.24

1.18

1.00

14.45

10.22

8.35

7.23

6.46

5.90

5.46

5.11

4.82

4.57

3.23

2.64

2.29

2.04

1.87

1.73

1.62

1.52

1.45

1.22

14.75

10.43

8.62

7.38

6.60

6.02

5.58

5.22

4.92

4.67

3.30

2.69

2.33

2.09

1.90

1.76

1.65

1.56

1.48

1.25

35
APPENDIX II

DEFINITION OF CERTAIN TERMS USED IN THIS REPORT

Terms Relating to Facilities

Facility .–Nursing homes included in the

1977 National Nursing Home Survey were those

classified by the 1973 Master Facility Inventory

(MFI) as nursing care homes, personal care

homes with nursing, personal care homes, and

domiciliary homes. Also included are nursing

homes opened for business between the time the

1973 MFI was conducted and December 1976.

A nursing home must have three beds or more

and may be either free standing or a distinct unit

of a larger facility.

Bed. –A bed is one that is setup and staffed

for use whether or not it was in use by a

resident at the time of the survey. Not included are beds used by staff or owners, or

beds used exclusively for emergency purposes, solely day care, or solely night care.

Certified bed. –A certified bed is one

that is certified: (a) as skilled under the

Medicare ,program, under the Medicaid

program, or both; or (b) as intermediate

under the Medicaid program. (See definition under “Certification” for details.)

Certification. –Certification refers to the

facility certification by the Medicare and/or

Medicaid program(s).

Medicare. –Medicare refers to the medical assistance provided in title XVIII of

the Social Security Act. Medicare is a

health insurance program administered

by the Social Security Administration

for persons aged 65 years and over and

for disabled persons who are eligible for

benefits.

Medicaid. –Medicaid refers to the medical assistance provided in title XIX of

the Social Security Act. Medicaid is a

State-administered program for the medically indigent.

Skilled nursing facility. –Skilled nursing

faciIity refers to certification as a skilled

nursing facility under Medicare, under

Medicaid, or under both programs.

Intermediate care facility. –Intermediate

care facility refers to certification as an

intermediate care facility under Medicaid.

Not certified. –Not certified refers to

facilities that are not certified as providers of care either by Medicare or

Medicaid.

Facility type .–The criteria for classifying

nursing homes are based on the following

factors: the percentage of residents receiving

nursing care in the week prior to the day of

the survey, the availability of registered professional or licensed practical nurses, the administration of medications and treatments

in accordance with physician’s orders, the

supervision over medications that may be

self-administered, and the provision of

assistance with certain personal services.

IW.msingcare. –This is the highest level.

All other. –Other types of facilities include those providing personal care with

nursing, personal care, or domiciliary

care.

36
financial I’ariab[es

Cost, fetal. –The total cost of providing

cm-c for residents for the facilit y‘s most

recently completed fiscal year. For

about half the facilities, this corresponded to calendar year 1976. For

those not reporting for the calendar

year, July and October were the most

prevalent starting dates. Excluded from

total costs are any losses sustained in the

sale or disposition of fixed assets and

other cxtraordinm-y losses not reIated to

the current cost of providing care.

Labor costs. –Labor costs consist of

wages and salaries, payroll taxes, and

fringe benefits.

operating costs. —Operating costs

consist of expenses for food and

other dietary items; drugs; supplies

and equipment; purchased maintez-mncc of buildings, grounds, and

equipment; laundry and linen; health

care and {)thcr services purchased

from outside sources; and utilities.

Fi,v(’d costs. –Fixed costs consist of

equipment rental, insurance, taxes

and licenses, interest and finance

charges, rent on building and land,

and amortization of leasehold improvement.

Miscellaneous costs. —Miscellaneous

costs arc for dues, subscriptions,

travel, automobile, advertising, other

services not included elsewhere, medical and nonrncdical fees, and unclassified expenses.

RCZW1llCS

Patient care. –Patient care revenues

inchldc payments from Medicare,

Meclicaid, other public assistance or

welfare programs, and private

sources, as well as other patient revenues for routine or ancillary health

care scrviceso

.4Tonputirn t. – Nonpat icnt revenues

incluck financial COIItZ_ibUti(JI_IS,

grants and subsidies received from

churches, foundations, voluntary

agencies, government agencies, and

similar groups for general operating

purposes. They also include all

other sources of”revenue not directly

related to patient health care (such

as beauty/barber services and vcncling machines) as well as any revenues

received in the form of interest,

dividend, and capital gains.

Net i~zcome. –Net income refers to revenues minus costs.

Capital returns. –Capital returns refer to

the net income (i.e., revenues minus

costs) plus interest. -

(2z.rh j70zL.’.–Cash flow refers to the net

income (i.e., revenues minus costs) plus

depreciation.

Location

Geographic region. –Facilities are classified by geographic area by ,grouping the

conterminous States into regions. These

regions correspond to those used by the

U.S. Bureau of the Census:

Region State~ included

Northeast ........ Maine, New Hampshire,

Vermont, Massachusetts, Rhode Island,

Connecticut, Ncw York,

New J m-sc~, Pennsylvania

North Central.. Afichigan, Ohio, Indiana,

Illinois, Wisconsin, Minnesota, Iowu, Missouri,

North Dakota, South

Dakota, Kansas, Nebraska

South .............. Delaware, Maryland,

District of Columbia,

Virginia, West Virginia,

North CaroIina, South

Carolina, Georgia, FIorida, KcntucIiy, Texas,

37
West ................

Tennessee, Alabama, “

Mississippi, Arkansas,

Louisiana, Oklahoma

Montana, Idaho, Wyoming, Colorado, New

Mexico, Arizona, Utah,

Nevada, Washington,

Oregon, California.

(Alaska and Hawaii are

excluded).

Standard Federal Administrative Re-

~“ons. –Facilities are classified by Standard Federal Administrative Regions by

grouping the conterminous States into

10 regions. These regions correspond to

those used throughout the Federal Government:

Region States included

Region 1....... Connecticut, Maine, Massachusetts, New Hampshire,

Rhode Island, Vermont

.

Region H...... New York, New Jersey.

(Puerto Rico and Vhgin

Islands are excIuded.)

Region III..... Delaware, Maryland, Pennsylvania, Virginia, West

Virginia, District of Columbia

Region IV ..... Alabama, Florida, Georgia,

Region V.....,

Kentucky, Mississippi,

North Carolina, South

Carolina, Tennessee

Illinois, Indiana, Michigan,

Minnesota, Ohio, Wisconsin

Region VI ..... Arkansas, Louisiana, New

Mexico, Oklahoma, Texas

Region VIL... Iowa, Kansas, Missouri,

Nebraska

Region VIII.. Colorado, Montana, North

Dakota, South Dakota,

Utah, Wyoming

Region IX ..... Arti~ona, California, Nevada. (Hawaii, Guam, Trust

Territory of Pacific Islands,

and American Samoa are

excluded.)

Region X..,... Idaho, Oregon, Washington. (Alaska is excluded.)

Ownership.–Type of ownership refers to the

type of organization that controls and operates the nursing home.

Proprietary facility. –A proprietary facility is operated under private commercial

ownership.

Nonprofit facility. –A nonprofit facility

is operated under voluntary or nonprofit auspices, including both churchrelated facilities and those not churchrelated.

Government facility.–A government

facility is operated under Federal, State,

or local government auspices.

Service.–Type of service refers to classes of

services offered by a nursing home to either

residents or nonresidents. These services fall

into five major categories: health care,

therapy services provided by professionals

at the nursing home, homemaking services,

social services, and other types of services,

Some of the individual categories are:

Day care.–Day care is a service in which

a person receives nursing and personal

care during the day only and does not

stay overnight in the facility.

Friendly visiting. –Friendly visiting is a

service program in which staff of the

facility regularly visits persons in their

own homes to maintain personal contact.

Homemaker or chore semice. –Homemaker or chore service is a program

under which a staff member of the

facility periodically visits the house of

a nonresident to perform basic housekeeping services, for example, dusting,

washing dishes, grocery shopping, etc.

Telephone check.–A telephone check

consists of a daily phone call from the

38
facility’s staff to a nonresident at aprearranged time to check on his/her condition.

Type of Facility .–(See “Facility type.”)

Type of Service. -(See “Service.”)

Terms Relating to Staff

Employee. –An employee is an individual

providing direct or health-related services to the

residents of the nursing home. Included under

this definition are full-time employees, parttime employees, personnel employed under contract who worked in the facility in the month

preceding the survey, and members of religious

orders who donated their services. Excluded are

volunteers who provided enrichment or extra

services, contract personnel who did not work in

the facility in the last month, and attending physicians who have only private patients in the

facility. AISO excluded are staff in certain facilities that were units of larger institutions when

staff could not specifically be designated as

working in the unit.

Employment Status

Full-time. –A “full-time” employee

worked 35 hours or more in the week

prior to the survey.

Part-time.–A “part-time” employee

worked less than 35 hours in the week

prior to the survey.

Full-time equivalent (FTE.). –Thirty-five

hours of part-time employees’ work per

week is considered equivalent to that of

one full-time employee.

Race/Ethnic On”~”n.– Race/ethnic origin refers to the primary racial or ethnic origin

as reported by the staff member personally.

White (not Hispanic) .–White (not Hispanic) refers to a person having origins

in any of the original peoples of Europe,

North Africa, or the Middle East.

Black (not Hispanic) .–Black (not Hispanic) refers to a person having origins

in any of the black racial groups of

Africa.

l+Iispanic. -Hispanic refers to a person of

Mexican, Puerto Rican, Cuban, Central

or South American, or other Spanish

culture or origin, regardless of race.

Other. –Other refers to a person having

origins in the American Indian, Alaska

native, or Asian or Pacific Islander

groups described as follows:

A men”can ‘Indian or Alaska native. –

An American Indian or Alaska native

is a person having origins in any of

the origimd peoples of North

America and who maintains cultural

identification through tribal affiliation or community recognition.

Asian or Pacific Islander. –An Asian

or Pacific Islander is a person having

origins in any of the original peoples

of the Far East, Southeast Asia, the

Indian subcontinent, or the Pacific

Islands. This area includes, for example, China, India, Japan, Korea,

the Philippine Islands, and Samoa.

Occupational Categories

Administrative and medical stafj –The

administrative and medical staff are

those staff members who are administrators, assistant administrators, physicians

(M.D. and “D.O.), dentists, pharmacists,

dietitians or nutritionists, registered

medical records administrators, other

medical record administrators and technicians, and members of other professional occupations.

Medical director. –The medical director

is the professional person or group who

coordinates the medical activities of the

facility, both internally and with respect

to Federal and State rules and regulations.

Other professional occupations. –Other

professional occupations include the

categories of psychologist, X-ray technician, and those professional occupations

39
not included in the administrative and

medical staff category.

Therapeutic staf&–The therapeutic staff

is those staff members who are registered

occupational therapists, registered physical therapists, activities directors, social

workers, speech pathologists or audiologists, occupational therapist assistants,

physical therapist assistants, or social

worker technicians and assistants.

Vacant staj~ positions. –Vacant staff

positions are unfilled staff positions in

the budget of the nursing home.

000
APPENDIX Ill

SURVEY INSTRUMENTS USED IN THE

FACILITY AND STAFF PORTION OF THE

1977 NATIONAL NURSING HOME SURVEY

Facility Questionnaire

PUBLIC HEALTH SERVICE

Health Resources Administration

National Center for Health Statistics

1977 National Nursing Home Survey

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE —

OMB # 68-S7S025 APPROVAL EXPIRES 12-31-77

FACILITY QUESTIONNAIRE

.

-—

L

A. TeledtoneN.rnber ~ - ~ B.lnterviewerNatne

——. Area Code Number

C, Data of Interview Clmm

lClam

D. Start Time

Mo. Day Year

..—

2Upm

l@7ER VIEWER NOTE: Please read the Facility Questionnaire Prompt Card BEFORE you begin the interview.

1. ACCORDING TO OUR RECOROS, THE NAME OF THIS FACILITY IS: (/?eadname of faci/ity on /abe/.)

a. tSTHERE AN ERROR IN THIS NAME?

I •l Yes 2 ❑ No (Skip to Q.2)

II. WHAT IS THE CORRECT NAME OF THIS FACILITY?

2.

a,

b.

ACCORIIING TO OUR RECOROS, THE MAILING AOORESS OF THIS FACILITY IS: (Readaddmsaon /abe/.)

IS THERE AN ERROR lN”THIS AOORESS?

i ❑ Yes 2 ❑ No (Skip to 0.3)

WHAT IS THE CORRECT MAILING AOORESS OF THIS FACILITY?

E

-t

P.O. Box, Route, etc.

City or Town County

.

State Zip Code

3, HAS THIS NURSING HOME BEEN IN BUSINESS AT THIS AOORESS FOR TWO YEARS OR LONGER? COUNT FROM THE

TIME IT FIRST OPENEO AT THIS ADDRESS AS A NURSING HOME, EVEN THOUGH THE OWNERSHIP OR THE SERVICES

OFFERED MAY HAVE CHANGED.

1 Cl Yes 20No

41
–4.

a.

b,

c.

d,

e.

f.

9.

h.

i.

INTER VIEWER: This facility is out-of-scope of the survey, Pleaseterminate interviewed

ARE ANY OF THE FOLLOWING SERVICES ROUTINELY PROVIDED TO RESIOENTS IN ADDITION TO ROOM AND

BOARO:

SUPERVISION OVER MEDICATIONS WHICH MAYBE SELF-ADMINISTERED? . . . . . . . 1 ❑ iYes 2~No

MEDICATIONS AND TREATMENTS AOMINISTEREO IN ACCORDANCE WITH

PHYSICIAN’S ORDERS? . . . . . . . . . . . . . . . . . . . . . . . . . . ..ln Yes 2nNo

RUB AND MASSAGE? . . . . . . . . . . . . . . . . . . . . . . . . . . .ln Yes 2mNo

HELP WITH TUB BATH OR SHOWER?. . . . . . . . . . . . . . . . . . . . . . lnYes 2mNo

HELP WITH DRESSING? . . . . . . . . . . . . . . . . . . . . . . . . . ..ln Yes 20No

HELP WITH CO~RESPONOENCE OR SHOPPING? . . . . . . . . . . . . . . . , . . I ❑ Yes 20No

HELP WITH WALKING OR GETTING ABOUT? . . . . . . . . . . . . . . . . . . . I ❑ Yes 20No

HELP WITH EATING? . . . . . . . . . . . . . . . . . . . . . . . . . . . . lnyes 2nt.lo

OR

NONE OF ABOVE SERVICES ROUTINELY PROVIDED, ONLY ROOM AND BOARD PROVIDED? I •l Yes

I

5a. IS THIS FACILITY A OISTINCT NURSING HOME U~ OF A HOSPITAL, ANOTHER HEALTH INSTITUTION, OR A

RETIREMENT CENTER?

I •l Yes 2 ❑ No (Skip to Q.6a)

b, HOW MANY BEDS ARE IN THE ENTIRE FACILITY INCLUDING THE NURSING HOME UNIT?

11111

READ: FOR THE REMAINDER OF THE INTERVIEW, THE QUESTIONS REFER ONLY TO THE NURSING HOME UNIT.

42
60. Show Flaahcard #1 WHAT IS THE TYPE OF OWNERSHIP WHICH OPERATES THIS FACILITY?

01 ❑ Individual

-1 1

02 ❑ Partnership

}

For profit I

03 ❑ Corporation J

}

b.

04 ❑ Church related

05 ❑ Nonprofit corporation

06 a Other nonprofit ownership

070 State

oa Cl County

09 •l City

10 0 CWf-County

I I a Hospital District

12 n U.S. Public Health Service

la ❑ Armed Forces

14 0 Veterans Administration

J

15 n Other Federal Agency, Specify

IS THIS FACILITY A MEMBER OF A GROUP OF FACILITIES OPERATING

UNDER ONE GENERAL AUTHORITY OR GENERAL OWNERSHiP?

1 Cl Yes 2DN0

7a.

b,

00ES YOUR FACILITY ACCEPT BOTH MALES AND FEMALES?

I n Yes (Skip to Q.8a) 20No

00ES IT ACCEPT ONLY MALES OR ONLY FEMALES?

1 ❑ Only males

2 ❑ Only females

8a. HAS YOUR FACILITY SET A MINIMUM AGE BELOW WHICH NO ONE IS ACCEPTED?

I •l Yes 2 ❑ No (Skip to Q.8c)

b. WHAT IS THAT MINIMUM AGE?

W Years

c, HAS YOUR FACILITY SET A MAXIMUM AGE ABOVE WHICH NO ONE IS ACCEPTED?

1 •l Yes 2 ❑ No (Skip to Q 9)

d. WHAT IS THAT MAXIMUM AGE?

1-1-1 Years

43
9. DOES YOUR FACILITY ACCEPT PERSONS WHO ARE PRIMARILY OIAGNOSEO AS:

a. MENTALLY ILL OR EMOTIONALLY DISTURBED? . . . . . . . . . . . . . . . . . I nYes 20No

b. MENTALLY RETAROEO? . . . . . . . . . . . . . . . . . . . . . . . . . ..n’fes 20No

c. ALCOHOLICS? . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..ln Yes 2fl No

d. ORUGAOOICTS? . . . . . . . . . . . . . . . . . . . . . . . . . . . ..lnyes 20No

a, SENILE? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..l Clyes 20No

10. WHAT IS THE TOTAL NUMBER OF BEOS REGULARLY MAINTAINED FOR RESIOENTS?

INCLUOE ALL BEOSSET UPANO STAFFED FOR USE WHETHER OR NOT THEY ARE IN USE BY RESIOENTSATTHE

PRESENT TIME. 00 ~T INCLUOE BEOS USEO BY STAFF OR OWNERS OR BEOS USEO EXCLUSIVELY FOR EMERGENCY PURPOSES, SOLELY OAY CARE, OR SOLELY NIGHT CARE.

Total beds ~

11. WHAT IS THE NUMBER OF BEOS IN THIS FACILITY THAT ARE LICENSEO BY THE HEALTH DEPARTMENT OR OTHER

RESPONSIBLE AGENCY?

Total licensed beds [1111

12a. WAS THERE A CHANGE IN THE TOTAL NUMBER OF BEOS REGULARLY MAINTAINED OURING 1976?

I •l Yes 2 ❑ No (Skip to Q. 13)

b. IN WHICH MONTHS WAS THE NUMBER OF BEOS CHANGEO?

C. (Ask for each charrge:) IN (’month), WAS THAT AN INCREASE OR OECREASE?

d. (Ask for each change:) HOW MANY BEDS?

Month Increase (Number added) Decrease (Number eliminated) ——

w

w

1111

1111

1111

1111

w 1111 1111

13. IS THIS FACILITY CERTIFIEO BY BOTH MEOICARE ANO MEOICAIO, MEOl~ARE ONLY, MEOICAIO ONLY, OR

NEITHER?

I ❑ Both Medicare and Medicaid

2 ❑ Medicare only

3 ❑ Medicaid only (Skip to Q. 16)

4 ❑ Neither (Skip to Q.24)

.

44
14a. HOW MANY BEOS ARE CERTIFIED UNDER MEDICARE? U beds

b. ARE THESE BEDS A PHYSICALLY DISTINCT UNIT FROM THE REST OF THE FACILITY? I 0 Yes 20No

150 Show Flashcard #’2 WHICH OF THE REIMBURSEMENT METHODS AUTHORIZED BY MEDICARE IS USED BY THIS

FACILITY?

10

20

30

90

RCCAC Method (Departmental-Relationship of Charges to Charges Applied to Cost Method; i.e., costs are apportioned by

applying a percentage representing the beneficiaries’ share of total charges, on departmental basis, to total costs for the

respective departments.)

Combination Method (For routine services such as room, board, and nursing services the providers total allowable costs are

apportioned on the basis of the relative number of patient davs for beneficiaries and for other patients. For non-routine or

anci]iary services, the providers allowable costs are apportioned on the basis of a percentage representing the beneficiaries’

share of the total charges to all patients for these services.)

Other, Specify

Don’t Know

INTER VIEWER NOTE: Skip to 0.23a if “Medicare only” in 0.13.

—

16. IS THIS FACILITY CERTIFIED AS AN SNF, THAT ISA SKILLED NURSING FACILITY, BY THE MEDICAID PROGRAM?

1 Cl Yes 2 n No (Skip to Q. 19)

17a. HOW MANY BEDS ARE CERTIFIED UNDER MEDICAID ASSNF BEDS? ~ beds

b. ARE THESE BEDS A PHYSICALLY DISTINCT UNIT FROM THE REST OF THE FACILITY?

I •l Yes 20No

18a. Show Flashcard #3 WHICH OF THE FOLLOWING REIMBURSEMENT METHOOS FOR ~F-MEDICAiD PATIENTS IS

USED BY THE FACILITY?

I ❑ Flat Rate Only ~ b, WHAT IS THE FLAT RATE? $ ~G per ~nday

per 2❑ week

per 30 month

per 4❑ other, specify

2 ❑ Flat Rate PIUSPoint System for Ancillary Services ~d. WHAT IS THE FLAT RATE PORTION?

a ❑ Cost Plus Allowable Profit $ ~e. per ~oday

4 ❑ Other, Specify

per za week

per 30 month

9 ❑ Don’t Know per 40 other, specify

45
19. IS THIS FACILITY CERTIFIED AS AN ICF, THAT IS AN INTERMEDIATE CARE FACILITY, BY THE MEDICAID

PROGRAM?

I •l Yes ; ❑ No (Skip to Note above 0.22)

20a. HOW MANY BEDS ARE CERTIFIED UNDER MEDICAID AS ICF BEDS? H bd

b, ARE THESE BEDS A PHYSICALLY DISTINCT UNIT FROM THE REST OF THE FACILITY? I ❑ ’fes 20No

Z!a. I Show Flashcard ?Y3 I WHICH OF THE FOLLOWING REIMBURSEMENT METHODS FOR —ICF-MEDICAID PATIENTS

IS USED BY THE FACILITY?

I ❑ Flat Rata Only~ b. WHAT IS THE FLAT RATE? $ ~c. per I ❑ day

per 2 ~ week

per 3 ❑ month

per 4 a other, specify

2 n Flat Rate Plus Point System for Ancillary Services — d, WHAT IS THE FLAT RATE PDRTION?

3 ❑ Cost Plus Allowable Profit $ k~ e. Per I ❑ day

4 ❑ Other, Specify

per 2 ❑ week

per 3 ❑ month

9 ❑ Don’t Know per 4 ❑ other, specify

INTER VIEWER NOTE: Skip to Q.23a if the facility is certified by only one progr.~m and at only one level of care,

22. SOMETIMES THE SAME BED IS CERTIFIED BY MORE THAN ONE PROGRAM. WITH REGARD TO THESE SO CALLED

“SWING BEDS”, HOW MANY BEDS IN YOUR FACILITY ARE CERTIFIED:

a. ASSNF BEDS UNDER BOTH MEDICARE AND MEDICAID? 11111

b. AS BOTH ICF AND SNF BEDS UNDER MEOICAIO? 111!1

c. AS MEDICAID-ICF ANO MEDICARE-SNF BEDS? 11111

d. UNDER ALL THREE PROGRAMS THAT IS, MEDICARE-SNF, MEDICAID-SNF, AND MEDICAID4CF? ~

23a, DO YOU HAVE ANY BEDS NOT CERTIFIED BY EITHER MEDICAIO OR MEOICARE?

1 ❑ Yes 2 ❑ No (Skip to 0.24)

b, HOW MANY OF THESE BEOS DOES YOUR FACILITY HAVE?

~ Beds

24. HOW MANY PERSONS WERE AOMITTED TO THIS FACILITY DURING 1976?

~ admissions none ❑

46
26a, DOES THIS FACILITY ACCEPT TEMPORARY ADMISSIONS OF PERSONS WHOSE USUAL CARETAKERS ARE ILL, ON

VACATION, OR OTHERWISE UNAVAILABLE?

1 •l Yes 2 ❑ No (Skip to 0.26)

b, HOW MANY TEMPORARY RESIOENTS WERE AOMITTED TO THIS FACILITY OURING 1976?

~ temporary admissions none ❑

26a. WE WOULD LIKE TO OBTAIN INFORMATION ON DAYS OF CARE PROVIDED BY THE FACILITY FQR YOUR MOST

RECENTLY COMPLETED FISCAL YEAR, THAT IS, THE TWELVE MONTH PERIOD ON WHICH YOU COMPUTE THE

FACILITY’S EXPENSES. IS THIS INFORMATION AVAILABLE FOR A FISCAL YEAR?

I •l Yes 2 ❑ No (Skip to Q.26c)

b. WHAT WAS THIS TIME PERIOD?

Mo. Year Mo. Year

from W W through W W

(If this is less than a twelve month period, please record the number of months in this box.) L-1

I Skipto 0.26d I

c.

d.

FOR WHAT TIME PERIOD IS THIS INFORMATION AVAILABLE?

Mo. Year MO. Year

from W W through W W

(If this is less than a twelve month period, please record the number of months in this box.)

FOR THIS PERIOO, WHAT WERE THE TOTAL INPATIENT DAYS OF CARE PROVIDED, THAT IS THE SUM OF THE

OAILY PATlENT CENSUS COUNT BY TYPE OF CERTIFICATION? DO NOT INCLUDE CASES THAT ARE DAY CARE

ONLY.

(1) Total Days: ~ days ❑ Mark (X) if estimated

(2) SNF-Medicare ~ days ❑ Mark (X) if estimated ❑ notapplicab[e

(3) SNF-Medicaid ~ days ❑ Mark (X) if estimated ❑ not applicable

(4) lCF-Medicaid ~ days ❑ Mark (X) if estimated ❑ not applicable

(5) All Other Days ~ days ❑ Mark (X) if estimated ❑ not applicable

47
Confidential Information

‘~

hrtewiewer, Read: Information contained on this form which would permit identification of any individual or establishment has

been collected with a guarantee that it will be held in strict confidence, will be used only for purposes stated for this study, and

will not be disclosed or released to others without the consent of the individual or the establishment in accordance with Section

308(d) of the Public Health Service Act (42 USC 242m).

27a, COUNTING FROM THE TIME IT WAS ORIGINALLY CONSTRUCTED, HOW OLD IS THIS BUILDING? (krterwewar: Round

fractions to nearest whole year. If interval is given, record mid-point and mark “if estimated” box.)

W Years (Mark (X) box ❑ if estimated) ❑ Don’t Know

b. WAS THIS BUILDING ORIGINALLY CONSTRUCTED SPECIFICALLY FDR USE AS A NURSING HDME? (hrterviewer: Other

terms for nursing homes are rest home, home for the aged, mentally ill, or mentally retarded.)

I ❑ Yes (Skip to Q.27d) 2 L7 No 9 ❑ Don’t know (Skip to C?.27d)

c. WHAT WAS THE DRIGINAL PURPDSE OR USE OF THIS BUILDING?

I ❑ Private home, apartment, hotel/motel

2 ❑ Hospital, sanitarium, or other health related building

3 ❑ Other, Specify .—— ——. —

d, NOT COUNTING PAINTING OR PAPERING, HAS THE STRUCTURE OF THIS BUILOING EVER BEEN RENOVATED OR

REMOOELED?

1 ❑ Yes 2 n No (Skip to 0.28) 9 ❑ Don’t know (Skip to 0.28)

e. Show Flashcard #4 WHICH OF THE FOLLOWING CHANGES f. IN WHAT YEAR WAS THE MOST RECENT

WERE MAO E? (Mark (X) all that apply; then ask 27f for each change.) (change)?

Year In Process Don’t Know

(1) Addition to the building constructed . . . . . . . . ❑ Wcl •1

(2) Fire safety equipment/construction added or changed . . ❑ Wn •1

(3) Interior remodeling . . . . . . . . . . . . . . ❑ w •1 ‘n

(4) Other, Specify ❑ Wm •1

28. HOW MANY ROOMS FOR RESIOENTS 00 ESTHIS FACILITY HAVE THAT CONTAIN:

a. 1 BEO ONLY? ~ rooms None ❑

b. 2 BEOS? L1-1--l rooms None ❑

c. 3 BEOS? ~ rooms None ❑

d. 4 OR MORE BEDS? ~ rooms None ❑

48
29a, FOR THE DAY SHIFT YESTERDAY, WAS THE PERSON IN CHARGE OF NURSING CARE FDR THE ENTIRE FACILITY

ON CALL OR ON OUTY, THAT IS AWAKE, ORESSED, ANO SER\’”-!G THE RESIDENTS?

I ❑ On Call (Skip to 0.30.9)

2 a On Duty

b. WHAT IS THE LEVEL OF SKILL OF THIS PERSON?

c.

I ❑ Registered Nurse

z ❑ Licensed Practical Nurse

3 ❑ Nurse’s Aide or Orderly

4 ❑ Other (Specify Occupation) —. —

WHAT HOURS DID TM PERSON ACTUALLY WORK YESTERDAY? (Mark (X) am orpm)

from Cd t Cd :~~ to Cl : El ~~~

301, FOR THE EVENING SHIFT YESTERDAY, WAS THE PERSON IN CHARGE OF NURSING CARE FOR THE ENTIRE

FACILITY ON CALL OR ON OUTY?

I ❑ On Call (Skip to 0.31a)

z.DOn Duty

3 ❑ No Such Shift (Skip to L1.3fa)

b. WHAT IS THE LEVEL OF SKILL OF THIS PERSON?

c.

~ ❑ Registered Nurse

2 ❑ Licensed Practical Nurse

3 ❑ Nurse’s Aide or Orderly

4 ❑ Other (Specify Occupation)

WHAT HOURS OID THIS PERSON ACTUALLY WORK YESTERDAY? (Mark (X) am orprn)

49
31&

b,

c.

FOR THE NIGHT SHIFT YESTERDAY, WAS THE PERSON IN CHARGE OF NURSING CARE FOR THE ENTIRE FACILITY

ON CALL OR ON OUTY?

I ❑ On Call (Skip to 0.32)

2 ❑ On Duty

3 ❑ No Such Shift (Skip to 0.32)

WHAT IS THE LEVEL OF SKILL OF THIS PERSON?

I ❑ Registered Nurse

2 ❑ Licensed Practical Nurse

3 ❑ Nurse’s Aide or Orderly ‘

.t ❑ Other (Specify Occupation)_

Q

WHAT HOURS 010 TM PERSON ACTUALLY WORK YESTERDAY? (Mark (X) am orpm)

32. HOW MANY OIFFERENT PHYSICIANS CURRENTLY ATTENO THEIR OWN PRIVATE PATIENTS IN THIS FACILITY?

(Do not count physicians who are on the staff of the faciliw or are employed under contract.)

~ Physicians or ❑ none

33a.

b.

DOES THE FACILITY HAVE A MEDICAL DIRECTOR?

I •l Yes 2 ❑ No (Skip to 0.34)

Show Flashcard #5 1

UNOER WHICH OF THESE TYPES OF ARRANGEMENTS IS THE MEDICAL DIRECTION OF THIS

FACILITY PROVIOED?

I ❑ An individual physician

2 ❑ A physician partnership or group practice

3 ~ Several individual physicians

4 ❑ An H. M. O., medical school, or medical society

5 ❑ Hospital Staff

6 ❑ Other, Specify -——. . ..— ..— —— ——— .— — ——

34. OOESTHIS FACILITY ROUTINELY PROVIDE ON THE PREMISES A.NY OF THE FOLLOWING THERAPIES BY A

LICENSED, REGISTERED, OR PROFESSIONALLY TRAINEO THERAPIST:

a, PHYSICAL THE RACY?.... . . . . . . . . . . . . . . . . . . . . . ..l Clyes 20N0

b. OCCUPATIONAL THERAPY? . . . . . . . . . . . . . . . . . . . . . . . ..l Clyes 20No

c. RECREATIONAL THERAPY? . . . . . . . . . . . . . . . . . . . . . . . ..lfl Yes 20No

d. SPEECH AND HEARING THERAPY? . . . . . . . . . . . . . . . . . . . . . . Iayes 2 aNo

e. COUNSELING/THERAPY BY PSYCHIATRIST, PSYCHOLOGIST, OR MENTAL HEALTH WDRKER? I •l Yes 2mN0

f. COUNSELING BY SOCIAL WORKER? . . . . . . . . . . . . . . . . . . . . . . lfl’fes 2~No

a. OTHER REHABILITATION THERAPIES? Specify I •l Yes 2DN0

50
35a. DOES THIS FACILITY KEEP A WAITING LIST OF’PERSONS TO BE AOMITTEO WHEN A BEO BECOMES AVAILABLE?

I •l Yes 2 u No (Skip to Q.36a)

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

M people or ~Norw

36a. DOES THIS FACILITY PROVIDE ANY SERVICES TO PERSONS WHO ARE UT RESIOENTS OF THE FACILITY?

I ❑ Yes 2 ❑ No (Skip to Q.38J

b. FOR WHICH OF THE FOLLOWING CATEGORIES OF NON-RESIOENTS 00 YOU PROVIOE SERVICES:

(1) (Inappropriate) PERSONS ON THE WAITING LIST? . . . . . . . . . . . . . . I ❑ IYes 20N0

(2) OISCHARGEO RESIDENTS? . . . . . . . . . . . . . . . . . . . . . . . ]C1’fes 20N0

(3) ANY PERSON WHO APPLIES?. . . . . . . . . . . . . . . . . . . . . . . ]nYes 20N0

(4) ANY OTHER TYPE OF NON. RESIDENT? Specify I ❑ Yes 2DN0

37. Show Flashcard #6 WHICH OF THE FOLLOWING SERVICES 00 YOU PROVIOE TO NON-RESIOENTS? (Mark (X) all

that apply.)

a.

b.

c,

d.

e.

f.

9.

h,

i,

i.

k.

1,

m.

❑ Day care (services provided during the day to persons who do not sleep in the facility overnight.)

❑ Physical therapy

❑ Occupational, recreational, or speech and hearing therapy

❑ Psychiatric care

❑ Home health care services

U Meals either home delivered or in a group setting

❑ Transportation and/or escort services

❑ Homemaker or chore services

❑ Information and/or referral for health needs

❑ Friendly visiting

U Daily telephone checking service .

❑ Arrangement or provision of recreational activities

❑ Laundry service

n, n Other, Specify .__–..-.__.__ _... _..-—— .——. . ..——. —

38. 00 ESTHIS FACILITY HAVE ANY VACANT STAFF POSITIONS IN ITS BUDGET THAT IT IS CURRENTLY TRYING TO

FILL?

I ❑ Yes 2 ❑ No (Skip to Note below Q.39)t

51
39. [Show F/ashcard~ HOW MANY VACANT FULL TIME ANO PART TIME STAFF POSITIONS ARE IN THE BUOGET FOR

THE FOLLOWING OCCUPATIONS? FULL TIME IS OEFINEO AS35 HOURS OR MORE PER WEEK.

a.

b.

c.

d.

e.

f.

9.

h.

i.

i.

k.

1.

m.

Administrator/Asst. Administrator . . . . .

Physician (M.D. or D.O.), Residents and Interns

Dentists . . . . . . . . . . . . . .

Pharmacists . . . . . . . . . . . .

Registered Occupational Therapists. . . . .

Registered Physical Therapists . . . . . .

Speech Pathologist and/or Audiologists . . .

Activities Directors . . . . . . . . . .

Dietitians or Nutritionists . . . . . . . .

Registered Medical Records Administrators . .

Social Workers . . . . . . . . . . .

Other Professional Occupations . . . . . .

Registered Nurses (R. N.) . . . . . . . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

. . .

.. .

. . .

. . .

. . .

. . .

n. Licensed Practical Nurses (L. P.N.) or Licensed Vocational

Nurses (L.V.N.) . . . . . . . . . . . . . .

0. Nurses Aides/Orderlies . . . . . . . . . . . .

p. Office Staff . . . . . . . . . . . . . . .

q. Food Service Personnel . . . . . . . . . . . .

r. Housekeeping/Maintenance Personnal . . . . . . .

s. Other, Specify

Full Time

w

I-1-J

w

w

w

w

I-J.-J

w

w

w

w

w

w

Part Time

w

w

w

w

w

w

w

w

w

w

w

❑ None

❑ None

❑ None

❑ None

❑ None

❑ None

❑ None

❑ None

❑ None

❑ None

❑ None

❑ None

❑ None

.O None

❑ None

❑ None

g None

❑ None

❑ None

Nameof the Respondent * Title

I ❑ lam

E. End Time F. Time Elapsed b-l-! Minutes

2Cipm

THANK YOU FOR YOUR TIME AND COOPERATION

INTER VIEWER NOTE: After completing the above items and thanking the respondent, continue the interviewing process with Prompt

Card ?Y3.

* u s GOVERNht ENT PRLNTf NG OF FSCC Ir177-724. e74/66s 3. I

52
Facility Worksheet

FACILITY WORKSHEET

Facility Name

Respondent Title

TOTAL NUMBER OF INPATIENT DAYS OF CARE

BY TYPE OF PROGRAM.

SNF MEDICARE DAYS:

SNF MEDICAID DAYS: +

ICF MEDICAID DAYS:

ALL OTHER DAYS:

+

+

PROVIDED

= Total numb er of

inpatient days of

care at this facility

for 19’i6.

53
Staff Classification Card

STAFF CLASSIFICATION CARD

WHICH OF THE FOLLOWING JOB CATEGORIES BEST FITS THE JOB WHICH THIS EMPLOYEE DOES IN THIS FACILITY? //f the

employee performs more than one job, select the job for which the employee spends the most time.)

01.

02.

03.

04.

05.

06.

07.

08.

09.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

Administrator, Assisrant Administrator

Physician (M.D. or 0.0.)

Residents and Interns

Denw.t

Pharmacist

Registered Occupational Therapist

Other Occupational Therapist or Assistant

iRegistered Physical Therap!st

Other Physical Therapist or Assistant

Activities Director (Recreational Therapist)

Dietitian or Nutritionist

Social Worker

Social Work Tectmician/Assistant

Speech Pathologist and/or Audiologist

Registered Medical Reccrds Adminlstraror

Other !Medical Records Administrator or Technician

Registered Nurse ( R. N.)

Licensed Practical Nurse ( L.?. N.) or Licen-ea Vocational Nurse ( L. V. N.)

Nurse’s Aide/Ordarly

Other Professional Occupations (Including Psychologist, X. Ray Technicians, etc.)

54
Staff Sampling List

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

PUBLIC HEALTH SERVICE Sheet _of _

[

OMB # 68-S75025

Health Resources Administration APPROVAL EXPIRES 12-31-77

National Center for Health Statistics

1977 National Nursing Home Survey STAFF SAMPLING LIST Control No. 11111

Confldentlal Information

information contained on this form which would permit identification of any individual or establishment has been collected with a guarantaa that it will be bald in strict Confidence, will be used only for purposes stated for this study, and will not be disclosed or released to

othws without the consent of the individual or the establishment in accordance with Section 308(d) of the Public Health Service Act

(42 USC 242m).

B. What is the total number of employees working in this facility, including

A. Start Tirna

loam contract personnel, the administrator, office and kitchen workers and

2apm maintenance staff?

11111

C. If this facility is a unit of a larger institution, @ respondent is unable to report employees D. Total in sample L-J-J

who work only in this unit of the facility, check here. ❑

loam

F. End Time

E. Plaaa@indicate in which Occupational Coda Groups you have chosen new SW and TE numbrs. 21Jpm

Group A ❑ Group C ❑ Group E ❑

G. Elapsed Time

Group B ❑ Group D n

!-UJ Minuttrs

INE

10, STAFF NAMES STAFF OCCUPATION CODES

iol CHARGE - YESTERDAY DAY SHIFT

;02 CHARGE – YESTERDAY EVENING SHIFT

;03 CHARGE – YESTERDAY NIGHT SHIFT

Sw LuJ Sw I_Ld Swill]

?+; “’”/ , , \

TEI,,I TEII,] TEI,] ~El,,[

“ihu$lm Number Number Number Numbar

‘W’84ULl, Seleeted Selactad Salected Selacted

,.

., .,.

01 :: ,.:;. . ,r. J

-,

: ,k; “ .

02 ,,

03 \

.,

.,l

04 . . . . !.

(#l ;:, ‘“’’~”” “’ “:. :> j +:.F. j:.:”””: ‘,:; ~ “ ““ -“ ‘ ‘“

,,

06 $;;:,:. ‘ “..

. .

07

.*. .; ‘;”

... . . . . . . . .

-,..:.

.,.

08 . . !.

.,,

09

,.

.!” I

t ,. I I

,. %,

55
STAFF SAMPLING LIST-CONTINUED

LINE

NO. STAFF NAMES STAFF OCCUPATION CODES

Group A” Group B Group C Group D Group E

(c@tract) 01-16

ol-16and and 17 18 19

20 20

11

12

13

14

.;W’

16

17

18

19

+@

,.

T“

. .

21

22

23

24

~ .: . ,.’

. .

...

26

27

28

29

30

31 ——.—-

32 ———

33

.—— —..

34 I

36

36 — .-

37, )

———

38 ——.———

39

40

56
STAFF SAMPLING LIST-CONTINUED

LINE

NO. STAFF NAMES STAFF OCCUPATION CODES

GrO@ A Group B Group C Group D Group E

(contract) 01-16

01-wmld and 17 18 19

20 20

41

42

43

44

46

47

48

49

~w

51

52

63

54

’56.

56

57

58

59

m

61

62

63

64

66

66

67

68

69

70

57
STAFF SAMPLING LIST-CONTINUED

LINE

NO. STAFF NAMES STAFF OCCUPATION CODES

I

,, I

, I

72

73

~ GroLJPB Group C Group D Group E

01-16

~fj and 17 18 19

~:, 20

76

.- 1

TOTAL LISTED IN GROUPS: A = B= c. ~= E=
Letterto Staff Member

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

PUBLIC HEALTH SERVICE

HEALTH RESOURCES ADMINISTRATION

ROCKVILLE. MARYLAND 20057

NATIONAL CENTER FOR

HEALTH STATISTICS

Dear Staff Member:

You were recently asked to complete a questionnaire for the

National Nursing Home Survey being conducted by the National Center

for Health Statistics of the U.S. Public Health Service in the Department of Health, Education, and Welfare.

I want to emphasize that the information you supply will be used

solely for statistical research and reporting purposes. No information

collected under che authority of Section 306 (42 USC 242K ) of the Public

Health Service Act may be used for any purpose other than the purpose

for which it was supplied, and such information may not be published

or released in other form if the individual or establishment is identifiable unless the individual or establishment has consented to such

release.

The published statistics based on this survey will show the background and training of nursing home employees at the national and regional levels. These data will be used to develop private and public health

manpower training programs. Because you were randomly selected in

the sample for a particular occupational group, your responses represent

others in that group. Although your participation is voluntary, it is

ess ential that all staff members respond s o that the data are accurate

and complete.

Since we have not received your completed questionnaire, another

COpy of the questionnaire and a postage-paid business reply envelope are

enclosed. We would greatly appreciate your cooperation in completing

and returning your questionnaire within five working days. The questionnaire takes only a few minutes to complete, and your answers are totally

confidential. If YOU have any questions, you may call 301/770-2048

collect for answers.

Sincerely yours,

A(.pzijF$’..

Dorothy P. R“ e

Director

Enclosures

59
Staff Questionnaire

DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE

PUBLIC HEALTH SERVICE

Health Resources Administration STAFF QUESTIONNAIRE

National Center for Health Statistics

1977 National Nursing Home Survey

I I

OMB # 68.S75025

APPROVAL EXPIRES 12.31.77

CONTROL NO. 111111

A. LINE NO. ~ B. OCCUPATION CODE ~ c.

(OcowationalTM.)

Confidential Information

Information contained on this form which would permit identification of any individual or establishment has bean mllactad with ● guarantee that it will be bald in strict confidence, will be used only for purposes stated for this study, and will not be disdosed or raleeeedto

otharswithout the consentof the individual or the establishmentin accordancewith Section 308(d) of the Public Health 8ervlae Act

(42 USC 242mL

PLEASE READ THESE INSTRUCTIONS BEFORE YOU BEGIN TO ANSWER THE STAFF QUESTIONNAIRE.

The letter accompanying this questionnaire explains the purposes of the survey, the usesof the information, and

the confidentiality of the data. Please read this letter carefully before completing the questionnaire.

The occupation for which you were sampled is cited in Item C above. All questions about your work refer to that

occupation and you should keep that in mind as you complete this instrument.

Most of the questions have detailed instructions printed in italics after them. The instructions were put thereto help

you to give the most accurate answer possible to the quest~ons. If you have any questions regarding items on the questionnaire or how you should complete it, pleasa call COLLECT 301-770-2048 and a National Nursing Home Survey

employee will be available to help you.

Your cooperation in carefully completing the questionnaire is greatly appreciated. It should take only a few minutes of your time and the information that you provide is very important, As stressedin the letter, these data are held

in strictest confidence. When you have completed the questionnaire, please seal it in the postage-paid envelope provided. You may return it to the interviewer if he is still in the facility or drop it in the mail to the address cited on the

bottom of page 4.

60
1.

a,

b.

HOW LONG HAVE YOU WORKEO IN THE IJCCUPATIIJN SPECIFIED [N ITEM c ON THE FRONT OF THIS

QUESTIONNAIRE:

(please be sure that both years and months are filled in. If less than one year,enter“OW in yrs.box; if less than one month, enter

“Win Mos. box.)

IN THIS FACILITY? l_lJl_#

IN OTHER NURSING HOMES, HOMES FOR

THE AGED, HOSPITALS, OR SIMILAR

FACILITIES? (Only count work experience

before your employment in this facility.) L-# L--# OR Mark this box if you have never worked in

any other nursing or hospital facility. ❑

2, ARE YOU A MEMBER OF THE STAFF OF THIS FACILITY OR EMPLOYEO UNDER CONTRACT?

(Mark only one box)

1 ❑ Staff member (Part Time or Full Time) 2 ❑ Under contract (Part Time or Full Time)

3 ❑ Other arrangement, Specify

3. DO YOU USUALLY PERFORM ANY OF THE FOLLOWING SERVICES IN THIS FACILITY?

(Mark the Yes or No box for —each line)

a. Administration of the facility . . . . . . . . . . . . . . . . . . . . . . . . lmYes 20No

b. Screening persons for admission . . . . . . . . . . . . . . . . . . . . . . . . lUYes 20No

c. Nursing care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . In Yes 20No

d. Medical and dental care.... . . . . . . . . . . . . . . . . . . . . ..l aYes 20No

e. Physical therapy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . lDYes 2!3N0

f. Occupational therapy . . . . . . . . . . . . . . . . . . . . . . . . . ..l CIYes 20No

g. Recreational therapy, . . . . . . . . . . . . . . . . . . ........lnyes 20No

h. Speech and hearing therapy . . . . . . . . . . . . . . . . . . . . . . . . . laYes 20No

i. Social work, counseling (religious, etc.) . . . . . . . . . . . . . . . . . . . . . I ❑ Yes 20No

j. Training of staff . . . . . . . . . . . . . . . . . . . . . .......$lnyes 20No

k. Supervision of staff . . . . . . . . . . . . . . . . . . . . . . . . . . ..l aYes 20No

1. Clerical work, medical and social record keeping . . . . . . . . . . . . . , . . . . ~ ❑ yes 20No

m. Kitchen/dietary work, grocery shopping . . . , . . . . . . . . . . . . . . . . . ~ ❑ yes 20No

n. Housekeeping services, maintenance, care of grounds . . . . . . . . . . . . . . . . . ~ ❑ yes 2!3N0

o. Other, Specify 1 •l Yes 2CN0

4. HOW MANY HOURS PER WEEK 00 YOU USUALLY WORK ——IN THIS FACILITY?

W hours per ~aweek

2 ❑ other time period, Specify

5a. 00 YOU USUALLY WORK ANY ADDITIONAL HOURS IN YOUR PROFESSION BESIOES THE HOURS WORKED IN THIS

FACILITY?

2 m No (Skip to Question 6.)

lCIYes~ b. HOW MANY? W hours per I ❑ week

2 ❑ other time period, Specify

61
6a. WHAT IS THE HIGHEST YEAR OF EOUCATION YOU HAVE COMPLETEO?

(Please circle only the h&hest completed year; jnclude wfrateverprofessional training YOU have had.)

~ ‘G =,

17 18+

\ )

v

Elementary High School More Than Four Years of

Other Training College and/or Other Training

If your highest year of completed education is less than 14 years, skip to Question 7. —

b. DO YOU HAVE AN ASSOCIATE, BACHELOR’S, MASTER’S, OR DOCTORATE DEGREE?

1 0 Yes 2 n No (Skip to Question 7)

c. WHICH OF THE FOLLOWING d, SPECIFY MAJOR FIELO’OF STUDY FOR e, SPECIFY YEAR

00 YOU HOLD? EACH DEGREE. COMPLETED

(1) Associate c1 (1) 19—

(2) Bachelor’s ❑ ,, (2) 19—

(3) Master’s •1 ‘?(3)

)

19—

(4) Doctorate ❑ (4) 19—

7. DURING THE LAST TWELVE MONTHS, HAVE YOU TAKEN A NON-DEGREE TRAINING COURSE IN ANY OF THE FOLLOWING AREAS?

(Training courses include class sessions and seminars. DO not include any courses YOU have taken for a degree. Mark the Yes or

No box for& line.)

a. Nursing care of the aged or chronically ill . . . . .

b. Medical or dental care of the aged or chronically ill .

c. Mental or social problems of the aged or chronically ill

d. Physical therapy or rehabilitation . . . .” . . .

e. Occupational therapy . . . . . . . . . . .

f. Nutrition or food services . . . . . . . . . .

g. Nursing home administration or management . . .

h. Inservice education . . . . - . . . . . . .

i. Medical records . . . . . . , . . . . . .

j. Activity programs for the aged or chronically ill . .

k. Social services for the aged or chronically ill . . . .

1. Pharmacology and care of drugs . . . . . . . .

20N0

2nNo

20N0

2DN0

2UN0

2DN0

20N0

20N0

2DN0

2nNo

20N0

2DN0

I ❑ Yes—+ How many courses?

I •l Yes~ How many courses?

I ❑ Yes —How many courses?

1 ❑ Yes ~How w courses?

I ❑ Yes ~How ma courses?

—

I U Yes~How m courses?

I 0 Yes~How many courses?—

I •l Yes~How many courses?

1 G Yes —How many courses?

I •l Yes —How g courses?

1 El Yes~How many courses?

I •l Yes ~How many courses?_

m. Other courses related to your work,

Specify 2DN0 I ❑ Yes —How many courses?

8. ARE YOU 2 ❑ Female? OR I ❑ Male?

9. WHAT IS YOUR DATE OF BIRTH?

++++

IO. WHICH ONE OF THESE GRouf’sg OESCRIBES yfJuR ETHNIC oRIGIN oR ANCESTRY?

1❑ White (Not of Hispanic Origin) 4 ❑ Asian or Pacific Islander

2 ❑ Black (Not of Hispanic Origin) 5 ❑ Hispanic

3 ❑ ’American Indian or Alaska Native

I

62
11, BEFORE DEDUCTIONS WHAT IS YOUR SALARY FOR THE WORK YOU PERFORM IN THIS FACILITY ONLY~ —.

(Mark only one box)

[

I ❑ hour

2 n day

Dollars Cents

m

● D per ~ ~~g;eeks

a ❑ one month

OR 6 •l year

7 ❑ other time period, specify

❑ I donate my services (Sk@ to C)uesdon 73)

12. IN ADDITION TO THIS SALARY, DO YOU RECEIVE:

(Mark the Yes or No box for@ line)

a.

b.

c,

d,

e.

f.

9.

h.

i.

i.

Paid vacation, and/or paid holidays, and/or paid sick leave? . . . . . . . . . . . . . I ❑ Yes 20No

Pension plan in addition to Social Security? . . . . . . . . . . . . . . . . . I ❑ Yes 2!3N0

Health insurance? .,,,.., . . . . . . . . . . . . . . . . . . . ..ln Yes 20No

Life Insurance? . . . . . . . . . . . . . . . . . . . . . . . . . . . ..l DYes 20No

Direct medical benefits? . . . . . . . . . . . . . . . . . . . . . . . . ..lm Yes 20No

Release time for attending training Institutes? . . . . . . . . . . . . . . . . . I ❑ Yes 20No

Civic or personal leave (such as leave for jury duty, military reserves, voting, funerals)? . . . . I ❑ Yes 20No

Room? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I •l Yes 20No

Meals? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. IO YI?S 20No

Other? Specify I ❑ Yes 20No

13. ARE YOU A PHYSICIAN? 2 a No (Skip to the message after Question 20.)

I D Yes (Go to Ouestion 14. Questions 14 through 20 apply on~y to physicians.)

14a. 00 YOU ATTENO YOUR OWN PRIVATE PATIENTS IN THIS HOME? I ❑ Yes 20 No (Skip to Question 15)

b. HOW MANY OF YOUR OWN PRIVATE PATIENTS DO YOU CURRENTLY ATTEND IN THIS FACILITY? !_i_d patients

15. ARE YOU TEMPORARILY ATTENDING PATIENTS IN THIS FACILITY TO COVER FOR THE PATlENT’S OWN PHYSICIAN?

I Cl Yes 20No

16. 00 YOU TAKE EMERGENCY CALLS FOR ~PATIENTS IN THIS HOME? 1 ❑ ’fes 20No

17. 00 YOU PROVIOE OTHER DIRECT PATlENT SERVICE IN BEHALF OF THE FACILITY’S RESPONSIBILITY FOR SECURING SUCH CO VERAG ES (e.g.,Admission exams, pronouncing deaths, securing medication and diet orders, etc.)?

1 U Yes 2UN0

18. 00 YOU PROVIDE FORMAL INSERVICE TRAINING TO THE FACILITY’S PERSONNEL? I ❑ yes 20No

19. ARE YOU THE MEDICAL DIRECTOR FOR THIS FACILITY? I Ci Yes 2mNo

20. FOR HOW MANY RESIOENTS IN THIS HOME 00 YOU PROVIOE MEOICAL CARE? ~ residents

THANK YOU FOR YOUR COOPERATION. PLEASE RETURN THE QUESTIONNAIRE TO THE INTERVIEWER IN THE POSTAGE

PAIO ENVELOPE PROVIOED OR OROP IT IN THE MAIL TO:

NATIONAL NURSING HOME SURVEY

IN FOR MATICS, INC.

6000 EXECUTIVE BLVD.

ROCKVILLE, MD. 20852

63
1

Series 1.

Series 2.

Series 3.

Series 4.

VITAL AND HEALTH STATISTICS Series

Programs and Collection Procedures. –Reports which describe the general programs of the National

Center for Health Statistics and its offices and divisions and data collection methods used and include

definitions and other material necessary for understanding the data.

Data Evaluation and Methods Research. –Studies of new statistical methodology including experi- “-

mental tests of new survey methods, studies of vital statistics collection methods, new analytical

techniques, objective evacuations of reliability of collected data, and contributions to statistical theory.

Analytical Studies. –Reports presenting analytical or interpretive studies based on vital and health

statistics, carrying the analysis further than the expository types of reports in the other series.

Documents and Committee Re~orts. –Final reports of maior committees concerned with vital and

heafth statistics and documents’ such as recommended model vital registration laws and revised birth

and death certificates.

Series 10. Data From the Health Interview Survey. –Statistics on illness, accidental injuries, disability, use of

hospital, medical, dental, and other services, and other health-related topics, all based on data collecte~

in a continuing national household interview survey.

Series 11. Data b’rom the Health Examination Survey and the Health and Nutrition Examination Survey. –Data

from direct examination, testing, and measurement of national samples of the civilian noninstitutionalized population provide the basis for two types of reports: (1) estimates of the medically defined

prevalence of specific diseases in the United States and the distributions of the population with respect

to physical, physiological, and psychological characteristics and (2) analysis of relationships among the

various measurements without reference to an explicit finite universe of persons.

Series 12. Data From the Institutionalized Population 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 Facilities. –Statistics on the numbers, geographic distribution, and characteristics of health resources including physicians, dentists, nurses, other heafth

occupations, hospitafs, nursing homes, and outpatient facilities.

Series 20. Data on Mortality. –Various statistics on mortality other than as included in regular annual or monthly

reports. Speciaf 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 Survey s.–Discontinued effective 1975. Future reports

from these sample surveys based on vital records will be included in Series 20 and 21, respectively.

Sen”es 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 probability sample of ever-married women 15-44 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

Hyattsville, hid. 20782
OFFICIAL BUSINESS

PENALTY FOR PRIVATE USE $300

POSTAGE AND FEES PAID

J S DEPARTMENT OF H H S

H}4S 3!36

‘1< R!> LLASS