From Vital and Health Statwtics of the National Center for Health Statwtlcs Number 111. September 20, 1985 

. 

PROPERTY OF WE “ 

PUBLICATION MANCH 

EDITORIAL LIBRARY 

An Overview of the 1982 National Master Facility 

Inventory Survey of Nursing 

by Al Slrrocco, Dwwon of 

Introduction 

This report describes the 1982 National Master Facility 

Inventory Survey of nursing and related care homes. The numbers of homes, beds, residents, and employees are distributed 

�

by such characteristics as ownership groups, bed size groups,

~d geographic regions. Additional topics covered in this report include survey procedures, imputation procedures, and 

definitions. 

The National Center for Health Statistics (NCHS) first 

conducted the National Master Facility Inventory (NMFI) 

Survey in 1963 and continued it in 1967, 1969, 1971, 1973, 

1976, 1978, 1980, and 1982. Prior to 1978, the survey included hospitals, nursing and related care homes, and other 

types of inpatient health facilities includins for example, homes 

for the blind, deaf, mentally retarded, and mentally ill. The 

1978, 1980, and 1982 NMFI surveys collected data only on 

nursing and related care homes. Data for hospitals are now 

obtained directly from the American Hospital Association. 

For convenience, this report will use the terms “nursing and 

related care homes” and “nursing homes” interchangeably. 

The NCHS definition of nursing homes has remained the 

same for each of the NMFI surveys. Basically, the definition 

states that a home must maintain three or more inpatient beds, 

and, at a minimum, must provide one or more personal care 

services (such as help with eating, walking, bathing, dressing, 

or shopping) and/or superviso~ services to adults. 

While this definition has remained unchanged, other factors 

have made it dii%cult, if not impossible, to stay within its 

boundaries. For example, thousands of board and care homes 

and residential care homes have emerged over the past 5 years 

nmarily because of changes in Federal and State programs. 

hese facilities vary from State to State not only by name, but 

e	 also by services offered and people served. The individual State 

laws and regulations (or the absence of such) determine whetier 

and Related Care Homes 

Health Care Statlstlcs 

the State surveys these facilities and, therefore, whether the 

State includes them on the nursing home file that is sent to 

NCHS. 

The NMFI included many of California’s residential community care facilities (RCCF’S) prior to 1980, but California 

was abIe to identi& an additional 1,000 such homes in 1980 and 

2,000 more in 1982, bringing the RCCF total to nearly 5,000. 

None of Michigan’s adult foster care homes (AFCH’S) was on 

the NMFI file prior to 1980, but in 1980 Michigan furnished 

NCHS with a file containing over 2,500 AFCH’S. In 1982, 

NCHS attempted to survey these Michigan AFCH’S, but of 

the nearly 2,250 still in business, approximately one-third did 

not respond and many others were found to be serving the 

mentally ill or the mentdy retarded. It has also been discovered 

that many of the California RCCF’S serve the mentally ill and 

mentally retarded. A facility that accepts only these types of 

residents is considered by NCHS to be out of scope for the 

nursing and related care home category, but a facility that accepts all types of residents (elderly, disabled, and so forth), but 

which currently only has mentally ill or mentally retarded residents, is considered to be a nursing or related care home (that 

is, in scope). 

Because there was very little information available for the 

RCCF’S and AFCH’S, and because no accurate count can be 

made of the number actually out of scope, all 7,228 of these 

facilities are presented in this report. In all cases, they are 

shown separately. 

The 1982 NMFI also included, for the fwst time, residential care homes in Florida and Kentucky. The 429 Florida 

adult congregate living facilities and the 373 Kentucky family 

care homes are defined in the Technical notes section. Because 

of the impact these figures have on the total number of homes 

in Florida and Kentucky, they have been combined with the 

residential facilities in Michigan and California so that they 

can be counted separately from the Florida and Kentucky nursing 

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service 
2 advancedata 

homes. Facilities meeting these definitions also exist in the 

other 46 States, but because they cannot be identKled precisely 

as residential, they appear in the counts of nursing homes. 

Starting in 1980, all ideritifiable hospital-based nursing 

homes were excluded from the survey. For the 1982 NMFI, 

the Health Care Financing Administration file of these hospitalbased facilities was obtained to more effectively remove these 

facilities from the NMFI file. At the same time, NCHS was 

able to get a more accurate count of these facilities. Some of 

the hospital-based facilities were out of scope for the NMFI 

(because residents were mentally ill or mentally retarded) and 

were, therefore, removed. The counts of hospital-based facilhies 

that appear in this report reflect the deletion of these out-ofscope facilities. 

The Health Care Financing Adminktration and the NMFI 

files both exclude those hospital-based facilities operated by 

the Veterans Administration. According to the Veterans Administration, there were approximately 100 such facilities with 

about 9,000 beds at the end of fiscal year 1981.1 These counts 

do not appear in the tables of this report. 

Finally, the tables also exclude the 238 nonresponding 

homes for which imputations from data of previous years were 

not possible. (There were 159 nonresponding homes for which 

imputations were made.) 

Discussion 

Facility characteristics 

If the hospital-based facilities; the Michigan, Califomi~ 

Florida, and Kentucky residential care homes; and the nonresponding nursing homes are all added to the basic nursing 

home tile, the 1982 number of nursing and related care homes 

totaled 26,817 (table 1). However, for purposes of this 1982 

NMFI report, the discussion of facility, resident, and employee 

characteristics will exclude the hospital-based facilities and the 

nonresponding homes. It will center on the basic nursing home 

file and the four State residential files, which will be called 

“nursing homes” and “residential facilities,” respectively. 

Table 1 shows there were 17,819 nursing homes their 

1,508,732 beds were occupied by 1,378,702 residents at the 

time of the survey. The 8,030 residential facilities had an estimated 133,335 beds and 114,704 residents. 

Table 2 shows that only 18 percent of the nursing homes 

had less than 25 beds, but an estimated 89 percent of the residential facilities had less than 25 beds. On the other hand, 76 

percent of the nursing homes had between 25 and 199 beds, 

while only 10 percent of the residential facilities were in this 

group. 

The remainder of table 2 shows distributions by ownership, 

region, and certification. Three-fourths of the nursing homes 

were under proprietary ownership. (Ownership information for 

the California and Michigan residential facilities was not generally available, so these facilities were imputed as proprietary). 

The West Region had less than half as many nursing homes 

and beds as either the North Central or the South Regions. 

IofflceofRewfi ~d statisti~ 1981Annual Report k’ekrms Atil~stration. 

Washington, D.C. 

Table 1, Number of nursing and related care homes, beds, and 

residents, by type of facility United States, 1982 

Type of facility Facilities Beds Resident 

Number 

All facilities . . . . . . . . . . . . . . . 26,817 1,700,744 1,546,406 

Nursing homes . . . . . . . . . . . . 17,819 1,508,732 1,378,702 

Hospital-based facilities . . . . 7730 58,677 253,000 

Residential facilities . . . . . . . . 38,030 4133,335 47148704 

Nonresponding homes . . . . . . 5238 . . . . . . 

‘Those skilled nursing facilities serving only the mentally ill or mentally retarded


were removed from this file, which was furnished by the Health Care Financing


Administrstion.


‘Estimated.


31ncludes California (4,985), Michigan (2,243), Florida (429}, and Kentucky (373).


4Data were imputed for California (1 03,275 beds; 88,600 reaidenta) and


Michigan (1 6,725 bedw 13,950 residents).


51ncludes only thoaa nonreapondlng homes for which imputations could


not be made (1 52 of these were Florida residential homes).


Regarding certification, about 40 percent of the nursing 

homes were certified as skilled (SNF), with the total beds in 

these SNF’S representing nearly 57 percent of all nursing home 

beds. However, noncertified homes, which represented 27 percent of the nursing homes, had only 13 percent of the beds. 

This points to a tendency toward skilled homes being large and 

noncertified homes being small, as can be seen more clearly in 

table 3, which shows that skilled homes had an average bed 

size of about 122 beds, whereas the noncertified homes averaged about 31 beds. 

The average bed size for all nursing homes was 84.7 (u@ 

from 83.1 in 1980); the occupancy rate was 91 percent, and 

the turnover rate was 7.7 admissions per 10 beds (both about 

the same as in 1980). Table 3 shows the average bed size, 

occupancy rates, and turnover rates in nursing homes by various 

characteristics of the home. 

Not only did 76 percent of the homes have between 25 and 

199 beds (table 2), but also the highest occupancy rates occurred 

for homes within this bed size range (table 3). The turnover 

rates in table 3 are highest in those homes with 50 to 299 beds, 

in those run for profit, and in those located in the West Region. 

Figure 1 shows the munbe~of nursing home beds per 1,000” 

population 65 years and over. The extended bars above the 

basic rates represent beds in residential facilities. The figure 

shows the strong impact the California residential care homes 

had on data for the West Region. The estimated 103,275 beds 

in these homes elevated the beds per 1,000 population figure 

more than 22 points. 

Resident characteristics 

Of the 1,378,702 nursing home residents in 1982,990,601 

(72 percent) could be put into age and sex groups. The remaining 388,101 residents were either in States for which age 

and sex information could not be obtained (Florida, Indiana, 

Michigan, Mississippi, and Missouri) or were in homes that 

did not furnish thk information. 

For those 990,601 homes with age and sex reported,m 

703,016 (71 percent) were female, 701,775 (71 percent) were 

75 years and over, and 356,069 (36 percent) were 85 years 

and over (table 4). Table 4 also shows that the ratio of women 
3


Table 2. Number of total homes, nursing homes, and residential facilities and their beds, by selected characteristics United States. 1982 

0 Total homesf Nursing homes Residential facilities 

Characteristic Homes Beds Homes Beds Homes Beds 

Total homes, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Bed size 

3-9 beds..................,., . . . . . . . . . . . . . . . . . . 

10-24 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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


50-74 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

75-99 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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

200–299 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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

5000r more beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Type of ownership 

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

Proprieta~ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Nonprofit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Geographic region 

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

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

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

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

Certificationz 

Medicare or Medicaid (skilled nursing facility) . . . . . . . . . 

edicaid (intermediata care facility) . . . . . . . . . . . . . . . . . 

,otcertifl Ed....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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

‘ Excludes hospital-based facilities and nonresponding homes. 

Number 

25,849 1,642,067 17,819 1,508,732 8,030 133,335 

6,955 40,294 1,399 7,568 5,556 32,726 

3.450 58,104 1,855 31,807 1,595 26,297 

3,0B3 113,357 2,718 100,900 365 12,457 

3,465 207,608 3,332 199,915 133 7,693 

2,472 216,4B3 2,366 208,074 106 8,409 

5,293 690,262 5,094 665,769 199 24,493 

832 192,439 788 182,729 44 9,710 

241 86,560 212 76,618 29 

58 36,960 55 35.352 3 1,608 

1,111 112,553 916 110,964 195 1,5B9 

21,132 1,194,000 13,410 1,066,181. 7,722 127,819 

3.606 335,514 3,493 331,587 113 3,927 

3,B66 329,684 3,866 329,684 

8,137 539,631 5,B94 522,906 2,243 16,725 

6,225 463,298 5,423 449,963 802 13,335 

7,621 309,454 2,636 206,179 4,985 103,275 

7,032 855,096 7,032 855,096


5,564 442,277 5,564 442,277


5,643 212,881 4,841 199,546 802 13,335


7,610 131,813 382 11,813 7,228 120,000
 e 

e 

‘Facilities certified as skl[led nursing facilities and intermediate care facilities have been classified as skilled nursing facilities. 

to men increases with age. Nursing homes had about the same 

number of men as women in the under 65 years age group, but 

more than 1% times as many women as men in the age group 

65-74 years. This increase accelerated to ahnost three times 

as many women in the 75 to 84 year age group, and to ahnost 

four times as many women in the 85 years and over age group. 

When age and sex were imputed for residents with unknown 

age and sex, an estimated 1,204,356 (87.4 percent) of the 

1,378,702 residents in nursing homes were 65 years and over 

(see Technical notes). Of these 1.2 million residents, ahnost 

34 percent were in the North Central Regioq by comparison, 

of the 26.8 million people in the United States who were 65 

years and over, 26 percent lived in the North Central Region 

(table 5). The most striking comparison is probably between 

the North Central and South Regions. Despite having 2 million 

more people 65 years and over, the South had 55,000 fewer 

residents 65 years and over in nursing homes than did the North 

Central Region. 

When these figures are expressed as rates (number of resients 65 years and over per 1,000 population 65 years and 

.wer), the North Central Region had a much higher rate (58.6) 

than any of the other regions (Northeast= 44.Q South = 39.5; 

West =35 .9). These rates were for nursing homes only; however, considering the large number of Michigan residential 

facilities, the difference between the North Central rate and the 

rates for the Northeast and South would be even greater if the 

residential facilities were included. The dtierences between 

the North Central and West Regions would be less because 

there were more residential facilities in California than in 

Michigan. 

Employee characteristics 

This section deals solely with fidl-time equivalent (FTE) 

registered nurses (RN’s) and licensed practical nurses (LPN’s). 

In computing the FTE’s, the sum of the fidl-time employees 

was added to one-half the sum of the pal-time employees. 

Because employee data were not available from all States, it 

was necessary to impute for missing data (see Technical notes). 

In 1982 there were an estimated 64,315 FTE RN’s and 

86,044 FTE LPN’s employed in nursing homes in the United 

States. The lNMH Surveys include in their counts only those 

employees who were on tke staff payro~, they exclude those 

employed under contract This must be taken into account when 

using these figures. 

The rates per home, as expected, increase as the bed size 

groups get larger for both FTE RN’s and LPN’s (table 6). The 

government-operated homes had the highest RN and LPN rates, 

while the proprietary homes, in general, had the lowest such 

rates. Perhaps the main reason for this was that the government 

homes were the largest (121-bed average, 24 homes having 

9.942 
4 adwncedata 

Table 3. Average bed size, occupancy rate, and admissions per 

10 beds (turnover rate) for nursing homes,’ by selected 90 

characteristics: United States, 1982 Residential 

Ezl facilities 

Average occupancy Admissions :~: Nursing � 

Characteristic bed size rete 2 per 10 beds3 80 77.4 •1“.-.”.”. homes 

Number Percent Number 

All nursing homes. . . . . . 84.7 91 7,7 

;

> 

70 ................ ........-. O...O. ... . . .. . ....4.-. 

67.3 

Bed size 0 . 

. 

. 

. . 

.. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

-o . . .. . . . . . . . . . . . . . . . . . . . . c :.:.:.:.:.:.:.

3-9 beds . . . . . . . . . . . . . . . 5.4 88 4.7 (0	 .. ..... ...... .. . ................ al 10-24 beds . . . . . . . . . . . . . 17.1 B8 5.4 m 60 . ...... ... .. .... 

m . ...... .. ... .... . ... .. ... ... .... 25-49 beds . . . . . . . . . . . . . 37.1 91 5.9 .... .. ... ... .... % ... ... ......... . 

50-74 beds . . . . . . . . . . . . . . . . . . . . . 60.0 93 7.0 L’ :.:.:.:.:.:.:.:. 51.7 

75–99 beds . . . . . . . . . . . . . 87.9 93 8.4 m 

100-199 beds . . . . . . . . . . 130.7 91 8.2 > 50 

200-299 beds . . . . . . . . . . 231.9 91 8.1 m 

a ................ 

300–499 beds . . . . . . . . . . 361.4 89 6.2 c 

o 

a) 

5000r more beds . . . . . . . . 642.8 87 4.9	 .- . . . . . . . . :.:.:.:.:.:.:.:. .:.:.:.:.:.:.:.: g 

2 .. .. ... ... ...... .:::::::::::::y . . . . . . . . n .. .. ......... ... :.:.:.:.:.:.:.:. . ............... .. .. ........ ... . ...... ... .. ... ... . . . . . . . Type of ownership 0 . ......... .. .... ... .. ... ... ...... .. ... ...... ... .. .. ......... ... .. . n	 .... .. .......... ... .. ... ......... .. ............ .. ................. .... .. ......... . ... .. ...... ... ... :yjjfj:: :: .:.:.:.:.WR Government . . . . . . . . . . . . . 121.1 93 5.0 0 . . . . . . . . ..

.

...

.

..

.

..

.

..

.

..

.

. .

.

..

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

..

.

..

.

.. ... ...

.

. .

.

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

Proprietary . . . . . . . . . . . . . . 79.5 92 8.4 0- .30 . . . . . . .. . .. . .. . . .::::::::::::::: :::::::::::::::: . . . . . . . . . . .. . . . . . . . . . . . .. . . . . . . . . 

Nonprofit . . . . . . . . . . . . . . . 94.9 90 6.2 . . . . . . .. . . . . . . . . 

.:.:.:. %.:.:.: 

jjj::::::::: 

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

:::::::::::::::: 

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

.W..:.:.:.:. 

:.:.~ .:.:.:.:., 

& .. . . .. . .. . . . . . . . . . . . . .. . .. . . . . . . . .:.:.:.:.:.:.:.: . .. . .. . .. . .. . .. . . 

Geographic region 

Q 

4 

. 

. 

. 

. 

. 

. . 

. . 

.. 

. . 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. . . 

. 

. . . 

. 

.. 

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

. . . . . . . .:.:.:.:.:.:.:.:. 

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

: .~..:. y..:. 

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

.:.:.:.:.: -:.:.: 

.:.:.:.:.:.:.:.:. 

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

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

Northeast . . . 

North Central 

. 

. 

. 

. 

. . . . . 

. . . . . 

. 

. 

. 

. 

. 

. 

. 

. 

. 

. 

85.3 

88.7 

94 

91 

7.1 

6.8 

L% 20 — w:::: 

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

$:fi:

.:.:.:.:.:.:.:. 

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

~ 

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

~.:: 

. . . . . . . . . 

.. 

. 

.. 

. 

.. 

. 

.. 

. 

.. 

. 

.. 

. 

.. 

. 

.. 

. 

. 

0 :.:.:.x.:.:.:. .:.:.:.:.:.:.:.:. ................ ::::::::::::::::: 

.

...

...........

.. ..

..

.

........

.

.....

.

..

.

. .................
 South . . . . . . . . . . . . . . . . . . 83.0 90 7.2 .

.

.

.

.

.

.

.

.

.

.

.

.

.

.

..

..

.

.

.

.

.

.

..

..

..

..

. .::::::::::::::: :.:.=.:.:.:. .................
 ................. ................,
 ................ ................, West . . . . . . . . . . . . . . . . . . 78.2 92 11.5 ................. .

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

. ..

........

.

...........

.

. 

10 — w:::: y..:.:.:.:.:. :.	 ................ ~.:.:.:.:.:.:. : ................ ................, ................ .:y:::::::::::. ................ :::::::::::::::: Certification	 ................ ................. ................ ................ ................. ................. :::::::::::::::: .:.:.:.:.:.:.:.: . . . . . . . . . . . . . . . ................ ................. :::::::::::% . :::::::::::::::: Skilled nursing facility 121.6 93 9.4 .

.

..

.

..

.

..

.

...

.

..

.

..

.

.

.

.

. .

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

..

.....

.

..

..

.

.

...... ................ ................. :.:.:.:.:.:.:.:. ................. . . . . . . . . . . . . . . . Intermediate care facility. 79.5 90 5.8 . . . . . . . . .%%%%..%%., 

Non certified . . . . . . . . . . . . 30.9 B6 0.5 � Unknown . . . . . . . . . . . . . . . 41.2 92 5.8 Northeast North South West 

Central 

1Excludes the 8,030 residential facilities, the 730 hospital-based facilities, and NOTE The 730 hospital-based facilities and the 238 nonresponding the 238 nonresponding homes. homes are excluded from this figure. 2Number of residents divided by number of beds set up and staffed X 100. 

31nciudes those nursing homes that reported admissions (1 4,51 8); excludes 

those that did not (3,301 ). 

4Facilities certified as skilled nursing facilities and intermediate care facilities Figure 1. Beds in nursing homes and residential facilities per 1,000 

have been classified aa skilled nursing facilities. population 65 years of age and over by region: United States, 1982 

Table 4. Number of nursing home residents in homesl reporting age and sex of residents by age-sex groups and geographic region: 

United States, 1982 

Geographic region 

Sex and age All nursing homes Northeast North Central South West 

Number 

ResidentsZ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 990,601 200,554 324,211 291,672 174,164 

Males . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287,585 54,172 99,754 82,529 51,130 

Under 65 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61,328 10,760 22,542 16,121 11,905 

65–74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62,359 11,713 19,944 19,751 10,951 

75–84years3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91,126 17,700 30,611 26,929 15,886 

85years andove# . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 72,772 13,999 26,657 19,728 12,388 

Females . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 703,016 146,382 224,457 209,143 123,034 

Under 65 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63,343 11,189 22,866 17,925 11,363 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101,796 19,413 30,555 35,208 16,62 

75–84years3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 254,580 52,422 79,127 80,302 42,729 a 

85years andove# . . . . . . . . . . . . . . . . . . . . . . . . . . . 2B3,297 63,358 91,909 75,708 52,322 

1 Excludes the 8,030 residential facilities, the 730 hospital-based facilities, and the 238 non responding homes. 

‘Excludes residents in Florida, Indiana, Michigan, Mississippi, Missouri, and homes in any other States for which complete age and sex data were not available. 

3Adjusted for Statea whose highest age group was 75 years and over. See Technical notes. 
akmedaa 5 

Table 5. Estimated number and percent distribution of resident the other hand, the Northeast had far fewer FTE LPN’s than 

population 65 years and over in general population and in nursing the South, resulting in lower LPN rates. There are nearly twice omesl by geographic region: United States, 1982 

as many large (200 beds or more) SNF homes in the Northeast 

Estimated numbe@ (Northeast =27 1; South= 143) and a much higher number of 

Total population 

65 yearn 

of nursing home 

residents 65 years 

less intensive (non-SNF) types of homes in the South (South = 

Region and over and over 3,789; Northeast = 2,151), facts that may explain the differences in the numbers of FTE RN’s and LPNs in these regions. 

Number in Number in When the FTE RN’s were combined with the FTE LPNs, 

thousands Percent thousands Percent the Northeast was found to have a rate of 12,0 nurses per 100 

United States . . . . . . 26,826 100.0 1,204 100.0 beds (derived from table 6). The West was second with a rate 

Northeast . . . . . . . . . 6.299 23.5 277 23.0 of 11.5, followed by the South with 9.3 and North Central with 

North Central . . . . . . 

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

6,970 26.0 

8,963 33.4 

409 33.9 

354 29.4 8.6. The North Central Region’s low rate cannot be explained 

West . . . . . . . . . . . . . 4,595 17.1 165 13.7 by a lack of SNF’S or a lack of large SNF’S, as was the case in 

the South and West. The North Central Region not only had lExcIudes the 8,030 residential facilities, the 730 hospital-based facilities, more total SNF homes than the Northeast 2,014 to 1,715, it and the 238 nonresponding homes.


2See Technical notes for estimation procedures. also had more large (200 or more beds) SNF’S, 312 to 271.


Furthermore, it also had nearly four times as many intermediate 

500 or more beds) and the propriet.ay homes were the smallest care facilities as the Northeas~ 2,437 to 645. Because these 

(79-bed average, 9 homes having 500 or more beds). - titermediate care facilities also require imrses, there appears to 

Although the Northeast had fewer nursing homes than the be either a lower ratio of nurses in the North Central Region or 

SoutlL it had a ,much higher number of FTE RN’s, resulting in a higher reliance upon contracted nurses to fill nursing home 

RN rates nearly 2?4 times higher than those for the South. On needs. 

Table 6. Estimated numberl of full-time equivalent RN’s and LPN’s in nursing homes,z number of FTE employees per home, and number of 

FTE employees per 100 beds, by bad size, type of ownership, geographic region, and certification: United States, 1982 

Estimated number of FTE RNs Estimated number of FTE LPNs 

Per Per 

Per 100 Per 100 

Characteristic Total home beds Total home beds 

Allmmsing homes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64,315 3.6 4.3 86,044 4.8 5.7 

Bed size 

3–9 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 0.0 0.8 114 0.1 1.5 

10–24 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 876 0.5 2.8 1,208 0.7 3.8 

25–49 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,767 1.4 3.7 5,332 2.0 5.3 

50-74 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7,673 2.3 3.8 10,967 3.3 5.5 

75-99 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,687 3.7 4.2 12,750 5.4 6.1 

100-199 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28,832 5.7 4.3 39,147 7.7 5.9 

200-299 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8,371 10.6 4.6 10,529 13.4 5.8 

300-499 beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3,696 17.4 4.8 3,846 18.1 5.0 

5000r more beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2,350 42.7 6.6 2,153 39.1 6.1 

Type of ownership 

Government . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5,958 6.5 5.4 7,558 8.3 6.8 

Proprietary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41,176 3.1 3.9 60,760 4.5 5.7 

Nonprofit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17,181 4.9 5.2 17,726 5.1 5.3 

Geographic region 

Northeast . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21,215 5.5 6.4 18,626 4.B 5.6 

North Central . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19,751 3.4 3.8 25,315 4.3 4.8 

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12,253 2.3 2.7 29,567 5.5 6.6 

West . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11,096 4.2 5.4 12,536 4.8 6.1 

Certification 

Skilled nursing facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48,990 7.0 5.7 55,051 7.8 6.4 

‘ntennediate care facility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10.909 2.0 2.5 25,312 4.5 5.7 

~t certified . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4,211 0.9 2.1 5,401 1.1 2.7 

nknown . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205 0.5 1.7 280 0.7 2.4 0 

1Sae Technical notes.


‘Excludes the 8,030 residential facilities, the 730 hospital-based facilities, and the 238 nonresponding homes.


3Facilities certifiedas skilled nursing facilities and intermediate care facilities have been classified as skilled nursing facilities. 

—- .> 
6 

Technical notes 

All National Master Facility Inventory (NMFI) Surveys 

(of nonhospitals) through 1973 were conducted directly by the 

National Center for Health Statistics (NCHS) with the assistance of the U.S. Bureau of the Census. From 1976 through 

1980 the Cooperative Health Statistics System (CHSS) was 

active. This system decentralized the responsibility for collecting data from the Federal to the State level. In 1976, 16 States 

within CHSS collected some or all of the NMFI dat% in 1978, 

26 States collected NMFI dat~ and in 1980, 38 States collected NMFI data. In each of these years, NCHS conducted 

surveys in non-CHSS States. 

Although CHSS was not active in 1982, arrangements 

were continued with 35 states for obtaining their data. A number 

of these 35 States did not survey every type of nursing and 

related care home that NCHS includes in its universe. Where 

this occurred, NCHS surveyed the homes excluded from the 

State’s survey. 

The agency within the CHSS States that collected the 

NMFI data for NCHS was usurdly the licensing agency. Because their surveys were tied into licensing laws, there were 

differences in definitions, scope, and timing of the surveys 

among the CHSS States. Although NCHS included personal 

care homes, homes for the aged, rest homes, and so forth, some 

States did not license these types of homes and did not survey 

them. 

The following imputations were made to the 1982 NMFI 

data 

�	 1980 data were used for approximately 500 nursing homes 

in New York State. 

�	 Little or no data were available for the 4,985 California 

residential community care facilities (RCCF’S) and the 

2,243 Michigan adult foster care homes (AFCH’S). Although a number of these facilities served only the mentally 

ill or mentally retarded, there was not enough information 

available to identify and remove them. As a result, all 

RCCF’S and AFCH’S were kept, and beds and residents 

were imputed using 1980 averages. 

�	 No resident or employee data were available for the 429 

Florida adult congregate living facilities or the 373 Kentucky 

family care homes. Total residents were imputed by multiplying beds by 0.90 (the average occupancy rate for 

nursing homes). 

� Registered nurse and licensed practical nurse data were 

imputed for Florida and Connecticut using 1980 data. 

� In four States (Alaska, Minnesota, Montana, and Texas) 

the highest resident age group was 75 years and over. Est] 

mates for residents 85 years and over were obtained by 

subtracting 50 percent from the 75 year and over age group 

and adding the result to the 85 year and over group. 

�	 The estimate of 1,204,356 nursing home residents 65 

years and over was derived from known age distributions 

within each region, and from applying those percents to 

the residents in each region whose ages were unknown. 

Almost 866,000 residents were actual counts, while the 

remaining 338,000 were imputed. 

�	 Some States issue a nursing home license and a residential 

license for the same facility. Whenever this occurred, it 

created duplicate homes but not duplicate beds. Every effort 

has been made to eliminate this duplication of the homes. 

The final paragraphs of this report provide definitions of 

the terms used. 

Nursing /tomes-These facilities have three or more beds 

and provide to adults who require it either (a) nursing care or 

(b) personal care (such as help with bathing, eating, using toilet 

facilities, or dressing) and/or supervision over such activities 

as money management, walking, and shopping. 

Residential facilities—These facilities offer no nursing 

services and provide only personal care or supervisory care. 

For purposes of this report, only those residential facilities in 

Florida, Michigan, Kentucky, and California are included i ‘ 

this category. (Note: Facilities meeting this deftition also exisr 

in the other 46 States, but because they cannot be identified 

precisely as residential, they appear in the counts of nursing 

homes. 

Adult congregate living facilities (Flonda)—These facilities provide housing, food services, and one or more personal 

services to four or more adults who are not related to the owner. 

Adult foster care homes (AFCH’S) (Michigan)-These 

facilities provide ongoing supervision, but not continuous nursing care, to adults who are aged, emotionally disturbed, developmentally disabled, or physically handicapped. 

Residential community care facilities (RCCF’S) (Califomia)—These facilities provide nonmedical care and supervision to the elderly, and to children who are either mentally 

disordered, developmentally disabled, or physically handicapped. 

Family care homes (Kentucky) —These facilities are licensed but not certified. They generally have either two or 

three beds. (Those with two beds are out of scope for the 

NMFI and are not included in the survey.) 
abncdaa7 

-


Symbols 

. . . Data not available 

. . . Categow not applicable 

Quantity zero 

0.0 Quantity more than zero but less than 

0.05


z	 Quantity more than zero but less than 

500 where numbers are rounded to 

thousands 

* Figure does not meet standard of 

reliability or precision 

#	 Figure suppressed to comply with 

confidentiality requirements 

T’

8 achncedata 

Recent Issues of Advance Data From Wtal and Health Statistics 

No. 110. OfFice-Based Ambulatory Care for Patients 75 Years Old 

and Ove~ National Ambulatory Medical Care Survey, 1980 and 

1981 (Issued August 1985) 

No. 109. Hospital Use by Children: United States, 1983 (Issued 

May 23, 1985) 

No. 108. Wanted and Unwanted Childbearing United States, 

1973-82 (Issued May 9, 1985) 

Suggested Citation 

National Center for Health Statistics, A. Sirrocco: 

An overview of the 1982 National Master Facility 

Inventoty Survey of nursing and related care 

homes. Advance Data From Vital and Health 

Statistics. No. Ill. DHHS Pub. No, (PHS) 85-1250. 

Public Health Service. Hyattsville, Md., Sept. 20, 1985 

U.S. DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Public Health Service 

National Center for Health Statistics


3700 East-West Highway


Hyattsville, Maryland 20782


OFFICIAL BUSINESS


PENALTY FOR PRIVATE USE, $300


To receive this publication regularly, contact


the National Center for Health Statistics by


calling 301 436–8500


DHHS Publication No. (PHS) 85–1 250


No. 107. Marriage and First Intercourse, Marriage Dissolution, L 

Remarriage: United States, 1982 (Issued Apr. 12, 1985) 9 

No. 106. Use of Topical Antimicrobial Druga in OiTice-Based Practice: United States, 1980–81 (Issued Apr. 10, 1985) 

Copyright Information 

This report may be reprinted without further 

permission. 

m 

m 

I