From Vital and Health Statistics of the National Center for Health Statistics Number 142. September 30, 1987 

Discharges From Nursing Homes: 

Preliminary Data From the 1985 National Nursing Home Survey 

by Edward S. Sekscenski, M.P.H. Division of Health Care Statistics 

This report presents information on discharged residents 

of nursing and related-care homes based on preliminary estimates from the 1985 National Nursing Home Survey (NNHS). 

The 1985 NNHS is the third in an ongoing series of sample 

surveys designed to provide a variety of data on nursing homes 

in the conterminous United States and is conducted periodically by the National Center for Health Statistics (NCHS). 

Previous surveys were conducted in 1973-74 (NCHS, 1977) 

and 1977 (NCHS, 1979). 

The data presented in this report were collected between 

August 1985 and January 1986 and deal specifically with 

demographic, health, and other characteristics of persons formally discharged from nursing homes during the 12-month 

period immediately prior to the survey date. Other reports already published present information on nursing home residents 

(NCHS, 1987a) and facilities (NCHS, 1987b) based on national estimates from the same survey. Two other reports resulting from the 1985 NNHS will provide information on registered nurses employed at nursing homes and on current and 

discharged nursing home residents. The latter report will be 

based on a followup survey of the next of kin of the sample 

population, A summary report presenting data fi-om all five 

components of the survey also will be prepared by NCHS. 

Because data in this report are preliminary, they may differ 

slightly from those published later after further edits are conducted. 

Facilities included in the 1985 NNHS were nursing and 

related-care homes in the conterminous United States that had 

three beds or more setup and stfied for use by residents and 

that routinely provided nursing and personal care services. A 

facility could be freestanding or could be a nursing care unit of 

a hospital, retirement center, or similar institution as long as 

the unit maintained financial and employee records separate 

from the parent institution. Facilities providing only room and 

board were excluded, as were those serving only persons with 

specific health problems (for example, mental retardation or 

alcoholism). 

The sampling frame for the 1985 NNHS consisted of the 

following components: 

�	 The 1982 National Master Facility Inventory (NMFI) 

(NCHS, 1986), a census of nursing and related-care homes 

conducted by NCHS. 

� Homes identified in the 1982 Complement Survey of the 

NMFI as “missing” from the 1982 NMFI. 

� Nursing homes opened for business from 1982 through 

June 1984 and identified by the NCHS Agency Reporting 

System (NCHS, 1968). 

. Hospital-based nursing homes identified in records of the 

Health Care Financing Administration. 

The resulting frame contained about 20,500 nursing homes, 

and a sample of 1,220 homes was selected. In this report, the 

terms “nursing homes” and “nursing and related-care homes” 

are used interchangeably. 

Estimates in this report are based on a sample of 6,023 

discharges from the 1,079 nursing homes participating in the 

survey. A more detailed description of the survey design, data 

collection methodology, and estimation procedures for the 

NNHS has been published elsewhere (Shimizu, 1987). A brief 

discussion of the standard errors associated with these data is 

presented in the Technical notes to this report. For convenience, this report uses the terms “discharges” and “discharged 

residents” interchangeably. 

Background and type of data 

Data in this report were obtained from personal interviews 

conducted in the sample nursing homes with the employees 

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

deemed most knowledgeable of the medical records of the discharged residents. In most cases the interviewee was either a 

nurse or medical records person who consulted with the available medical records of the discharged resident during the interview. As was true in the NNHS of previous years, no discharges were consulted personally in this component of the 

survey. The full sample consisted of six or fewer discharges 

from each nursing home whose discharge dates fell within the 

12 months prior to the survey date. 

The 12-month reference period from which the discharged 

residents’ sample was drawn for the 1985 survey ended on the 

date immediately preceding the survey date. Previous survey 

reference periods for discharges were the calendar years 1972 

and 1976. The reference period of the 1985 survey was changed 

in an attempt to obtain more current and readily available data 

and to provide information on the utilization of nursing homes 

by both residents and discharges over a more closely related 

period of time. However, data from the 1985 NNHS for the 

discharged resident population and cument resident population 

differ in several major areas. These differences me discussed in 

more detail in other NCHS publications (NCHS, 1978). Briefly, 

while the discharged resident estimates represent all discharges 

over a 12-month period, the current resident population is 

estimated for a single night, that immediately prior to the survey date. The discharge sample, therefore, may underestimate 

those nursing home residents who tend to stay for very lengthy 

periods, while the current resident population may underestimate those persons with very short durations of stay. While the 

current resident file provides for what may be considered a 

“snapshot” of nursing home residents on any given day, the 

discharged resident tile provides for some indication of the overthe-year changes in the nursing home population. 

Because the methodology for counting discharged residents from the 1973–74 NNHS differed from that of the 1977 

(NCHS, 1981) and 1985 surveys, no comparisons will be 

made in this report between estimates from the 1973–74 survey and those derived from the 1985 NNHS. The 1973-74 

NNHS estimated the total number of discharges from each 

nursing home in the sample from one question in the facility 

component of the survey. The 1985 NNHS obtained a complete listing of all discharges from the sample nursing home. 

Comparisons will be presented of estimates from the 1977 and 

1985 discharged resident components of the NNHS where ap 

propriate. 

Demographic characteristics, dependency, 

and duration of stay 

The 1985 NNHS found that an estimated 1,223,500 persons were discharged from an estimated 19,100 nursing and 

related-care homes during the 12 months prior to the survey 

date, Because the survey was conducted between August 1985 

and January 1986, the 12-month reference period could have 

fallen anywhere beginning August 1984 and ending January 

1986. The preliminary 1985 estimate represents about a 9.5-

percent increase over the 1,117,500 discharges estimated by 

the 1977 NNHS. Of the recent total, about 37 percent were 

men while 63 percent were women, roughly the same as was 

found in the 1977 survey (see table 1). In contrast to the discharge population of 8 years earlier, however, the distribution 

of discharges in the 1985 survey was more heavily weighted 

with persons aged 85 years and over and by persons more dependent on the nursing home staff in terms of performance of 

selected activities of daily living. 

Although nearly 9 of every 10 discharges in both surveys 

were aged 65 years and over, the proportion aged 85 years or 

over rose from 30 to 38 percent between 1976 and 1984–85. 

Partly as a result of the aging of the discharge population, the 

proportion of all discharges who were not dependent in either 

mobility or continence decreased during the 8-year period from 

40 to 31 percent while the proportion who were dependent in 

both of these functions increased from 35 to 45 percent. The 

proportion of all discharges who were totally bedfast also rose 

between surveys from about 21 to 35 percent and the proportion who were chairfast remained about 25 percent, Although 

in both the 1977 and 1985 surveys older discharges tended to 

be more dependent than were younger discharges (NCHS, 

198 1), increased dependencies were evident in all major age 

groups between surveys (see tables 2 and 3), 

In the 1977 and 1985 surveys, persons who were discharged at older ages were more likely to have had lengthier 

durations of stay in the nursing home than persons discharged 

at younger ages. Thk was as true for men as it was for women, 

The median duration of stay for all discharges was 82 days 

according to the 1985 surve~ for persons aged 85 years and 

over, however, it was 145 days (see table 4). Women discharges, who tend to be older than discharged men (overall 

median ages, 83 and 79 years, respectively), also had a longer 

median duration of stay, 93 as compared with 66 days, according to the 1985 survey. Older women, however, also tended to 

stay longer in nursing homes than older men. At least half of all 

women over 84 years of age had been confined to the sample 

nursing home for more than 4 months according to the 1985 

survey, while comparable older men had a median duration of 

stay of a little over 3 months. 

Although the estimated overall median durations of stay 

for all discharges, as well as those for all men and all women in 

the 1985 survey show observable increases over comparable 

estimates from the 1977 survey, none of these increases is statistically significant (according to a Z test with 0.05 level of 

significance). Similarly, none of the differences between surveys in the proportional distribution of discharges by similar 

duration-of-stay categories was significant. Nearly two-thirds 

of all discharges in either survey had stays of less than 6 

months. About 31 percent in the 1985 survey had been discharged within 1 month of their admission, while 32 percent 

were discharged after stays of 1 month to less than 6 months. 

The remaining 37 percent of discharges in the 1985 survey had 

been confined to the nursing home for 6 months or more (see 

table 4). 

Because these data represent durations of stay in a nursing 

home identified with a single discharge, they tend to underestimate the overall duration of stay for persons who may have 

had a series of admissions and discharges to the same or multiple nursing homes over one episode or more of illness. Definitions of nursing home stays used in this report coincide with 
those used in the 1977 NNHS. The 1985 NNHS also attempted collection of information on multiple stays in nursing 

homes of the discharged residents with histories of other nursing 

home stays. These data will be presented in forthcoming publications on the 1985 NNHS. 

The 1985 NNHS was the first in the series to obtain race 

and Hispanic origin information on discharged residents. According to the 1985 survey, about 92.8 percent of all discharged 

residents were white persons, while only 6.7 percent were 

black persons. Another half percent were of other racial groups 

including Asian and Pacific Islander, American Indian, and 

Alaskan native. About 3 percent of the total were known to 

have been of Hispanic origin, an ethnicity designation distinct 

from race (see table 1). These distributions are similar to the 

distributions by race and Hispanic origin of current nursing 

home residents in the 1985 survey (NCHS, 1987a). Although 

differences in overall durations of stay are suggested in the 

median estimates of white aqd black discharged residents, these 

differences are not statistically significant at the 0.05 level of 

significance. Similarly, no statistically significant difference 

exists between the medhn duration of stay of Hlsprmic persons 

and that for all discharges in the 1985 survey. Discharged residents of Hispanic origin, however, had a male-to-female ratio 

nearly the reverse of that of the overall discharged population, 

66 to 34 percent, 

The distribution of discharged residents by marital status 

did not change appreciably between the 1977 and 1985 surveys, It appears, however, that factors associated with a person 

being married at the time of discharge impact favorably on 

shorter durations of stay in a nursing home. Other studies have 

also found that the availability of a spouse as home caregiver is 

one factor in decreasing the likelihood of admission to a nursing 

home (for example, Butler and Newacheck, 1981), and previous NNHS’S have found similar favorable impacts on short 

durations of stay for nursing home discharges. 

Widowed persons constituted the majority of all discharges, 

55 percent in the 1985 survey. Their median duration of stay 

was 107 days (see table 4). By contrast, the median duration of 

stay of married discharges, who constituted the next largest marital group, 22 percent, was only 41 days. Discharges who were 

never married, however, as well as divorced or separated discharges also had relatively lengthy median stays (see table 4). 

Not surprisingly, widowed discharged residents, noted 

above as having relatively long stays, were also the oldest of 

the marital groups, with an overall median age of 85 years. 

However, married discharged residents, who as a group had 

relatively short durations of stay, had an older median age, 78 

years, than discharges who were divorced or separated, 70 

years. 

The effects of age do appear to explain many of the differences in the abilities of discharged residents to perform selected activities of daily living during their final week in the 

nursing home. While about 40 percent of persons who were 

aged 65-74 years at discharge had been dependent in both 

mobility and continence, about half of all discharges older than 

84 years were dependent in both categories. In terms of specific 

dependencies, about one-third of discharges between ages 65 

and 84 years were bedfast in their last week in the nursing 

home, while about 4 in 10 aged 85 years or over were bedfast 

(see table 2). 

Bladder and bowel incontinence was also related to age at 

discharge. About half of all discharges aged 75–84 years were 

incontinent of bladder in their last 7 days in the nursing home. 

Among persons aged 85 years and over, this proportion rises to 

about 59 percent. Similarly, while about 39 percent of discharges aged 65–74 years were incontinent of bowel in their 

last week in the nursing home, the comparable proportion rises 

to 52 percent for persons aged 85 years or over. As might be 

expected, median duration of stay was longer for discharges 

who were dependent in both continence and mobility, 108 days, 

than for those not dependent in either of these daily activities, 

64 days. 

Differences in fi.mctional statuses in selected activities of 

daily living for discharges in the 1977 and 1985 NNHS are 

summarized in table 3. As is noted above, discharges in the 

1985 survey were generally less mobile and more likely to have 

been incontinent of bowel, bladder, or both in their last 7 days 

in the nursing home than were discharges in the 1977 survey. 

These general increases in dependencies are partially a function 

of the increased proportion of discharges aged 85 years and 

over, who as a group are more dependent in these activities 

than are younger discharges. However, there were also increases in the proportions of discharges who were dependent in 

both mobility and continence among those under 65 years, 65– 

74 years, and 75–84 years, as well as those aged 85 years and 

over (see table 3). 

Living arrangements before admission and 

after discharge 

The 1985 NNHS collected information on the living arrangements of all discharged residents for the periods immediately prior to admission and, for live discharges, immediately 

atler discharge. The 1977 survey obtained comparable data 

only for the living arrangements after discharge. Information 

on both prestay and poststay living arrangements of discharged 

nursing home residents provides for a more comprehensive 

understanding from a wider perspective of the population that 

utilizes nursing homes. 

A minority, about 28 percent of all discharged residents, 

had been admitted to the nursing home from a private or semiprivate residence (see table 5). Slightly over half of these discharged residents had been living with family members at the 

time of their admission. 

About 69 percent of all nursing home discharges had been 

admitted directly from another health facility, with 8 of every 

10 of them representing transfers horn general or shofi-stay 

hospitals. A slightly higher proportion of female discharges had 

been admitted from general or short-stay hospitals than had 

men, 57 versus 51 percent. However, another 7 percent of the 

male discharges had been admitted directly from a veterans 

hospital. About 1 in every 10 discharges who had been admitted from another health facility came from another nursing 

home. The proportions were about the same for both men and 

women. 
4 akmeckm 

The median duration of stay in the sample nursing home 

was far longer for those discharges who had been admitted 

from a private or semiprivate residence, 118 days, than for 

those admitted from a hospital, 57 days. This was partially due 

to the differences in ages of those in either group. Among those 

discharges admitted from a residence, about 42 percent were 

over age 84 years at their dkcharges. About 37 percent of 

those admitted from a hospital were aged 85 years or over. 

Discharges who had originally been admitted from another 

nursing home also tended to have long durations of stay. According to the 1985 survey, their median duration of stay was 

263 days. The proportion of those discharges over 84 was 

comparable to that of persons admitted from private or semiprivate residences, 43 percent. 

The proportion of live discharges going to private or semiprivate residences immediately following their nursing home 

stay decreased between the 1977 and 1985 surveys from 37 to 

30 percent (see table 6). As a corollary, the proportion of live 

discharges who were discharged to another health facility increased from 59 to 68 percent. The latter was almost entirely 

the result of an increase in the proportion of live discharges 

going to general or short-stay hospitals, from41 to 49 percent. 

(Unknown living arrangements following discharge remained 

about 2–4 percent of the total.) 

The increase in live discharges to hospitals, although partially a result of the increased proportion of older persons among 

all discharged residents, is not fully explained by this shift in 

demographics. While the proportion of discharges aged 85 

years or over going directly to hospitals is slightly larger than is 

the comparable proportion for discharges aged 65–84 years in 

both the 1977 and 1985 surveys, the increase in either proportion between surveys is greater among the younger age group. 

Among live discharges aged 85 years or over, the proportion 

discharged to hospitals did not rise significantly between the 

1977 and 1985 surveys. In 1977 it was 52 percent and in 1985 

it was 54 percent. Among live discharges aged 65–84 years 

old, however, the proportion discharged directly to hospitals 

increased from 39 to 50 percent over the same period. 

The median duration of stay was longer for those persons 

discharged to another health facility, 113 days, than for those 

discharged to a private or semiprivate residence, 36 days. 

Among the former, those who were discharged to a general or 

short-stay hospital had a median duration of stay of 130 days. 

In contrast, among those discharged to a private or semiprivate 

residence, those who went to live with family members had a 

median duration of stay of 34 days. 

Primary source of payment at admission 

and discharge 

For the first time, the 1985 NNHS collected information 

on the primary sources of payment for all discharges for the 

month in which they were admitted to the sample nursing home 

as well as for the month in which they were dkcharged. The 

1977 NNHS obtained primary source of payment data only 

for the month of discharge from the nursing home. As might be 

expected, primary payment sources often differed depending 

on whether the payment was for the admission or the discharge 

month. These dfierences generally are greater the longer the 

duration of stay. When observation is made of the total discharge population as a whole, much less shiftiig among various 

payment sources is evident, partially due to the large proportion of persons with relatively short durations of stay. However, 

patterns are evident in shifts of primary payment sources, especially among discharges who shift to medicaid at some time 

during their stay. 

For the month of admission, own income or family support 

was the primary source of payment for the largest proportion of 

discharges regardless of their eventual durations of stay. About 

4 of every 10 discharges relied primarily on this source to pay 

for nursing home care in the month of admission, a ratio that 

was the same whether the completed stay was of short, medium, 

or lengthy duration (see table 7). The median duration of stay 

for persons whose primary source of payment for their admission month was own income or family support, 77 days, was 

similar to that of the overall discharge population. Their distribution by duration of stay was also similar to that for all discharges. 

According to the 1985 surveys, the proportion of all discharges who relied on medicaid as the primary payment source 

in their month of admission totaled about 35 percent. Medicaid 

coverage for nursing home care is divided into two categories, 

skilled and intermediate, depending on the certification status 

of the nursing home. While about 15.5 percent of all discharges 

relied on medicaid skilled funds in their admission month, 

another 19.6 percent relied on medicaid intermediate cme funds. 

Unlike the proportion of discharges relying on own income to 

pay for care in their admission month, the proportion of discharges relying primarily on medicaid differed by the eventual 

durations of stay. Discharges whose completed stays were 

relatively lengthy were more likely to have relied on a type of 

medicaid in their admission month than were those whose 

stays were relatively short (see table 7). 

For example, while 12 percent of all discharges whose 

stays were less than 1 month in duration relied primarily on 

medicaid skilled care funds to pay for their nursing home care, 

19 percent of those whose stays were 6 months or longer relied 

primarily on this source in their admission months. Comparable 

proportions for discharges who relied on medicaid intermediate 

care funds were 11 percent among those whose stays were less 

than 1 month and 27 percent for those whose completed stays 

were 6 months or more, 

The median durations of stay of discharges who relied on 

either medicaid skilled or medicaid intermediate funds to pay 

for nursing home care in their admission months were 145 and 

187 days, respectively, each of which is significantly above the 

median for the discharge population as a whole. 

Medicare accounted for a smaller proportion of all discharges’ primary sources of payment in their admission months 

than either their own income or family support, or the combined total of medicaid. Medicare, however, varied quite widely 

as a primary admission month payment source according to 

eventual completed duration of stay. Unlike similar differences 

outlined above for those relying on medicaid, the proportion of 

all discharges relying on medicare as their primary source of 
achancedata 5 

payment in their admission month was greater among discharges with relatively short durations of stay and smaller for 

those with longer completed stays. About 18 percent of all 

discharges relied primarily on medicare for payment for nursing 

home care in their admission months. But, while the proportion 

was 30 percent among discharges whose stays were less than 1 

month, for discharges whose completed stays were 6 months or 

more, only 6 percent had relied primarily on medicare in their 

admission month. The median duration of stay was 29 days for 

all discharges whose primary source of payment in the month 

of admission was medicare, significantly below the median for 

all discharges. 

All other sources of payment, including other government 

assistance or welfare, religious organizations, volunteer agencies, Veterans Administration contracts, initial payment-forIife care funds, and others accounted for about 5 percent of all 

discharges’ primary sources of payment for month of admission. This proportion did not vary significantly by completed 

duration of stay. Discharges relying on these other sources, 

however, tended to be younger than those whose primary payment sources were medicare, medicaid, or own income. Only 

about 22 percent were over age 84 years at their discharges, 

which is significantly below the comparable proportion for all 

discharges. 

For the month of discharge, own income or family support 

was also the primary source of payment for about 4 of every 10 

discharges. Although some variability exists in this ratio by 

duration of stay, as many as 38 percent of all discharges whose 

stays were 6 months or more relied primarily on this source for 

payment of nursing home care in their discharge month as opposed to 45 percent among discharges whose stays were 1 

month to less than 6 months in length. 

Medicaid, skilled and intermediate care funds combined, 

accounted for another 40 percent of all discharges- primary 

payment sources in their discharge months. The overall proportion who relied primarily on medicaid, however, was larger 

for those with longer stays than for those with relatively short 

stays. For example, while a total of 22 percent of discharges 

with stays of less than 1 month relied on some form of medicaid as their primary payment source, among discharges whose 

stays were 6 months or longer, a total of 56 percent relied on 

medicaid in their discharge months. About 25 percent of those 

who stayed 6 months or longer relied on medicaid skilled care 

funds, and another 31 percent relied on medicaid intermediate 

care funds as the primary payment sources in their discharge 

months. 

The proportion of discharges who relied on medicare as 

the primary payment source in their discharge month is a reflection of the limitations of coverage for nursing home care 

imposed by this Federal health care program. Medicare is 

limited to the first 100 days of nursing home care for residents 

who had been admitted directly from a general, shofi-stay 

hospital. The resident must also require specific medical assistance according to criteria established by the Federal Health 

Care Financing Administration (Health Care Financing Administration, 1986). Reliance on medicare as the primary 

source of payment for the discharge month, therefore, is restricted to discharges with relatively short durations of stay. 

Among all discharges, about 12 percent used medicare as 

their primary source of payment in their discharge months. 

Among those whose stays were less than 1 month, however, 

about 29 percent relied primarily on medicare, as opposed to 

about 9 percent with stays of from 1 month to less than 6 

months in length. 

Changes in primary sources of payment between admission and discharge months are summarized in table 8 for all 

discharges with a duration of stay of 1 month or more. The 

percent distributions show that except for those entering with 

medicare as their primary payment source, more than 8 of 

every 10 discharges relied on the same primary source of payment in their discharge month as they had utilized in their admission month. For example, among persons using primarily 

their own income or family support in their admission month, 

85 prcent relied primarily on this source also in their discharge 

month. The comparable proportion for medicaid (skilled and 

intermediate combined) is about 90 percent, while about 87 

percent who primarily used other sources in their admission 

month also relied on those other sources in their discharge 

month. 

Among all persons with durations of stay of 1 month or 

more who utilized medicare as their primary payment source in 

their admission month, however, only about 37 percent relied 

primarily on medicare in their discharge month as well. This 

was largely the result of the 100-day limitation for medicare 

coverage of nursing home care. About 32 percent of dkcharges 

who used primarily medicare in their admission month shitled 

to their own income or family support as primary payment 

source in their discharge month, while another 28 percent 

shifted to some form of medicaid. 

As noted above, while the overall proportion of discharges 

relying primarily on medicare decreased between admission 

and discharge months, the proportion using some form of 

medicaid rose. Shifts to medicaid as the primary source of 

payment varied by both duration of stay and primary payment 

source in admission month (see table 9). About 11 percent of 

persons who entered with other than medicaid as their primary 

payment source shifted to medicaid by the month of their discharge. The proportions of discharges shifting in this manner 

varied ftom 10 percent for those with stays of 1 month to less 

than 6 months to about 22 percent for those with stays of 6 

months or more in duration. 

Persons entering with medicare as the primary payment 

source in their admission month were more likely to shift to 

medicaid than persons entering with own income or family support. This was especially true for discharges whose durations 

of stay were beyond the 100-day limit imposed by the medicare program. About 10 percent of discharges who had used 

their own income in their admission month shifted to medicaid 

by their discharge month, while 15 percent of those relying 

primarily on medicare in the admission month converted to 

medicaid. About 8 percent of persons who entered using primarily their own income or family support and had stays of 

from 1 month to less than 6 months shifted to medicaid, as 

opposed to 19 percent of those with equal durations of stay 

who relied primarily on medicare in their admission month. 

Among discharges entering with medicare whose durations of 
6 

stay were 6 months or longer, 52 percent shifted to some form 

of medicaid by their discharge months. 

It is not possible from the discharged resident data to pinpoint, however, when during a discharged resident’s stay a shift 

from one payment source to another may have occurred. Differences in primary sources of payment in admission and discharge months are indicative only of a change between two 

points in time. While a pattern is suggested in the differential 

proportions of discharges shifting flom one primary payment 

source to another, especially for discharges shifdng to medicaid, it is not discernible from the data when these shifts occurred. Although the disaggregation of discharges who shift to 

medicaid by various duration of stay categories provides some 

evidence of a “spend down” to medicaid, more detailed data 

are required to determine when during a resident’s stay thk 

shift actually occurs and, for those with multiple stays, in 

which stay it occurred. Data on the latter issue are available 

from the next-of-kin component of the survey. Data from the 

next-of-kin component of the 1985 NNHS wiII be published in 

a forthcoming report from NCHS. 

Summary and highlights of data 

The 1.22 million nursing home discharges in the 1985 

NNHS represent about a 9.5-percent increase from the 1977 

survey. Dependencies in both mobility and continence were 

more prevalent among all age groups in the most recent survey 

while there was also an increase of from about30to38 percent 

in the proportion of discharges aged 85 years and over. While 

the overall median duration of stay, as well as those of men and 

women, showed observed increases between the 1977 and 

1985 surveys, none of these increases is statistically significant. The rise from 41 to 49 percent in the proportion of live 

discharges going to a hospital, however, is statistically significark The increase is largely the result of increased hospitalization of live nursing home discharges aged 65 to 84 years, although the proportion of discharges to a hospital remains larger 

among those aged 85 years and over. 

About 4 of every 10 discharges used own income or family 

support as primary payment source in both admission and discharge months. The proportion using medicaid, however, generally rose with duration of stay, while only discharges with 

relatively short stays relied primarily on medicare, due to the 

limitations on coverage for nursing home care by the medicare 

program. 

More detailed information from the 1985 NNHS, especially on sources of payment, diagnoses at admission and discharge, and duration of stay by admission and dkcharge characteristics, will be forthcoming in subsequent publications from 

NCHS. 

Symbols 

. . . Data not available 

. . . Category not applicable 

Quantity zero 

0.0 Quantity more than zero but less than 

z 

* 

# 

0.05 

Quantity more than zero but less than 

500 where numbers are rounded to 

thousands 

Figure does not meet standard of 

reliability or precision (more than 30 

percent relative standard error) 

Figure suppressed to comply with 

confidentiality requirements 
amcedaa7 

Tabla 1. Number and percent distribution of nursing home discharges by selected characteristics: United Stetes, 1984-85 and 1976 

Characteristic 

Discharge status 

Alldiacharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Live discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Dead discharges ., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Sex 

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

Female, ,,, ,,, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Age st discharge 

Under 65 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Under 45 yeara, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

45-54 yeara . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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

65yeara and over . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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

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

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

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

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

90-94 yesrs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

95yeara and over, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Marital status at discharge 

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

Widowed . . .!, .,,.., . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Divorced orseparated, , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Never married .,, , . .,, ,, .,..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

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

Race 

Hispanic origin 

Hiepanic. . . ...,,,,, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Non- Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Unknown, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

1Figures may not add to totala due to rounding. 

2TOtalincludes small number of unlamwna. 

1984-85 discharges 1976 discharges 

Percent Percent 

Numberl.2 distribution Numberl.2 distribution 

1,223,500 2100.0 1,117,500 2100.0 

877,400 77.7 825,500 73.9 

343,800 28.1 289,800 25.9 

455,500 37.2 407,700 36.5 

768.000 62.8 709,800 63.5 

129,400 10.6 136,200 12.1 

33,400 2.7 33,900 3.0 

29,200 2.4 33,500 3.0 

66,800 5.5 66,800 6.2 

1,094,100 89.4 981,300 87.8 

63,500 5.2 81,300 7.3 

119,400 9.8 122,300 10.9 

196,500 16.1 204,600 18.3 

255,700 20.9 241,200 21.6 

233,900 19.1 210,100 18.8 

155,900 12.7 90,500 8.1 

69,200 5.7 31,100 2.8 

273,200 22.3 255,900 22.9 

669,200 54.7 628,400 56.2 

84,800 6.9 75,200 6.7 

151,800 12.4 127,200 11.4 

44,600 3.6 30,800 2.8 

1,135,900 92.8 . . . . . . 

82,000 6.7 .-. . . . 

5.600 0.5 . . . ..-

35,500 2.9 ..- .-. 

1,130,700 92.4 . . . . . . 

57,400 4.7 . . . . . . 

Table 2, Number of nursing homa discharges by sex and age at discharge, and percent distribution by type of depandancy during last 7 days in 

nursing home, according to sax and age at discharga: United Statas, 1984-85 

Type of dependency 

Incontinent Incontinent 

Sex and age Discharges Total 8edfast Chairfast of bladder of bowel 

Sex Number Percent distribution 

Both sexes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,223,500 00.0 34.8 25.4 52.8 45.2 

Male . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 455,500 00.0 33.2 26.9 54.8 46.3 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 768,000 00.0 35.8 24.6 51.6 44.6 

Age at discharge 

Under 65vears . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129,400 00.0 23.9 22.6 40.4 30.2 

65 years and over . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,094,100 100.0 36.1 25.8 54.2 47.0 

65-74 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 182,900 100.0 32.8 24.5 45.5 39.1 

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 452,300 100.0 32.9 27.7 52.8 44.7 

85 years and over . . . . . . . . . . . . . . . . . . . . . . . . . 458,900 100.0 40.6 24.3 59.1 52.4 
Table 3. Numbar �nd pert.nt distribution of nursing home discharges by partial index of dependency, eccording to age at discharge: United States, 1984-85 and 1976 

Discharges in 1984-85 Discharges in 1976 

Partial index of dependency PatTial index of dependency 

Not Not 

dependent Dependent Dependent dependent Dependent Dependent 

in mobility Dependent in in mobility in mobility Dependent in in mobility 

or in mobility continence and or in mobility continence and 

Age Total Total continence only only continence Total Total continence only only continence 

Number Percent distribution Number Percent distribution 

Al[ discharges . . . . . . . . . . . . . . . . 1,223,500 100.0 31.0 14.8 8.8 45.4 1,117,500 100.0 40.1 12.8 

Under 65 years . . . . . . . . . . . . . . . 129,400 100.0 44.9 13,6 8.5 33.0 136,300 100.0 52.4 13.5 

65 years and over . . . . . . . . . . . . . 1,094,100 100.0 29.3 15.0 8.8 46.9 981,200 100.0 38.4 12.5 

65-74 years . . . . . . . . . . . . . . . 182,900 100.0 35.5 17.2 7.2 40.1 203,600 100.0 43.2 11.6 

75-84 years . . . . . . . . . . . . . . . 452,300 100.0 30.3 15.7 9.2 44.9 445,800 100.0 40.9 12.7 

85 years And over . . . . . . . . . . . 458,900 100.0 25.9 13.5 9.1 51.5 331,800 100.0 32.3 12.8 

2.7 34.5 

9.7 24.3 

3.1 35.!3 

3.5 31.7 

3.5 32.9 

2.3 42.6 
achncedata 9 

Table 4. Percent distribution of nursing home discharges by duretion of stay, according to salected demographic characteristics, with madian 

duration of sta~ United States, 19S4-85 

Characteristic 

Discharge ststus 

All discharges . . . . . . . . . . . . . . . . . . . . . . . . . . 

Live discharges . . . . . . . . . . . . . . . . . . . . . . . . . 

Dead discharges . . . . . . . . . . . . . . . . . . . . . . . . 

Sex 

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

Female, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Age at discharge 

Under 65 years . . . . . . . . . . . . . . . . . . . . . . . . . 

65 years and over . . . . . . . . . . . . . . . . . . . . . . . 

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

75-84 years . . . . . . . . . . . . . . . . . . . . . . . . . 

85 years and over . . . . . . . . . . . . . . . . . . . . . 

85-94 years . . . . . . . . . . . . . . . . . . . . . . . 

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

Marital status at discharge 

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

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

Divorced orseparated . . . . . . . . . . . . . . . . . . . 

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

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

Race 

White . . . . . . . . . ..!..!. . . . . . . . . . . . . . . . . 

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

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

Hispanic origin 

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

Non- Hispanic . . . . . . . . . . . . . . . . . . . . . . . . . . 

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

Duration of stay 

1 month 3 months 6 months 1 year 3 years 

Less to less to less to less to less to less Median 

than than 3 than 6 than 12 than 3 than 5 5 years duration 

Total 1 month months months months years years or more 

Percent distribution 

100.0 31.0 20.6 11.2 

100.0 32.3 23.1 12.2 

100.0 27.8 14.3 8.7 

100.0 35.7 20.1 11.3 

100.0 28.2 20.9 11.1 

100.0 33.2 24.3 12.2 

100.0 30.7 20.2 11.0 

100.0 34.9 22.8 11.8 

100.0 34.7 21.6 11.5 

100.0 25.1 17.8 10.3 

100.0 26.6 17.7 10.0 

100.0 16.7 18.2 12.1 

100.0 44.1 21.3 9.3 

100.0 27.3 20.0 11.5 

100.0 28.6 20.6 13.5 

100.0 24.9 23.5 11.0 

100.0 31.2 15.6 13.2 

100.0 31.1 20.6 11.0 

100.0 29.2 19.8 14.4 * * 100.0


11.2 15.1 5.2 5.7 

11.2 13.9 3.8 3.6 

11.1 18.4 8.6 11.1 

11.8 13.3 3.8 3.9 

10.9 16.2 6.0 6.8 

10.6 13.0 3.5 3.1 

11.3 15.4 5.4 6.0 

10.8 13.8 2.5 3.4 

11.6 13.6 3.8 3.3 

11.2 17.8 8.0 9,7 

11.9 17.8 7.5 8.6 

7.6 18.4 10.8 16.1 

10.5 10.5 2.3 2.0 

11.2 16.7 6.5 6.7 

12.1 14.8 4.2 6.3 

11.1 17.2 4.7 7.6 

of stay 

Days 

82 

70 

163 

66 

93 

70 

84 

56 

66 

145 

136 

297 

41 

107 

90 

101 * * 14.6 13.2 125 

11.1 15.1 5.2 5.8 82 * 13.1 14.9 4.2 101 

* * * * . . . 44 

100.0 30.1 16.4 14.7 7.1 23.0 “4.9 *3.8 113 

100.0 30.7 20.9 11.3 *11.2 15.0 5.2 5.7 83 

100.0 37.4 18.4 *6.7 14.3 12.9 *4.2 *6.1 71 
10 acklncedata 

Table 5. Number of nursing home discharge and number and percent distribution of live discharges, by destination and living arrangement 

prior to admisaion: United States, 1984-85 

Live discharges 

Destination 

Private or Other


All semiprivate health


Living arrangement prior to admission discharges Total Totafl rasidence facility


Number Percent distribution 

All discharges . .,, .,, . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,223,500 877,400 100.0 30.4 67.5 

Private orsemiprivate residence.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340,700 238,100 100.0 40.5 58.1 

Alone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 110,200 77,500 100.0 38.1 60.1 

With family members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185,100 128,400 100.0 41.8 57.3 

With nonfsmily members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23,300 16,300 100.0 46,4 51.9 

Unknown ifwith others . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22,100 16,000 100.0 35.4 61.4 

Another health facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 848,700 616,400 100.0 27.0 70.8 

Another nursing home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82,500 52,400 100.0 12.5 84.5 

General orshort-stay hospital, except psychiatric unit . . . . . . . . . . . . . . . . . . . . . . . . . . 674,300 489,200 100.0 30.0 68.6 

Veterans hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 33,000 26,800 100.0 i 8,9 75.4 

Other health facility or unknown type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59,100 46,200 100.0 17.5 75.4 

Unknown br other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34,100 22,800 100.0 15.2 74.9 

lTotal includes small percent of unknown destination. 

Table 6. Number and percent distribution of live discharges by living arrangement after discharge, according to year of discharges: 

United Statea, 1984-85 and 1976 

Discharges in 1984-85 Discharges in 1976 

Percent Percent 

Living arrangement after discharge Number distribution Number distribution 

All live discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 877,000 100.0 825,500 100.0 

Private orsemiprivate residence.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 266,400 30.4 306,700 37.2 

Another health facility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 591,500 67.5 484,200 58.7 

Another nursing home . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 98,000 11.2 108,600 13.2 

General orshort-stay hospital, except psychiatric unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 430,200 49.1 339,500 41.1 

Veterans hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20,800 2.4 . . . . . . 

Other health facility orunknown type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42,600 4.9 36,000 4.4 

Unknown or other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19,000 2.2 34,700 4.2 
ackmedata 11 

Table 7, Numbar of �ll nursing homa discharges by duration of stay and percent distribution by prima~ source of payment for admission and 

discharge months, �ccording to duration of stay with madian duration of stay and percant of parsons ages 85 years and ovec United States, 

1984-85 

Duration of stay 

1 month Persons 

Less to less Median ages 85 

All than 1 then 6 6 months duration years 

Primary source of payment stays month months or more of stay and over 

Number Daya Percent — — 

All discharges . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,233,500 379,000 388,900 455,600 82 37.5 

Primary source of payment for admission month Percent distribution 

Ail sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 82 37.5 

Ownincome or family support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.9 42.5 40.9 42.3 77 42.9 

Medicare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17.6 29.8 18.9 6.4 29 33.2 

Medicaid 

Skilled ,,, ..,.,, . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . 15.5 11.5 15.3 19.0 45 35.2 

Intermediate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19.6 10.6 19.7 27.0 87 35.8 

All other sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5.4 5.6 5.2 5.4 04 22.3 

Primaty source of payment for discharge month 

Allaources. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100.0 100.0 100.0 100.0 82 37.5 

Ownincome or family support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41.8 43.4 45.1 37.6 67 41.4 * Medicare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.1 28.5 8.8 19 30.4 

Medicaid 

Skilled . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18.9 12.2 18.0 25.2 178 39.2 

Intermediate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21.3 9.9 21.2 30.9 220 37.1 

Another sourcea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6.0 6.1 6.9 5.1 83 21.0 

Table 8. Numbar and parcant distribution of nursing homa dischargaa with 1 or more months’ duration of stay by primary source of payment 

for discharga month, according to primary sourca of payment for admission month: United States, 1984-85 

Discharges Primary source of payment for discharge month 

with 1 

or more Own 

months’ income Medicaid All 

Primary source of payment All duration All or family other 

for admission month discharges of stay sources support Medicare Skilled Intermediate sources 

Number Percent distribution 

All sources . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,223,500 844,500 100.0 41.1 4.7 21.9 26.4 5.9 

* * Own income or family suppon . . . . . . . . . . . . 512,600 351,500 100.0 84.8 5.9 7.9 * Medicare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215,500 102,500 100,0 32.0 36.9 21.5 6.4 

Medicaid * * Skilled . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163,700 145,800 100.0 3.3 * 89.7 4.6 * Intermediate . . . . . . . . . . . . . . . . . . . . . . . . . 220,100 199,700 100.0 4.3 * * 4.8 * 90.5 * All other sources . . . . . . . . . . . . . . . . . . . . . . . 54,900 45,100 100.0 86.6 
12 acklncedata


Table 9. Number of nursing home discharges and percent shifting to medicaid by nonmedicaid primery source of payment for admission month, 

duration of stay, end source of payment with median duration of stay United States, 1984–85 

Duration of stay 

Nonmedicaid primary Median 

source in admission 1 month to less duration 

Source of payment month Less than 1 monthl than 6 months 6 months or more of stay 

Percent Percent Percent Percent 

shifting to shifting to shifting to shifting to 

Number medicaid Number medicaid Number medicaid Number medicaid Days 

All sources except medicaidz . . . . 794,500 10.9 295,400 2.1 252,900 10.3 246,200 22.1 56 

* Own income or family support . . . 512,600 9.7 161,200 159,000 7.6 192,500 18.9 77 

Medicare . . . . . . . . . . . . . . . . . . . . 215,500 15.3 112,900 3.9 73,600 18.5 29,000 51.9 29 

lShifts may occur in stays of less than 1 month where admission and discharge are in different calendar months. 

21ncludes other sources not shown separately. 
aciwlncedata 13 

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home characteristics, preliminary data from the 1985 NationaJ Nursing 

Home Survey. Advance Data From Vital and Health Statistics. No. 

131. DHHS Pub. No. (PHS) 87–1250. Public Health Service. 

Hyattsville, Md. 

13Shimizu. I. 1987. The 1985 National Nursing Home Survey design. 

Proceedings of Section on Survey Research Methods, 1986 Annual 

Meetings of the Amen-can Statistical Association. Chicago American Statistical Association. 
14 adAncedata


Technical notes 

Because the 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 variab~lity 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. The chances are 95 out of 100 that an estimate 

from the sample differs from the value that would be obtained 

from a complete census by less than twice the standard error. 

The standard errors used in this report were approximated 

using the balanced repeated-replication procedure. This method 

yields overall variability through observation of variability 

among random subsamples of the total sample. A description 

of the development and evaluation of the replication technique 

for error estimation has been published (NCHS, 1966, 1969). 

AIthough exact standard error estimates were used in tests 

of significance, it is impractical to present exact standard error 

estimates for all statistics used in this report. Thus, a generalized 

vmiance function was produced for aggregated discharge estimates by fitting the data presented in this report into a curve 

using the empirically determined relationship between the size 

of an estimate X and its relative variance (rel var X). This 

relationship is expressed as 

CJ2 

relvar X=x 

X2 

b =a+— x 

NOTE: A list of references follows the text. 

Table 1. Standard errors of percents for discharges 

Estimated percent 

Basa of percent 1 or 5 or 10 or 20 or 40 or 

(discharges) 99 95 90 80 60 50 

Standard errors in percentage points 

5,000 . . . . . . . . . 2.87 6.29 8.66 11.55 

10,000. . . . . . . . 2.03 4.45 6.13 8.17 

30,000 . . . . . . . . 1.17 2.57 3.54 4.72 

50,000 . . . . . . . . 0.91 1.99 2.74 3.65 

100,000 . . . . . . . 0.64 1.41 1.94 2.58 

200,000 . . . . . . . 0.45 1.00 1.37 1.83 

400,000. ... . . . 0.32 0.70 0.87 1.29 

800,000 . . . . . . . 0.23 0.50 0.68 0.91 

1,000,000 . . . . . 0,20 0.45 0.61 0.82 

1,223,500 . . . . . 0.18 0.40 0.55 0.74 

14.15 14.44 

10.00 10.21 

5.78 5.90 

4.47 4.57 

3.16 3,23 

2.24 2.28 

1.58 1.61 

1.12 1.14 

1.00 1.02 

0.90 0.92 

where a and b areregression estimates determined by an iterative procedure. Preliminary estimates of standard errors for the 

percents of the estimated number of discharges are presented in 

table I. 

Preliminary estimates of relative standard errors are presented in figure I for estimated numbers of discharges. The 

formula for obtaining these standard error estimates is 

where RSE is the relative standard error in percent and N is the 

estimated number of discharges, 

The Z-test with a 0.05 level of significance was used to 

test all comparisons mentioned in this report. Not all observed 

differences were tested, so lack of comment in the text does not 

mean that the difference was not statistically significant, 
1 I 

1 I 

I 1 

50 

40 

30 

20 

ICJ


8 

7 

6


5 I I I I I I I I I I 111111


4 

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I I i 11111111111111 I I I I I 1111111111111 I I I I 1 [111111111111 I I I I 111111111 2 

I I I I I 1111111111 (J I 0.8 

0.7 

0.6 1 1 I 1 1 1 ! i I 11111 

0.5 I I I I I I I 1111 

0.4 

0.3 I I I I I I I I I 11+++111 

0,2 

0.1 

A 2 3 456789A 2 3 456789A 2 3 456789A 2 3 456789A 2 3 456789A 

100 

% 

70 

60 

50 

40 

30 

20 

10 

9 

8 

7 

6 

5 

4 

3 

2 

1 

N 

0.7 

0.6 

0.5 

0.4 

0.3 

0.2 

0.1 

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

Size of estimate II 

Figure 1. Provisional relative standard arrors for astimated number of discharge: Unitad States, 1984-85 G 
16 aciwncedata 

Recent Issues of Advance Data From Vital and Health Statistics 

No. 141. Health Practices and Perceptions of U.S. Adults With Non- No. 138. Highlights of Osteopathic Oftice Practice: National Arnbuinsulin-Dependent Diabetes: Data from the 1985 National Health latory Medical Care Survey, 1985 (Issued September 18, 1987) 

Interview Survey of Health Promotion and Disease Prevention (Is- No. 137. Diagnosis-Related Groups Using Data From the National 

sued September 30, 1987) Hospital Discharge Survey: United States, 1985 (Issued July 2, 1987) 

No. 140. Recent Trends in Hospittilzatiorx United States, 1982–86 

(Issued September 24, 1987) 

No. 139. Health Care Coverage by Age, Sex, Race, and Family 

come: United States, 1986 (Issued September 18, 1987) 

Suggested citation 

National Center for Health Statistics, E. S. 

Sekscenski. 1987. Discharges from nursing 

homes: Preliminary dsta from the 1985 National 

Nursing Home Survey. Advance Data From Vital 

and Hea/th Statistics. No. 142. DHHS Pub. No. 

(PHS) 87-1250. Public Health Service. Hyattsville, 

Md. 

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