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U.S. Department of Health and Human Services 

Public Health Service

Agency for Health Care Policy and Research

Nursing Homes—Structure and

Selected Characteristics, 1996

Research 

 Findings

Research 

 Findings #4
Health Care Information and Electronic Ordering

Through the AHCPR Web Site

The Agency for Health Care Policy and Research’s

Web site—http://www.ahcpr.gov/—makes practical,

science-based health care information available in

one convenient place.

Buttons correspond to major categories of Web

site information, including funding opportunities,

research findings, quality assessments, clinical

information, consumer health, and data and

surveys.

The Web site features an Electronic Catalog to the

more than 450 information products generated by

AHCPR, with information on how to obtain these

resources. Many information products have an

electronic ordering form and are mailed free of

charge from the AHCPR Clearinghouse within 5

working days.

Abstract

The primary goal of the Medical Expenditure Panel

Survey (MEPS) Nursing Home Component (NHC) is to

produce national estimates of insurance coverage and the

use of services, expenditures, and sources of payment for

persons residing in or admitted to a nursing home. The

NHC also gathered information on nursing home

characteristics—such as facility type, ownership, chain

affiliation, certification, facility size, and location—for a

nationally representative sample of nursing homes.

On January 1, 1996, approximately 1.56 million

residents were receiving care in 16,840 nursing homes

with 1.76 million beds. Proprietary (for-profit) nursing

homes, representing the majority of nursing homes (65.9

percent), dominated this sector of the health care market.

The majority of for-profit nursing homes were part of a

chain, and they tended to have only nursing beds (90.9

percent). While almost all nursing home beds were

certified, the type of certification varied by region. The

proportion of Medicare skilled nursing facility beds was

50 to 100 percent higher in the Northeast than in other

regions of the United States. Hospital-based nursing

homes tended to be smaller, have a higher rate of patient

turnover as measured by number of admissions per 100

beds (306 admissions vs. 97 admissions per 100 beds for

all remaining nursing homes), and had greater

representation in locations outside metropolitan statistical

areas. The overall occupancy rate of 88.8 percent varied

little based on facility characteristics. There was slight

variation among regions, ranging from 93.3 percent in

the Northeast to 87.0 percent in the West.

Suggested citation

Rhoades J, Potter DEB, Krauss N. Nursing homes—structure and

selected characteristics, 1996. Rockville (MD):Agency for Health

Care Policy and Research; 1998. MEPS Research Findings No. 4.

AHCPR Pub. No. 98-0006.

http://www http://www.ahcpr .ahcpr.g.goov/ v/
Research 

 Findings

Research 

 Findings

U.S. Department of Health and Human Services 

Public Health Service

Agency for Health Care Policy and Research

AHCPR Pub. No 98-0006

January 1998

Nursing Homes—Structure and

Selected Characteristics, 1996

#4
The Medical Expenditure Panel

Survey (MEPS)

Background

The Medical Expenditure Panel Survey (MEPS) is

conducted to provide nationally representative estimates

of health care use, expenditures, sources of payment,

and insurance coverage for the U.S. civilian

noninstitutionalized population. MEPS also includes a

nationally representative survey of nursing homes and

their residents. MEPS is cosponsored by the Agency for

Health Care Policy and Research (AHCPR) and the

National Center for Health Statistics (NCHS).

MEPS comprises four component surveys: the

Household Component (HC), the Medical Provider

Component (MPC), the Insurance Component (IC), and

the Nursing Home Component (NHC). The HC is the

core survey, and it forms the basis for the MPC sample

and part of the IC sample. The separate NHC sample

supplements the other MEPS components. Together

these surveys yield comprehensive data that provide

national estimates of the level and distribution of health

care use and expenditures, support health services

research, and can be used to assess health care policy

implications.

MEPS is the third in a series of national probability

surveys conducted by AHCPR on the financing and use

of medical care in the United States. The National

Medical Care Expenditure Survey (NMCES) was

conducted in 1977, the National Medical Expenditure

Survey (NMES) in 1987. Beginning in 1996, MEPS

continues this series with design enhancements and

efficiencies that provide a more current data resource to

capture the changing dynamics of the health care

delivery and insurance system.

The design efficiencies incorporated into MEPS are

in accordance with the Department of Health and

Human Services (DHHS) Survey Integration Plan of

June 1995, which focused on consolidating DHHS

surveys, achieving cost efficiencies, reducing respondent

burden, and enhancing analytical capacities. To

accommodate these goals, new MEPS design features

include linkage with the National Health Interview

Survey (NHIS), from which the sample for the MEPS

HC is drawn, and enhanced longitudinal data collection

for core survey components. The MEPS HC augments

NHIS by selecting a sample of NHIS respondents,

collecting additional data on their health care

expenditures, and linking these data with additional

information collected from the respondents’ medical

providers, employers, and insurance providers.

Household Component

The MEPS HC, a nationally representative survey

of the U.S. civilian noninstitutionalized population,

collects medical expenditure data at both the person and

household levels. The HC collects detailed data on

demographic characteristics, health conditions, health

status, use of medical care services, charges and

payments, access to care, satisfaction with care, health

insurance coverage, income, and employment.

The HC uses an overlapping panel design in which

data are collected through a preliminary contact

followed by a series of five rounds of interviews over a 

2 1/2-year period. Using computer-assisted personal

interviewing (CAPI) technology, data on medical

expenditures and use for 2 calendar years are collected

from each household. This series of data collection

rounds is launched each subsequent year on a new

sample of households to provide overlapping panels of

survey data and, when combined with other ongoing

panels, will provide continuous and current estimates of

health care expenditures.

The sampling frame for the MEPS HC is drawn

from respondents to NHIS, conducted by NCHS. NHIS

provides a nationally representative sample of the U.S.

civilian noninstitutionalized population, with

oversampling of Hispanics and blacks. A subsample of

10,500 households was drawn from the NHIS sampling

frame for the initial 1996 MEPS HC panel. Every 5

years the HC sample size is increased. Beginning with

the 1997 panel, policy-relevant population subgroups are

oversampled. The subgroups initially targeted include

adults with functional impairments, children with

functional limitations in their activities, individuals aged

18-64 who are predicted to have high levels of medical

expenditures, and individuals with family income less

than 200 percent of the poverty level.

II
Medical Provider Component

The MEPS MPC supplements and validates

information on medical care events reported in the

MEPS HC by contacting medical providers identified by

household respondents. The MPC sample includes all

hospitals, hospital physicians, home health agencies, and

pharmacies reported in the HC. Also included in the

MPC are all office-based physicians: 

• Providing care for HC respondents receiving

Medicaid.

• Associated with a 75-percent sample of households

receiving care through an HMO (health maintenance

organization) or managed care plan.

• Associated with a 25-percent sample of the

remaining households.

The 1996 sample is projected to provide data from

approximately 2,700 hospitals, 12,400 office-based

physicians, 7,000 separately billing hospital physicians,

and 500 home health providers.

Data are collected on medical and financial

characteristics of medical events reported by HC

respondents, including:

• Diagnoses coded according to ICD-9 (9th Revision,

International Classification of Diseases) and DSMIV (Fourth Edition, Diagnostic and Statistical

Manual of Mental Disorders).

• Physician procedure codes classified by CPT-4

(Current Procedural Terminology, Version 4).

• Inpatient stay codes classified by DRGs (diagnosisrelated groups).

• Charges, payments, and the reasons for any

difference between charges and payments.

The MPC is conducted through telephone

interviews and mailed survey materials.

Insurance Component

The MEPS IC collects data on health insurance

plans obtained through employers, unions, and other

sources of private health insurance. Data obtained in the

IC include the number and types of private insurance

plans offered, benefits associated with these plans,

premiums, contributions by employers and employees,

and employer characteristics.

Establishments participating in the MEPS IC are

selected through four sampling frames:

• A list of employers or other insurance providers

identified by MEPS HC respondents who report

having private health insurance at the Round 1

interview.

• A Bureau of the Census list frame of private-sector

business establishments.

• The Census of Governments from the Bureau of the

Census.

• An Internal Revenue Service list of the selfemployed.

To provide an integrated picture of health insurance,

data collected from the first sampling frame (employers

and other insurance providers) are linked back to data

provided by the MEPS HC respondents. Data from the

other three sampling frames are collected to provide

annual national and State estimates of the supply of

private health insurance available to American workers

and to evaluate policy issues pertaining to health

insurance.

The MEPS IC is an annual panel survey. For the

survey conducted in 1997, the sample includes

approximately 7,000 establishments identified through

the MEPS HC, 27,000 identified through the business

establishments list frame, 1,900 from the Census of

Governments, and 1,000 identified through the list of

the self-employed. Data are collected from the selected

organizations through a prescreening telephone

interview, a mailed questionnaire, and a telephone

followup for nonrespondents.

Nursing Home Component

The 1996 MEPS NHC is a survey of nursing homes

and persons residing in or admitted to nursing homes at

any time during calendar year 1996. The NHC gathers

information on the demographic characteristics,

residence history, health and functional status, use of

services, use of prescription medications, and health

care expenditures of nursing home residents. Nursing

home administrators and designated staff also provide

information on facility size, ownership, certification

status, services provided, revenues and expenses, and

other facility characteristics. Data on the income, assets,

family relationships, and care-giving services for

sampled nursing home residents are obtained from nextof-kin or other knowledgeable persons in the

community. In keeping with the DHHS Survey

III






























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|||| Integration Plan, the NHC is designed to be conducted

every 5 years.

The 1996 MEPS NHC sample was selected using a

two-stage stratified probability design. In the first stage,

facilities were selected; in the second stage, facility

residents were sampled, selecting both persons in

residence on January 1, 1996, and those admitted during

the period January 1 through December 31.

The sample frame for facilities was derived from the

National Health Provider Inventory, which is updated

periodically by NCHS. The MEPS NHC data are

collected in person in three rounds of data collection

over a 1 1/2-year period using the CAPI system.

Community data are collected by telephone using

computer-assisted telephone interviewing (CATI)

technology. At the end of three rounds of data collection,

the sample will consist of approximately 800 responding

facilities, 3,100 residents in the facility on January 1,

and approximately 2,200 eligible residents admitted

during 1996.

Survey Management

MEPS data are collected under the authority of the

Public Health Service Act. They are edited and

published in accordance with the confidentiality

provisions of this act and the Privacy Act. NCHS

provides consultation and technical assistance.

Data collection is conducted under contract by

Westat, Inc., Rockville, MD, and the National Opinion

Research Center at the University of Chicago, as well as

through an interagency agreement with Bureau of the

Census. Technical consultation is provided by Medstat,

Inc., Boston, MA. Data processing support is provided

under contract by Social & Scientific Systems, Inc.,

Bethesda, MD.

As soon as data collection and editing are

completed, the MEPS survey data are released to the

public in staged releases of summary reports and

microdata files. Summary reports are released as printed

documents and electronic files. Microdata files are

released on CD-ROM and/or as electronic files.

Printed documents and CD-ROMs are available

through the AHCPR Publications Clearinghouse. Write

or call:

AHCPR Publications Clearinghouse

Attn: (publication number)

P.O. Box 8547

Silver Spring, MD 20907

800/358-9295

410/381-3150 (callers outside the United States

only)

888/586-6340 (toll-free TDD service; hearing

impaired only)

Be sure to specify the AHCPR number of the

document or CD-ROM you are requesting. Selected

electronic files are available on the Internet in the MEPS

section of the AHCPR home page: 

http://www.ahcpr.gov/

Additional information on MEPS is available from

the MEPS project manager or the MEPS public use data

manager at the Center for Cost and Financing Studies,

Agency for Health Care Policy and Research, 2101 East

Jefferson Street, Suite 500, Rockville, MD 20852

(301/594-1406).

IV
V

Table of Contents

Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Findings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Tables showing:

1. Characteristics of nursing homes and beds. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

2.Type of facility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

3. Characteristics of nursing home beds and affiliated non-nursing beds . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

4. Facility size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

5. Use data for nursing homes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Technical Appendix

Data Sources and Methods of Estimation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Facility Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Definitions of Variables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Reliability and Standard Error Estimates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Standard Error Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Introduction

Because of the dramatic growth in the number of

Americans over age 75 and the desire to minimize the

duration of expensive inpatient hospital care, data

pertaining to the nursing home industry are of critical

importance. The trend in long-term care is toward

expansion of community-based care for persons with

functional limitations. However, there continues to be a

subset of individuals who need sophisticated 24-hour

skilled supervision. A better understanding of the

current nursing home market can contribute to informed

decisions about the provision of long-term care.

This report is based on the 1996 Nursing Home

Component (NHC) of the Medical Expenditure Panel

Survey (MEPS). It provides estimates of the number and

distribution of nursing homes by nursing home type,

ownership and chain affiliation, certification status, size,

and geographic distribution. The estimates of nursing

home characteristics presented in this report are derived

from information provided by facility administrators and

designated staff in sampled nursing homes.

The 1996 MEPS NHC is a national,

yearlong survey of nursing homes and

their residents. MEPS is the third in a

series of surveys sponsored by the Agency

for Health Care Policy and Research

(AHCPR) to collect information on the

health care use and expenditures of the

American public. The first survey was the

1977 National Medical Care Expenditure

Survey (NMCES), and the second was the

1987 National Medical Expenditure

Survey (NMES).

Findings

In 1996 there were 16,840 nursing homes with three

beds or more, for a total of 1,756,800 beds (Table 1).

The average size of a nursing home was just over 104

beds. Three-quarters (75.1 percent) of nursing homes

had fewer than 125 beds. Nursing homes with 125 beds

or more represented only a quarter (24.9 percent) of all

nursing homes but almost half (45.5 percent) of all

nursing beds.

Ownership

Approximately 92 percent of nursing homes were

privately owned. Of all nursing homes, 65.9 percent

were for-profit and 26.2 percent were nonprofit. The

remaining 7.9 percent were owned by Federal, State, or

local governments. For-profit nursing homes were much

more likely than nonprofit nursing homes to be part of a

group or chain. Nearly 70 percent of for-profit nursing

homes were affiliated with a group or chain, while less

than 30 percent of nonprofit nursing homes had such an

affiliation (derived using data from Table 1).

Analysis of nursing home type by ownership reveals

another unmistakable pattern (Table 2). The for-profit

segment of the nursing home market was nearly entirely

represented (90.9 percent) by nursing homes with only

nursing home beds, as opposed to other, more complex

nursing home types (defined in detail in the technical

appendix). Nonprofit facilities were more evenly

distributed among the three different types of nursing

homes, as follows: 

• Nursing homes with only nursing home beds (53.1

percent).

• Nursing homes with independent living or personal

care units (20.8 percent).

• Hospital-based nursing homes (26.1 percent).

Reflecting this distribution by type of facility,

nonprofit facilities were more likely than for-profit

facilities to have affiliated non-nursing beds (derived

using data from Table 3). Non-nursing beds included

personal care and independent living beds.

In each region of the United States, approximately

three-quarters of facilities were nursing homes with only

nursing home beds. In three of the four regions, the

remaining quarter of the facilities were fairly evenly

1

On January 1,

1996, there

were about

16,800 U.S.

nursing

homes with

1.6 million

residents

Nursing Homes—Structure and Selected Characteristics, 1996

by Jeffrey Rhoades, Ph.D., D.E.B. Potter, M.S., and Nancy Krauss, M.S., Agency for Health Care Policy and Research
split between nursing homes with

independent living or personal care units

and hospital-based nursing homes. Only

the West failed to follow this pattern.

The West had roughly double the

proportion of hospital-based facilities

found in the Northeast and South

Regions of the United States. Hospitalbased nursing homes were twice as

prevalent in areas that were not

metropolitan statistical areas (MSAs) as

compared to MSAs.

Facility Certification Status

An important characteristic of nursing homes is

certification status. A nursing home can receive

certification from both the Medicare and Medicaid

programs or from either one separately. In addition, a

nursing home may not meet certification criteria or may

choose not to participate in the programs. In these cases,

the nursing home would be classified as not federally

certified. Nearly all nursing homes had some form of

certification in 1996. Close to three-quarters (73.2

percent) of all nursing homes, representing four-fifths

(80.5 percent) of all nursing beds, were certified by both

Medicare and Medicaid (Table 1). However, while 96.3

percent of the beds in these dually certified facilities

were certified for Medicaid, only 47.9 percent of the

beds were certified by Medicare (Table 3).

A very small percentage of all nursing homes were

certified neither by Medicare nor Medicaid (Table 1). If

a nursing home was neither Medicare nor Medicaid

certified, it was included in the sample if it met both of

the following criteria: 

• It was licensed by the State health department or

some other State or Federal agency.

• It provided 24-hour, 7-day, onsite supervision by a

registered nurse or licensed practical nurse.

Nursing Bed Characteristics

The distribution of Medicare skilled nursing facility

(SNF) beds was quite similar for three regions of the

United States (Table 3). In the Midwest, South, and West

Regions, approximately 30 to 45 percent of all beds

were Medicare certified. In contrast, nearly two-thirds

(64.3 percent) of the beds in the Northeast were SNF

beds. About 90 percent of nursing beds in all four

regions were certified by Medicaid as nursing facility

beds.

Facility Size

The overall average size for nursing homes was 104

beds. The size distribution of nursing homes was similar

for nursing homes with only nursing home beds and

nursing homes with independent living or personal care

units (Table 4). Approximately 35 to 45 percent of both

types of facilities had 75-124 beds. However, for

hospital-based nursing homes the picture was quite

different. Less than 25 percent of hospital-based nursing

homes had 75-124 beds, and nearly 70 percent had

fewer than 75 beds.

Size also varies by ownership and chain affiliation.

As facility size increases, the proportion of nursing

homes that report independent ownership decreases.

However, nursing homes reporting chain affiliation were

clustered within a narrow size range—almost half (49.0

percent, based on calculations using data from Table 4)

had 75-124 beds.

The size distribution of nursing homes also differed

by region. For the Midwest and West, the most

numerous facilities were those with fewer than 75 beds

(46.0 and 43.6 percent, respectively). In contrast, the

Northeast and South had larger facilities on average;

most common were facilities with 75-124 beds (38.8

and 48.2 percent, respectively). The average size of

nursing homes by region ranged from a low of 86.2 beds

in the West to a high of 129.3 beds in the Northeast

(data not shown). Nearly half (46.7 percent) of nursing

homes not located in MSAs had fewer than 75 beds,

while less than a third (29.1 percent) of nursing homes

in MSAs had fewer than 75 beds. Over two-thirds (69.0

percent) of nursing beds were located in MSAs. Nursing

homes located outside MSAs were twice as likely to be

hospital based.

Use

Measures of nursing home care use are presented in

Table 5. The total nursing home population was

approximately 1.56 million. The occupancy rate is a

measure of the percent capacity at which a nursing

home is operating. The ratio of residents to beds

produced an overall occupancy rate of 88.8 percent.

2

Of all nursing

homes, about

two-thirds

are operated

for profit and

over half are

part of a

chain.
Generally, there was little variation in occupancy rates

by facility characteristics. There was slight variation

among regions, however, ranging from 93.3 percent in

the Northeast to 87.0 percent in the West.

There were 1.96 million admissions in 1995. This

represents a rate of 111.8 admissions per 100 beds, or a

turnover rate of approximately one admission per bed

per year.

The admissions rate was greatest for hospital-based

nursing homes (306 admissions per 100 beds), while the

admissions rate for nursing homes with only nursing

home beds and nursing homes with independent living

or personal care units combined was approximately 97

admissions per 100 beds (Table 5). The higher

admissions rate for hospital-based nursing homes was

due in part to the fact that such nursing homes had a

greater proportion of Medicare SNF beds (Table 3).

Length of stay would be constrained by Medicare

reimbursement policy, leading to a greater admissions

rate than in the other two types of nursing homes.

Admissions rates were also highest in facilities with

fewer than 75 beds (181 admissions per 100 beds) and

facilities located in the West (198 admissions per 100

beds), as shown in Table 5. This is probably at least

partially accounted for by the greater proportion of

hospital-based nursing homes in the West and in

facilities with fewer than 75 beds.

References

Agency for Health Care Policy and Research.

Round 1, facility-level public use file codebook. In:

Medical Expenditure Panel Survey (MEPS) NHC-001:

Round 1 Sampled Facility and Person Characteristics,

March 1997 [CD-ROM]. Rockville (MD), 1997.

AHCPR Pub. No. 97-DP21.

American Hospital Association: American Hospital

Association guide to the health care field, 1996-97

edition. Chicago; 1996.

Bethel J, Broene P, Sommers JP. Sample design of

the 1996 Medical Expenditure Panel Survey Nursing

Home Component. Rockville (MD): Agency for Health

Care Policy and Research; 1998 (forthcoming). MEPS

Methodology Report No. 4.

Potter DEB. Design and methods of the 1996

Medical Expenditure Panel Survey Nursing Home

Component. Rockville (MD): Agency for Health Care

Policy and Research; 1998 (forthcoming). MEPS

Methodology Report No. 3.

Shah BV, Barnwell BG, Bieler GS. SUDAAN user’s

manual: software for the statistical analysis of correlated

data. Research Triangle Park (NC): Research Triangle

Institute; 1995.

U.S. Bureau of the Census. Statistical abstract of the

United States: 1996 (116th edition). Washington; 1996.

3
Table 1. Number of nursing homes and beds by selected characteristics:

United States, 1996

Facility characteristic

Percent

Number distribution Numbera Percentdistribution

Nursing homes Nursing home beds

Total 16,840 100.0 1,756,800 100.0

Type of nursing home

Nursing home with only nursing home bedsb 13,020 77.3 1,425,100 81.1

Nursing home with independent living

or personal care unitc 1,910 11.3 208,200 11.9

Hospital-based nursing home d1,910 d11.4 d123,500 d7.0

Ownership

For profit 11,090 65.9 1,171,800 66.7

Independent 3,490 20.8 348,200 19.8

Part of group or chain 7,600 45.1 823,600 46.9

Nonprofit 4,420 26.2 423,400 24.1

Independent 3,170 18.8 295,700 16.8

Part of group or chain d1,250 d7.4 d127,700 d7.3

Government 1,330 7.9 161,600 9.2

Facility certification status

Medicare and Medicaid certified 12,320 73.2 1,414,200 80.5

Medicare certified only (e) (e) (e) (e)

Medicaid certified only 2,870 17.0 227,700 13.0

Not federally certified (e) (e) (e) (e)

Facility size

Fewer than 75 beds 6,010 35.7 282,400 16.1

75-124 beds 6,630 39.4 674,700 38.4

125-199 beds 2,880 17.1 448,300 25.5

200 or more beds 1,320 7.8 351,400 20.0

Census region

Northeast 2,910 17.3 375,900 21.4

Midwest 5,680 33.8 544,300 31.0

South 5,080 30.2 561,900 32.0

West 3,170 18.8 274,700 15.6

Metropolitan statistical area (MSA)

MSA 10,490 62.3 1,212,000 69.0

Not MSA 6,350 37.7 544,800 31.0

aExcludes unlicensed nursing home beds.

bIncludes a small number of nursing homes (less than 1 percent of this category) with an intermediate care unit for the mentally retarded. cIncludes continuing care retirement communities and retirement centers that include independent living and/or personal care units, as well as

nursing homes that contain or are affiliated with independent living or personal care units.

dBecause this statistic is based on a sample of less than 75, statistical tests that assume a normal distribution may not be appropriate,

especially in applications with proportions. eSample size less than 50.

Source: Center for Cost and Financing Studies, Agency for Health Care Policy and Research: Medical Expenditure Panel Survey

Nursing Home Component, 1996 (Round 1).

4
5

Table 2. Percent distribution of nursing homes by type of facility and selected

characteristics: United States, 1996

Facility characteristic

Nursing homes

with only nursing

home bedsa

Total nursing

homes

Nursing homes

with independent

living or personal

care unitb

Hospital-based

nursing home

Type of facility

Percent distribution

Total 16,840 77.3 11.3 11.4

Ownership

For profit 11,090 90.9 7.2 *1.9

Independent 3,490 91.0 6.7 *2.2

Part of group or chain 7,600 90.9 7.4 *1.7

Nonprofit 4,420 53.1 20.8 26.1

Independent 3,170 51.6 18.3 30.1

Part of group or chain c1,250 c56.8 c27.4 *c15.8

Government 1,330 43.9 *14.3 41.8

Facility certification status

Medicare and Medicaid certified 12,320 80.2 10.4 9.4

Medicare certified only (d) (d) (d) (d)

Medicaid certified only 2,870 79.4 13.4 *7.1

Not federally certified (d) (d) (d) (d)

Facility size

Fewer than 75 beds 6,010 66.4 11.5 22.1

75-124 beds 6,630 83.2 10.0 6.8

125-199 beds 2,880 85.6 12.6 *1.8

200 or more beds 1,320 79.6 14.2 6.2

Census region

Northeast 2,910 81.2 10.2 8.6

Midwest 5,680 75.7 13.0 11.3

South 5,080 78.4 13.5 8.1

West 3,170 74.9 *5.7 19.3

Metropolitan statistical area (MSA)

MSA 10,490 80.2 11.5 8.3

Not MSA 6,350 72.5 11.1 16.4

aIncludes a small number of nursing homes (less than 1 percent of this category) with an intermediate care unit for the mentally retarded.

bIncludes continuing care retirement communities and retirement centers that include independent living and/or personal care units, as well as

nursing homes that contain or are affiliated with independent living or personal care units. cBecause this statistic is based on a sample of less than 75, statistical tests that assume a normal distribution may not be appropriate,

especially in applications with proportions.

dSample size less than 50.

*Relative standard error greater than 0.3.

Source: Center for Cost and Financing Studies, Agency for Health Care Policy and Research: Medical Expenditure Panel Survey

Nursing Home Component, 1996 (Round 1).
Table 3. Selected characteristics of nursing home beds and affiliated non-nursing

beds: United States, 1996

Facility characteristic

Non-nursing beds affiliated

with nursing home—ratio to

100 nursing home beds

Nursing home beds

Total 1,756,800 40.3 90.0 6.9 5.1 6.5

Type of nursing facility

Nursing home with only

nursing home bedsd 1,425,100 38.5 92.9 6.8 — —

Nursing home with independent

living or personal care unite 208,200 39.4 81.9 7.9 41.5 54.6

Hospital-based nursing home f123,500 f62.8 f69.9 *f 5.7 *f 2.7 * f 0.4

Ownership

For profit 1,171,800 34.5 91.8 6.3 2.4 *2.3

Independent 348,200 38.7 88.4 4.7 *3.4 *2.5

Part of group or chain 823,600 32.7 93.1 7.0 2.0 *2.3

Nonprofit 423,400 55.3 87.7 7.4 13.1 20.1

Independent 295,700 54.7 85.8 6.6 9.8 12.4

Part of group or chain f127,700 f56.6 f92.2 f 9.1 *f 20.6 *f 37.9

Government 161,600 43.2 83.2 9.2 3.6 *1.3

Facility certification status

Medicare and Medicaid certified 1,414,200 47.9 96.3 7.1 4.5 4.5

Medicare certified only (g) (g) (g) (g) (g) (g)

Medicaid certified only 227,700 — 96.4 3.0 *4.4 *9.4

Not federally certified (g) (g) (g) (g) (g) (g)

Facility size

Fewer than 75 beds 282,400 38.9 83.4 *2.0 7.7 * 9.9

75-124 beds 674,700 40.6 90.8 5.1 6.3 * 7.0

125-199 beds 448,300 39.7 94.5 10.3 3.5 * 6.6

200 or more beds 351,400 41.7 87.9 9.7 2.7 * 2.7

Census region

Northeast 375,900 64.3 91.5 8.0 4.0 *3.7

Midwest 544,300 31.2 90.8 6.6 *7.0 6.6

South 561,900 31.7 88.6 5.9 4.8 *9.6

West 274,700 42.9 89.1 7.6 *3.5 *3.7

Metropolitan statistical area (MSA)

MSA 1,212,000 42.8 87.4 7.9 6.1 7.0

Not MSA 544,800 34.8 95.7 4.5 2.8 * 5.3

aFederally certified as Medicare only or dually certified by both Medicare and Medicaid.

bFederally certified as Medicaid only or dually certified by both Medicare and Medicaid. cNursing home units designated for specific nursing home populations, e.g., Alzheimer’s and subacute care. 

dIncludes a small number of nursing homes (less than 1 percent of this category) with an intermediate care unit for the mentally retarded. eIncludes continuing care retirement communities and retirement centers that include independent living and/or personal care units, as well as

nursing homes that contain or are affiliated with independent living or personal care units.

f

Because this statistic is based on a sample of less than 75, statistical tests that assume a normal distribution may not be appropriate,

especially in applications with proportions.

gSample size less than 50.

*Relative standard error greater than 0.3.

Source: Center for Cost and Financing Studies, Agency for Health Care Policy and Research: Medical Expenditure Panel Survey

Nursing Home Component, 1996 (Round 1).

6

Total

Percent

certified as

skilled nursing

facilitya

Percent

certified as

nursing

facilityb

Percent in

special care

unitsc

Personal care

beds

Independent

living beds
7

Table 4. Percent distribution of nursing homes by facility size and selected

characteristics: United States, 1996

Facility characteristic

75-124

beds

Fewer than

75 beds

Total nursing

homes

125-199

beds

200 or more

beds

Facility size

Percent distribution

Total 16,840 35.7 39.4 17.1 7.8

Type of nursing facility

Nursing home with only

nursing home bedsa 13,020 30.7 42.4 18.9 8.0

Nursing home with independent

living or personal care unitb 1,910 36.3 35.0 19.0 9.8

Hospital-based nursing home c1,910 c69.5 c23.5 *c2.7 *c4.2

Ownership

For profit 11,090 30.6 45.1 17.5 6.7

Independent 3,490 41.6 36.3 13.6 8.5

Part of group or chain 7,600 25.5 49.2 19.3 5.9

Nonprofit 4,420 42.7 31.8 17.6 8.0

Independent 3,170 48.3 25.6 16.7 9.4

Part of group or chain c1,250 c28.6 c47.4 c19.7 *c4.4

Government 1,330 55.2 16.8 11.9 16.1

Facility certification status

Medicare and Medicaid certified 12,320 25.7 44.5 20.7 9.0

Medicare certified only (d) (d) (d) (d) (d)

Medicaid certified only 2,870 60.9 26.8 9.5 *2.9

Not federally certified (d) (d) (d) (d) (d)

Census region

Northeast 2,910 24.7 38.8 23.5 13.0

Midwest 5,680 46.0 31.9 13.2 8.8

South 5,080 25.5 48.2 20.0 6.4

West 3,170 43.6 39.3 13.5 3.6

Metropolitan statistical area (MSA)

MSA 10,490 29.1 39.4 20.7 10.9

Not MSA 6,350 46.7 39.5 11.2 2.7

aIncludes a small number of nursing homes (less than 1 percent of this category) with an intermediate care unit for the mentally retarded.

bIncludes continuing care retirement communities and retirement centers that include independent living and/or personal care units, as well as

nursing homes that contain or are affiliated with independent living or personal care units. cBecause this statistic is based on a sample of less than 75, statistical tests that assume a normal distribution may not be appropriate,

especially in applications with proportions.

dSample size less than 50.

*Relative standard error greater than 0.3.

Source: Center for Cost and Financing Studies, Agency for Health Care Policy and Research: Medical Expenditure Panel Survey

Nursing Home Component, 1996 (Round 1).
Table 5. Selected use data for nursing homes by selected characteristics: United

States, 1995 and 1996

Facility characteristic

Admissions,

1995a

Mean occupancy

rate for nursing

beds, 1996 Residents, 1996

Admissions per

100 nursing

beds, 1995a

Total 88.8 1,963,200 1,559,700 111.8

Type of nursing facility

Nursing home with only nursing home bedsb 88.7 1,374,900 1,263,500 96.5

Nursing home with independent living

or personal care unitc 91.3 211,100 190,000 101.4

Hospital-based nursing home d86.0 d377,200 d106,200 d305.6

Ownership

For profit 87.5 1,281,600 1,025,400 109.4

Independent 88.0 314,200 306,300 90.2

Part of group or chain 87.3 967,400 719,200 117.5

Nonprofit 91.5 567,800 387,400 134.1

Independent 92.1 447,700 272,400 151.4

Part of group or chain d90.0 d120,100 d114,900 d94.1

Government 90.9 113,800 146,900 70.4

Facility certification status

Medicare and Medicaid certified 89.3 1,495,600 1,263,500 105.8

Medicare certified only (e) (e) (e) (e)

Medicaid certified only 89.9 111,400 204,700 48.9

Not federally certified (e) (e) (e) (e)

Facility size

Fewer than 75 beds 88.1 509,800 248,800 180.5

75-124 beds 88.2 723,800 595,300 107.3

125-199 beds 89.8 441,200 402,700 98.4

200 or more beds 89.1 288,400 312,900 82.1

Census region

Northeast 93.3 336,600 350,600 89.5

Midwest 87.5 567,900 476,100 104.3

South 87.9 515,100 493,900 91.7

West 87.0 543,600 239,100 197.9

Metropolitan statistical area (MSA)

MSA 89.2 1,501,300 1,081,200 123.9

Not MSA 87.8 461,900 478,500 84.8

a1996 figures will be available with the full-year data release in fall 1998.

bIncludes a small number of nursing homes (less than 1 percent of this category) with an intermediate care unit for the mentally retarded. cIncludes continuing care retirement communities and retirement centers that include independent living and/or personal care units, as well as

nursing homes that contain or are affiliated with independent living or personal care units.

dBecause this statistic is based on a sample of less than 75, statistical tests that assume a normal distribution may not be appropriate,

especially in applications with proportions. eSample size less than 50.

Source: Center for Cost and Financing Studies, Agency for Health Care Policy and Research: Medical Expenditure Panel Survey

Nursing Home Component, 1996 (Round 1).

8
Technical Appendix

Data Sources and Methods of

Estimation

The data in this report were obtained from a

nationally representative sample of nursing homes from

the Nursing Home Component (NHC) of the 1996

Medical Expenditure Panel Survey (MEPS). The

sampling frame was derived from the updated 1991

National Health Provider Inventory. The NHC was

primarily designed to provide unbiased national and

regional estimates for the population in nursing homes,

as well as estimates of these facilities and a range of

their characteristics.

The sample was selected using a two-stage stratified

probability design, with facility selection in the first

stage. The second stage of selection consisted of a

sample of residents as of January 1, 1996, and a rolling

sample of persons admitted during the year (Bethel,

Broene, and Sommers, forthcoming). Of the 1,123

eligible nursing homes sampled in the NHC, 85 percent

responded. Estimates in this report are based on these

952 eligible responding facilities. To bring the sample

size in line with the original design of approximately

800 facilities by the end of Round 3, the facility sample

was subsampled at the end of Round 1. A total of 127

facilities were randomly deselected.

The MEPS NHC data analyzed here were collected

in person during the first of three rounds of data

collection. A computer-assisted personal interview

(CAPI) system was used for data collection. The Round

1 interview took place during the period March-June

1996. The entire three-round data collection effort took

place over a 1-1/2 year period, with the reference period

being January 1, 1996, to December 31, 1996 (Potter,

forthcoming).

The facility questionnaire was designed to elicit

information on the complex structure of institutions that

provide residential care or treatment. Some nursing

homes or units exist within larger establishments. In

such cases, the entity that appeared on the sampling

frame might be the larger facility, the nursing home or

unit within the larger facility, or only one of several

nursing units within the larger facility. Therefore, the

NHC’s Round 1 facility questionnaire was designed to

identify the larger facility, each eligible nursing home or

unit within the larger establishment, and other

nonhospital residential parts. Because of this, the point

of reference for a specific question may be the sampled

nursing home or unit (hereafter referred to as “nursing

home”), a larger facility, another nonhospital residential

part of a larger facility, one or several nursing homes

within a larger facility, or a smaller subunit of the

eligible nursing home (Agency for Health Care Policy

and Research, 1997).

Data on the sampled nursing homes were obtained

using a facility questionnaire administered through

CAPI to facility administrators or designated staff.

Estimates provided are preliminary and are subject to

revision as more information from other parts of the

NHC becomes available.

Data in data files released to the public have, in

some instances, been masked to preserve the

confidentiality of responding nursing homes. As a result,

estimates made using the public use version of the data

may differ slightly from the estimates presented in this

report.

Facility Eligibility 

Only nursing homes were eligible for inclusion in

the MEPS NHC. To be included as a nursing home, a

facility must have at least three beds and meet one of the

following criteria: 

• It must have a facility or distinct portion of a facility

certified as a Medicare skilled nursing facility

(SNF).

• It must have a facility or distinct portion of a facility

certified as a Medicaid nursing facility (NF).

• It must have a facility or distinct portion of a facility

that is licensed as a nursing home by the State health

department or by some other State or Federal agency

and that provides onsite supervision by a registered

nurse or licensed practical nurse 24 hours a day, 7

days a week (Bethel, Broene, and Sommers,

forthcoming).

By this definition, all SNF- or NF-certified units of

licensed hospitals are eligible for the sample, as are all

Department of Veterans Affairs (VA) long-term care

nursing units. In such cases, and in the case of

retirement communities with nursing facilities, only the

long-term care nursing units(s) of the facility were

eligible for inclusion in the sample. If a facility also

9
contained a long-term care unit that provided assistance

only with activities of daily living (e.g., a personal care

unit) or provided nursing care at a level below that

required to be classified as a nursing facility, that unit

was excluded from the sample (Potter, forthcoming).

Definitions of Variables

Facility Type

This variable, constructed from data from the

facility questionnaire, defines the facility’s

organizational structure as one of three types:

• Hospital-based nursing home. This indicates that the

sampled nursing home was part of a hospital or was

a hospital-based Medicare SNF.

• Nursing home with independent living or personal

care unit. This category includes continuing care

retirement communities (CCRCs) and retirement

centers that have independent living and/or personal

care units, as well as nursing homes that contain

personal care units. Non-hospital-based nursing

homes with a separate unit in which personal care

assistance is provided also are included.

• Nursing home with only nursing home beds. This

category includes a small number of nursing homes

(less than 1 percent) with an intermediate care unit

for the mentally retarded (ICF-MR).

The order of priority for coding facility type

followed the sequence listed above. Eleven facilities

initially classified as “other nursing home type” were

recoded to the latter two categories on further review.

Ownership

Respondents reported the ownership type that best

described their facility (or larger part of the facility, in

situations where the sampled nursing home was part of a

larger facility), as follows: 

• For-profit (i.e., individual, partnership, or

corporation).

• Private nonprofit (e.g., religious group, nonprofit

corporation).

• One of four types of public ownership—city/county

government, State government, VA, or other Federal

agency.

Respondents also reported whether their facility was

part of a chain or group of nursing facilities operating

under common management. Three facilities whose

ownership type originally was reported as “other

specify” were recoded based on the 1996 American

Hospital Association Guide to Hospitals (American

Hospital Association, 1996).

Facility Certification Status

Respondents were asked whether any unit in their

facility or part of the larger facility (in cases where the

sampled nursing home was reported to be part of a

larger facility) was certified by Medicare as an SNF

and/or Medicaid as an NF. For the purpose of this

report, facilities were assigned to mutually exclusive

categories based on their responses.

Facility Size

The size of the sampled nursing home was

determined by the number of nursing beds regularly

maintained for residents. Beds contained within the

sampled nursing home but not licensed for nursing care

were excluded; 65 of the 952 nursing homes reported

having such unlicensed beds. There were 28,000

unlicensed beds in addition to the 1,756,800 total

weighted beds in the sample. These unlicensed beds

represented less than 2 percent of the beds in the

sampled nursing homes. If the sampled nursing home

was part of a larger facility, only the licensed nursing

home beds were included.

Census Region

Sampled nursing homes or units were classified in

one of four regions—Northeast, Midwest, South, and

West—based on their geographic location according to

the MEPS NHC sampling frame. These regions are

defined by the U.S. Bureau of the Census.

Facility Location

A metropolitan statistical area (MSA) is defined as

including (1) at least one city with 50,000 or more

inhabitants or (2) a Census Bureau-defined urbanized

area of at least 50,000 inhabitants and a total

10
metropolitan population of at least 100,000 (75,000 in

New England) (U.S. Bureau of the Census, 1996).

MSA data were missing for 14 facilities; an

MSA/non-MSA determination was made after a review

of the county’s population density according to the 1990

census.

Special Care Beds

Respondents were asked about any special care

units within the licensed part of the sampled nursing

home—that is, units with a specified number of beds

identified and dedicated for residents with specific

needs or diagnoses. If the nursing home had a special

care unit, respondents were asked to select the type of

special care unit(s) from a list provided and to supply

the number of beds in each identified unit. The types of

special care units identified were Alzheimer’s and

related dementias, AIDS/HIV, dialysis, children with

disabilities, brain injury (traumatic or acquired), hospice,

Huntington’s disease, rehabilitation, ventilator/

pulmonary, subacute, and “some other kind of unit.”

Beds from all identified special care units within the

sampled facility were added to obtain total special care

beds.

Non-Nursing Beds

Respondents were asked whether the sampled

nursing home was part of a larger facility or campus, or

if the sampled nursing home had any beds not licensed

or certified as nursing home beds. If so, all the parts or

units of the larger facility or campus were enumerated

and/or the number of unlicensed beds was obtained. The

numbers of personal care beds, independent living beds,

and hospital beds also were obtained.

Personal care beds. The total number of personal

care beds was derived by adding the number of beds

from all identified parts or units of the sampled nursing

home or larger facility that the respondent reported to be

“assisted living,” “board and care,” “domiciliary care,”

“rest home unit,” or “personal care.”

Independent living beds. The total number of

independent living beds was derived by adding the

number of beds from all parts or units of the larger

facility or campus or unlicensed units identified as

“independent living units.”

Hospital beds. The total number of hospital beds

was derived by adding the number of beds from all parts

or units of the larger facility or campus or unlicensed

units identified as “hospital.”

1995 Admissions

The number of admissions the sampled nursing

home/unit(s) had in 1995— that is, from January 1,

1995, through December 31, 1995—for the certified or

licensed nursing beds in the sampled facility/unit(s) was

obtained from the Self-Administered Questionnaire

(SAQ). During the interview, the SAQ was left with the

facility administrator or designated staff for completion.

Approximately 12.5 percent of the sample had missing

responses, which were imputed.

1996 Residents

Respondents were asked how many residents were

in the sampled facility/unit(s) at midnight on the date of

interview. Residents in unlicensed parts of the sampled

nursing home were excluded.

Occupancy Rate

The occupancy rate was calculated as the number of

residents divided by the total number of nursing home

beds within the sampled nursing home, excluding

unlicensed beds.

Reliability and Standard Error

Estimates

Since the statistics presented in this report are based

on a sample, they may differ somewhat from the figures

that would have been obtained if a complete census had

been taken. This potential difference between sample

results and a complete count is the sampling error of the

estimate.

The chance that an estimate from the sample would

differ from the value for a complete census by less than

one standard error is about 68 out of 100. The chance

that the difference between the sample estimate and a

complete census would be less than twice the standard

error is about 95 out of 100.

11
Tests of statistical significance were used to

determine whether differences between estimates exist at

specified levels of confidence or whether they simply

occurred by chance. Differences were tested using Zscores having asymptotic normal properties, based on

the rounded figures at the 0.05 level of significance.

Estimates for sample sizes of less than 50 do not

meet standards of reliability or precision and are not

reported. In addition, estimates with a relative standard

error greater than 30 percent are marked with an

asterisk. Such estimates cannot be assumed to be

reliable.

Rounding

Estimates presented in the tables have been rounded

to the nearest 0.1 percent. The rounded estimates,

including those underlying the standard errors, will not

always add to 100 percent or the full total.

Standard Errors

The standard errors in this report are based on

estimates of standard errors derived using the Taylor

series linearization method to account for the complex

survey design. The standard error estimates were

computed using SUDAAN (Shah, Barnwell, and Bieler,

1995). The direct estimates of the standard errors for the

estimates in Tables 1-5 in the text are provided in Tables

A-E, respectively.

For example, the estimate of 77.3 percent for

nursing homes with only nursing home beds (Table 1)

has an estimated standard error of 1.6 percentage points

(Table A). The estimate of 1,263,500 residents for

nursing homes with only nursing home beds as of

January 1, 1996 (Table 5) has an estimated standard

error of 20,557 residents (Table E).

12
13

Table A. Standard errors for number of nursing homes and beds by selected

characteristics: United States, 1996

Corresponds to Table 1

Facility characteristic

Percent

Number distribution Numbera

Percent

distribution

Nursing homes Nursing home beds

Standard error

Total 368 0.0 11,241 0.0

Type of nursing facility

Nursing home with only nursing home bedsb 335 1.6 22,196 1.2

Nursing home with independent living

or personal care unitc 185 1.1 18,396 1.1

Hospital-based nursing home 254 1.4 10,657 0.6

Ownership

For profit 342 1.8 26,781 1.4

Independent 283 1.6 23,638 1.3

Part of group or chain 312 1.9 28,579 1.6

Nonprofit 342 1.8 23,863 1.4

Independent 319 1.7 20,900 1.2

Part of group or chain 163 1.0 14,781 0.8

Government 171 1.0 15,226 0.9

Facility certification status

Medicare and Medicaid certified 336 2.0 24,316 1.3

Medicare certified only — — — —

Medicaid certified only 275 1.6 19,290 1.1

Not federally certified — — — —

Facility size

Fewer than 75 beds 469 2.1 20,222 1.2

75-124 beds 227 1.8 27,777 1.6

125-199 beds 164 1.1 25,363 1.4

200 or more beds 96 0.7 24,110 1.3

Census region

Northeast 214 1.3 23,112 1.3

Midwest 343 1.7 22,602 1.3

South 279 1.7 26,856 1.5

West 274 1.5 18,706 1.1

Metropolitan statistical area (MSA)

MSA 362 2.0 28,217 1.5

Not MSA 383 2.0 26,722 1.5

aExcludes unlicensed nursing home beds.

bIncludes a small number of nursing homes (less than 1 percent of this category) with an intermediate care unit for the mentally retarded. cIncludes continuing care retirement communities and retirement centers that include independent living and/or personal care units, as well as

nursing homes that contain or are affiliated with independent living or personal care units.

Source: Center for Cost and Financing Studies, Agency for Health Care Policy and Research: Medical Expenditure Panel Survey

Nursing Home Component, 1996 (Round 1).
Table B. Standard errors of selected characteristics of nursing homes by type of

facility: United States, 1996

Corresponds to Table 2

Facility characteristic

Nursing homes

with only nursing

home bedsa

Total nursing

homes

Nursing homes

with independent

living or personal

care unitb

Hospitalbased nursing

home

Type of facility

Standard error

Total 368 1.6 1.1 1.4

Ownership

For profit 342 1.5 1.1 1.0

Independent 283 2.4 2.0 1.5

Part of group or chain 312 1.8 1.4 1.3

Nonprofit 342 4.2 2.9 4.3

Independent 319 5.4 3.1 5.7

Part of group or chain 163 6.7 6.0 5.4

Government 171 6.6 4.5 7.1

Facility certification status

Medicare and Medicaid certified 336 1.8 1.2 1.6

Medicare certified only — — — —

Medicaid certified only 275 4.1 3.2 3.0

Not federally certified — — — —

Facility size

Fewer than 75 beds 469 4.0 2.2 3.8

75-124 beds 277 2.0 1.6 1.3

125-199 beds 164 2.3 2.2 0.8

200 or more beds 96 3.1 2.8 1.6

Census region

Northeast 214 3.2 2.4 2.4

Midwest 343 3.3 2.0 3.1

South 279 2.9 2.3 2.3

West 274 4.5 1.8 4.3

Metropolitan statistical area (MSA)

MSA 362 1.9 1.4 1.5

Not MSA 383 3.3 1.8 3.2

aIncludes a small number of nursing homes (less than 1 percent of this category) with an intermediate care unit for the mentally retarded.

bIncludes continuing care retirement communities and retirement centers that include independent living and/or personal care units, as well as

nursing homes that contain or are affiliated with independent living or personal care units.

Source: Center for Cost and Financing Studies, Agency for Health Care Policy and Research: Medical Expenditure Panel Survey

Nursing Home Component, 1996 (Round 1).

14
15

Table C. Standard errors of selected characteristics of nursing home beds and

affiliated non-nursing beds: United States, 1996

Corresponds to Table 3

Facility characteristic Total

Percent certified

as skilled

nursing facilitya

Percent in

special care

unitsc

Percent

certified as

nursing facilityb

Personal

care beds

Independent

living beds

Non-nursing beds affiliated

with nursing home—

Nursing home beds ratio to 100 nursing beds

Standard error

Total 11,241 1.3 0.9 0.5 0.8 1.3

Type of nursing facility

Nursing home with only

nursing home bedsd 22,196 1.4 0.8 0.5 — —

Nursing home with independent

living or personal care unite 18,396 3.8 3.3 1.4 6.0 9.7

Hospital-based nursing home 10,657 5.5 5.7 1.9 1.3 0.2

Ownership

For profit 26,781 1.4 1.0 0.6 0.6 1.1

Independent 23,638 3.1 2.4 1.0 1.5 1.9

Part of group or chain 28,579 1.5 0.9 0.7 0.5 1.4

Nonprofit 23,863 2.9 2.1 1.0 3.0 4.2

Independent 20,900 3.5 2.6 1.1 2.0 3.1

Part of group or chain 14,781 5.2 3.2 2.1 8.6 11.6

Government 15,226 4.8 3.8 1.7 1.0 1.3

Facility certification status

Medicare and Medicaid certified 24,316 1.4 0.4 0.5 0.9 1.1

Medicare certified only — — — — — —

Medicaid certified only 19,290 — 1.1 0.7 1.7 3.3

Not federally certified — — — — — —

Facility size

Fewer than 75 beds 20,222 3.4 2.8 0.8 1.9 4.3

75-124 beds 27,777 2.0 1.4 0.7 1.9 2.3

125-199 beds 25,363 2.4 1.1 1.1 0.8 2.2

200 or more beds 24,110 3.1 2.3 1.1 0.7 1.1

Census region

Northeast 23,112 2.7 1.8 1.0 1.1 1.6

Midwest 22,602 2.1 1.5 0.8 2.3 1.9

South 26,856 2.1 1.7 0.8 1.0 3.3

West 18,706 3.2 2.2 1.1 1.3 1.6

Metropolitan statistical area (MSA)

MSA 28,217 1.5 1.2 0.6 1.2 1.5

Not MSA 26,722 2.3 0.9 0.6 0.6 2.4

aFederally certified as Medicare only or dually certified by both Medicare and Medicaid.

bFederally certified as Medicaid only or dually certified by both Medicare and Medicaid. cNursing home units designated for specific nursing home populations, e.g., Alzheimer’s and subacute care.

dIncludes a small number of nursing homes (less than 1 percent of this category) with an intermediate care unit for the mentally retarded. eIncludes continuing care retirement communities and retirement centers that include independent living and/or personal care units, as well as

nursing homes that contain or are affiliated with independent living or personal care units.

Source: Center for Cost and Financing Studies, Agency for Health Care Policy and Research: Medical Expenditure Panel Survey

Nursing Home Component, 1996 (Round 1).
Table D. Standard errors of percent distribution of nursing homes by facility size and

selected characteristics: United States, 1996

Corresponds to Table 4

Facility characteristic

Total nursing

homes

75-124

beds

Fewer than

75 beds

125-199

beds

200 or more

beds

Facility size

Standard error

Total 368 2.1 1.8 1.1 0.7

Type of nursing facility

Nursing home with only

nursing home bedsa 335 2.3 2.0 1.3 0.8

Nursing home with independent living

or personal care unitb 185 5.3 4.8 3.4 2.1

Hospital-based nursing home 254 6.1 5.4 1.3 1.4

Ownership

For profit 342 2.5 2.2 1.4 0.8

Independent 283 4.7 4.0 2.2 1.5

Part of group or chain 312 2.8 2.6 1.7 0.9

Nonprofit 342 4.6 3.5 2.3 1.3

Independent 319 5.5 3.8 2.7 1.7

Part of group or chain 163 7.3 6.7 4.3 1.7

Government 171 6.6 4.5 3.2 3.2

Facility certification status

Medicare and Medicaid certified 336 2.3 2.1 1.4 0.8

Medicare certified only — — — — —

Medicaid certified only 275 4.5 4.0 2.1 0.9

Not federally certified — — — — —

Census region

Northeast 214 4.4 4.0 3.0 1.9

Midwest 343 3.7 3.0 1.7 1.2

South 279 3.4 3.3 2.2 1.1

West 274 5.2 4.5 2.4 1.0

Metropolitan statistical area (MSA)

MSA 362 2.7 2.2 1.5 1.0

Not MSA 383 3.5 3.1 1.5 0.7

aIncludes a small number of nursing homes (less than 1 percent of this category) with an intermediate care unit for the mentally retarded.

bIncludes continuing care retirement communities and retirement centers that include independent living and/or personal care units, as well as

nursing homes that contain or are affiliated with independent living or personal care units.

Source: Center for Cost and Financing Studies, Agency for Health Care Policy and Research: Medical Expenditure Panel Survey

Nursing Home Component, 1996 (Round 1).

16
17

Table E. Standard errors of selected use data for nursing homes by selected

characteristics: United States, 1995 and 1996

Corresponds to Table 5

Facility characteristic

Admissions,

1995a

Mean

occupancy rate

for nursing

beds, 1996

Residents,

1996

Admissions per

100 nursing

beds, 1995a

Standard error

Total 0.4 105,143 11,416 5.9

Type of nursing facility

Nursing home with only nursing home bedsb 0.4 59,753 20,557 3.8

Nursing home with independent living

or personal care unitc 0.9 25,873 16,888 8.5

Hospital-based nursing home 1.9 89,835 9,085 70.0

Ownership

For profit 0.5 79,437 24,056 6.2

Independent 1.0 32,787 20,798 7.3

Part of group or chain 0.6 77,468 25,464 8.2

Nonprofit 0.7 83,168 22,051 18.4

Independent 0.8 82,808 19,428 26.1

Part of group or chain 1.4 17,492 13,410 8.4

Government 1.1 15,674 13,968 8.1

Facility certification status

Medicare and Medicaid certified 0.4 55,152 22,239 3.4

Medicare certified only — — — —

Medicaid certified only 1.0 11,362 17,533 2.8

Not federally certified — — — —

Facility size

Fewer than 75 beds 1.0 101,216 17,962 33.3

75-124 beds 0.7 44,060 24,765 4.8

125-199 beds 0.7 34,101 23,003 5.2

200 or more beds 0.9 26,274 21,546 4.7

Census region

Northeast 0.6 37,524 21,777 8.5

Midwest 0.7 69,208 19,981 11.9

South 0.7 35,164 24,047 4.3

West 0.9 78,049 16,353 25.3

Metropolitan statistical area (MSA)

MSA 0.4 107,186 25,565 8.3

Not MSA 0.7 39,677 23,722 6.0

a1996 figures will be available with the full-year data release in fall 1998.

bIncludes a small number of nursing homes (less than 1 percent of this category) with an intermediate care unit for the mentally retarded. cIncludes continuing care retirement communities and retirement centers that include independent living and/or personal care units, as well as

nursing homes that contain or are affiliated with independent living or personal care units.

Source: Center for Cost and Financing Studies, Agency for Health Care Policy and Research: Medical Expenditure Panel Survey

Nursing Home Component, 1996 (Round 1).


































































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AHCPR Pub. No. 98-0006

January 1998

U.S. Department of Health 

and Human Services

Public Health Service

Agency for Health Care Policy

and Research

2101 East Jefferson Street

Suite 501

Rockville, MD 20852

Official Business

Penalty for Private Use $300

BULK RATE

POSTAGE & FEES PAID

PHS/AHCPR

Permit No. G-282