NATIONAL CENTER Series 12 

For HEALTH STATISTICS I Number 8 

VITAL and HEALTH STATISTICS 

DATA FROM THE NATIONAL HEALTH SURVEY 

prevalence of 

Chronic Conditions 

and Impairments 

Among Residents of Nursing 

and Personal Care Homes 

United States - May - June 1964 

Statistics on specific chronicconditions and impairments, limitation of mobility, time interval since last 

saw doctor, length of stay, primary type of service, 

nurse or nurse’s aide on duty, supervisory nurse in 

nursing and personal care homes. Based on data 

collected from institutions during the period MayJune 1964. 

Washington, D. C. July 1967 

U.S. DEPARTMENT OF Public Health Service 

HEALTH, EDUCATION, AND WELFARE William H. Stewart 

John W . Gardner Surgeon General 

Secretary 

. 
Public Health Service Publication No. lOOO-Series 12-No. 8 

For sale by the Superintendent of Documents, U.S. Government Printing Office 

Washington, D.C., 20402 - Price 30 cents 
NATIONALCENTERFOR HEALTHSTATISTICS 

FORREST E. LINDER, PH.D., Director 

THEODORE D. WOOLSEY, Deputy Director 

OSWALD K. SAGEN, PH.D., Assistant Director JOT State Relations 

WALT R. SIMMONS, M.A., Statzstical Advzsor 

PHILIP S. LAWRENCE Sc.D., Planning O//icer 

ALICE M. WATERHOUSE, M.D., Mrdzcal Consultant 

JAMES E. KELLY, D.D.S., Dental Advisor 

LOUIS R. STOLCIS, M.A., Executive Officer 

DONALD GREEN, In/otmatzon O/fzcer 

DIVISION OF HEALTH RECORDS STATISTICS 

MONROEG. SIRKEN,PH.D., Director 

JOHNMONROE,M.S., Assistant Director 

ARNEB. NELSON,M. A., Chief, Vital Records Survey Branch 

PETER L. HURLEY, Chief, institutional Population Survey Branch 

COOPERATION OF THE BUREAU OF THE CENSUS 

Under the legislation establishing the National Health 

Survey, the PublicHealth Service is authorized to use, insofar 

as possible, the services or facilities of other Federal, State, 

or private agencies. 

In accordance with specifications established by the 

National Center for Health Statistics, the Bureau of the Census, under a contractual arrangement, participated in planning 

the survey and collecting the data. 

Public Health Service Publication No. 1000~Series 12.No. 8 

Library of Congress Catalog Card Number 67-60076 
CONTENTS 

Selected Findings---- _____-__- ---_-__--_-- -_-----------------_L_______ 

Source and Qualifications of Data------- -----------_-------_------------

Prevalence of Chronic Conditions and Impairments-----------------------

Sex __--_-_---------__---------------------------------------------

Age and Sex-------------------------------------------------------

Mobility Status-----------------------------------------------------

Comparison WithGeneral Population------------------------------------

Length of Stay----------------------------------------~---------------

Time Interval Since Last Saw Doctor ___---__ -__-___--__c--_--_-_------­

primary Type of Service-----------------------------------------------

Supervisory Nurse and Nurse or Nurse’s Aide on Duty--------------------

References-----------------------------------------------------------

Detailed Tables----~--------------------------------------------------

Appendix I. 

A. Technical Notes on Methods ---------_----_-----------------------

Survey De*ign--------------------------------------------------

B. General Qualifications-------------------------------------------

Appendix II. 

A. Definitions of Certain Terms Used in This Report------------------

B. Classification of Homes by Type of Service------------------------

C. Rules for Coding Chronic Conditions and Impairments--------------

D. Basic List of Diagnostic Categories Reported for Residents in 

and personal Care Homes 

Page 

1 

3 

4 

4 

4 

6 

7 

9 

9 

IO 

I1 

13 

15 

23 

23 

25 

28 

28 

29 

Nursing _________________________- --__- - 30 

Appendix 111. Forms and Questionnaires-------------------------------- 32 
IN THIS REPORT residents of nursing and personal cave homes aye 

described in terms of their health and related characteristics and ceytain health services available to them in these homes. Health and 

related characteristics of the residents include chronic conditions and 

impairments, mobility status, and length of stay in the home. Measures 

of health services include time interval since resident last saw a doctor 

in the home, primary type of service provided in the home, nuP-se OY 

nuzse’s aide on duty, and a supervisory nurse. 

At the time of the survey, the Nation’s 17,400 nursingand personal cave 

homes had an estimated 554,000 residents, 15 percent of whom weye 85 

years of age and ovey. On the average there weye 3.1 conditions per 

resident, and only 4 percent had no chronic conditions OY impairments. 

The highest prevalence rates among residents weye for the major caydiovascular conditions, vascular lesions affecting central nervous system 

and diseases of the heart. Males had higher prevalence rates than females for such chronic conditions as diseases of the heart, malignant 

neoplasms, and for most types of impairm&ts. Females had higher 

prevalence rates for diabetes mellitus, vascular lesions, advanced senility, and arthritis and rheumatism. 

Over one-third of the residents with impairments due to stroke were 

bedridden as compared with one-fourth with vascular lesions (with OY 

without mention of impairments) and one-fifth with diseases of the heart. 

The shortest median lengths of stay were for residents with malignant 

neoplasms, diabetes mellitus, and fracture of the femur (old). Only a 

small proportion of the residents had not seen a doctor since entering 

the home. 

In homes having a nurse on duty 24 hours the highest prevalence rates 

prevailed for residents with vascular lesions, diseases of the heart, advanced senility, and arthritis and rheumatism. For those with a nurse 

on duty less than 24 hours the leading conditions weye other mental disorders, diseases of the heart, hearing impairments, and vascular lesions. 

The conditions most closely related to increasingage included advanced 

senility, diseases of the heart, arthritis and rheumatism, severe visual 

impairments, aizd hearing impairments. 

SYMBOLS 

Data notavailable--------------- ____ --_- ___ 

Category notapplicable------------------ . . . 

Quantity zero-------- ____-_-_-_________ _ 

Quantity more than 0 but less thanO.OS---- 0.0 

Figure does not meet standards of 

reliability or precision----------------- * 
PREVALENCE OF 

CHRONIC CONDITIONS AND IMPAIRMENTS 

AMONG RESIDENTS OF NURSING AND 

PERSONAL CARE HOMES 

Arne B. Nelson, Division of Health Records Statistics 

SELECTED FINDINGS 

An estimated 554,000 persons were residents 

or patients of the Nation’s 17,400 nursing and 

personal care homes during the period May-June 

1964. These persons were predominantly the aged 

and chronically ill who commonly had conditions 

and impairments characteristic of advanced age 

and often had more than one condition. On the 

average there were about 3.1 conditions per resident. Only 4 percent of the residents had no chronic 

conditions. 

An appreciable proportion of the population 

75 years and over were residents of nursing and 

personal care homes (table A). About 15 percent 

of those 85 years and over and 4 percent of those 

75-84 were in these homes. There were more 

females than males in each age category except 

for those under 65. 

About two-thirds of the residents 65 years 

and over and three out of every five under 65 

were residents of homes where the primary and 

predominant type of service is nursing care. 

The conditions which affected the greatest 

number of residents were the two major cardiovascular conditions vascular lesions affecting 

central nervous system and disease of the heart. 

Males had higher prevalence rates than 

females for diseases of the heart and malignant 

neoplasms; for diseases related to the respiratory 

Table A. Selected data on residents of nursing and personal care homes, by age: United 

States, May-June 1964 ” 

I I I 

Age 

All ages-20 years and over------------------

20-64 years---------------------------------------

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

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

85 years and over--------------------------------­

'Number of Ratio of Percent 

residents females of all 

per 1,000 Pgl;OO residents 

hmn**1ation in nursing

residents care homes 

5 186 67 

1 

9 1;: :; 

212 67 

1:: 255 70 

1 
system, the digestive system, and the urinary 

system; and for most types of impairments. Some 

of the conditions for which females had higher 

prevalence rates were vascular lesions, advanced 

senility, arthritis and rheumatism, diabetes mellitus, and fracture of the femur (old). 

The conditions and impairments which were 

most closely related to increasing age were 

advanced senility, diseases of the heart, arthritis, and rheumatism, severe visual impairments 

and hearing impairments. 

The proportion of bedridden residents with 

certain conditions varied according to the severity of the disease. More than one-third of the 

residents with malignant neoplasms and more 

than one-third with impairments due to stroke 

were bedridden, while a smaller proportion 

(one-fourth) with vascular lesions, with or Bithout mention of impairments, were bedridden. A 

high proportion, one-fifth, of the residents with 

diseases of the heart was also bedridden. 

The proportion of persons who were room 

limited was uniformly high for all conditions 

shown in table B. When considering theconditions 

restricting the greatest proportion of bed-limited 

and room-limited residents, the leading condiTable B. Number and percent of specified chronic nuraing and personal care homes, by mobility status 

states, May-June 1964 

-

All Chronic conditions and resi­ impairments dents 

Major cardiovascular diseases 

Vascular lesions affecting central nervous system--------. 188,100 Diseases of the heart----------, : j

156,500 

Hypertension without mention of heBTt-------------------------. 35,100 General arteriosclerosis-------. 43,500 

Mental conditions and senility 

Advanced senility--------------. . :121,000 

Senility, not psychotic--------. 27,400 Other mental disorders---------. - :L00,700 

Other selected chronic 

conditions 

Malignant neoplasms-----J-------- 18,500 Diabetes mellitus--------------. 44,300 

Other chronic conditions of the digestive system--------------. 68,900 Arthritis and rheumatism-------. - :L22,300 

selected impairments 

VFsuel 3mpaLment: inability to read newspaper with glasses'

Hearing Fmpairmente------------

Paralysis, palsy due to strokeParalysis, palsy due to other cause*--;-----;--------------- 26,000 

Impairments, limbs, back, t-k------------------------~ 75,200 

tions were paralysis, palsy due to stroke; severe 

visual impairments; advanced senility; malignant 

neoplasms; and vascular lesions. 

In regard to length of time spent inthe home, 

residents with malignant neoplasms, diabetes 

mellitus, and fracture of the femur (old) had the 

shortest median lengths of stay. Residents with 

conditions of varying severity had exceptionally 

long lengths of stay-epilepsy, varicose veins, 

sinus and other respiratory conditions, and paralysis or palsy due to other causes. 

Only a small proportion of the residents had 

not seen a doctor since entering the home. The 

median number of months since the residents 

last saw a doctor varied by type of condition 

from about 1 to 1% months. 

There is some relationship between the type 

of service provided in the homes and the conditions 

prevalent among residents of the homes. In homes 

where the primary and predominant type of service is nursing care, four-fifths of all residents 

had vascular lesions, three-fourths had diseases 

of the heart, and four-fifths had paralysis or 

palsy due to stroke. Likewise, four-fifths of the 

residents with advanced senility were in nursing 

care homes as was a large proportion with 

conditions and impairments among residents of and other selected charabteristics: United 

Percent of residents 
malignant neoplasms, fracture of the femur (old), 

Parkinson’s disease, hemorrhoids, and speech 

impairments. 

Considerable variation existed in the proportion of residents with different conditions who 

were in homes with a registered nurse (RN) as 

nursing supervisor and those with 24-hour nursing service. In the extreme situation with regard 

to the level of nursing services, 98 percent of the 

residents with fracture of the femur (old) were 

in homes with a nurse or nurse’s aide on duty 

24 hours, and 78 percent were in homes with an 

RN supervisor. A comparatively small percent 

of residents with “other mental disorders” and 

with epilepsy were in homes with an RN supervisor 

(57 percent) or in homes with a nurse or nurse’s 

aide on duty 24 hours (83 percent). 

SOURCE AND QUALIFICATION 

OF DATA 

The data in this report are based on the 

findings of a sample survey of institutions in the 

United States which provide nursing or personal 

care to the aged and chronically ill. The survey, 

commonly referred to as Resident Places Survey-2 (RPS-2), was conducted during May and 

June 1964 by the Division of Health Records 

Statistics in cooperation with the U.S. Bureau of 

the Census. 

The scope of RPS-2 included such institutional establishments as nursing homes, homes 

for the aged, and similar types of places as well 

as geriatric hospitals. Two basic criteria for 

including an establishment in the survey were (1) 

it must routinely provide some level of nursing 

or personal care and (2) it must maintain three 

beds or more for residents or patients. Thus 

homes providing room and board only were not 

within the scope of the survey. 

RPS-2 was a multiple-purpose survey, collecting statistics about establishments, residents 

or patients domiciled in the establishments, and 

the employees. Reports have been published on 

the number and types of employees and on their 

work experience, special training, wages, and on 

chronic illness of residents as reflected by the 

number of chronic conditions and impairments.11273This report accounts for the health 

of residents as reflected by the specific chronic 

conditions and impairments reported for them 

and on health service provided them by the establishments. 

In order to interpret the statistics presented 

in this report properly, the reader should become 

familiar with the material in the appendixes. In 

Appendix I a general description of the survey, 

the sampling frame used, the sample design, and 

the survey procedures are given. Also discussed 

are imputation procedures, estimation techniques, 

and sampling variation. Tables and charts of 

standard errors are provided with illustrations 

of their use. Definitions of terms, the procedure 

for classifying establishments, and rules for diagnostic coding are shown in Appendix II. 

It is important to note that classification of 

establishments in the study is based on the type 

of service provided in the home and on the availability of nursing staff rather than on what the 

home might be called or how it is licensed by the 

State. 

Facsimiles of questionnaires and forms used 

in the survey are reproduced in Appendix III. The 

study did not include an attempt to determine the 

prevalence of all types of chronic conditions and 

impairments; rather, it was directed toward those 

thought to have special significance for the aged 

population. These conditions are listed on Cards 

D and E in Appendix III. By the use of these 

flash cards, health data were obtained from 

nurses or other respondents who were said to 

be best acquainted with the health of the residents. 

The respondent was also asked to refer to the 

available medical records. The amount of medical 

data in the records varied considerably in the 

presence or absence of medical information. However, it is not known for what proportion of homes 

records were actually used for medical information in the survey. 

Since much of this report is based on an 

analysis of certain specified chronic conditions 

and impairments, the -procedures followed in coding conditions are especially important. In general, the International Classification of Diseases4 

was used in coding conditions, supplemented by 

a special procedure for classifying impairments. 

The list of conditions and impairments used in 

the coding process appears in Appendix II. 

Most residents had one or more oftheconditions contained in the list. However, this report 

3 
does not attempt to establish relationships among 

the reported conditions although certain of the 

conditions are recognized as being more serious 

than others and as having more adverse consequences on a person’s well-being. The possibility 

exists, therefore, that with certain given conditions the person’s health might be seriously impaired regardless of the other types of illness he 

might have. This report will treat conditions 

separately and will relate individual conditions 

to other characteristics of the individual. 

PREVALENCE OF CHRONIC 

CONDITIONS ‘AND IMPAIRMENTS 

As shown in table C, cardiovascular conditions were responsible for much of the chronic 

illness among residents of nursing and personal 

care homes-more than one-third had vascular 

lesions affecting central nervous system, and 

almost three-tenths had some form of heart 

disease. A large proportion of the residents had 

mental conditions-about one-fourth had advanced 

senility, and more than one-sixth had some other 

mental disorder. Nearly one-fourth of the residents had arthritis or rheumatism. 

Impairments were a frequent result of illness 

among residents. One-eighth had paralysis or 

palsy due to stroke, and a slightly higher proTable C. Percent of resgdents in nursing and personal care homes with specified chronic conditions and impairments: United States, May-June 1964 

I 

Chronic conditions and Percent impairments 

Vascular lesions affecting central nervous system--------- 34 

Diseases of the heart-----------

Arthritis and rheumatism-------- ii 

Advanced senility--------------- Hearing impairments------------- 2; Other mental disorders---------- 18 

Impairments, limbs, back, trunk-------------------------- 14 

Other chronic conditions of the 

digestive system---------------

Visual impairment: inability 

to read newspaper with glasses- Paralysis , palsy due to stroke-­

portion had paralysis or palsy due to other causes. 

About one-fifth of the residents had hearing impairments, one-eighth had severe visual impairments, and one-tenth speech impairments. 

Sex 

Prevalence rates for chronic conditions present a contrasting picture by sex of resident. This 

was true for cardiovascular conditions (table 1). 

The prevalence rate for vascular lesions was 

higher for females than for males (350 per 1,000 

for females and 336 for males). The reverse was 

true for diseases of the heart, for which the prevalence rate was 307 per 1,000 for males and 284 

for females. The differences were not statistically significant, however. For hypertension without mention of heart the rate was higher for 

females as it was for general arteriosclerosis. 

Further evidence of contrasting patterns by 

sex are shown in the rates for mental conditions 

and senility. More females than males had advanced senility (239 per 1,000 females and 208 

per 1,000 males), and males had about the same 

rate as females for other mental disorders (166 

per 1,000 males and 168 per 1,000 females). 

Females had higher rates than males for 

arthritis and rheumatism; and higher rates also 

prevailed among females for such conditions as 

diabetes mellitus, chronic diseases of the eye, 

and fracture of the femur (old). 

Rates for males were higher for asthma, 

bronchitis and emphysema, ulcer of stomach and 

duodenum, and hernia of abdominal cavity. With 

the exception of severe visual impairments and 

impairments of the limbs, back, and trunk, males 

had higher rates for the differenttypesofimpairments but not significantly higher in every 

instance. 

Age and Sex 

The prevalence of some conditions increased 

with age while others showed a varying relationship to age (table 1 and fig. 1). Principal chronic 

conditions showing an increasing rate by age 

were advanced senility, diseases of the heart, 

general arteriosclerosis, and arthritis and rheumatism. Severe visual impairments and hearing 

impairments were similarly related to increasing 

age. Conditions and impairments inversely related 

4 
RATE BER 1,000 RESIDENTS RATE PER 1,000 RESIDENTS 

I I I 1 AGE 

42.6 0 30.5 100 200 300 400 Al--~~,‘~lyo “,:;; ” ‘PO 40 

14.0 

30.0 

65-74 P-l 33.1 

Years,.,,. ,I;, ,_- 34.6 

467 

32.6 

5 0.0 47.4 

25.4 54.1 

Malignant Neoplasms Diabetes Mellitus 

I 1 f I I I I I I 

All 

ages..... 

Under 

65 years 

65-74 

yews... 

75-64 

yews 

8Syears 

.I and over 1 

Advanced Senility Vascular Lerionrr Affecting Central Nervous System 

I I I I I I I I I 

All 

age*..... 1 

65-74 

Y.SWS... 

65 yews

and over 

Dlteosss of the Heart Arthritis and Rheumatism 

Figure I. Nimber of residents in nursing and personal care homes per 1,000 population with specified 

chronic conditions and impairments, by sex and age. 

268-3750 - 67 - 2 5 
to age included other mental diso.raers, epilepsy, 

speech impairments, and paralysis or palsy due 

to other causes. 

Variable relationships to age existed for 

other conditions. The prevalence rate for diabetes 

reached a peak at ages 65-74 and then declined 

at each succeeding age group. For vascular 

lesions the prevalence rate was lowest for ages 

under 65 years and highest (rates of about an 

equal magnitude) for ages 65 and over. This is 

in contrast with paralysis or palsy due to stroke, 

for which the rate was highest at ages 65-74 and 

lowest at ages 85 and over. 

Generally, the agepatterns for specific conditions were similar for both males and females, 

but there were some differences. For malignant 

neoplasms there was an increasing rate by age 

for males and not for females. For diabetesmellitus the general pattern by age and sex was 

similar, but the greatest difference by sex was 

at age group under 65years. For chronic diseases 

of the eye there was more of a relationship to 

age for females than for males. For herniaof the 

abdominal cavity there was an increasing rate by 

age for males and females but to a lesser extent 

for females. For diseases of the urinary svstem 

there was a close relationship by age for males 

but not for females. 

For certain conditions where the rate differed by sex the differences by age were not 

consistent. For example, the female rate for 

malignant neoplasms wes higher than the male 

rate at ages under 65, .Id the rates were about 

the same at ages 65-74. The male rate for 

vascular lesions was higher in the middle-aged 

groups even though the total rate was higher for 

females. Similar differences in certain age groups 

also characterized males and females with general 

arteriosclerosis, other diseases of the digestive 

system, diseases of the urinary system, speech 

and hearing impairments, and paralysis or palsy 

due to stroke. 

Mobility Status 

The respondent was asked the following 

questions about the resident’s mobility status: 

“Does he stay in bed most of the day?“; “Does 

he stay in his own room all or most of the day?“; 

and “Does he go off the premises just to walk, 

shop, or visit with friends or relatives and so 

forth?” The residents for whom “yes” was checked 

for the question, “Does he stay in bedall or most 

of the day?” are defined in this report as being 

bed limited. Those for whom “yes” was checked 

for “Does he stay in his room all or most of the 

day?” are defined as being room limited. The 

remaining residents for whom “yes” or “no” 

was checked for “Does he go off the premises 

just to walk, shop, or visit with friends or relatives 

and so forth?” are defined as being neither bed 

nor room limited. Residents who were routinely 

taken out of the room in a wheelchair for most 

of the day were considered as being neither bed 

nor room limited and were therefore included 

as a part of this last group. 

Pronounced mobility restriction existed 

among residents with a number of conditions having widespread prevalence and also conditions of 

lesser magnitude; this was true of the principal 

cardiovascular diseases-vascular lesions and 

diseases of the heart (table 2). It likewise characterized advanced senility and such impairments 

as those related to hearing disability, speechloss, 

and particularly paralysis or palsy due to stroke. 

The rate for bed-limited residents with vascular 

lesions was considerably higher than the rate for 

room-limited residents and was almost twice that 

of residents not limited to room or bed. Again, for 

diseases of the heart a somewhat similar pattern 

existed with the prevalence rate being nearly 1% 

times the rate for those who were not limited. 

For advanced senility the prevalence rate for 

bedridden residents was double the rate for those 

not restricted to bed or room. Arthritis and 

rheumatism differed in that the prevalence rate 

for room-limited residents was above that for 

those who were bed limited. Other conditions 

that were similar to arthritis and rheumatism 

in mobility restriction were ulcer of the stomach 

and duodenum and chronic diseases of the eye. 

Conditions for which there was a large proportion of bed-limited residents without increased 

room limitation were malignant neoplasms and 

absence of major extremities (fig. 2). 

For other conditions the relationship to 

mobility was not clear-cut, and for some there 

was an inverse relationship. Conditions for which 

there were increasing prevalence rates with 

higher mobility were hypertension without mention 

of heart, general arteriosclerosis, varicose veins, 

and other visual impairments. 

6 
RATE PER 1.000 RESIDENTS RATE PER 1,000 RESIDENTS 

0 100 200 300 400 0 100 200 300 401 

MOBILITY 

%+Th+# STATUS 

Bed Bed 

limitation limitation 

Room Room limitation 25.6 limitation 

Neither Neither 

limitation 25.4 limitation 

Malignant Neoplarmr 

Bed Bed 

limitation limitation 

Room Room 

limitation IImitation 

Naithar 

IimitatIon 

Advanced Senility 

Bed Bed 

limitation limltation 

Room Room 

IImItation limitation 

Diseases of ihs Heart 

Bed 

limltation 

Room Room 

limitation limltot~on 

Nel ther 

llmltatlon 

Paralysis, Palsy Due to Strake 

Diabetes Mellitus 

Vascular Lesions Affecting Central Nervous System 

Arthritis and Rheumatism 

Impairments, Limbs, Back,Trunk 

Figure 2. Number of residents in nursing and personal care homes per 1,000 population with specified 

chronic conditions and impairments, by mobility status. 

COMPARISON W ITH GENERAL 

POPULATION 

Data on the distribution of chronic conditions 

and impairments among the aged in the general 

civilian, noninstitutional population have been 

available for some time through the National 

Health Survey.5t6 These data were collected 

through household interviews and described persons in terms of their ma jor activity limitation 

(ability to work, keep house). Although there are 

different sources of measurement error in the two 

surveys, individual comparisons of specific conditions do give a rough indication of differences in 

7 
43:9 

Table D. A comparison of the prevalence with limitation of major activity1 in 

among residents of nursing and personal United States 

Chronic conditions and impairments 

Malignant neoplasms--------------------

Diabetes mellitus----------------------

Mental and nervous conditions----------

Vascular lesions affecting central 

nervous system------------------------

Diseases of the heart------------------

Hypertension without mention of heart-­

Ulcer of stomach and duodenum----------

Hernia of abdominal cavity------------- Other chronic conditions of the 

digestive system----------------------

Conditions of genitourinary system----- Arthritis and rheumatism---------------

Visual impairment: inability to read 

newspaper with glasses----------------

Hearing impairments--------------------

Paralysis, palsy due to stroke---------

Orthopedic impairments----------------­

of selected chronic conditions among persons the civilian, noninstitutional population and 

care homes, for persons 65 years and over:

- Limited persons in 13esidents of nursing civilian, noninstitu- and personal tional population 1 care homes 

Number in Prevalence Wnber in Prevalence 

per 100 per 100 thousands population thousands population 

194 2.9 

252 

t5'; 1;:: 

484 36.0 

1,926

1,128 

2E 

16:6 

30.5 

4.6 

254 3.7 

593 8.7 i:: 

1,108

867 

16.3 

12.7 

13.5 

2,781 40.9 2;:; 

1,534

2,002 

354 

22.5 

29.4 

19.1 

20.3 

15.7 

1,669 2::; 15.1 

IThese estimates were derived from data collected in the Health Interview Survey

during the period July 1961-June 1963. Major activity refers to ability to work or 

keep house. 

NOTE: Prevalence rates are based on 6,803,OOO limited persons 65 years and over in 

the civilian, noninstitutional population and on 488,000 residents of nursing and per­ sonal care homes 65 years and over during May-June 1964. 

the distribution of disabling conditions in the 

institutional and noninstitutional population. In 

the Health Interview. Survey the questions were 

somewhat more thorough, possibly because household members were the respondents. For example, the respondent was asked if anyone in 

the family had any of a list of selected conditions during the past 12 months. This type of 

probing possibly re$ulted in more complete 

reporting in the household than in nursing and 

personal care homes. 

Residents 65 years of age andoverinnursing 

and personal care homes were generally sicker 

than persons who were restricted in their major 

activity in the general population as shown by 

the comparisons of prevalence rates for selected 

conditions in table D. Although the definitions of 

chronic limitation differ for the two surveys, the 

fact that 96 percent of the residents had one condition or more and that about 45 percentofthese 

were bed or room limited is evidence that this 

population would generally meettherequirements 

for the distribution of persons classified as 

limited in their major activity. 

The prevalence rate among residents was 

five times that of nonresidents for vascular lesions 

and three times that for paralysis, palsy due to 

stroke. Mental and nervous conditions were likewise of much higher prevalence in nursing and 

personal care homes. Prevalence rates were 

slightly higher for malignant neoplasms, diabetes 

mellitus , and heart conditions. 
Higher rates prevailed among the general 

population for the balance of the conditions. The 

greatest difference was represented by much 

higher rates for high blood pressure and hernia. 

Substantial differences also existed for arthritis 

and rheumatism, peptic ulcer, hearing impairmerits, and orthopedic impairments. 

LENGTH OF STAY 

Residents with such conditions as malignant 

neoplasms , diabetes mellitus, and fracture of the 

femur (old) had a relatively short median length 

of stay of about 1% years (table 3). Likewise, 

residents with diseases of the heart, ulcer of 

stomach and duodenum, diseases of urinary 

system, diseases of prostate and other male 

genital organs, paralysis or palsy due to stroke, 

and absenceof major extremities had short median 

PERCENT DISTRIBUTION 

0 20 40 60 80 100 

I I I I I I 

All rsridento.,w..w 

NC conditions or impa*mmtsMalipnont 

nsoplosmlr-.-

Vascular lesIona affsctlnp central narvcu~ systemDia*arrr of 

heart-­

Arthritis and 

rhsumotlsm _I 

Parelyrls. palsy 

due to stroke 

Impairments. 

limbs, back,trunk. 

LENGTH OF STAY 

Under 

6 months m 2-4 yews 

m 6-11 months 

M l-2 years 

Figure 3. Percent distribution of residents in 

nursing and personal care homes, by specified 

chronic conditions and impairments according to 

length of stay. 

lengths of stay. In contrast, residents with no 

reported conditions and some with certain minor 

conditions had long lengths of stay. This possibly 

reflects the influence of a longer life span on 

length of stay. 

In terms of the actual length of stay, more 

than one-fourth of the residents with the following 

conditions had lengths of stay under 6 months: 

malignant neoplasms, diseases of the prostate 

and other male genital organs, and fracture of 

the femur (old) (table 3 and fig. 3). About onefourth of the residents with the following conditions 

had lengths of stay of 5 years or more: epilepsy, 

varicose veins, sinus and other respiratory conditions, and paralysis or palsy due to other causes. 

A comparison of the lengths of stay for 

residents with vascular lesions, advanced senility, 

and arthritis and rheumatism illustrates some of 

the differences in periods of stay. A slightly 

higher median length of stay was indicated for 

those with arthritis and rheumatism (2.1 years) 

than for those with vascular lesions (1.8 years) 

or advanced senility (1.8 years). Aroundone-third 

of residents with vascular lesions and advanced 

senility had a length of stay of less than 1 year 

as compared with 28 percent of those with arthritis and rheumatism. At the other end of the scale 

16 percent of the residents with vascular lesions 

or advanced senility had lengths of stay of 5 years 

or more compared with 21 percent of the residents 

with arthritis and rheumatism. 

TIME INTERVAL SINCE LAST 

SAW DOCTOR 

A small proportion of the residents with 

chronic conditions and impairments had not seen 

a doctor since entering a home (table4 and fig. 4). 

This ranged from 1 percent of the residents with 

bronchitis and emphysema to 5 percent of those 

with “other mental disorders.” In direct Contrast, 

almost one-fifth of the residents with no reported 

conditions had not seen a doctor. 

Over one-half of the residents with neoplasms, either malignant or benign, had seen 

a doctor within the past month. This was also true 

for residents who were impaired due to absence 

of major extremities. Between 45 and 50 percent 

of the residents with the following conditions had 

seen a doctor during the past month: diabetes 

mellitus, diseases of the heart, Parkinson’s 

9 
PERCENT DISTRIBUTION 

0 20 40 60 60 101I 

I I I I I I 

All residents ,.,..___._. 

No conditions or 

impairments __._... 

Arthritis and rheumallsm .,,,_... ^ 

Parelysis. palsy

due to stroke . ..._. 

Impairments. 

limbs, back. trunk 

INTERVAL SINCE LAST SAW DOCTOR 

Figure 4. Percent distribution of residents in 

nursing and personal care homes, by time interval since last saw a doctor in the home according to specified chronic conditions and impairments. 

disease, bronchitis and emphysema, sinus and 

other respiratory conditions, diseases of the 

urinary system, fracture of the femur (old) and 

paralysis or palsy due to other causes. 

When those residents who had seen a doctor 

in a 3-month period (which includes the above 

residents), a high proportion of residents had seen 

a doctor during this time period. Leading were 

residents with ma lignant neoplasms (87 percent), 

benign and unspecified neoplasms (85 percent), 

fracture of the femur (old) (85 percent), varicose 

veins (84 percent), diseases of the heart (83 percent), and absence, ma jor extremities (83 percent). 

A high proportion of residents with senility 

and mental conditions had not seen a doctor for 

an extended period of time, varying from 6-11 

months to 1 year or more. These included residents with advanced senility (9 percent), senility, 

not psychotic (10 percent), and other mental disorders (13 percent). Other conditions in this 

category were epilepsy (12 percent), hypertension 

without mention of heart (12 percent), sinus and 

other respiratory conditions (11 percent), and 

certain impairments. 

PRIMARY TYPE OF SERVICE 

Residents in nursing care homes had much 

higher prevalence rates than those in personalcare-with-nursing homes or personal carehomes 

for the following conditions: ma lignant neoplasms, 

advanced senility, vascular lesions, diseases of 

urinary system, fracture of the femur (old), and 

paralysis or palsy due to stroke (table 5). 

The conditions for which the prevalence rates 

for residents in personal-care-with-nursing 

homes exceeded those for residents in nursing 

care homes or personal care homes were: 

benign and unspecified neoplasms and chronic 

diseases of the eye. 

For some of the conditions rates were about 

the same for residents of nursing care homes 

and personal-care-with-nursing homes. These 

conditions were epilepsy, chronic diseases of the 

eye, sinus and other respiratory conditions, 

arthritis and rheumatism, other visual impairments. 

The only condition for which the prevalence 

rate was higher for residents in personal care 

homes than for those in other types of homes 

was other mental disorders. 

Table E shows the conditions and impairments affecting the greatest number of residents 

in nursing and personal care homes. The prevalence rates for all conditions listed in this table 

except other mental disorders were higher for 

residents in nursing care homes. It was slightly 

higher for arthritis and rheumatism for residents in nursing than in personal-care-with-nursing homes. When compared with personal care 

homes, the picture is the same for personal-carewith-nursing homes except for higher rates inpersonal care homes for residents with other mental 

10 
Table E, Number of persons with specified chronic conditions and impairments among residents of nursing and personal care homes per 1,000 residents, by primary type of 

service: United StaEes, May-June 1964 

Chronic conditions and impairments 

Vascular lesions affecting central nervous 

system -------------------_______________^__ 

Diseases of the heart-----------------------

Arthritis and rheumatism--------------------

Advanced senility--------------------------- Hearing impairments------------------------- Other mental disorders----------------------

Impairments, limbs, back, trunk-------------

Other chronic conditions of the digestive 

system -------_L--------------"-------------

Visual impairment: inability to read 

newspaper with glasses---------------------

Paralysis, palsy due to stroke--------------

Rate per 1,000 residents 

340 408 214 132 

283 II 319 221 146 

221 229 219 

218 267 123 52 

188 162 

E 203 467: 

11% 149 116 81 

105 64 

106 

77 

L 

disorders and hearing impairments. An almost 

equal number of residents in personal-care-withnursing homes had vascular lesions, diseases of 

the heart, arthritis and rheumatism, and other 

mental disorders. In contrast, the highest prevalence rates within personal care homes were for 

residents with other mental disorders. This was 

followed in order by hearing impairments, diseases of the heart, arthritis and rheumatism, 

and vascular lesions. 

SUPERVISORY NURSE AND NURSE 

OR NURSE’S AIDE ON DUTY 

The questions were asked in the survey “Is 

the person who supervises nursing care a registered professional nurse, a licensed practical 

nurse, or someone else?” And “Is there a nurse 

or nurse’s aide on duty 24 hours?” In homes that 

had a nurse or nurse’s aide on duty 24 hours and 

also had an RN supervisor, moderately higher 

prevalence rates prevailed for residents with 

malignant neoplasms, asthma, diabetes mellitus, 

Parkinson’s disease, chronic diseases of the eye, 

hypertension without mention of heart, general 

arteriosclerosis, varicose veins, bronchitis and 

emphysema, fracture of the femur (old), and 

absence, major extremities (table 6). 

For homes with an LPN supervisor higher 

prevalence rates existed for residents with advanced senility, vascular lesions, epilepsy, ulcer 

of stomach and duodenum, diseases of the urinary 

system, and most types of impairments. Prevalence rates for diseases of the heart and impairments of limbs, back, and trunk were about the 

same among residents in homes with an RN 

supervisor and in homes with an LPN supervisor. In homes where the supervisor was a 

nurse’s aide prevalence rates were higher among 

residents with benign or unspecified neoplasms; 

senility, not psychotic; other mental disorders; 

and arthritis and rheumatism. These differences 

were all moderate. 

In regard to conditions of highest prevalence, 

the pattern among residents of homes with a 

nurse or nurse’s aide on duty less than 24 hours 

was not clearly defined. Generally speaking, the 

rates were more variable and not entirely consistent with those for residents in homes with a 

nurse or nurse’s aide on duty 24 hours. This 

was due in part to the smaller frequencies. The 

prevalence rates were generally lower for residents in homes with no nurse or nurse’s aide on 

duty. The one condition for which the rate was 

higher in homes where nursing care was not provided was hypertension without mention of heart. 

11 
The distribution of conditions with the highest overall frequencies among residents in homes 

with a nurse or nurse’s aide on duty and an RN 

or LPN supervisor indicates some contrasts in 

the types of conditions prevalent among patients 

cared for by the different nursing staffs (table 

F). Residents in homes not providing nursing 

care were excluded from this table, and this 

exclusion affects the comparison of individual 

rates with the overall rates. 

In homes having a nurse on duty 24 hours, 

as compared with those having a nurse on duty 

less than 24 hours, more residents had vascular 

lesions; arthritis and rheumatism; advanced senility; other chronic conditions of the digestive 

system; impairments of limbs, back, and trunk; 

paralysis or palsy due to stroke; and diseases 

of the heart. The difference in prevalence rates 

was not as great for diseases of the heart and 

impairments of limbs, back, and trunk as for the 

other conditions. The conditions with the highest 

prevalence rates in homes having a nurse or 

nurse’s aide on duty less than 24 hours were 

other mental disorders (289); diseases of the 

heart (238); and hearing impairments, all types 

(182). 

The prevalence rates in homes with an RN 

or LPN in charge of nursing care were generally 

of the same magnitude. The greatest differences 

were the higher rates for other mental disorders 

and severe visual impairments among residents 

in homes that had an LPN supervisor. The rates 

for diseases of the heart, hearing impairments, 

and impairments of limbs, back, and trunk were 

about the same. Except for arthritis and rheumatism, moderately higher rates prevailed for 

most conditions among residents in homes having 

an LPN in charge. 

Table F. Number of specified chronic conditions and impairments per 1,000 residents of 

nursing and personal care homes, by nurse or nurse’s aide on duty and supervisory 

nurse: United States, May-June 1964 

Chronic conditions and impairments 

Rate per 1,000 residents 

Vascular lesions affecting central nervous 

system----------------------------------------- 340 364 170 361 370 Diseases of the heart--------------------------- 283 295 238 300 293 Arthritis and,rheumatism------------------------ 221 231 143 232 212

Advanced senility------------------------------- 218 233 124 226 252 

Hearing impairments ----c------------------------ 188 189 182 192 201

Other mental disorders ---------_---------------- 182 289 215 

Impairments, limbs, back, trunk----------------- 136 :z10 117 111”; 142 

Other chronic conditions of the digestive system----------------------------------------- 124 132 75 128 140 

Visual impairment: inability to read 

newspaper with glasses------------------------- 121 123 151 115 

Paralysis, palsy due to stroke------------------ 120 129 72 124 :zz 

12 
REFERENCES 

INational Center for Health Statistics: Employees in nursing and personal care homes. Vital and Health Statistics. PHS 

Pub. No. 1000~Series 1%No. 5. Public Health Service. Washington. U.S. Government Printing Office, Sept. 1966. 

‘National Center for Health Statistics: Employees in nursing and personal care homes: number, work experience, special 

training, and wages. Vital and Health Statistics. PHS Pub. 

No. lOOO-Series 1%No. 6. Public HealthService. Washington. 

U.S. Government Printing Office, Jan. 1967. 

3National Center for Health Statistics: Chronic illness 

among residents of nursing and personal care homes. Vital c 

and Health Statistics. PHS Pub. No. 1000Series 1%No. 7. 

Public Health Service. Washington. U.S. GovernmentPrinting 

Office, Mar. 1967. 

4World Health Organization: Manual of the International 

Statistical G’lassification of Diseases, Injuries, and Causes 

of Death, Based on the Recommendations of the Seventh Re -

vision Conference, 1955, Vol. 1. Geneva, Switzerland. 1957. 

.5U.S. National Health Survey: Chronic conditions causing 

limitation of activities. Health Statistics. PHS Pub. No. 584 

000 

B36. Public Health Service. Washington. U.S. Government 

Printing Office. Oct. 1962. 

6~National Center for Health Statistics: Chronic conditions 

and activity limitation. Vital and Health Statistics. PHS Pub. 

No. lOOO-Series IO-No. 17. Public Health Service. Washington. 

U.S. Government Printing Office, May 1965. 

7National Center for Health Statistics: Development and 

maintenance of a national inventory of hospitals and institutions. Vital and Health Statistics. PHS Pub. No. IOOO-Series 

l-No. 3. Public Health Service. Washington. U.S. Government Printing Office, Feb. 1965. 

%ational Center for Health Statistics: Orgin, program, and 

operation of the U.S. National Health Survey. Vital and Health 

Statistics. PHS Pub. No. 1000Series l-No. 1. Public Health 

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

1963. 

gNational Center for Health Statistics: Medical Coding 

,UanuaZ and the Short Index. NHS-HIS- 1000, FY 1965. Public 

Health Service, Washington, D.C. July 1964. 

268-375 0 - 61 - 3 13 

1 
DETAILED TABLES 

Page 

Table 1. Number of residents and number of specified chronic conditions and impairments 

per 1,000 residents of nursing and personal care homes, by sex and age: United 

States, May-June 1964----------------------------------------------------------- 16 

2. Number of residents and number of specified chronic conditions and impairments 

per 1,000 residents of nursing and personal care homes,by mobility status:United 

States, May-June 1964------------------------------------------------------------ 18 

3. Number and percent distribution of residents of nursing and personal care homes, 

by length of stay accordin to specified chronic conditions and impairments:

United States, May-June 196 8 _-----_--------_------------------------------------ 19 

4. Number and percent distribution of residents of nursing and personal care homes,

by time interval since last saw doctorinthe home according to specified chronic 

conditions and impairments: United States, May-June 1964------------------------ 20 

5. Number of residents and number of specified chronic conditions and impairments 

per 1,000 residentsofnursing and personal care homes,by primary type ofservice: 

United States, May-June 1964---------------------------------------------------- 21 

6. Number of residents and number of specified chronic conditions and impairments 

per 1,000 residents of nursing and personal care homes, by nurse or nurse's aide 

on duty and supervisory nurse: United States, May-June 1964--------------------- 22 

15 
Table 1. Number of residents and number'of specified chronic conditions and impairmentsti,per 1,000

residents of nursing and personal care homes, by sex and age: United States, May-June 1964 

Both sexes 

Chronic conditions and impairments 

All 85 years ages' and over 

Number of residents 

All residents-------------------------- 554,00011 66,200( 104,500j 230,9001 152,400 

Hate per 1,000 residents 

Malignant neoplasms-------------------------- 33.3 34.0 37.1 32.4 

Benign and unspecified neoplasms------------- 12.3 :2’-0’ 10.6 13.3 12.2 Asthma--------------------------------------- 29.7 30:4 31.2 28.1 31.0 Diabetes mellitus---------------------------- 80.0 66.9 109.8 88.2 52.7 Advanced senility---------------------------- 218.4 41.0 145.0 241.1 311.3 

Senility, not psychotic---------------------- 49.5 13.8 41.3 55.0 62.4 Other mental disorders----------------------- 181.9 473.5 244.1 131.8 88.5 

system--------------------------------------

Parkinson's disease ------------------^-___^__ 339.5 

22.6 

187.8 

33.9 

351.2 

31.1 

362.4 

22.7 

362.7 

11.7 

Epilepsy------------------------------------- 21.1 83.1 30.2 10.5 4.1 

Chronic diseases of the eye------------------ Diseases of the heart------------------------

Hypertension without mention of heart--------

General arteriosclerosis---------------------

Varicose veins-------------------------------

62.5 

2:5* !G 

7815 

32.0 

32.7 

117.0 

40.1 

23.9 

21.2 

48.5 

238.1 

63.7 

58;3 

28.1 

65.5 

313.1 

71.2 

83.6 

37.1 

80.3 336E 

108:5 

31.7 

Hemorrhoids----------------------------------

Bronchitis and emphysema---------------------

38.2 

2% %i 

38.3 

36.9 E 

Sinus and other respiratory conditions-------

Ulcer of stomach and duodenum----------------

E?z 

17:6 

27:5 

18.5 

20:8 

15.7 

17.2 

18.9 

1814 

16.7 

Hernia of abdominal cavity------------------- 35.5 26.7 26.3 38.9 40.3 

Other chronic conditions of the digestive system-------------------------------------- 124.4 97.8 107.6 120.4 153.5 

Vascular lesions affecting central nervous 

Diseases of urinary system------------------- 58.2 50.0 58.0 58.2 62.0 

genital organs------------------------------

Arthritis and rheun?atism---------------------

Fracture, femur (old)------------------------

95.2 

220.8 

31.1 

25.0 

104.1 

4.0 

77.1 

w- . 

All other chronic conditions----------------- 148.7 186.9 170.9 138.3 132.4 

Visual impairment: inability to read newspaper with glasses---------------------- 59.3 87.5 '113.5 180.5 Other visual impairments--------------------- % : 44.1 71.6 60.8 

Hearing impairments--------------------------

Speech impairments, all types----------------

18716 

98.6 “;z 

zoo:3 

103.5 

129.5 

176.1 

85.0 

312.2 

53.8 

Diseases of prostate and other male 

Paralysis, palsy due to stroke--------------- 120.3 118.1 176.3 

Paralysis, palsy due to other causes--------- 46.9 124.2 50.3 l:?4 xi 

Absence, major extremities------------------- 20.9 28.5 32.2 19:1 12:5 

Impairments, limbs, back, trunk-------------- 135.8 113.5 133.5 161.7 All other ~mpairmehts------------------------ 13.7 %*i . 15.7 13.8 10.9 

IMale rates are adjusted to age distribution of females in nursing and personal care homes, 'except for diseases of prostate and other male genital organs. 

16 
85 years 

Table 1. Number of residents and number of specified chronic conditions and impairments per 1,000

residents of nursing and personal carehomes, by sexand age: United States,May-June 1964-Con. 

Male Female 

All ages1 65 65

Under 65-74 75-84 and over All Under 65-74 75-84 85 years 

years years years ages years years years and over 

Number of residents 

193,800 11 36,200 1 40,4001 74,lOOl 43,100 1360,200 11 30,000 1 64,000 1156,800 I 109,300 

Rate per 1,000 residents 

42.6 14.0 33.1 50.0 30.5 32.6 25.4 13.4 19.9 10.6 11.7 4:-i 3t-; 13.2 12.8 38.6 339'1 31.0 25.0 26:9 2217 21.3 30.9 

208.0 28.9 130:8 271.2 238.6 55.6 154.0 246.4 327.0 

47.8 

165.6 46;:; 

44.0 

261.8 

54.6 

123.3 

51.2 

88.8 

53.0 

167.9 

20.2 

487.4 

39.5 

232.9 

55.2 

135.8 

66.8 

88.4 

335.6 

20.2 

18.5 

176.1 

28.1 

71.7 

357.5

;2: 

368.1 

';*i . 

20.0 

10.7 

6.0 

350.4 

23.1 

18.5 

201.9 

40.9 

96.8 

347.3 

35.8 

25.3 

359.7 

22.2 

11.3 

379.5 

12.1 

53.2 

307.3 

51.8 

36.1 

119.5 

35.2 

39.3 

238.0 

41.9 

59.7 

32* : 

56.8 

374.3 

47.8 

68.9 

284.3 

70.7 

28.5 

114.0 

46.1 

54.3 

238.2 

77.4 

68.3 

307.6 

75.6 

89.5 

324.6 

66.4 

67.4 48:5 2: 47.4 86.6 89.1 119.7 94.9 54.7 

. 

19.8 67.3 89:O 119.7 118.6 28.7 52.5 81.0 104.1 2;. 29.5 38.8 43.5 33.4 29.0 11.3 21.4 34.1 31.0 

36.0 29.0 30.0 34.0 44.2 25.0 31.8 40.3 49.0 67.9 82.3 56.5 65.9 73.6 440’92 24.1 24.3 23.3 27.7 30.6 20.2 21.8 20.7 17:6 23.7 21.2 15.0 17.5 . fk*Z 24.0 22.8 30.2 30.8 12.3 11.8 11.1 13.6 11.1 72:0 43.3 48.3 77.4 85.9 18.6 6.6 12.4 20.7 22.4 

110.9 

65.9 FE*: . 73.0 

56.3 

22.4 

69.0 

123.9 

74.9 

134.6 

56.3 

113.8 

64.6 

129.4 

59.0 

119.5 

53.0 

165.1 

57.0 

95.2 

Yf* . 2 

25.0 

90.8 

2.9 

77.1 

121.1 

17.5 

110.0 

182.5 

19.1 

103.7 

229.3 

32.6 

. . . 251.9 

37.7 

. . . 120.1 

5.4 

. . . 214.6 

30.7 

. . . 

2:E . 

. . . 

22: . 

140.2 177.3 177.7 129.7 123.2 149.5 198.5 166.6 142.4 136.1 

118.2 

63.3 

219.7 

105.2 

51.2 

:97*2 

195:3 

79.3 

42.2 

125.7 

171.7 

113.4 

78.7 

195.2 

102.0 

166.2 

57.8 

351.0 

46.1 

128.1 

60.1 

185.3 

86.2 

69.1 

41.6 

77.7 

206.4 

92.6 

45.4 

89.5 

102.8 

113.5 

68.2 

167.1 

77.0 

22.4 115.8 183.0 72.1 116.6 120.8 172.0 111.1

45.8 128.0 w 24.4 41.7 119.5 48.1

32.5 42.4 29:8 31.2 13.8 11.8 29.2 ME 130.8 134.2 140.9 132.5 117.3 133:2 22.9 ‘2; . 20.4 ‘E . 9.1 16.3 9.5 10.6 

17 

3.3 
Table 2. Number of residents and number of specified chronic conditions and impairments per 1,000

residents of nursing and personal care homes, by mobility status: United States, May-June 1964 

Mobility status 

Chronic conditions and impairments Total 

Malignant neoplasms------------------------------------------

Benign and unspecified neoplasms-----i-----------------------

Asthma-------------------------------------------------------

Diabetes mellitus--------------------------------------------

Advanced senility--------------------------------------------

Senility, not psychotic--------------------------------------

Other mental disorders---------------------------------------

Vascular lesions affecting central nervous system------------

Parkinson's disease------------------------------------------

Epilepsy-----------------------------------------------------

Chronic diseases of i-he eye----------------------------------

Diseases of j-he heart----------------------------------------

Hypertension without mention of heart------------------------

General arteriosclerosis------------------------------------­

varicose veins-----------------------------------------------

Hemorrhoids--------------------------------------------------

Bronchitis and emphysema-------------------------------------

Sinus and other respiratory conditions-----------------------

Ulcer of stomach and duodenum--------------------------------

Hernia of abdominal cavity-----------------------------------

Other chronic conditions of the digestive system-------------

Diseases of m-nary system-----------------------------------

Diseases of prostate and other male genital organs-----------

Arthritis and rheumatism--- __-----__----___-__---------------

Fracture, femur (old)----------------------------------------

All other chronic conditions---------------------------------

Visual impairment: inability to read newspaper dth glasses--------------------------------------

Other visual impairments-------------------------------------

Hearing impairments------------------------------------------

Speech impairment-, all types-------------------------------­

paralysis, palsy due to stroke-------------------------------

Paralysis , palsy due to other causes-------------------------

Absence, major extremities-----------------------------------

Impairments, limbs, back, trunk------------------------------

All other impairments---------------------------------------­

w 

Number of residents 

554,000~~92,200 1 llb,900 1 344,900 

Rate per 1,000 residents 

33.3 72.7 25.6 25.4 

12.3 16.8 15.5 10.1 

29.7 32.9 32.7 27.9 

80.0 84.8 74.8 80.4 

218.4 329.3 292.1 163.7 

49.5 41.2 49.6 51.7 

181.9 160.8 147.8 199.1 

339.5 522.7 400.4 269.9 

22.6 31.2 26.8 18.9 , 

21.1 22.3 17.7 22.0 

62.5 56.3 66.8 62.6 

282.6 357.4 312.8 252.3 

63.3 30.2 58.0 73.9 

78.5 55.4 79.4 84.4 

32.0 25.2 31.7 34.0 

38.2 47.6 44.3 33.6 * 

40.2 38.0 39.7 41.0 

19.4 19.5 19.1 19.5 ; 

17.6 14.2 21.2 17.3 

35.5 31.7 37.2 35.9 

124.4 175.3 137.7 106.3 

58.2 109.2 57.8 44.7 

30.0 39.8 31.3 27.0 

220.8 256.3 272.5 193.8 

31.1 50.7 39.7 22.9 

148.7 187.2 159.2 134.8 

120.5 199.8 166.1 83.9 

60.2 47.1 59.5 64.0 

187.6 222.2 226.0 165.3 

98.6 172.7 107.4 75.8 

120.3 249.7 126.4 83.6 

46.9 73.6 46.6 39.8 

20.9 27.1 19.5 19.6 

135.8 170.5 173.3 113.8 

13.7 18.1 12.3 12.9 

18 
Table 3. Number and percent distribution of residents of nursing and personal care homes, by length of 

stay according to specified chronic 

-

conditions and impairments: United States, May-June 1964 

-

Length of stay Number 

of 3edian Chronic conditions and impairments resi- All 6 

1 

dents lengths Under 6-11 1 2 3-4 5 years years 

of stay months months year years years or more 

Percent distribution 

All residents----------------- 554,ooc 100.0 19.2 14.0 20.4 13.7 14.9 17.7 I 1.8 

Malignant neoplasms----------------- 18,5OC 100.0 26.8 14.0 18.8 11.5 14.4 14.4 1.5 

Benign and unspecified neoplasms---- 6,800 100.0 19.6 11.7 21.0 12.0 17.0 18.7 1.9 

Asthma------------------------------ 16,500 100.0 13.3 15.6 18.7 18.7 14.4 19.2 2.1 

Diabetes mellitus------------------- 44,300 100.0 21.5 17.1 22.2 13.4 12.8 13.0 1.5 

Advanced senility------------------- 121,000 100.0 18.6 14.6 20.8 14.5' 15.3 16.2 1.8 

Senility, not psychotic------------- 27,400 100.0 17.1 14.7 21.7 15.0 17.9 13.6 1.8 

Other mental disorders-------------- ~00,700 100.0 17.1 13.6 22.3 13.3 14.5 19.2 1.9 

Vascular lesions affecting central nervous system------------- 188,100 100.0 18.4 15.1 21.3 14.8 15.0 15.5 1.8 

Parkinson's disease----------------- 12,500 100.0 19.2 13.2 23.3 14.8 14.4 15.0 1.8 

Epilepsy---------------------------- 11,700 100.0 17.3 11.9 19.4 10.8 14.3 26.3 2.1 

Chronic diseases of the eye--------- 34,600 100.0 17.0 13.0 21.1 12.4 16.4 20.2 2.0 

Diseases of the heart--------------- 156,500 100.0 21.5 15.3 20.3 14.6 12.9 15.4 1.7 

Hypertension without mention of heart--------------------------- 35,100 100.0 13.3 14.3 21.7 13.2 17.2 20.4 2.1 

General arteriosclerosis------------ 43,500 100.0 21.1 13.7 20.1 13.6 14.8 16.7 1.8 

Varicose veins---------------------- 17,700 100.0 19.3 10.9 16.0 14.4 16.3 23.1 2.3 

Hemorrhoids------------------------- 21,200 100.0 13.7 13.4 18.8 18.3 15.4 20.4 2.2 

Bronchitis and emphysema------------ 22,300 100.0 14.0 18.1 17.7 17.4 15.2 17.6 2.0 

Sinus and other respiratory conditions------------------------- 10,800 100.0 10.3 13.6 20.9 15.9 14.6 24.6 2.3 

Ulcer of stomach and duodenum------- 9,800 100.0 22.8 12.4 19.8 16.7 11.6 16.6 1.7 

Hernia of abdominal cavity---------- 19,600 100.0 19.7 12.0 17.1 17.2 15.5 18.6 2.1 

Other chronic conditions of the digestive system------------------- 68,900 100.0 17.0 13.1 18.5 16.6 15.9 18.9 2.1 

Diseases of urinary system---------- 32,200 100.0 21.0 13.9 22.4 12.9 15.6 14.1 1.7 

Diseases of prostate and other male genital organs--------------------- 16,600 100.0 25.5 12.1 20.0 12.7 13.1 16.7 1.6 

Arthritis and rheumatism------------ 122,300 100.0 15.0 13.0 20.3 14.8 16.3 20.6 2.1 

Fracture, femur (old)--------------- 17,200 100.0 26.6 15.2 18.7 15.0 11.4 13.2 1.4 

All other chronic conditions-------- 82,300 100.0 19.3 14.3 19.4 14.9 14.9 17.3 1.8 

Visual impairment: inability to read 

read newspaper with glasse&------- 66,800 100.0 16.0 12.7 20.0 15.1 17.7 18.5 2.1 

Other visual impaFrments------------ 33,400 100.0 17.8 11.7 22.0 16.1 15.7 16.7 1.9 

Hearing impairments----------------- 103,900 100.0 17.9 13.2 19.1 14.8 16.6 18.4 2.0 

Speech impairments,all types-------- 54,600 100.0 17.8 15.7 19.5 13.8 15.2 17.9 1.8 

Paralysis, palsy due to stroke------ 66,600 100.0 19.8 15.6 22.9 13.0 14.5 14.1 1.6 

Paralysis, palsy due to other causes----------------------------- 26,000 100.0 15.0 13.0 19.0 12.2 17.9 23.0 2.2 

Absence, major extremities---------- 11,500 100.0 18.9 18.6 18.5 13.6 10.8 19.5 1.7 

Impairments, limbs, back, trunk----- 75,200 100.0 14.4 14.9 20.9 15.3 16.5 18.0 2.0 

All other impairments--------------- 7,600 100.0 23.4 9.3 19.3 10.1 16.5 21.3 1.9 

19 
1 

Table 4. Number and percent distribution of residents of nursing and personal care homes, by time interval 

since last saw doctor in the home accordingto specified chronic conditions and impairments: United States,

May-June 1964 

- Time interval since last saw doctor in home 

Number 

of Chronic conditions and impairments resi- All 

Tedian 

nonths 

dents inter- :,"zn 

Under 1-2 3-5 6-11 1 

1 year 

or 1

vals month months months months more 

Percent distribution 

All residents------------------ 554,000 - 100.0 E

4.3 -38.7 - 35.9 - 11.1 - 6.1 - 3.9 1- 1.5 

Malignant neoplasms------------------ 18,500 100.0 2.2 51.5 35.8 6.4 2.2 1.9 0.9 

Benign and unspecified neoplasms----- 6,800 100.0 1.5 53.5 31.1 8.0 5.1 0.8 0.9 

Asthma------------------------------- 16,500 100.0 1.8 42.4 38.4 9.4 3.9 4.0 1.3 

Diabetes mellitus--------------------

Advanced senility--------------------

44,300 

121,000 

100.0 

100.0 

1.6 

2.9 

46.3 

38.3 

38.1 

37.3 

8.4 

12.3 

3.7 

6.4 

1.8 

2.8 

1.1 

1.5 

Senility, not psychotic-------------- 27,400 100.0 2.3 37.0 39.1 11.6 5.7 4.4 1.6 

Other mental disorders--------------- 100,700 100.0 5.3 36.5 35.0 10.6 7.2 5.4 1.6 

Vascular lesions affecting central nervous system-------------- 188,100 100.0 2.2 42.0 36.9 10.4 5.8 2.7 1.4 

Parkinson's disease------------------

Epilepsy-----------------------------

12,500 

11,700 

100.0 

100.0 

3.2 

4.8 

47.2 

36.4 

31.6 

38.4 

9.0 

8.2 

5.3 

6.3 

3.6 

5.8 

1.1 

1.6 

Chronic diseases of the eye---------- 34,600 100.0 2.1 41.5 39.1 9.8 4.6 3.0 1.4 

Diseases of the heart---------------- 156,500 100.0 2.1 47.6 34.9 9.1 4.2 2.2 1.1 

Hypertension without mention of heart---------------------------- 35,100 100.0 2.7 34.0 39.4 12.1 7.1 4.8 1.7 

General arteriosclerosis------------- 43,500 100.0 4.0 39.8 35.4 12.5 4.8 3.6 1.5 

varicose veFns----------------------- 17,700 100.0 1.6 42.2 41.6 8.3 4.0 2.3 1.3 

Hemorrhoids-------------------------- 21,200 100.0 1.4 38.6 42.6 11.6 3.4 2.4 1.5 

Bronchitis and emphysema------------- 22,300 100.0 0.9 45.7 34.3 10.7 5.9 2.4 1.2 

Sinus and other respiratory conditions-------------------------- 10,800 100.0 1.4 46.0 34.1 7.4 5.5 5.6 1.2 . 

Ulcer of stomach and duodenum-------- 9,800 100.0 1.6 44.0 35.0 10.6 4.6 4.3 1.3 

Hernia of abdominal cavity-----------

Other chronic conditions of the digestive system--------------------

19,600 

68,900 

100.0 

100.0 

1.9 

2.0 

42.8 

43.1 

39.0 

36.5 

9.8 

11.1 

4.6 

4.8 

1.9 

2.6 

1.3 

1.3 

/ 

Diseases of urinary system----------- 32,200 100.0 2.3 45.6 36.5 10.6 2.5 2.5 1.2 

Diseases of prostate and other 

male genital organs----------------- 16,600 100.0 3.0 48.4 33.3 8.7 4.3 2.2 1.0 -

Arthritis and rheumatism------------- 122,300 100.0 2.3 38.9 39.5 10.7 5.2 3.4 1.5 . 

Fracture, femur (old)---------------- 17,200 100.0 2.1 45.8 38.8 6.5 5.0 1.8 1.2 

All other chronic conditions--------- 82,300 100.0 2.0 48.6 34.1 9.1 4.2 1.9 1.0 

Visual impairment: inability to read 

newspaper with glasses-------------- 66,800 100.0 2.8 38.8 37.9 11.0 5.3 4.2 1.5 

Other visual impairments------------- 33,400 100.0 2.3 41.3 39.1 9.0 5.5 2.8 1.4 

Hearing impairments------------------ 103,900 100.0 3.3 38.4 37.5 11.3 6.1 3.5 1.5 

Speech impairments, all types-------- 54,600 100 :o 3.7 41.1 34.6 10.4 6.0 4.3 1.4 

Paralysis, palsy due to stroke------- 66,600 100.0 2.4 43.5 38.4 9.4 4.0 2.3 1.3 

Paralysis, palsy due to other causes- 26,000 100.0 2.5 44.6 33.5 10.3 4.9 4.2 1.2 

Absence, major extremities----------- 11,500 100.0 1.8 51.4 31.7 7.5 4.9 2.7 1.0 

Impairments, limbs, back, trunk------ 75,200 100.0 3.4 37.5 37.9 12.3 6.2 2.7 1.6 

All other impairments---------------- 7,600 100.0 2.0 36.0 42.0 9.4 5.2 5.4 1.6 

20 

I 
Table 5. Number of residents and number of specified chronic conditions and impairments per 1,000

residents of nursing and personal care homes, by primary type of service: United States,May-June

1964 

= 

Chronic conditions and impairments 

-

All residents---------------------------------------

Malignant neoplasms---------------------------------------

Benign and unspecified neoplasms--------------------------

Asthma----------------------------------------------------

Diabetes mellitus-----------------------------------------

Advanced senility-----------------------------------------

Senility, not psychotic----------------------------------­

other mpnj--1 disorders------------------------------------

Vascular lesions affecting central nervous system---------

Parkinson's disease---------------------------------------

Epilepsy--------------------------------------------------

Chronic diseases of the eye-------------------------------

Diseases of the heart-------------------------------------

Hypertension without mention of heart---------------------

General arteriosclerosis----------------------------------

Varicose ve~ns--------------------------------------------

Hemorrhoids-----------------------------------------------

Bronchitis and emphysema----------------------------------

Sinus and other respiratory conditions--------------------

Ulcer of stomach and duodenum-----------------------------

Hernia of abdominal cavity--------------------------------

Other chronic conditions of the digestive system----------

Diseases of urinary system--------------------------------

Diseases of prostate and other male genital organs--------

ArthrFtis and rheumatism----------------------------------

Fracture, femur (old)-------------------------------------

All other chr0nf.c conditions------------------------------

Visual impairment: inability to read newspaper with glasses-----------------------------------

Other visual impairments----------------------------------

Hearing impairments---------------------------------------

Speech impairments, all types----------------------------­

paralysis, palsy due to stroke----------------------------

Paralysis, palsy due to other causes----------------------

Absence, major extremities--------------------------------

Impairments, limbs, back, trunk---------------------------

All other impairments-------------------------------------

Primary type of service 

0:. 

Number of residents 

554,000 11373,300 1 145,400 1 35,300 

Rate per 1,000 residents 

33.3 39.7 22.5 10.1 

12.3 12.1 15.3 2.9 

29.7 33.6 21.7 22.2 

80.0 89.7 65.6 36.3 

218.4 267.2 123.1 94.4 

49.5 51.8 46.3 38.7 

181.9 166.1 202.6 263.0 

339.5 407.8 214.5 132.5 

22.6 26.7 15.1 10.1 

21.1 21.0 21.3 21.5 

62.5 62.7 65.2 48.7 

282.6 319.4 221.3 145.6 

63.3 54.7 81.5 79.5 

78.5 83.8 70.4 56.1 

32.0 36.8 24.3 13.7 

38.2 44.9 27.7 10.9 

40.2 45.2 32.8 17.8 

19.4 19.3 19.8 19.5 

17.6 20.0 11.6 18.0 

35.5 38.4 28.6 32.9 

124.4 137.8 104.7 63.8 

58.2 68.2 41.4 22.1 

30.0 33.2 26.0 13.8 

220.8 228.7 219.4 142.5 

31.1 37.1 21.4 7.8 

148.7 165.4 122.2 80.7 

120.5 131.3 106.3 65.4 

60.2 60.5 59.4 61.2 

187.6 198.9 161.6 175.0 

98.6 111.2 74.6 64.0 

120.3 144.8 77.5 37.8 

46.9 53.0 34.8 32.1 

20.9 24.1 13.4 16.7 

135.8 148.8 115.7 80.8 

13.7 13.1 15.0 13.9 

21 
- Table 6. Number of residents and number of specified chronic conditions and impairments per 1,000 residents 

of nursing and personal care homes, by nurse or nurse's aide on duty and supervisory nurse: United States, 

May-June 1964 

Nurse or nurse's aide on duty 

24 hours Less than 24 hours Nursing Chronic conditions and impairments Total I care not RNI

LPN 

I 

I

Neither RN LPN Neither provided 

super- super- RN nor super- super- RN nor visor I

visor LPN visor visor LPN 

I I I I 

Number of residents 

554,000 11356,300 199,600 1 34,900 1 6,500 1 5,100 1 16,300 1 35,300 All residents-------------------

Malignant neoplasms-------------------

Benign and unspecified neoplasms------

Asthma--------------------------------

Diabetes mellitus---------------------

Advanced senility---------------------

Senility, not psychotic---------------

Other mental disorders----------------

Vascular lesions affecting central nervous system---------------

Parkinson's disease-------------------

Epilepsy------------------------------

Chronic diseases of the eye-----------

Diseases of the heart-----------------

Hypertension without mention

of heart-----------------------------

General arteriosclerosFs--------------

Varicose veins------------------------

Hemorrhoids---------------------------

Bronchitis and emphysema--------------

Sinus and other respiratory conditions---------------------------

Ulcer of stomach and duodenum---------

Hernia of abdominal cavity------------

Other chronic conditions of the digestive system---------------------

Diseases of urinary system------------

Diseases of prostate and other male genital organs-----------------------

Arthritis and rheumatism--------------

Fracture, femur (old)-----------------

All other chronic conditions----------

Rate per 1,000 residents 

33.3 37.7 30.7 32.2 38.0 

12.3 12.0 13.2 15.9 7.6 

29.7 32.2 27.1 26.2 7.7 

80.0 86.9 70.4 64.4 69.1 

218.4 228.1 255.6 213.3 115.1 

49.5 50.3 50.4 54.4 61.6 

181.9 153.3 207.4 233.5 215.1 

339.5 362.7 374.9 346.0 243.9 

22.6 27.0 16.5 20.3 14.8 

21.1 18.2 25.8 21.8 30.5 

62.5 66.8 48.5 60.1 76.4 

282.6 300.6 301.4 218.9 256.7 

63.3 66.8 53.7 48.8 69.1 

78.5 89.0 64.3 60.6 75.9 

32.0 36.8 33.3 12.7 14.8 

38.2 39.2 49.4 47.0 7.7 

40.2 49.5 23.8 30.8 22.9 

19.4 20.1 20.2 13.3 15.3 

17.6 16.6 26.7 7.1 

35.5 37.1 40.0 17.7 30.9 

124.4 128.9 144.6 121.2 83.2 

58.2 60.1 69.1 63.8 54.0 

30.0 33.4 28.4 34.1 14.5 

220.8 233.0 218.1 245.7 98.6 

31.1 37.3 24.9 29.5 15.2 

148.7 167.3 109.7 146.1 167.5 

19.9 

7.8 

19.9 

87.2 

175.7 

17.5 

356.9 

276.3 

85.6 

133.2 

122.8 

31.7 

19.9 

21.6 

27.5 

48.8 

29.3 

18.3 

87.6 

118.9 

291.8 

82.8 

218.8 

110.6 

145.4 

10.2 

95.8 

9.5 10.1 

8.6 2.9 

27.2 22.2 

116.5 36.3 

111.1 94.4 

45.5 38.7 

297.3 263.0 

107.1 132.5 

6.8 10.1 

30.5 21.5 

60.9 48.7 

266.3 145.6 

48.4 79.5 

49.3 56.1 

17.4 13.7 

12.3 10.9 ' 

18.6 17.8 

21.1 19.5 

12.4 18.0 

18.7 32.9 

79.7 63.8 

26.6 22.1 ' 

'2.9 13.8 ' 

137.4 142.5 

3.4 7.8 

133.9 80.7 

133.9 65.4 

71.2 61.2 

137.1 175.0 

93.9 64.0 

51.2 37.8 

43.3 32.1 

15.0 16.7 

128.2 80.8 

11.9 13.9 

Visual impairment: inability to read 

newspaper with glasses--------------- 120.5 116.2 152.3 105.4 67.9 

Other visual impairments-------------- 60.2 59.0 65.2 42.2 99.9 

Hearing impairments------------------- 187.6 190.7 199.8 138.5 265.9 

Speech impairments, all types--------- 98.6 97.5 119.3 91.2 67.7 

Paralysis, palsy due to stroke-------- 120.3 125.3 142.4 127.2 67.7 

Paralysis, palsy due to other causes-- 46.9 51.4 36.0 52.7 60.8 

Absence, major extremities------------ 20.9 23.7 16.1 12.8 23.5 

Impairments, limbs, back, trunk------- 135.8 142.7 144.8 109.2 107.2 

All other impairments----------------- 13.7 14.6 13.6 7.0 15.9 

22 

i 
APPENDIX I 

A. TECHNICAL NOTES ON METHODS 

Survey Design 

General. -The Resident Places Survey-Z (RPS-2) 

was conducted during May and June 1964 by the Division 

of Health Records Statistics in cooperation with the 

U.S. Bureau of the Census. It was a survey of resident 

institutions in the United States providing nursing or 

personal care to the aged and chronically ill, of their 

patients or residents, and of their employees. The 

institutions within the scope of the survey included such 

places as nursing homes, convalescent homes, rest 

homes, homes for the aged, other related facilities and 

geriatric hospitals. To be eligible for the survey an 

establishment must have maintained three beds or more 

and must have provided some level of nursing or personal care. The procedure for classifying establishments for the RPS-2 universe is described in Appendix 

II-B. 

This appendix presents a brief description of the 

survey design, general qualifications of the data, and 

the reliability of estimates presented in this report. 

Succeeding appendixes are concerned with classification procedures, definitions, and questionnaires used 

in the survey for collecting informationabout employees. 

Sampling frame. -A “multiframe” technique was 

used in establishing the sampling universe for RPS-2. 

The principal frame was the Master Facility Inventory (MFI) which contained the names, addresses, and 

descriptive information for about 90-95 percent of the 

nursing and personal care homes in the United States. 

Establishments not listed in the MFI were, theoretically, on another list referred to as the Complement 

Survey. A description of the MFI and the Complement 

Survey has been published? 

The Complement Survey is based on an area probability design, using the sample design of the Health 

Interview Survey (HIS).’ In the HIS, interviewers make 

visits each week to households located in probability 

samples of small segments of the United States. In 

addition to collecting information about the health of 

the household members, the interviewers are instructed 

to record the names and addresses of hospitals and 

institutions located wholIy or partially within the 

specified areas. The Complement Survey list is composed of the establishments identified in these sample 

areas between January 1959 and July 1963 which were 

not listed in the MFI but which were in business as of 

July 1, 1962. The Complement Survey sample for RPS-2 

included four establishments representing an estimated 

toral of about 800 such facilities in the United States 

not included in the Master Facility Inventory. 

Sample design.-The sample design was a stratified, two-stage probability design. The first stage was 

a selection of establishments from the MFI and the 

Complement Survey, and the second stage was a 

selection of employees and residents from registers 

of the sample establishments. In preparation for the 

first-stage sample selection, the MFI was divided into 

two groups on the basis of whether or not current 

information was available about the establishment. 

Group I was composed of establishments which had 

returned a questionnaire in a previous MFI survey. 

Group II contained places which were possibly within 

the scope of RPS-2 but which were not confirmed in 

the MFI survey, e.g., nonresponses and questionnaires 

not delivered by the post office because of insufficient 

addresses. Group I was then sorted into three type-ofservice strata: nursing care homes, including geriatric 

hospitals; personal-care-with-nursing homes; andpersonal care homes. Group II was treated as a fourth 

type-of-service stratum. Each of these four stratawas 

further sorted into four bed-size groups, producing 16 

primary strata as shown in table I. Within each prrmary 

stratum, the listing of establishments was ordered by 

type of’ ownership, State, and county. The sample of 

establishments was then selected systematically after 

a random start within each of the primary strata. 

Table I shows the distribution of establishments in 

the MFI and in the sample by primary strata and the 

final disposition of the sample places with regard to 

their response and in-scope status. Of the 1,201 homes 

originally selected, 1,085 were found to be in business 

and within the scope of the survey. 

The second-stage sample selection or residents 

was carried out by the Bureau of the Census interviewers in accordance with specific instructions given 

for each sample establishment as contained in the 

Resident Questionnaire (HRS-3c, Appendix III). Allresidents on the register of the establishment on the day of 

the survey were listed on the Establishment Question23 
-------------------------------------- 

Table I. Distribution of institutions for the aged in the Master Facility Inventory and in the 

RPS-2 sample by primary strata (type of service and size of institution) and by response status 

to the RPS-2: United States 

Number of homes in sample 

Number TIn scope and 

out Type of service and size of institution of 

in 

homes 

Total scope 

of 

or 

in business 

the 

MFIl nomesl out of 

.business Nonre- Responding sponding

homes homes 

All types--------------------------------- 19.520 1.201 116 12 1,073 

Nursing bares----------------------------- 8,155 634 37 8 589 

Under 30 beds----------------------------------- 4,400 179 21 153 

30-99 beds-------------------------------------- 3,247 260 11 246 

100-299 beds-------------------------------------- 448 135 3 132 

300 beds and over------------------------------- 60 60 2 58 

Personal care with nursing---------------- 4,972 381 12 367 

Under 30 beds----------------------------------- 3,168 128 10 117 

30-99 beds-------------------------------------- 1,423 114 1 112 

100-299 beds------------------------------------ 345 103 1 102 

300 beds and over-,------------------------------ 36 36 36 

personal care----------------------------- 3,621 113 13 98 

Under 30 beds----------------------------------- 3,187 64 11 53 

30-99 beds-------------------------------------- 402 32 31 

100-299 beds------------------------------------ 29 14 2 11 

300 beds and over------------------------------- 3 3 3 

Group I13-----------------_----------,------ 2,772 73 54 19 

Under 25 beds----------------------------------- 2,578 52 37 15 

25-99 beds 185 15 12 3 

&00-299 beds--------------------------------:---- 6 3 3 

300 beds and over------------------------------- 3 3 2 1 

1 The universe for the RPS42 sample consisted of the MFI and the Complement Survey. Included in 

the RPS-2 sample were 4 homes from the Complement Survey. 

21ncludes geriatric hospitals.

'3Group II consists of those institutions assumed to be in scope of the RPS-2 survey but for 

which current data were not available. 

24 
naire (HRS-3a). The interviewers were furnished with 

the numbers of predetermined sample lines for each 

home (e.g., every seventh line). The first three sample 

designations were entered on the questionnaire worksheet, and the interviewer entered the remaining predetermined numbers until the last selected number 

exceeded the total number then on the register. The 

name of the sample resident (patient) was entered 

opposite the sample designation number. For each 

sample resident a questionnaire was completed by the 

interviewer from information furnished by the respondent. The total sample selected from establishments in 

the survey consisted of 10,560 residents. 

Survey procedure.- The Bureau of the Census employed about 140 of their regular interviewers for the 

survey. All were experienced in the continuing surveys 

conducted by the Bureau,of the Census; about half were 

employed in the Health Interview Survey-one of the 

major programs of the National Center for Health 

Statistics-and about half in other surveys. Since the 

interviewers were well trained in general surveymethodology, it was relatively easy to train them in the 

specific methods used in RPS-2. Briefly, their training 

consisted of home study materials and observation by 

the Census Regional Supervisor on the first interview 

assignment. 

The initial contact with an establishment was a 

letter signed by the Director of the Bureau of the Census. 

The letter (HRS-Sf, Appendix III) notified each administrator about the survey, requested his cooperation, and 

stated that a representative would contact him for an 

appointment. The interviewer’s telephone call usually 

followed within 3 or 4 days. 

During the course of the interview, the interviewer 

collected data about the establishment, the residents, and 

the employees. The establishment and resident information was obtained by personal interview, and the 

staff information was collected by personal interview 

and by means of a self-enumeration questionnaire. The 

respondent for the Resident (Patient) Questionnaire 

(HRS-3c) was a member of the staff who had close 

contact with the resident, thus having firsthand knowledge of the resident’s health condition. This was usually 

a nurse who was responsible for the individual sample 

resident. One nurse might have completed questionnaires for all residents in a small home or shared 

the responsibility in a large home. The interviewer 

was instructed to encourage maximum use of records 

by the respondent. For data on chronic conditions and 

impairments, medical records, if available, were routinely used to supplement the information provided by 

the respondent. 

The Census regional offices also performedcertain 

checks during the course of the survey to insure that 

the interviewers were conducting the survey according 

to specified procedures. They reviewed all questionnaires for completeness prior to transmittal to the 

Washington office and made inquiries as necessary to 

obtain the missing information. 

The completed questionnaires were edited and coded 

by the National Center for Health Statistics, and the 

data were processed on an electronic computer. This 

processing included assignment of weights, ratio adjustments, and other related procedures necessary to produce national estimates from the sample data. It also 

included matching with basic identifying information 

contained in the Master Facility Inventory as well as 

carrying out internal edits and consistency checks to 

eliminate “impossible”responses and errors in editing, 

coding, or processing. 

B. GENERAL QUALIFICATIONS 

Nonresponse and imputation of missing data.-The 

survey was conducted in 1,073 homes, or about 89 percent of the original sample. About 7 percent of the sample places were found to be out of business, and an 

additional 3 percent were found to be out of scope of the 

survey, that is, they either did not provide nursing or 

personal care to their residents or maintained fewer 

than three beds. Only 12 homes, or about 1 percent of 

the sample, refused to cooperate in the survey (table 

1). The response rate for the in-scope sample was 

98.9 percent. 

Statistics presented in this report were adjusted 

for the failure of a home to respond by use of a separate nonresponse adjustment factor for each servicesize stratum further stratified by three major ownership groups. This factor was the ratio of all in-scope 

sample homes in a stratum to the responding in-scope 

sample homes in the stratum. 

Data were also adjusted for nonresponse of sample 

residents within an establishment by a procedure which 

imputed to residents for whom data were not obtained 

the characteristics of residents of the same age and 

in the same type of home. For item nonresponse on 

age, the adjustment was restricted to characteristics 

of residents in the same type of home. Adjustment for 

nonresponse in resident data for responding homes 

ranged from 0.7 percent for age to 3.5 percent for 

date last saw doctor. 

Rounding of numbers.- Estimates relating to residents have been rounded to the nearest hundred, and 

homes to the nearest ten. For this reason detailed 

figures within the tables do not always add to totals. 

Percents were calculated using the original unrounded 

figures and will not necessarily agree with percents 

which might be calculated from rounded data. 

Estimation procedure.-Statistics reported in this 

publication are the result of two stages of ratio adjustments, one at each stage of selection. The purpose of 

ratio estimation is to take into account all relevant 

information in the estimation process, thereby reducing 

25 
Figure I. Approximate relative standard errora,ofeatimated numbersofreeidents and conditions shown 

in this report 

100.0 

60.0 

60.0 

40.0 

20.0 

2

v 

8 ~~ 

2 8.0 

pl 6.0 

-a8 4.0 

"e 

: 2.0 

1

u 1.0 

2i 0.6 

2 0.6 

0.4 

al 

l0,000 ,00,000 600,000 

Size of estimate 

:ample of use of figure I: An eatimateof100,OOO total conditions has a relative standard error of 

3 percent (read from scale at left side of figure). The estimate has a standard error of 3,300 i.3 percent of 100,000). 

the variability of the estimate. The first-stage ratio 

adjustment was included in the estimation of establishment and resident data for all primary service-size 

strata from which a sample of homes was drawn. This 

factor was a ratio, calculated for each stratum. The 

numerator was the total beds according to the Master 

Facility Inventory for all homes in the stratum. The 

denominator was the estimate of the total bedsobtained 

through a simple inflation of the Master Facility Inventory data for the sample homes in the stratum. The 

effect of the first-stage ratio adjustment was to bring 

the sample in closer agreement with the known universe 

of beds. The second-stage ratio adjustment was included 

in the estimation of resident data for all primary strata. 

For resident data, the second-stage ratio adjustment 

is the product of two fractions: the first is the ratio of 

the total number of residents in the establishment to 

the number of residents for whom questionnaires were 

completed within the home; the second is the sampling 

fraction for residents upon which the selection is based. 

Reliability of estimates.- Since statistics presented in this report are based on a sample, they will 

differ somewhat from figures that would have been obtained if a complete census had been taken using the 

same schedules, instructions, and procedures. 

As in any survey, the results are also subject to 

reporting and processing errors and errors due to 

nonresponse. To the extent possible, these types of 

errors were kept to a minimum by methods built into 

survey procedures. 

The sampling error (or standard error) of a 

statistic is inversely proportional to the square root 

of the number of observations in the sample. Thus, as 

the sample size increases, the standarderror decreases. 

The standard error is primarily a measure of the 

variability that occurs by chance because only a sample 

rather than the entire universe is surveyed. As calculated for this report, the standard error also reflects 

part of the measurement error, but it does not measure 

any systematic biases in the data. The chances are 

about two out of three that an estimate from the sample 

differs from the value which would be obtained from 

a complete census by less than the standard error. The 

chances are about 95 out of 100 that the difference 

is less than twice the standard error and about 99 out 

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

Relative standard errors of aggregates shown in 

this report can be determined from figure I of this 

appendix. The relative standard error of an estimate 

is obtained by dividing the standard error of the esti26 
Table II. Approximate standard errors of percentages shown in this report for residents 

(patients) and conditions 

Estimated percent Base of percent (number

of residents) T$J-q$-

Standard error expressed in percentage points 

2: 13.6 15.8 

10.0

4:2 x 

3.0 4:3 2: 

3.0 3.5 ;*: is’5

116 2:2 

proximate confidence intervals for these estimated 

medians can be computed as follows: 

(a) Determine the standard error of a SO-percent characteristic whose denominator is 

equal to the estimated number of persons 

in the frequency distribution on which the 

median is based. For example, the median 

length of stay of residents with malignant 

neoplasms is 1.5 years. The estimated 

number of residents with malignant neoplasms is 18,500 (table II). The standard 

error of a SO-percent characteristic whose 

base is 18,500 is shown in table II by 

interpolation to be 3.73 percentage points. 

(b) Apply this standard error to thecumulative 

frequency distribution to obtain a confidence 

interval around themedian. The steps are as 

follows: for the above example, using the 9.5-

percent level of confidence, determine the 

points on the cumulative frequency distribution corresponding to the 42.5 percent (50 

percent minus two standard errors) and 57.5 

percent (50 percent plus two standard errors). The points are 7,863 (42.5 x 18,500) 

and 10,638 (57.5 x 18,500). From table 

determine the lengths of stay that correspond to these points. They are 1.1 and 1.9 

years, respectively. Therefore, the confidence limit for the estimated median ageof 

1.5 years is 1.1 - 1.9 years at the 95-percent level of confidence. 

::: 2: 8:: ::: 

mate by the estimate itself and is expressed as a 

percent of the estimate. An example of how to convert 

the relative error into a standard error is given with 

figure I. Standard errors of estimated percentages are 

shown in table II. 

To determine the standard error of a mean value, 

of a median value, or of the difference between two statistics, the following rules may be used. 

Standard eryov of prevalence rates for conditions.-

From figure I, obtain the relative standard error of the 

estimated number of conditions and of the estimated 

number of persons on which the rate is based. The 

square root of the sum of the squares of these two 

relative standard errors provides an approximation for 

the relative standard error of the desired rate. The 

standard error of the rate may be obtained by multiplying the relative standard error by the rate. For example, for a rate of 50.0 per 1,000 persons based on a 

denominator of 50,000 residents, the standard error 

may be obtained as follows: 

1. The relative standard error of 2,500 residents 

with the condition is about 20.0 percent, or .20. 

2. The relative standard error of 50,OOOresidents 

is about 4.6 percent, or .046. 

3. The relative standard error of the rate of 50.0 

per 1,000 persons is 4(.201’+ C.046)’ = .205 

4. The standard error is .205 x 50.0 = 10.3 per 

1,000 persons. 

Standard ever of a median.-The medians shown 

in this report were calculated from grouped data. ApIt is possible to investigate whether an observed 

difference between two estimated medians can be 

attributed to sampling error alone by obtaining the 

upper 6%percent confidence limit, U’, of the smaller 

observed median, M’,. and the lower 68-percent confidence limit, L’,. of the larger median, M’,. These 

limits may be found by using themethodoutlined above, 

but by using one standard error instead of two. The 

square root of the sum of the squared differences between M’, and .?J; and M’, and L’, is the standard 

error of the difference between M’, and M’,; that is 

s tu;- M;) = f(M’, - U’,)2 + (M; -L*,)’ 

For the purpose of this report any difference between 

M’l and M’, greater than 2So., _ M,2) is considered 

statistically significant. 

Standard ewo’oy of a difference between two estimates. -The standard error of a difference is approximately the square root of the sum of the squares 

of each standard error considered separately. This 

formula will represent the actual standard error quite 

accurately for the difference between separate and 

uncorrelated characteristics although it is only a 

rough approximation in most other cases. 

oo27 

3 
APPENDIX II 

A. DEFINITIONS OF CERTAIN 

Resident: 

A resident is defined as a person who has been 

formally admitted to an establishment but not 

discharged. All ‘such persons were included in 

the survey even though they were not physically 

present. 

Chronic conditions and impairments: 

These are defined as the conditions and impairments contained in Cards D and E of Appendix III. 

This list was expanded, based on the further query 

“Does he have any other chronic conditions listed 

in his record you have not told me about?” and 

on additional questions about specified conditions. 

The expanded list is contained in Appendix II- C as 

a basic list of diagnostic categories used for coding purposes. 

Condition: 

This term is used synonomously with the term 

“chronic conditions and impairments” since no 

distinction has been made between the two groups 

in this report. 

Mobility status: 

Restriction in mobility is defined in this report as 

being limited to bed or room. All other residents, 

TERMS USED IN THIS REPORT 

including those who were routinely taken out of the 

room in a wheelchair for most of the day, were considered neither bed nor room limited. 

Length of stay: 

Length of stay is defined as the current period of 

stay in the institution. The period of stay starts 

with the date of last admission to the institution and 

ends with the date of the survey. 

Time interval since last saui doctor: 

This is defined as the period of time from the date 

the resident last saw a doctor in the institution 

during his current stay to the date-of-the survey. 

Supervisory nwse: 

This is defined as the person in charge of the 

daily nursing activities provided in the home, 

such as the head nurse. 

Nurse OY numets aide on duty 24 hours a day: 

Nursing service is routinely provided at all hours 

of the day or night by either a nurse or a nurse’s 

aide. A person is not “on duty” if she is available to provide care only upon call or in emergencies. 

B. CLA%lFlCATlON OF HOMES BY TYPE OF SERVICE 

For purposes of stratification of theuniverseprior 

to selection of the sample, the homes on the MFI were 

classified as nursing care, personal-care-with-nursing, 

personal care, or domiciliary care homes. The latter 

two classes were combined to produce the three types 

of service classes shown in table I, Appendix I. Details 2. 

of the classification procedure in the MFI have been 

published. 7 

Due to the P-year interval between the MFI survey 

and the RPS-2 survey, it was felt that, for producing 

statistics by type of service from the RPS-2 survey, 

the homes should be reclassified on the basis of the 

current data collected in the survey. This classification 

procedure is essentially the same as the MFI scheme. 

‘Ihe three types of service classes delineated for RPS-2 

are defined as follows: 3. 

1. A nursing cave home is defined as one in which 

50 percent or more of the residents received 

nursing care (see definition, AppendixII-A) during the week prior to the survey in the home, 

with an RN or LPN employed 15 hours or more 

per week. In this report, geriatric’hospitals 

are included with the nursing care homes. 

A personal-care-with-nursing home is defined 

as one in which either (a) over 50 percent of the 

residents received nursing care during the week 

prior to the survey, but there were no RN’s or 

LPN’s on the staff, or (b) some, but less than 

50 percent, of the residents received nursing 

care during the week prior to the survey regardless of the presence of RN’s or LPN’s on the 

staff. 

A personal: caye home is defined as one in 

which residents routinely received personal 

care, but no residents received nursing care 

during the week prior to the survey. 

28 
C. RULES FOR CODING CHRONIC 

The list of diagnostic categories which was used 

for coding chronic conditions and impairments is shown 

below. This list represents an expansion of the two 

lists (Cards D and E) furnished to the interviewers. 

The classification scheme was based on the International 

Classification of Diseases, with some modifications. 

Certain medical coding principles developed by the 

Health Interview Survey (HIS), from which statistics 

on the institutional population of the United States are 

derived,9 were used in coding the data for RPS-2. The 

medical coding consisted of assigning a code to each 

codable chronic condition and impairment reported for 

a resident. All codable conditions which were not 

specified as chronic but which could be acute or chronic 

(i.e., sinusitis, bronchitis, gastritis, or a hearing or 

visual disturbance) were assumed to be chronic. 

The medical coding principles developed by the 

HIS were adapted to the coding of chronic diseases and 

impairments as follows: Impairments were coded in the 

same general manner as for the HIS, but in less detail. 

CONDITIONS AND IMPAIRMENTS 

Symptoms and conditions said to be due to other conditions were coded for the most part as for HIS. Heart, 

hypertensive, and arteriosclerotic conditions were combined as for HIS. 

The coding rules allow for the assignment of one 

or more chronic conditions and impairments for each 

resident, with some loss of detail due to the restricted 

number of diagnostic categories. Some restriction exists 

for the assignment of impairments which are a result 

of the chronic condition. Some chronic conditions are 

not reported separately, but are combined with other 

categories under coding rules. 

Special coding procedures were followed in coding 

categories related to senility and mental conditions. 

Injuries and traumatic origin of chronic conditions were 

not identified as such except in cases of fracture of the 

hip. Also, specific coding procedures for other individual chronic conditions and impairments were followed. 

29 
-- 

D. BASIC LIST OF DIAGNOSTIC CATEGORIES REPORTED FOR RESIDENTS 

IN NURSING AND PERSONAL CARE HOMES 

Condition Group International Classification of L&eases 

Code Numbers, 1955 Revision 

Malignant neoplasms, without mention of surgery----- 140-205 

Malignant neoplasms, with mention of surgery-------- 140-205 

Benign and unspecified neoplasms------------------- 210-239 

Asthma ________________________________________-- 241 

Diseases of thyroid gland -____________ _ _ _____ __ ____ _ 250-254 

Diabetes melllNs---------------------------------

Avitaminoses and other nutritional weight problems---

Mental retardation without mention of senility1 

Mental retardation with mention of senile psychosis1 

Mental retardation with senility not specified as psychoticl 

Senile psychosis with or without other mental conditionSenility without mentionofpsychosis-----------------

Specified mental disorders -_____-___-______________ 

Vascular lesions affecting central nervous system----

Multiple sclerosis _________________________________ 

Parkinson’s disease (paralysis agitans)-------------

Epilepsy ________________________________________-

Other nervous system disorders--------------------

Cataract ________________________________________-

Glaucoma ________________________________________ 

Other diseases of the eye--------------------------

Diseases of he ear--------------------------------

Diseases of he heart------------------------------

Hypertension without mention of heart---------------

General ~teriosclerosis _____- _ _-__--__- - __-_-_ _--_ 

Varicose veins-----------------------------------

Hemorrhoids--------------------------------------

Other conditions of circulatory system--------------

Chro& sinusitis _________________________________ 

Bronchitis, witi emphysema-----------------------

Bronchitis, without emphysema--------------------

Emphysema without mention of bronchitis------------

Other chronic respiratory conditions----------------

Ulcer of stomach and duodenum---------------------

Hernia of abdominal cavity _________________________ 

Diseases of gallbladder and bile ducts---------------

Other chronic conditions of the digestive system------

Incontinence (urine or feces)-----------------------

Diseases of urinary system ________________________ 

Diseases of male genital organs--------------------

Diseases of breast and female genital organs--------

Diseases of skin and other subcutaneous tissue-------

Arthritis-----------------------------------------

Rheumatism ____ _ _ _ _____ _ __ _ _ __ _ __ __-_-- ___ ------_ 

Other specified diseases of bones and organs of movement ________________________________________---

Fracture, femur (old) _____----___------------------

All other chronic conditions, excluding impairments260 

280-283,285,286’ 

304 

794 

300-303,305-324 

330-334 

345 

350 

353 

340-343,354-357,361-369 

385 

387 

370-379,380-384,386,388 

390-396 

410-443,782.1,782.2,782.4 

444-447 

450 

460,462 

461 

400-403,451-456,463-468,782.0,782.3,782.5-782.9 

513 

502 .O 

502.1 

527.1 

510.0,512,514-526,527.0,527.2,783 

540-542 

560,561 

584-586 

530-539,543-545,552,553,570,572-574,577,578,580-

583,587,784 

785.7,786.2 

591-594,600-609,786.0,786.1,786.3-786.5,789 

610-617,786.6 

620,621,623,625,626,630-637,786.7 

700-716 

720-725 

726.0,726.1,726.3,727 

730.1,730.3,731-733,735,738,740-744 

N820.9,N821.9 

Residual 

30 
Visual impairment: inability to read newspaper with 

glasses’ 

Other visual impairments’ 

Hearing impairments1 

Speech impairments due to stroke’ 

Speech impairments due to other or unspecified 

causes1 

Paralysis, palsy due to stroke* 

Paralysis, palsy due to other unspecified causes1 

Absence, fingers and/or toes1 

Absence, major extremities1 

Impairment, limbs, back, trunk1 

All other impairments’ 

Iselected conditions and all impairments are classified by meanx of a special supplementary code developed for the Household Interview Survey. The details of this classification are contained in the Medicai Coding Manual and Short Index, NW-RIClflOF, 1965. 

31 
APPENDIX III 

FORMS AND QUESTIONNAIRES 

U.S. DEPARTMENT OF COMMERCE 

BUREAU OFTHE CENSUS 

WASHINGTON, D.C. 20233 

r 1 

I- J 

Dear Administrator: 

The Bureau of the Census, acting as the collecting agent for the 

United States Public Health Service, is conducting a nationwide survey

of nursing homes, homes for the aged, and other establishments providing

nursing, personal, and domiciliary care to the aged and infirm. The 

purpose of this survey is to collect much needed statistical information 

on the health of residents and on the types of employees in these homes. 

This survey is part of the National Health Survey program authorized by 

Congress because of the urgent need for up-to-date statistics on the 

health of our people. 

The purpose of this letter is to request your cooperation and to inform 

you that a representative of the Bureau of the Census will visit your 

establishment within the next week or so, to conduct the survey. Prior 

to his visit, the Census representative will call you to arrange for a 

convenient appointment time. 

All the information given to the Census representative will be,kept 

strictly confidential by the Public Health Service and the Bureau of 

the Census, and will be used for statistical purposes only. 

Your cooperation in this important survey will be very much appreciated. 

Sincerely yours, 

GhG 

Richard M. Scammon 

Director 

Bureau of the Census 

32 
--_.. - _.__ - . . ____.____ .I__._.-_r..______...__. ~_,_,__ CONFIDENTIAL - This information is collected for the U.S. Public Heath Service under au?hority of Public Law 652 of the 84rh Congress 

(70 sat. 48% 42 U.S.C. 305). All information which would pernut idenrification of the individual ~111 be held srricrly confidential. will be 

used only by persons engaged in and for the purposes of the survey, and dll no1 be disclosed or released w orhcrs for any other purposes 

(22 FR 1687). 

FORM HRS-30 c.. ,44, fvarify nans and address and ma*s any nsce.*sry correcrion*) 

U.S. DEPARTMENT OF COMMERCE BUREAU OF THE CENSIU.7 

ACTING AS COLLECTING AGENT FOR THE 

U.S. NATIONAL HEALTH SURVEY 

ESTABLISHMENT QUESTIONNAIRE 

Number I 

3. During the post 7 doys how monr of there - - residents OR i-~ None (patients) received nursing care. By nursing care we meon / (Go to g. 7) any of the rsrvicas listed on this cord. (Show cud A) I 

Re isrered Licensed 

4. Is the person who supervises NURSING CARE 1 0 pro -7essional 2 0 pracrical 3 c $p= 

a registered professional nurse, a Iiz,ersed nurse nurse 

practical nurse, or son~eon* else? 

I 0 Full-time 2 0 Part-time 5. Does she work full-time or part-time?

By full-time we mean 40 or more hours a week. 

t 0 Yes 20 No 

6. Is there q nurse or nurse’s aide ON DUTY 24 hours o day? 

33 
Budger Bureau No. G&RGZO.R2; Approval Expires December 31, 1964 

Esrablisbmenc number Resident’s (patient’s) Line No. 

Month ; Year 

1. What is the month and yeor of this resident’s (po+ien+‘s) birth? I 

2 Sex I 0 Male (Ask question 3) 2 0 Female (Go to question 4) 

30. Has he served in 3c. NOTE TO Ifl-TERVEWER: 

the Armed Forcer of Source of Veteran status the United States? I 0 Yes (Ask Q. 3b) 2 0 No (Go to 0. 4) 3 0 Unknown information 

b. Did ho sowe in 10 Record 2 0 Sample person 

World War I? t 0 Yes ZI-JNO 3 0 Unknown 3 0 Respondent 

widowed, resident separated, 4. Is this divorced, (patient) married, or 1 0 Married 2 0 Divorced s 0 Never married 

never married? 2 0 Widowed 4 0 Separated 

1 Month ’ Year 

5. In what month and ysor war he (lost) admitted +o this home? I 

I 

6. With whom did he live o+ I 0 spouse only 7 0 In another nursing home or 

the’time of his admission? 2 0 Children only related facility 

(Check 

that 

the FIRST 2 0 Spouse and children B 0 In mental hospital

box applies) 

4 0 Relatives ocher than spouse or 9 0 In a long-term specialty hospital 

children (except mental) 

s 0 Lived i n apartmenr or own home- 10 0 In a general or short-stay hospital 

alone or with unrelated persons I I 0 Other place (Specify) 

6 0 In boarding home 

7. How often do friends or 

relatives visit him? 

(Check the FIRST 

box that eooliesl 

80. Does he stay in bed 011 or most of the day? I 0 Yes (Go to question 9) 2 0 No (Ask question 86) 

b. Does he stay in his own room all or most of the day? + 0 Yes 2 0 No (Ask question SC) 

C. Does he go off the premises iust to walk, shop, or 

visit with friends or relatives ond so forth? 1 rl Yes 2 II No 

9. Which of there spesiol aids (Check all that apply) does this resident (po+icn+) 

use? (Show cam C) 1 0 Hearing aid 4 0 Braces 7 0 Eye glasses 

2 u Walker 5 I-J Wheel chair OR 

3 0 Crutches 6 0 Artificial limb(s) B 0 None of these aids used 

10. During his s+oy here when did he los+ see a Month 1 Year 

doctor for +reo+man+, medication, or for an c] Neyer saw doctor 

examination by the doctor? I 

whzle here 

110. During his stay here, 

has he seen a dentist? 1 0 Yes (Ask question Zlb) 2 0 No (Go to question 12) 

Month !YM 

b. When war the lost time he saw o dentist? I 

120. Has he lost ALL of his teeth? I n Yes &4$ question 126) 2 0 No (Go to question 13) 

b. Doe. he weor full uppcr and lower dentures? 3 0 Yes 40No 

3. Doer this resident (patient) hove any of these conditions? 

(Show card D. Record in’ Table 1 each condition which the patient has) I OYes ‘2nNo 

4. Door ho have any of these conditions? 

(Show card E. Record in Table 1 each condition which the patient has) 10 Yes 2uNo 

So. Does he hove any o+her CHRONIC conditions listed in his record that you hove not told me about? 10 Yes 20No 

If “Yes,!’ ask: 

b. What ore they? 

(Record in Table 2 eech chronic condition mentioned) 

‘ORM HRS4C ~3-2344, 
Enter conditions from questions 13, 14 ot 15 For the followinS conditions ask these questions 

ILL EFFECTS OF STROKE. . . . . What a. the pruent 111 offacts? 

SPEECH DEFECT. . . . . . . . . . . What coused the speech defect? Do 

P&M.;;, PERMANENT not 

Enter the words used by the respondeor to . . . . . . . . . . . . . . . What port of the body is ofhcted? writ. 

dewzribe the condition. TUMOR, CYST, OR GROWTH. . . . What port of the body is affected? 

Is It malIgnant or benign? 

in 

this 

DEAFNESS, HEARING TROUB:;. column 

OR ANY EYE CONDITION. . . . . . lsoso;~; both ears (eras)

(Include glaucana md cataract@ 

(a) (h) CC) 

1. 

1. 

1. 

i. 

i. 

‘. 

I. 

I. If any eye conditions have been recorded in Table 1, ask: 0 No eye condition reported (Go to quusstim 17) 

You told m. about this raidant’s ( atimPs) ey. condition. 

Can he s.. wall enough to wad or B inary n.wspopw print with ,$.sl.r? 10 Yes Z[JNO 

: During th. past 1 0 Help with dressing, shaving, 7 day. which of or care of hair lh.s* SWViC~S 

dld this nsldant z 0 He1 with tub bath 

(patimt) rocdvr? or sR over 

10 Help with eating 

(Show cud F and (feeding the resldent(patient)) 

check each ooe 4 f-J Rub and mass.ge 

mentioned) 5 ~,Administrarioo of 

medications or treanenr 

6 0 Special diet 

7 0 Application of sterile 

dressings or baadnges 

. At the tlma this raidant (patient was admitted to 

thl~ hoot*, what kind of can did b l receive-primarily 

nursing care. prlmarlly p*rsonol car., or 1oom and 

board only? (Check one box only) 

8 0 Temperarure-pulse- 17 0 Intravenous injecrion reapuarion (1) u Intramuscular injection 0 c] Full-bed barb 19 n Nasal feeding 10 0 Enema 

11 0 Carheterira~ion OR 12 0 Bowel and bladder 

rerraining 20 I-J None of rhe above t 6 0 Blood pressure services received 14 0 Irrigarion 

1 I 0 Oxygen rhcrspy 

16 0 Hypodermic injection 

1 0 Primarily 2 0 Primarily 3 0 Room and nursing pCrSO”d board only care care 

Amount . What mr* the TOTAL charge for this rmsidmt’s (patime’s) car. last month? s 

m. what Is the PRIMARY sourc. of paym.nt for his con? I ZOb. Are there my oddltimoi sources of payment?

(check mvE box only) I (check ALL boxes that apply) 

t 0 Own income or family support (Include private plma. I 1 0 Own income or family rupporc fhclude private plana, ntiranmt funda, social ascatty, etc.) I retirement ftmda, social security. etc.) 

1 c] Gwrch support I P f-J Church support 

3 0 Veterana benefits ~0 Veterans benefits 

4 0 Public assistance or welfare I 4 0 Public 8ssisrmce 01 welfare . . I 5 0 Initial psymenr - life cm.2 I 

I 6 i-J Other (Plears describe) 

I 

I 

I OR 

I 

I 7 0 No additional sources 

35 
Card D 

LIST OF CHRONIC CONDITIONS 

Does this resident have any of these conditions? 

1. Asthma 

2. CHRONIC bronchitis 

3. REPEATED attacks of sinus trouble 

4. Hardening of the arteries 

5. High blood pressure 

6. Heart trouble 

7. Ill effects of a stroke 

8. TROUBLE with varicose veins 

9. Hemorrhoids or piles 

10. Tumor, cyst or growth 

11. CHRONIC gall bladder or liver trouble 

12. Stomach ulcer 

13. Any other CHRONIC stomach trouble 

14. Bowel or lower intestinal disorders 

15. Kidney stones or CHRONIC kidney trouble 

16. Mental illness 

17. CHRONIC nervous trouble 

18. Mental retardation 

19. Arthritis or rheumatism 

20. Diabetes 

21. Thyroid trouble or goiter 

22. Epilepsy 

23. Hernia or fupture 

24. Prostate trouble 

25. ADVANCED senility 

Card E 

LIST OF SELECTED CONDITIONS 

Does this resident have any of these conditions? 

1. Deafness or SERIOUS trouble hearing with one or both ears 

2. SERIOUS trouble seeing with one or 

both eyes even when wearing glasses

3. Any speech defect 

4. Missing fingers, hand, or arm--toes,

foot, or leg

5. Palsy

6. Paralysis of any kind 

7. Any CHRONIC trouble with back or spine

8. PERMANENT stiffness or any deformity of the foot,leg, fingers, arm, or back 

36 U. S. GOVERNMENT PRINTING OFFICE : 1961 0 - 268-375 
Series 1. 

Series 2. 

Series 3. 

Series 4. 

Series 10. 

Series 11. 

Series 12. 

Series 13. 

Series 20. 

Series 21. 

Series 22. 

OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publication No. 1000 

Programs and collection procedures.- Reports which describe the general programs of the National 

Center for Health Statistics and its offices and divisions, data collection methods used, definitions, 

and other material necessary for understanding the data. 

Data evaluation and methods research. -Studies of new statistical methodology including: experimental tests of new survey methods, studies of vital statistics collection methods, new analytical 

techniques, objective evaluations of reliability of collected data, contributions to statistical theory. 

Analytical studies.- Reports presenting analytical or interpretive studies based on vital and health 

statistics, carrying the analysis further than the expository types of reports in the other series. 

Documents and committee reports.- Final reports of major committees concerned with vital and 

health statistics, and documents such as recommended model vital registration laws and revised birth 

and death certificates. 

Data from the Health Interview Survey.- Statistics on illness, accidental injuries, disability, use of 

hospital, medical, dental, andother services, andotherhealth-related topics, based on data collected 

in a continuing national household interview survey. 

Data from the Health Examination Survey.- Data from direct examination, testing, and measurement of national samples of the population provide the basis for two types of reports: (1) estimates 

of the medically defined prevalence of specific diseases in the United States and the distributions of 

the population with respect to physical, physiological, and psychological characteristics; and (2) 

analysis of relationships among the various measurements without reference to an explicit finite 

universe of persons. 

Data from the Institutional Population Surveys.- Statistics relating to the health characteristics of 

persons in institutions, and on medical, nursing, and personal care received, based on national 

samples of establishments providing these services and samples of the residents or patients. 

Data from the Hospital Discharge Survey.- Statistics relating to discharged patients in short-stay 

hospitals, based on a sample of patient records in a national sample of hospitals. 

Data on mortality.- Various statistics on mortality other than as included in annual or monthly 

reports- special analyses by cause of death, age, andother demographic variables, also geographic 

and time series analyses. 

Data on natality, marriage, and divorce. - Various statistics on natality, marriage, and divorce other 

than as included in annual or monthly reports- special analyses by demographic variables, also 

geographic and time series analyses, studies of fertility. 

Data from the National Natality and Mortality Surveys. - Statistics on characteristics of births and 

deaths not available from the vital records, basedon sample surveys stemming from these records, 

including such topics as mortality by socioeconomic class, medical experience in the last year of 

life, characteristics of pregnancy, etc. 

For a list of titles of reports published in these series, write to: Office of Information 

National Center for Health Statistics 

U.S. Public Health Service 

Washington, D.C. 20201