NATIONAL CENTER Series 12 

For HEALTH STATISTICS I Number 4 

VITAL and IZEALTN STATISTICS 

DATA FROM THE NATIONAL HEALTH SURVEY 

. Utilization of 

Institutions 

for the aged 

and chronically ill 

UnitedStates-April- June1963 

Statistics on the number of beds, admissio.ls, discharges, recipients of public assistance, and rate of 

occupancy in institutions for the aged and chronically 

ill. Based on data collected from institutions during 

the period April-June 1963. 

Washington, D.C. ‘ebruary 1964 

U.S. DEPARTMENT OF 

HEALTH, EDUCATION, AND WELFARE Public Health Service 

John W. Gardner William H. Stewart 

Secretary Surgeon General 
Public Health Service Publication No. 1000~Series 12-No. 4 

For sale by the Superintendent of Documents, U.S. Govenmwnt. Printing Offiw 

Washington, DC., 20402 - Price 30 cents 
--- 

NATIONALCENTERFOR HEALTHSTATISTICS 

FORREST E. LINDER, PH. D., Director 

THEODORE D. WOOLSEY, Deputy Director 

OSWALD K. SAGEN, PH. D., hristant Director 

WALT R. SIMMONS, M.A., Statistical khisor 

ALICE M. WATERHOUSE, M.D., Medical A&SOT 

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

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

DIVISIONOF HEALTHRECORDSSTATISTICS 

Monroe G. Sirken, Ph.D., Chief 

E. Earl Bryant, M-A., Chief, hstitutional Popuhtion Survey Branch 

Milton C. Rossoff, M.S., Chief, Hospital Discharge Survey Branch 

Gordon F- Sutton, Ph.D., Chief, VitaI Records Sumeys Branch 

COOPERATION OF THE BUREAU OF THE CENSUS 

Under the legislation establishing the National Health Survey, the Public Health 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, collecting the data, and carrying out certain parts of 

the data processing. 

Public Health Service Publication No. lOOO-Series 12-No. 4 

Library of Congress Catalog Card Number 66-60011 
-- 

CONTENTS 

Page 

Introduction----------------------------------------------------------

Background--------------------------------------------------------

General Survey Design and Qualifications-----------------------------

Beds in Institutions for the Aged ____________________________- --____ - ____ 

Type of Service and Type of Ownership-------------------------------

Provision of Round-the-Clock Nursing Service-------------------------

Geographic Region--------------------------------------------------

Percent Change in Available Beds: 1%2-1963---------------------------- 5 

percent of Beds Occupied---------------------------------------------- 7 

Admissions, Discharges, and Length of Stay------------------------------ 7 

Residents on public Assistance--------- --_- ---_-----__- -___ - -_-_- ---_-_ 

Type of Service and Type of Ownership--------------- -----_----_--_-_ 

Geographic Region--------------------------------------------------

11 

11 

12 

&tailed Tables------------------------------------------------------- 13 

Appendix I. Technical Notes on the Survey Design and Procedures---------- 22 

General --__-_-_-_-_----__----------------------------------------- 22 

Sampling Frame---------------------------------------------------- 22 

Sample &sign-------------- -_-- - ---___--_-_- - -_-_-___- __-__-____ 22 

Survey procedure and Response------------------------------------- 24 

Imputation of Missing Data---------------------- _--- - __---___- d __-_- 24 

Estimation and Reliability of Estimates------------------------------- 24 

Appendix II. 

A. Definitions of Certain Terms Used in This Report------------------ 27 

Terms Relating to Establishments or Residents-------------------- 27 

Demographic Terms-------------------------------------------- 27 

B. Classification of Establishments by Type of Service and Ownership--- 28 

1. Source of Data for Classifying Establishments------------------- 28 

2. Criteria for Classifying Establishments by Type of Service------- 28 

Appendix III. 

A. Questionnaire for the Resident Places Survey-l------------------- 29 

B. Questionnaire for the Master Facility Inventory Survey-------------- 33 
IN THIS REPORT statistics aye presented on the number of beds, 

admissions, discharges, recipients of public assistance, and on the 

rate of occupancy in institutions for the aged and chronically ill. This 

is the fourth in a series of reports based on data collected during 

April- June 1963 in a survey of nursing homes and related facilities, including chronic disease, geriatric and mental hospitals, and all types 

of homes for the aged. Previous reports in this series (Vital and 

Health Statistics, Series 12, Nos. 1, 2, and 3) have dealt with health 

and demographic characteristics of residents in mental hospitals and 

in institutions for the aged as well as with the characteristics of the 

institutions themselves, such as admission policies, type of nurse in 

charge of nursing care, whether round-the-clock nursing service was 

provided, and the charges for caYe of residents. 

Institutions for the aged (excluding mental hospitals) aye classified in 

this report into four types, depending on the primary type of se?-vice 

provided. The basic utilization statistics aye cross-classijied by these 

type-of-service groups, by type of ownership and size of the institutions, and by geographic region. 

An estimated 660,000 beds were maintained by 17,100 institutions, of 

which 88 percent were occupied. Homes providing primarily nuMng 

care maintained about half of these beds and had the highest occupancy 

rate (90 percent) among the types of institutions. About half of the yesidents in institutions for the aged weYe recipients Of public assistance. 

During 1962 approximately 554,000 persons weYe admitted to the institutions and 531,000 weye discharged. Of the persons discharged, 

about one-third weye because of death. Although over 60 percent of 

the 1962 admissions weye discharged before the end of the calendar 

yeay, average length of stay of residents in the institutions at the time 

of the survey was 3 years. This indicates that many residents stay 

short periods as well as long periods of time. 

SYMBOLS 

Data nor available ________________________ ___ 

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

Quantity zero ____________________________ _ 

Quantity more than 0 but less than 0.05~---- 0.0 

Figure does not meet standards of 

reliability or precision------------------ * 
UTILIZATION OF INSTITUTIONS FOR THE 

AGED AND CHRONICALLY ILL 

E. Earl Bryant and Carl A. Taube, D:uision of Health Records Statistics 

INTRODUCTION 

Background 

This is the fourth report to be published on 

the findings of the Resident Places Survey-l 

(RPS-1). The RPS-1 was conducted during the 

spring of 1963 by the National Center for Health 

Statistics in cooperation with the U.S. Bureau of 

the Census. It was based on a probability sample 

of mental hospitals and institutions in the United 

States which provide nursing, personal, or domiciliary care to the aged and chronically ill. Previous reports in this series have presented 

statistics on the health and demographic characteristics of the residents and patients in these 

hospitals and institutions. Statistics on the 

characteristics (e.g., primary type of service, 

type of ownership, admission policies, type of 

nurse in charge of nursing care, whether roundthe-clock nursing service was provided, and the 

amount charged for the care of residents) of the 

hospitals and institutions themselves have also 

been published.l-” This report is concerned with 

INationalCenter for Health Statistics: Institutions for the 

aged and chronically ill, UnitedStates, April-Junel963. Vital 

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

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

Office, July 1965. 

9National Center for Health Statistics: Characteristics of 

residents in institutions for the aged and chronically ill, United 

States, April-June 1963. Vital and Health Statistics. PHS 

Pub. No. lOOO-Series 1%No. 2. Public Health Service. Washington. U.S. Government Printing Office, September 1965. 

3National Center for Health Statistics: Characteristics of 

patients in mental hospitals, United States, April-June 1963. 

Vital and Health Statistics. PHS Pub. No. 1000~Series B-No. 

3. Public Health Service. Washington. U.S. Government Printing Office, in press. 

the utilization of institutions for the aged and 

chronically ill (excluding mental hospitals) in 

terms of the number of available beds, occupancy 

rates, residents on public assistance, and the 

number of admissions to and discharges from 

these institutions. 

General Survey Design and Qualifications 

All resident institutions in the United States 

which provide care to the aged or chronically 

ill were within the scope of the RPS-1. This 

includes nursing homes, convalescent homes, rest 

homes, and other similar types of places with 

three beds or more; nursing-home units and 

chronic disease wards of general hospitals; and 

chronic disease and geriatric hospitals. Institutions such as boarding homes for the aged which 

did not routinely provide some level of personal 

care (i.e., provided only rcom and board) and 

homes which specialized in the care of children 

were not within the scope of the survey. The 

chronic disease wards and, possibly, some of the 

nursing-home units are not usually considered 

as institutions but as integral parts of short-stay 

hospitals. They were included in this survey because of the type of service provided. It is also 

recognized that most of these establishments 

within the scope of the survey are not commonly 

referred to as institutions. However, for convenience and for the sake of clarity, the term 

institution for the aged is used in this report to 

refer to all types of establishments, except 

mental hospitals, that are within the scope of 

the survey. Also for convenience, the term 

“hospital” is used to refer to the group of nonmental hospitals and hospital units providing 

care to the aged and chronically ill. 

1 
The sampling frame for the survey was the 

Master Facility Inventory (MFI), which is discussed in Appendix I. Also, a detaileddescription 

of the development and content of the MFI and of 

a procedure for evaluating its coverage has been 

published. 4 It should be emnhasized that the data 

in this report can be no more representative of 

the institutions in the United States than the 

universe from which the sample was selected. 

According to preliminary research to evaluate 

the coverage of the MFI, the sampling frame for 

the RPS-1 is estimated to be 85 to 90 percent 

complete in terms of establishments and about 

95 percent complete in terms of beds. This 

should be remembered when interpreting the data. 

The statistics shown in this report are based 

on data collected from a&probability sample of 

3,178 nonmental facilities which were found to 

be in business and in scope at the time of the 

survey. With the exception of establishments 

with 300 beds or more, the survey was conducted 

by mail. Personal visits were made to the larger 

homes and “hospitals” to select a sample of 

patients or residents and to aid in the completion 

of the questionnaires. Health and related information about residents in the sample as well as 

certain information about the institutions was 

collected. Details about the sample design and 

survey procedures are described in Appendix I 

of this report. A facsimile of the questionnaire 

used in the survey is shown in Appendix III. 

Since the estimates derived from the survey 

are based on a sample rather than on all institutions in the United States, the estimates are 

subject to sampling variability. The sampling 

errors for most of the estimates shown in the 

report are relatively small; however, caution 

should be taken in interpretation when estimates 

are based on small numbers. Tables of approximate sampling errors and illustrations on the use 

of the tables are given in Appendix I. 

Definitions of certain terms used in this 

report may be found in Appendix II-A. To interpret the data properly, the reader should become 

familiar with the definitions. Special attention is 

4National Center for Health Statistics: Development and 

maintenance of a national inventory of hospitals and institutions. Vita2 and Health Statistics. PHS Pub. No. WOO-Series 

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

called to the procedure for classifying institutions, 

which is described in Appendix II-B. The classification of nursing and personal care homes (i.e., 

nursing homes, rest homes, and related types of 

places) is based on the type of service provided 

in the home rather than on what the home may be 

called or on definitions used by State licensing or 

regulatory agencies. 

The data used for classifying institutions by 

type of service and type of ownership were 

collected primarily during April-June 1962 in a 

survey of all establishments listed in the Master 

Facility Inventory. Thus, there was a time interval of about a year between the MFI survey and 

RPS-1. During this time, the type of service or 

ownership may have changed for some of the 

establishments. However, because of the relatively short time period between the two surveys, 

any changes which may have occurred should not 

have a large effect on the statistics presented in 

this report. 

BEDS IN INSTITUTIONS 

FOR THE AGED 

On the basis of data collected in the spring 

of 1963, there were an estimated 17,100 institutions in the United States which providednursing, 

personal, or hospital care to the agedandchronitally ill. These facilities maintained about 660,000 

beds and provided care to 582,000 residents or 

patients, Tables 1 and 2, which follow the text of 

this report, show the distribution of beds according to primary type of service provided in the 

institutions, type of ownership, size of institution, 

and geographic region. Detailed statistics on the 

number and types of institutions andtne characteristics of their residents have been pub1ished.r 2 

Type of Service and Type of Ownership 

Almost half of the beds in institutions for the 

aged were maintained in nursing care homes 

(table 1). These facilities provided nursing care 

as their primary and predominant service. An 

additional 29 percent of the beds were inpersonalcare-with-nursing homes (the primary and predominant service was personal care but nursing 

care was provided), 14 percent were in “hospitals,” and 9 percent in homes providing only 

2 
Table A. Number and percent distribution of institutions for the aged and the beds 

and residents in these institutions, by type of service and type of owner ship : 

United States, April-June 1963 

Type of service and type of ownership 

All institutions------------------------

Type of service 

A11 types-------------------------------

Nursing care----------------------------------

Personal care with nursing-------------------­ personal care---------------------------------

Hospital care---------------------------------

Type of ownership 

A11 types-------------------------------

Proprietary-----------------------------------

Nonprofit-------------------------------------

Government-----------------------------------­

personal care. Nearly two-thirds of the “hospital” beds were in chronic disease hospitals 

or chronic disease wards of general hospitals, 

and the remaining beds were divided proportionately between geriatric hospitals and nursing 

home units of general hospitals. 

About half of the beds were in proprietary 

facilities, with the remainder about evenly divided 

between government and nonprofit ownerships 

(table A). Proprietary institutions were smaller 

on *the average than those operated under nonprofit auspices (church and other nonprofit), 

and nonprofit institutions were smaller than those 

operated by governments (Federal, State, county, 

city). This becomes apparent when comparing 

the distributions of institutions and beds in 

table A by type of ownership. 

As shown in figure 1 the distribution of beds 

by type of ownership varied considerably between 

type-of-service groups. For example, about 70 

percent of the beds in both nursing care homes 

and personal care homes were proprietary in comparison with 45 percent in personal-care-withnursing homes and only 6 percent in “hospitals.” 

Institutions Beds Residents 

Number 

17,100 I 660,000 I 582,000 

Percent distribution 

100 100 100 

46 48 49 

29 29 

2”; 

4 183 

100 100 100 

79 

14 ;i 2 

7 23 22 

Comparison of the distribution of beds with the 

distribution of institutions by type of service 

and type of ownership gives an idea of the 

relative size of these institutions (fig. 1). For 

example, about 16 percent of the “hospitals” 

and only 6 percent of the total “hospital” beds 

were under private control. On the other hand, 

government-controlled “hospitals,” representing 

only 40 percent of total “hospitals,” contained 

almost 70 percent of the total “hospital” beds. 

In terms of average bed size, government-otied 

“hospitals” maintained 227 beds on the average, 

about three times the average bed size of nonprofit “hospitals,” and about five times the average bed size of proprietary “hospitals.” 

Provision of 

Round -the - Clock Nursing Service 

When nursing and personal care homes were 

further classified by whether or not a nurse or 

nurse’s aide was on duty 24 hours a day, it was 

found that 9 out of every 10 beds were in homes 

3 
PERCENT OF TOTAL BEDS AND INSTITUTIONS 

TYPE OF SERVICE 0 20 40 60 80 100 

I I I I I I 

NURSING CARE 

Beds.. . . . . . . . . . . . . . 

Institutions. . . . . . . . . . . 

PERSONAL CARE 

WITH NURSING 

Beds. . . . . . . . . . . . . . . 

Institutions . . . . . . . . . . . 

PERSONAL CARE 

Beds. . . . . . . . . ..,... 

lnstltutions . . . . . . . . . . . 

HOSPITAL CARE 

Beds.. . . . . . . . . . . . . . 

40 60 

TYPE OF OWNERSHIP 

Proprietory Nonprofit Government 

Figure I. Percent distribution of th‘e number of institutions for the aged and the number of beds in 

these institutions, by type of service and type of ownership. 

which provided such round-the-clock nursing 

service. A similar proportion was observed for 

each ownership class, but the proportion varied 

by type of service provided and by type of ownership within certain type-of-service classes (table 

B). Almost all of the beds in nursing carehomes 

were in homes which had a nurse or nurse’s aide 

on duty at all times. The porportion was also high 

for personal-care-with-nursing homes operated 

under proprietary and government auspices. However, for nonprofit personal-care-with-nursing 

homes, the proportion was noticeably lower and of 

a magnitude more similar to that for personal care 

homes. 

It seems that a sizable proportion of the 

establishments classified as personal care homes 

in this report may have been staffed to provide 

nursing care; nearly half of the beds in personal 

care homes were in homes which reported that 

a nurse or nurse’s aide was on duty 24 hours per 

day. Also, a fourth of the personal care homes 

employed either a full- or a part-timeregistered 

or licensed practical nurse. 

Geographic Region 

The North Central Region had the largest 

number of beds, about twice the number maintained by institutions for the aged in the West 

(table 1). Relative to the population 65 years 

and over, however, about the same number of 

beds was available in all regions except thesouth 

(table 3). The South Region had 27 beds per 1,000 

population 65 years and over in comparison with 

rates of 40 beds or more per 1,000 for each of 

4 
Table B. Percent of total beds in nursing and personal care homes providing round-theclock nursing service, by type of service and type of ownership: United States, 

April-June 1963 

Type of ownership 

Type of service 

All homes Proprietary Nonprofit Government 

Percent of total beds 

Al1 types------------------ 89 88 91 89 

Nursing care---------------------

Personal care with nursing------- 8997 2 2 89: 

persons1 care-------------------- 45 47 47 38 

the other regions. A lower rate prevailed in the PERCENT CHANGE IN

South Region for each type of service and ownership class. AVAILABLE BEDS: 1962-1963 

Nearly half of the total beds in personal-carewith-nursing homes were in the North Central Table C presents the estimated number of 

Region. In fact, there were almost as many beds beds in institutions for the aged in 1962 and the 

in personal-care-with-nursing.homes in the North percent change in the number of beds approxiCentral Region as in nursing carehomes. Inother mately 1 year later. The bed size for each 

regions, nursing-care-home beds were in rhe sample establishment in RPS-1 was available 

majority by ratios of about two to one (table 1). from the Master Facility Inventory Survey conTable C. Number of beds in institutions for the agedin and the percent change in 

number of beds between 1962 and 1963 by type of service and type of ownership:

United States 

Type of ownership 

T Nonprofit Government 

, 

Percent 

Proprietary 

I 

I Percent 

Number change 

of beds 

in 1962 b”lEen 

and 

1963 

Type of 

service 

Number 

of beds 

in 1962 

Percent 

change

between 

1962 

and 

1963 

+6,9 

+3.0 

+7.3 

-3.1 

+10.9 

1 change

between 

1962 

and 

1963 

Number change Number 

of beds between of beds 

in 1962 1962 in 1962 and 

1963 

151,529 f2.4 142,109 

45,785 +5.5 45,214 

69,952 +0.9 34,275 

12,296 0.0 6,002 

23,496 +2.4 56,618 

I I I I 

All types--

P==l== 

Nursing care-- 307,235

Personal care 

with nursing- 189,497 

Personal care- 57,226

Hospital care- 83,951 

f2.4 85,270 f1.6 

+2.0 38,928 +3.4 

+9.4 3,837 +31.0 
ducted primarily during the spring of 1962. 

(The MFI is discussed in Appendix I.) ‘The 

estimated number of beds in 1962 then is the 

weighted number of beds as measured in 1962 

for the RPS-1 in scope sample cases. The estimate of total beds in 1963 is the weighted number 

of beds reported in RPS-1 for these same 

institutions. The percent change therefore represents the estimated increase or decrease in the 

number of beds in those establishments which 

were operating at the time of both the RPS-1 and 

the MFI survey. The decrease in number of beds 

due to establishments going out of business between the date of the MFI survey and the RPS-1 

is not included nor is the increase in beds due to 

the beginning of new businesses between the date 

of the MFI Survey and the RPS-1. Thus, table C 

shows only one of the three components of change 

in the total number of beds available in institutions for the aged. 

The percent change shown in table C also 

underestimates the change during the year for 

two additional reasons: (1) the number of beds in 

1962 was not available for 10 percent of the 

establishments, and thus these establishments did 

not contribute to the estimated change, and (2) 

for about 20 percent of the establishments, the 

MFI survey was conducted during SeptemberOctober 1962. For this segment of the sample 

therefore the interval between the two surveys 

was only about 9 months. 

During the year between the two surveys 

about 22,000 new beds were added to the existing 

facilities. This is an increase of 3.5 percent over 

1962 in the number of available beds. Almost 

half of these additional beds were in nursing care 

homes ( and over a third were addedto “hospitals.” 

“Hospitals,” however, showed the greatest 

relative growth, with a 9.4 percent increase in 

the number of beds. This is more than three times 

the relative increase in the number of beds in 

nursing and personal care homes. While proprietary “hospitals” showed the greatest relative 

increase in the number of beds (31.0 percent), 

the additional proprietary “hospital” beds accounted for only about one-eighth of the total 

“hospital” beds added. There was an increase of 

10.9 percent in the number of beds in governmentcontrolled “hospitals” during the year, accounting 

REGION PERCENT CHANGE IN BEDS: 1962-63 

Uorthaost. . . . . . . . . . . . . . . . . . . . . . 

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

SO”,h . . . . . . . . . . . . . . . . . . . . . . . . . . 

west . . . . . . . . . . . . . . . . . . . . . . . . . . 

-20 -10 0 t10 t20 

m Homes for the Aged m “Hospilalr’ 

Figure 2. Percent change in number of beds between 1962 and 1963 in "hospitals" and homes 

for the aged, by geographic region. 

for over three-fourths of the total “hospital” beds 

added. 

The increased number of “hospital” beds was 

not evenly distributed by geographic region. The 

number of “hospital” beds changedonly slightly in 

the Northeast Region but increased 8 percent in 

the North Central Region and increased over twice 

as much (about 19 percent) in the South and West 

Regions (fig. 2). 

Among nursing and personal care homes, 

there was a 2- to 3-percent increase in the 

number of beds for each type of home. However, 

over three-fifths of the beds addedin these homes 

were in nursing care homes, about three-tenths 

were in personal-care-with-nursing homes, and 

about one-tenth were in personal care homes. 

The relative increase in bed size varied considerably by type of ownership within eachtype-ofservice class. For instance, there was no real 

difference in the relative increase for the three 

ownership classes for nursing care homes. However, for personal-care-with-nursing homes, the 
increase in government-controlled homes was 

much higher than that for both types of nongovernment homes; over half the beds added 

to personal-care-with-nursing homes were added 

to those under government auspices. For personal care homes there was about a 3-percent 

increase in the number of beds in proprietary 

homes. a decrease of equal size in the number of 

beds in government homes, and no change innonprofit and church homes. 

There were no significant differences by 

region in the percent increase in the number of 

beds in homes for the aged and chronically ill. 

PERCENT OF BEDS OCCUPIED 

One measure of the utilization of institutions 

for the agedis the occupancy rate, i.e., the percent 

of beds occupied on the day of the survey. As 

calculated in this report, the number of residents 

on the register of the institution was used as the 

numerator of the occupancy rate. This included 

about 1 percent of the residents who were in a 

hospital or some other place at the time of the 

survey; and their beds were considered occupied. 

Including these persons in the numerator of the 

occupancy rate gives a more valid picture of the 

proportion of beds actually available for new admissions. 

Tables 1 and 2 present occupancy rates by 

type of institution, ownership and size of the institution, and geographic region. The highest 

occupancy rate was observed for nursing care 

homes where about 91 percent of the beds were 

occupied at the time of the survey. Personalcare-with-nursing homes were utilized at almost 

as high a rate, with 88 percent of beds occupied. 

The lowest rate (83 percent) was observed for 

personal care homes and “hospitals.” 

Utilization of nursing and personal care 

homes varied by whether or not round-theclock nursing service was provided. Homes 

providing 24-hour nursing service has a ?Ipercent occupancy rate as opposed to a rate of 

83 percent for homes not providing 24-hour 

nursing service. 

Government-controlled institutions had a 

lower rate of occupancy (84 percent) than proprietary or nonprofit homes (90 percent). This 

varied by type of institution, however. For instance, 9 out of every 10 beds were occupied 

in nursing care homes regardless of the type 

of ownership. Par “hospitals,” on the other 

hand, only about three-fourths of the beds in the 

proprietary “hospitals” were occupied compared 

with four-fifths of the beds in government-controlled “hospitals.” 

The occupancy rate varied slightly by size 

of institution (table 2). Considering all types of 

facilities, the occupancy rates were lowest for 

places with less than 30 beds and with 300 beds 

or more. It may be seen, however, that factors 

other than size caused the major part of the differences. For example, the low rate for large institutions was mainly due to the lower proportion of 

beds occupied in government-operated “hospitals ,” which accounted for over 50 percent of 

the beds in establishments with 300 beds or more. 

The overall occupancy rate was a little lower 

in the South than in any of the other regions, due 

largely to the much smaller proportion of “hospital” 

beds occupied. About 7 out of every 10 hospital 

beds in the South were occupied as opposed to 

over 8 in the West and about 9 in the Northeast 

and North Central Regions (tables 1 and D). 

This is related to the difference in occupancy 

rates by type of ownership. Because over threefifths of the beds in the South under government 

control were in “hospitals,” the low occupancy rate 

for “hospitals” was reflected in the overalloccupanty rate for government-owned facilitiesabout 75 percent in the South as compared with 85 

percent in the Northeast and North Central and 

90 percent in the West. 

ADMISSIONS, DISCHARGES, 

AND LENGTH OF STAY 

During calendar year 1962, an estimated 

554,000 persons were admitted to institutions for 

the aged and 531,000 were discharged. Of the 

discharges, about one-third were because of death. 

Tables 4 and 3 show how these dataare distributed according to the primary type of service 

provided in the institutions, type of ownership, and 

geographic region. The tables also show the 

number of admissions per bed, a relative measure 

of turnover which allows a comparison of admissions to the various types of institutions. 

7 
Table D. Percent of beds occupied in institutions for the aged, by primary type of 

service and geographic region: United States, April-June 1963 

Primary type of service 

Region Nursing Personal care Personal Hospital 

care with nursing care care 

Percent of beds occupied 

All regions--------- 91 1 88 1 83 1 84 

I I I Northeast-----------------

North Central------------- South--------------------- 89 west---------------------- 92 

The ratio .of admissions to beds varied 

somewhat by type of service,type of ownership, 

and region. The highest rate of turnover in 

residents was observed for "hospitals" and the 

lowest for personal-care-with-nursing homes. 

Considering all types of service, there was little 

Table E. Selected measures of utilization 

variation in the ratio by type of ownership. However, within type-of-service groups there were 

several notable differences. For example, the 

ratio was only half as large for nonprofit personal-care-with-nursing homes as it was for 

similar homes under other types of ownership. 

of institutions for the aged, by primary type of service: United States, 1962 

-

T Primary type of service 

Measure of utilization Personal 

All Nursing care Personal Hospital

types care with care care

nursing 

Number of admissions during 1962----- 554,138 264,955 93,529 44,412 151,242 

Percent discharged before end of 1962--------------------------- 62.4 58.5 45.5 66.2 78.7

Percent remaining at end of 1962--- 37.6 41.5 54.5 33.8 21.3 

Number of discharges during 1962----- 530,607 253,156 86,106 39,064 152,281 

Percent admitted during 1962------- 65.2 61.2 49.5 75.3 78.1

Percent admitted before 1962------- 34.8 38.8 50.5 24.7 21.9 

Mean length of stay per admission (in years)------------------------- 1.1 1.1 1.8 1.1 0.5

Mean length of stay of current 

residents (in years)--------------- 3.0 2.5 3.8 3.4 3.1

Median length of stay of current 

residents (in years)--------------- 1.7 1.6 2.2 2.0 1.5 
Table F. Selected measures of utilization of institutions for the aged, by type of 

ownership: United States, 1962 

-

T Type of ownership 

Measure of utilization 

All 

types /I Proprietary Nonprofit Government 

Number of admissions during 1962----- 554,138 305,145 105,870 143,123 

Pzrfc;;;2discharged before end 

--------------------_____c_ 62.4 58.7 64.5 68.8 

Percent remaining at end of l.962--- 37.6 41.3 35.5 31.2 

Number of discharges during 1962----- 530,607 286,998 99,851 143,768 

Percent admitted during 1962-------

Percent admitted before 1962-------

65.2 62.4 

34.8 37.6 

68.4 

31.6 

68.5 

31.5 

Mean length of stay per admission (in years)------------------------- 1.1 1.0 1.3 0.9 

Mean length of stay of current 

residents (in years)--------------- 3.0 2.3 4.0 3.7 

Median length of stay of current 

residents (in years)--------------- 1.7 1.5 2.5 1.9 

Proprietary “hospitals” had a ratio of more than 

twice that for government and nonprofit “hospitals.” 

The data indicate a more rapid rate of turnover in residents for nursing care homes in the 

West Region than for nursing care homes in 

other regions; the homes in the West had about 

1.2 admissions per year per bed compared with 

0.8 admissions per bed in other regions. Also, 

it may be noted in table 4 that the ratio was higher 

for “hospitals” in the West and South than in the 

Northeast and North Central Regions. 

Other statistics which provide further insight 

into the patterns of utilization are shown in tables 

E and F. In comparing the three measures of 

length of stay-i.e., the average (mean) stay per 

admission, the average (mean) stay of current 

residents, and the median stay of current residents-it is important to distinguish between 

them and to realize what is being measured. 

The average duration of stay per admission 

may be considered the projected average period 

of time that admissions will stay in the institutions before being discharged, assuming a constant admission and discharge rate. This average 

is a measure of the length of stay in relation to 

both current residents and those who have been 

discharged. As computed in this report, the 

average length of stay per admission is an 

approximation based on the ratio of the number 

of residents on the register of institutions at 

the time of the survey to the number of admissions to these insritutions during 1962. 

The average length of stay of current residents was based on the length of time that 

residents had been in the particular institution 

at the time of the survey. The average length 

of stay of current residents was relatively long 

because of the influence of very long stays. The 

median length of stay of current residents is probably a better measure of central tendency than 

the average since it is not influenced by the 

magnitude of the extremes of the distribution. 

(The median is the point in the distribution 

where half of the residents had shorter stays 

than the median and half had longer stays.) 

It should also be realized that the percent of 

1962 admissions who were discharged in 1962 

is also an approximation, as are the other 

percentages shown in tables E and F. The percent of 1962 admissions who were discharged 

before the end of the year was computed by 

9 
subtracting from the 1962admissions the number 

of residents in the institutions at the time of the 

survey with stays of less than 1 year and dividing this difference by the number of admissions. 

Thus it is assumed that the number of residents 

with less than 1 year of stay at the time of the 

survey (April- June 1963) was similar to the 

number with less than 1 year of stay who were 

in the institution on January 1, 1963. It is 

also assumed that residents with less than 1 

year of stay had been admitted only once during the year. Similar assumptions were made 

in computing the percent of 1962 discharges 

who were admitted during the year and prior to 

the year. 

Two facts stand out in tables E and F. One 

is that a large proportion of the residents in institutions for the aged and chronically ill stayed 

relatively short periods of time; nearly two-thirds 

of the admissions during 1962 were discharged 

before the end of the year. The other fact to be 

noted is that some residents also stayed for 

long periods of time. The average length of stay 

of residents who were in the institutions at the 

time of the survey was 3 years; about a third of 

the residents had been admitted 3 years or more 

prior to the survey. These facts emphasize the 

dual nature of institutions for the aged. They are 

both “short-stay” and “long-stay” in character. 

This is true for each type-of-service class as 

well as for each type-of-ownership class as indicated in tables E and F. 

About a third of all discharges from institutions for the aged were because of death. These 

deaths represent approximately 10 percent of ali 

deaths in the United States in 1962. 

The death rate of 308 per 1,000 residents 

was about 5 times that of the U.S. population 

65 years and over (61 per 1,000). One reason for 

this higher rate is the relatively larger number of 

very old people in these institutions. However, if 

the residents were to have experienced thesame 

age-specific death rates as the U.S. population 

35 years and over, the observed number of deaths 

(179,000) would still be about 3 times the expected 

number of deaths (58,000). For the purpose of 

this computation, it was assumed that all residents 

or patients under 45 years of age were between 

35 and 45 years. 

Thus, if the effect of age on the death rate 

is held constant, it is seen that factors other 

than age caused about 3 times as many deaths in 

the institutional population as in the U.S. population of similar age groups. Undoubtedly a major 

factor contributing to this difference is the poor 

health of residents in institutions for the aged. 

As shown in table 4, the proportion of death 

discharges varied by type of service. In homes 

providing nursing care, the proportion was about 

twice as large as in personal care homes and 

“hospitals.” The health of ‘hospital” patients 

appeared to be slightly better than that of patients 

in nursing care homes in terms of the proportion 

of patients confined to bed and of patients who 

never walk or get about. Probably a primary 

reason for the smaller proportion of “hospital” 

death discharges was related to the younger ages 

of “hospital” patients. The average age of “hospital” patients was 71 years and of nursing care 

home patients, 78 years. A detailed comparison 

of the two populations is provided in another 

report. 2 

There was some variation in the proportion 

of death discharges between geographic regions 

as shown in table 4. The highest proportion 

was observed for the North Central Region and 

the lowest for the West Region. This difference 

is apparent for all types of institutions except 

personal care homes for which the pattern is 

reversed. More than 8 out of every 10 patients 

in personal care homes in the North Central 

and Northeast Regions were discharged alive. This 

is in comparison with less than 7 out of every 10 

live discharges in the West and South. 

By type of ownership, the largest proportion of death discharges were in proprietary 

institutions. This higher rate, however, is probably more related to type of service than to type 

of ownership. Over three-fourths of the proprietary institutions were nursing care and personal-care-with-nursing homes, which experienced a higher proportion of death discharges 

than did personal care homes and “hospitals.” 

The largest proportion of deaths in any type of 

ownership type-of-service class was observed 

for nonprofit personal-care-with-nursing homes 

for which more than half of the discharges were 

because of deaths. 

10 
TYPE OF OWNERSHIP 

All types 

Proprietary 

Nonprofit 

Government 

Nursing care Personal care with nursing Personal care Hospital care 

Figure 3. Percent of residents on public assistance in institutions for the aged, by primary type of 

service and ownersh i p. 

RESIDENTS ON PUBLIC ASSISTANCE 

One of several questions concerning an 

establishment’s admission policy was “Do you 

accept persons who are recipients of public assistance or welfare?” Public assistance or welfare 

was defined to include general welfare programs 

of State and local governments and the following 

federally sponsored programs: Old Age Assistance, Aid to Permanently and Totally Disabled, 

Aid to the Blind, and Medical Assistance for the 

Aged. Those answering “yes” were asked, ‘Wow 

many residents do you have who are on public 

assistance or welfare?” On the basis of answers 

provided to these questions, it is estimated that 

about 90 percent of the institutions did accept 

persons on public assistance, and about 280,000 

such persons were residents in these institutions. 

This represents nearly half of all residents in 

institutions for the aged and chronically ill. 

Type of Service and Type of Ownership 

As shown in table 6 and figure 3, the proportion of residents on public assistance varied 

according to type of ownership and primary type 

of service provided in the institution. In general, 

the proportion of residents on public assistance 

was higher for proprietary institutions than for 

other types. Of the total residents on public 

assistance, about 60 percent were in proprietary 

facilities. Moreover, more than half of the res11 
idents in proprietary homes within each type-ofservice group except “hospitals” were recipients 

of public assistance. 

Recipients of public assistance composed 

about half of the residents in government facilities, most of whom were in institutions operated 

by city or county governments. 

By type of service, the largest proportion of 

residents on public assistance was observed for 

nursing care homes. This higher proportion is 

attributable in part to the high cost of long-term 

illness, in part to liberalized provisions for 

medical indigence under public assistance programs which authorizes care in “skilled” nursing 

homes but not in other types of homes, and in 

part to restrictions in payment of public assistance 

funds to persons in government institutions, except 

in those of a medical type. 

Geographic Region 

Considering all types of institutions, there 

was little, if any, variation by geographic region 

in the proportion of residents on public assistance 

(table 6). The patterns observed for the Nation 

as a whole when the establishments were classified by type of service and ownership were also 

evident within each region. 

12 
DETAILED TABLES 

Page 

Table 1. Number of beds in institutions for the aged and percent of beds occupied, by geographic re ion,primary type of service, and type of ownership: United States,

April-June 19g3---- _c-----___-----_-_------------------------------------------- 14 

2. Number of beds in institutions for the aged and percent of beds occupied, by primary type of service, type of ownership,and sizeofinstitution: United States,

April-June 1963----------------------------------------------------------------- 16 

3. Number of beds in institutions for the aged per 1,000 total civilian population 65-k years of age, by geographic region, primary type of service, and type of 

ownership: United States, April-June 1963--------------------------------------- 18 

4. Number of admissions and discharges during calendar year 1962, number of admissions per bed, and percent of discharges-discharged alive or dead-by geo­ graphic region and primary type of service: United States----------------------- 19 

5. Number of admissions and discharges during calendar year 1962, number of admissions per bed, and percent of discharges-discharged alive or dead-by primary type of service and type of ownership: United States----------------------- 20 

6. Number of residents in institutions for the aged and percent of residents on 

public assistance, by geographic region, primary type of service, and type of 

ownership: United States, April-June L963--------------------------------------- 21 

7. Population aged 6!5+ years used in obtaining rates shown in this publication, by geographic region: United States, July 1, 1962---------------------------------- 21 

13 
Table 1. Number of beds in institutions for the aged and percent of beds occupied, by geographic region, primary type of service, and type of ownership: United States, April-June 1963 

Type of ownership 

II I I Region and primary type of service 

*" types I/ Proprietary 1 z;sd 1 Government 

All regions Number of beds 

All types------------------------- 660,407 353,2371 155,2291 151,941 

I I Nursing care---------------------------- 46,570 Personal care with nursing-------------- EyZ 36,776 Personal care--------------------------- 58:366 5,818 Hospital caTe--------------------------- 91,861 62,777 

Northeast 

All types------------------------- 195,659 96,536 50,331 48,792 

I I 

Personal care with nursing-------------- Personal care--------------------------- Hospital care---------------------------

46,057

16,420

27,566 

21,424

3,332

10,557 

10,321

1,132

16,024 

North Central 

All types------------------------- 231,469 115,539 1 60,8441 55,086 

I I 

Nursing care---------------------------- 99,834 65,089 17,609 17,136 

Nursing care---------------------------- 105,616 15,018 21,315 

Personal care with nursing-------------- 88,034 36,770 31,234 20,030 personal care--------------------------- 20,113 12,920 4,189 3,004 Hospital care--------------------------- 23,488 760 7,812 14,916 

South 

All types------------------------- 132,695 83,180 1 24,116 25,399 

Nursing care---------------------------- 64,289 9,270 Personal care with nursing-------------- 35,319 9,329 ?% Personal care--------------------------- 12,638 2,111 1:310 Hospital care--------------------------- 20,449 3,406 15,009 

West 

All types------------------------- 100,584 

Nursing care---------------------------- 46,436 37,225 6,404 2,807 Personal care with nursing-------------- 24,595 13,350 8,588 2,657 Personal care--------------------------- 9,195 6,161 2,662 Hospital care--------------------------- 20,358 1,246 2,284 16,828 

14 

372 
Table 1. Number of beds in institutions 

region, primary type of service, and 

Region and primary type of service 

All regions 

All types-------------------------

N-sing care----------------------------

Personal care with nursing-------------­ personal care---------------------------

Hospital care---------------------------

Northeast 

All types-------------------------

Nursing care----------------------------

Personal care with nursing-------------- Personal care---------------------------

Hospital care---------------------------

North Central 

All types-------------------------

N-sing care----------------------------

Personal care with nursing-------------­ personal care---------------------------

Hospital care---------------------------

South 

All types-------------------------

Nursing care----------------------------

Personal care with nursing-------------­ personal care---------------------------

Hospital care---------------------------

West 

All types-------------------------

Nursing care----------------------------

Personal care with nursing-------------­ personal care---------------------------

Hospital care--------------------------­

for the aged and percent of beds occupied, by geographic 

type of ownership: United States, April-June 1963-Con. 

Type of ownership 

All 

types Proprietary / ChECh;xd 1 Government 

Percent of beds occupied 

88.2 89.01 90.31 84.2 

I I 

90.6 

88.0 

90.6 

88.3 

90.8 

91.8 

90.1 

79.9 

82.6 82.9 86.4 72.2 

83.9 75.5 86.8 83.5 

88.8 90.0 89.8 85.3 

90.1 91.3 89.0 87.0 

87.9 88.3 89.6 83.7

83.0 84.0 86.0 63.8

88.5 90.6 92.6 85.7 

82.7 

88.9 89.11 91.81 85.2 

I I 

91.9 91.0 92.2 

86.9 88.3 93.1 97:.ii 

82.9 87.2 75:9

88.7 69.7 87.8 90.2 

84.9 86.5 89.9 74.8 

88.5 88.0 91.2 88.0 

87.5 87.0 90.0 84.5

79.9 81.5 82.4 64.4

72.0 66.0 90.7 68.5 

89.8 

91.8 

92.5 ; 85.1 

84.1 

15 
Table 2. Number of beds in institutions for the aged and percent of beds occupied, by primary type of service, type of ownership, and size of institution: United States, April-June

1963 

Size of institution 

Primary type of service and 

type of ownership All sizes Under 30 30-99 300-lbeds beds l%:gg beds 

All types 

Total------------------------------

Proprietary--------------------------------

Church and other nonprofit--------------- Government-------------------------------

Nursing care 

Total------------------------------

Proprietary------------------------------

Church and other nonprofit--------------- Government-------------------------------

Personal care with nursing 

Number of beds 

260.407 137.364 95.289 

169,082 32,665 2,874

64,206 19,459

3%;, 40,493 72,956 

153,462 64,864 20,279 

122,491 23,123 1,616

17,137 22,637 5,524

13,834 19,104 13,139 

Total------------------------------ 194,005 11 49,001 74,855 50,654 19,495 

Proprietary------------------------------

Church and other nonprofit--------------- Government---------------------------------

86,654

70,575

36,776 

43,623

3,005

2,373 

35,107

28,753

10,995 

6,666

32,779

11,209 

1,258

6,038

12,199 

Personal care 

Total------------------------------ 58,366 11 36,139 16,892 5,015 

Proprietary------------------------------

Church and other nonprofit--------------- Government-------------------------------

40,254

12,294

5,818 

30,448

4,458

1,233 

8,199

5,157

3,536 

1,607

2,359

1,049 

32; 

Hospital care 

Total------------------------------ 15.198 16,831 55,195 

Proprietary------------------------------

Church and other nonprofit--------------- Government-------------------------------

5,025

24,059 I/

62,777 

471 

2,641

1,525 

3,285

7,410

4,503 

1,269

6,431

9,131 

7,57;

47,618 

16 

320 
------------------------------ 

Table 2. Number of beds in institutions for the aged and percent of beds occupied, by primary type of service, type of ownership, and size of institution: United States, April-June 1963-Con. 

Size of institution 

Primary type of service and II I I I type of ownership 30-99 100-299 300-F All sizes Under 30 

beds beds beds beds

All types Percent cf beds occupied 

Total------------------------------ 88.2 86.4 90.0 90.0 83.9 

Proprietary------------------------------

Church and other nonprofit--------------- Government-------------------------------

89.0 

2: . 

8604 

88.9 

78.8 

90.8 

89.2 

87.1 

90.5 

90.9 

88.0 

93.8 

92.4 

81.2 

Nursing care 

Total------------------------------ 90.6 89.3 91.7 89.7 90.1 

Proprietary------------------------------

Church and other nonprofit--------------- Government-------------------------------

90.6 

90.8 

90.1 

89.0 

93.5 

100.0 ;z

91:o 

90.3 

89.8 

88.6 

90.7 

87.6 

91.0 

Personal care with nursing 

Total------------------------------ 88.0 85.8 89,7 91.8 77.0 

Proprietary------------------------------

Church and other nonprofit--------------- Government-------------------------------

88.3 

91.8 

79.9 

86.0 

86.8 

81.4 

90.3 

90.8 

84.8 

91.0 

92.7 

89.5 

PB 

6614 

Personal cars 

Total------------------------------ 82.6 81.0 85.1 84.8 91.9 

Proprietary

Church and other nonprofit--------------- Government-------------------------------

82.9 

86.4 

72.2 

81.0 

86.1 

62.5 

88.4 

86.9 

74.8 

90.5 

85.5 

74.7 

91.9 

Hospital care 

Total------------------------------ 83.9 85.2 79.4 87.2 I

84.0 

Proprietary------------------------------ 75.5 66.5 70.6 91.4 

Church and other nonprofit--------------- 86.8 90.9 76.8 87.5 94.; Government------------------------------- 83.5 81.0 90.2 86.4 82.3 

17 
Table 3. Number of beds in institutions for the aged per 1,000 total civilian population 65+ 

years of age,by geographic region, primary type of service,and type of ownership: United States,

April-June 1963 

Type of ownership 

Region and primary type of service 

All Church and 

types Proprietary other Government 

nonprofit 

All regions 

All types--------------------------------

Nursing care-----------------------------------

Personal care with nursing--------------------- Personal care----------------------------------

Hospital care----------------------------------

Northeast 

All types--------------------------------

Nmsing care-----------------------------------

Personal care with nwrsing---------------------

Personal care----------------------------------

Hospital care----------------------------------

North Central 

All types--------------------------------

N-sing care-----------------------------------

Personal care with nursing--------------------- Personal care----------------------------------

Hospital care----------------------------------

South 

All types--------------------------------

Nursing care-----------------------------------

Personal care with nursing--------------------- Personal care----------------------------------

Hospital care----------------------------------

West 

All types--------------------------------

Nursing care-----------------------------------

Personal care with nursing--------------------- Personal care----------------------------------

Hospital care----------------------------------

18 

Number of beds per 1,000 population

65+ years of age 

38.2 20.4 9.c 8.8 

18.3 12.8 

11.2 ;-: z*: 25 

a:3 il:f 0:3 

“L-1 . 3.6 

41.9 20.7 10.8 10.4 

22.6 14.8 22 z E 1.6' 017 0:2 

5:9 0:2 2.3 3.4 

44.2 22.0 11.6 10.5 

19.0 12.4 

16.8 fz g-8’ 

E 0:s 016 

2:; 0:1 1.5 2.8 

27.4 17.2 1. 0 5.2 

13.3 10.2 

4.6 ::; 2s’ 

z-6' 0:3 

4:2 0':: i:‘; 3.1 

39.5 22.8 7.8 8.9 

18.2 14.6 

z-6' z 

8:0 0:5 
Table 4. Number of admissions and discharges during calendar year 1962, number of admissions per 

bed,and percent of discharges-discharged alive or dead -by geographic region and primary type of service: United States 

umber of Number of Number of Percent Percent 

Region and primary type of service lmissions 

n 1962 

admissions 

per bed dischargesin 1962 di;&zeged discharged dead 

All regions 

All types--------------------- 554,138 0.8 530,607 66.2 33.8 

Nursing care------------------------

Personal care with nursing---------- Personal care-----------------------

Hospital care-----------------------

264,955

93,529

44,412

151,242 

253,156

86,106

39,064

152,281 

59.6 

56.9 

77.9 

79.5 

40.4 

43.1 

22.1 

20.5 

Northeast 

All types--------------------- 161,024 0.8 153,004 65.6 34.4 

Nursing care------------------------

Personal care with nursing---------- personal care-----------------------

Hospital care-----------------------

85,913

25,484

13,817

35,811 

E 

0:8 

1.3 

82,974

24,879

11,243

33,908 

61.4 

61.8 

86.4 

71.8 

38.6 

38.2 

13.6 

28.2 

North Central 

All types--------------------- 157,872 0.7 152.219 61.3 38.7 

Nursing care------------------------

Personal care with nursing---------- Personal care-----------------------

Hospital care-----------------------

68,691

35,383

18,258

35,540 

i-z 

0:9 

1.5 

65,582

31,889

16,242

38,506 

55.1 

49.8 

81.8 

72.8 

44.9 

50.2 

18.2 

27.2 

South 

All types--------------------- 120,123 0.9 114,208 67.4 32.6 

Nursing care------------------------ 56.1

Personal care with nursing---------- 32; Ei 48% 55.1 2; Personal care----------------------- 7:187 0:6 7;289 62.8 3712 

Hospital care----------------------- 40,130 2.0 41,265 86.6 13.4 

West 

All types--------------------- 115,119 0.9 111,176 72.7 27.3 

N-sing care------------------------ 55,840 54,975 65.6 34.4

Personal care with nursing---------- 14,367 0’2 13,309 67.0 33.0 Personal care----------------------- 5,150 0:6 4,290 67.1 32.9 

Hospital care----------------------- 39,762 2.0 38,602 85.5 14.5 

19 
Table 5. Number of admissions and discharges during calendar year 1962, number of admissions per bed, and percent of discharges-discharged alive or dead- by primary type of service and type of ownership: United States 

Primary type of service and Number of Number of Number of Percent Percent 

type of ownership admissions admissions discharges discharged discharged in 1962 per bed in 1962 alive dead 

All types 

Total------------------------- 554,138 0.8 530,607 66.2 33.8 

Proprietary------------------------- 305,145 286,988 61.5 38.5 Nonprofit--------------------------- 105,870 E 99,851 68.6 31.4 Government-------------------------- 143,123 019 143,768 74.0 26.0 

Nursing care 

Total------------------------- 264,955 0.8 253, .56 59.6 40.4 

Proprietary------------------------- 206,185 E -;;, ;;; 59.3 40.7 Nonprofit--------------------------- 24,441 55.8 Government-------------------------- 34,329 0:7 33;218 64.1 2;. Personal care with nursing 

Total-------------------------

Proprietary-------------------------

Nonprofit---------------------------

Government--------------------------

Personal care 

Total-------------------------

Proprietary-------------------------

Nonprofit---------------------------

Government--------------------------

Hospital care 

Total-------------------------

Proprietary-------------------------

Nonprofit ---_-_-----_--_-_---------- Government--------------------------

20 

93,529 0.5 86,106 56.9 43.1 

51,316 0.6 46,626 56.0 

21,988 20,154 43.5 

“;i*: 20,225 22 19,326 72.9 2711 

44,412 0.8 39,064 77.9 22.1 

24,044 19,586 63.6 36.4

11,332 29” 1;,;;; 90.2 

9,036 1:6 , 95.0 E 

151,242 1.6 152,281 79.5 20.5 

23,600 5.0 23,386 89.2 10.8 

48,109 46,336 80.8 19.2 

79,533 I:: 82,559 76.1 23.9 
Table 6. Numberof residents ininstitutions for the aged and percentofresidents on public assistance,

by geographic region, primary type of service, and type of ownership: United States, April-June 1963 

-

T Type of ownership 

Region and primary type of service All Proprie- Non- Govern- All 

types tary profit ment types 

Percent residents All regions Number of residents on public of 

assistance 

All types------------ 582.318 314,208 140,157 127,953 48-C 54.5 31.8 49.7 - - - -

Personal care with nursing- Personal care--------------

Hospital care--------------

la;> f;f 

77;076 

76,501 

33,363 

3,792 

64,793

10,628 

20,882 

29,384 

4,200 

52,402 

42.0 

$E . 

55.6 

56.6 

42.2 

24.0 

25.4 

40.9 

';E 

43:4 

Northeast 

All types----- -______ 173,672 86,848 45,204 41.620 47.3 52.3 31.6 53.8 

Nursing care---------------

Personal care with nursing- personal care--------------

Hospital care--------------

95,176 

2%;

24:390 

13,364

19,203 

2,864 

9,773 

18,538 

8,635 

722 

13,725 

53.4 

34.5 

42.0 

47.2 

53.6 

47.6 

48.8 

60.3 

41.2 

20.4 

15.5 

45.5 

61.7 

E-68 

4716 

North Central 

All types------------ 205,722 102,944 55,829 46,949 47.0 53.3 30.4 52.8 

Nursing care--------------- 286,373 200,552 43,854 41,967 53.0 54.0 40.4 61.5 

Nursing care--------------- 59,250 16,235 16,228 51.1 51.7 39.1 60.9

Personal care with nursing- x42 32,452 29,087 14,985 55.4 24.3 Personal care-------------- 16;643 10,712 3,651 2,280 $ii? 56.8 31.3 ‘;E Hospital care-------------- 20,842 530 6,856 13,456 47:6 37.9 35.0 54:4 

South 

All types------------ 112,600 71,941 21,673 18,986 49.2 56.4 36.9 36.0 

Nursing care---------------

Personal care with nursing- personal care--------------

Hospital care--------------

56,876

30,913 

2 , E 

43,752 

19,336 

7,511 

1,342 

8,450 

8,393 

1,740 

3,090 

4,674 

3,184 

844 

10,284 

54.2 

47.7 

55.3 

28.7 

55.9 

56.6 

63.3 

32.3 

4% 

32:6 

40.9 

52.6 

49.8 

30.8 

24.5 

West 

All types----------- 90,324 52,475 17,451 20,398 50.3 58.2 30.2 47.3 

Nursing care--------------- 42,608 34,276 5,805 2,527 54.7 56.5 32.8 81.5

Personal care with nursing- 22,762 12,072 8,110 2,580 62.7 29.5 44.5 personal care-------------- 7,826 5,099 2,373 354 ti-i 62.0 22.8 19.8 Hospital care-------------- 17,128 1,028 1,163 14,937 4212 41.7 37.0 42.6 

Table 7. Population aged 65+ years used in obtaining rates shown in this publication, by geographic region: United States, July 1, 1962' 

Geographic region All 

regions Northeast North Central South West 

65+ years---------------- 17,308,000 4,670,OOO 5,242,OOO 4,850,OOO 2,546,OOO 

*U.S. Bureau of the Census: Estimates of the population by age, for States and Puerto Rico: July 1,

1962. Current Population Reports, Series P-25, No. 280. Washington, D.C., Mar. 2, 1964. 

21 
APPENDIX I 

TECHNICAL NOTES ON THE SURVEY DESIGN AND PROCEDURES 

General 

The Resident Places Survey-l was a survey of 

resident institutions in the United States which provide 

psychiatric, medical, nursing, and personal care to the 

aged, infirm, or chronically ill. The survey was directed toward the aged, institutional population; however, all people who were residents of facilities within 

the scope of the survey were included regardless of 

age. The survey was conducted during April-June 1963 

in a probability sample of the following types of establishments: nursing homes, convalescent homes, homes 

for the aged and other related facilities, chronic disease 

and geriatric hospitals, chronic disease wards andnursing home units of general hospitals, and psychiatric hospitals, both private and public. 

The U.S. Bureau of the Census collected andedited 

the data according to specifications of the National Center for Health Statistics. The data collection procedure 

was primarily by self-enumeration; the survey was conducted by mail in establishments with less than300 beds. 

For larger homes and “hospitals ,” personal visits were 

made to select the sample of residents and to aid in the 

completion of questionnaires. Health and related information about residents in the sample as wellas certain 

information about the institutions was collected. Some 

types of information requested, especially the health 

information, were provided on the basis of a nurse’s 

or other responsible employee’s memory or personal 

knowledge. However, maximum use of records was 

encouraged. 

Since mental hospitals are not included in this report, the procedures described in this appendix refer 

only to the survey of nonmental facilities. A description of the design of that part of the survey dealing 

with mental hospitals as well as data on the characteristics of mental hospital patients has been published.” 

Sampling Frame 

The Master Facility Inventory (MFI) was the sampling frame for the Survey.4 The MFI includes the 

names, addresses, and certain descriptive information about all hospitals and resident institutions in the 

United States. It was developed by collating a large number of published and unpublished lists of establishments 

and by obtaining information by mail inquiries from 

each of the establishments to classify them by their 

nature and status of business. Among the lists used in 

assembling the MFI were: (1) a list of nursing homes, 

convalescent homes, and homes for the aged that were 

in the files of State licensing agencies in 1961, (2) 

skilled nursing homes listed in “State Plans” submitted 

by the States to the Public Health Service under the 

provisions of the Hill-Burton Hospital Construction 

Act, and (3) a list of hospitals and institutions in which 

people were born or had died during January and February 1958 as shown on birth and death certificates on 

file in the Division of Vital Statistics. 

It is estimated on the basis of preliminary results 

of research to evaluate coverage of the MFI that the 

sampling frame for RPS-1 was at least 85-90 percent 

complete in terms of establishments and about 95 

percent complete in terms of beds. The indications are 

that the places not on the MFI are relatively small, 

possibly no more than half as large, on the average, 

as those listed. 

The scope of the MFI excluded all nursing homes 

and related facilities which maintained less than 3 beds 

or which did not routinely provide some personal care 

to residents. About 1.400 homes which were confirmed to be in business were excluded from the MFI 

on this basis. 

Sample Design 

The sample was a stratified, multistage design. The 

sampling frame 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 returned a questionnaire in the previous 

MFI Survey. Group II contained places which were 

possibly within the scope of the RPS-1 but were not confirmed in the MFI, i.e., nonresponses, questionnaires 

not delivered by the Post Office because of insufficient 

addresses. Group I was then sorted into 16 type-ofservice, bed-size groups. Further stratification within 

each of these basic strata was accomplished by sorting 

by geographic division, type of ownership, and county 

within each State. Group II was stratified in a similar 

22 
----- 

----- 

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

RPS-1 sample by strata (type of service and size of institution), by whether or not the sample institutions were in business and within the scope of the survey: United States 

Number of institutions in the sample 

Number of instiand size of Out of scope, out of Type of service tutions in the MFI 

In-scope and in business business, or duplicate institution :otal 

Zroup I :roup II' Total Group I Zroup 11 Total Group I Zroup II 

Total 

All types-- 16,962 2,516 3,486 3,178 3.056 122 308 154 154 

Nursing care? 

Under 30 beds

(and unknown)- 4,690 2,144 455 331 290 41 124 102

30-99 beds----- 3,389 1,243 1,160 1,085 75 83 22 42

100-299 beds--- 526 3:61 362 336 331 5 26 20 

300+ beds------ 96 5 101 91 90 1 10 6 : 

Personal care 

with nursing 

Under 30 beds 

368;; yn:rwd -

LOO-299 beds---

3,129

1,479

357 

209 

494 

236 

196 

478 

228 

196 

2:: 

:6’ 

8 

16 

300+ beds------ 41 41 39 39 2 ; 

Personal care 

Under 30 beds 

36a;; crowd - 2,279 146 132 132 14 14 

13 

. 313 104 100 100 4 4 

loo-299 beds---

3001- beds------

23 

5 

18 

5 

17 

4 

17 

4 : : 

Domiciliary * 

care 

U der 30 beds 

? and unknown)- 551 42 6 6

30-99 beds----- 77 27 ;“7 9;

100-299 beds--- 7 3 3 3 

300+ beds-----­

'The institutions in Group II are classified on the basis of old information obtained from establishment source lists that were used in assembling the sampling frame (MFI). They are shown 

under the nursing care category in this table for convenience.

"Included are long-stay geriatric and chronic disease hospitals and chronic disease wards of 

general hospitals. The nursing home units are spread through the various type-of-service strata 

depending on the primary type of service provided in the units. 

manner except. that the specific type of institution was 

not known. The information that was available for Group 

II establishments was that recorded on source lists used 

in assembling the MFI. After stratification the Group 

II places were listed at the end of those in Group i for 

corresponding size groups. The sample of establishments was then selected systematically after a random 

start within each of the 16 basic strata. 

The second-stage sample was a systematic selection of residents or patients who were domiciled in the 

sample establishments. The sampling rate for the selection of establishments was variable, depending on 

the number of beds maintained by an establishment. 

However, the product of this first-stage sampling rate 

and the second-stage rate was a constant (l/15). 

Further discussion of the procedure for samplingresidents appears in the report which deals with the characteristics of residents of nursing and personal care 

homes.” 

Table I shows the distribution ofnonmentalinstitutions in the RPS-1 sampling frame and the number in 

the sample by strata. The initial sample contained 

23 
Table II. Number and percent distribution of respondents and nonrespondents in the Group I 

sample, and nonresponse rate, by size of institution 

Respondents Nonrespondents 

Number of beds Nonresponse 

rate

Number Per cent Number Percent 

All sizes----------------- 2,902 

Under 30 beds------------------- 617 

30-99 beds---------------------- 1,587

100-299 beds-------------------- 565 

3()0+ beds----------------------- 133 

3,486 places. Of these, 3,178 were found to be in business and within the scope of the survey. As shown in 

table I, less than half of theplacesin the Group II sample and about 95 percent of those in the Group I sample 

were part of the final sample. A large proportion of 

the deletions from the Group I sample was due to duplications in the MFI. 

Survey Procedure and Response 

For places with less than 300 beds a questionnaire 

was sent by first-class mail. Using certified mail and 

an interval of 3 weeks after each preceding letter, two 

reminder letters were sent to nonrespondents. Telephone calls were made to establishments which had not 

responded to the mail inquiries; appointments for personal visits were routinely requested during the telephone call for all places with 100 beds or more. A 

personal visit was offered for smaller places if the respondent indicated that help was needed. After all waves 

of solicitations 203 establishments, or about 6 percent 

of the total in-scope sample, failed to cooperate in the 

survey. Forty-nine of these were in Group II of the sampling frame. (Group II consists of establishments not 

responding in the MFI Survey.) In Group I the nonrespondents were somewhat smaller than were the respondents; this is indicated in table II. 

Imputation of Missing Data 

The missing information due to establishment nonresponse has been imputed to be the same as that reported by responding establishments in the survey of 

similar classification. A nonresponse adjustment consisting of 3 type-of-ownership groups within each of 

the 16 type-of-service, bed-size strata was made for 

each of 48 subdivisions of the sample. 

Any bias in estimates that may have resulted from 

this procedure should be small, since a high proportion 

of the establishments in the sample returned a questionnaire. The nonresponse rate was smaller for about 

three-fourths of the 48 groups than the 6 percent that was 

100.0 154 100.0 5.0 

21.3 10’: 24.0 

54.7 66.9 

19.5 14 9.1 

4.6 

experienced for the total sample. The highest rate for 

any group was 17 percent; for about 95 percent of the 

groups the nonresponse rate did not exceed 10 percent. 

Also, certain of the individual items were imputed 

when left blank by responding establishments. Tbeproportion of the sample establishments with particular 

items unknown ranged from “zero” for questions 

about the number of beds and the number of residents 

to 6.8 percent for the question about a nurse or 

nurse’s aide being on duty 24 hours a day. For the 

number of residents on public assistance or welfare, 

the number of admissions, and the number of discharges-discharged alive or dead-about 3 percent of 

the cases for each were imputed. The general imputation procedure for al1 of these items except the number 

of welfare recipients was to sort the sample establishments into the 16 type-of-service and bed-size 

strata used in the sample design and within these 

groups to assign to the case with the unknown item 

the answer that had been given for the preceding establishment in the listing. The number of residents 

on public assistance was imputed by multiplying the 

number of residents in the establishment by the ratio: 

number of people on public assistance as reported by 

al1 establishments divided by the total number of 

residents in homes accepting people on public assistance or welfare. 

Estimation and Reliability of Estimates 

The statistics presented in this report are essentially the product of 3 ratio-estimation technique. An 

adjustment factor R - B,/B’, was determined for each 

noncertainty stratum of the sample design. Bi is the 

total number of beds for establishments inthe i th stratum according to the MFI. B; is the estimated number 

of beds for establishments in the rth stratum; it is obtained through a ,simple inflation of the MFI data for 

sample establishments in the ith stratum. The purpose 

of ratio estimation is to take into account all relevant 

information in the estimation process, thereby reducing 

the variability of the estimate. 

24 
Table III. Approximate standard errors of percentages shown in this report 

Estimated percent Base of 

estimated percent (number of beds 5 95or 1090 or 2080 or 3070 or 4060 or or residents) 50

Standard error expressed in percentage points 

Illustration of the use of table III: Table 1 

personal-care-with-nursing homes were occupied at 

the standard error of 90 percent based on 200,000

polation, the desired standard error is approximately 

Since the statistics presented in this report are 

based on a sample, they will differ somewhat from figures that would have been obtained if a complete census 

had been taken using the same schedules, instructions, 

and procedures. As in any survey, the results are also 

subject to reporting and processing errors and errors 

due to nonresponse. 

The standard error is primarily a measure of sampling variability. It does not include estimates of any 

biases which may be reflected in the data. The chances 

are about 68 out of 100 that an estimate from the sample 

would differ from a complete census by less than the 

standard error. The chances are about 95 out of 100 

that the difference would be less than twice the standard 

error and about 99 out of 100 that it would be less than 

2% times as large. 

In general, the standard error of one statistic is 

different from that of another even when the two come 

from the same survey. In order to derive standard 

errors that would be applicable toawidevariety of sta11.5 15.3 17.5 18.7 19.1 

7.3 11.1 11.8 12.1 

4:: 8.6 

$2 . 2: 68-i 

4.8 5:5 5:9 f?: 

Ei 3:8 

9:: 5-z z-6’ 

::“3 2:o 2:2 53 

::“5 

29’ :-: i-z i-6’ 

::f 1:2 1:3 1:4 

E 

0:5 Z 8:; E 0’:: 

shows that 88 percent of the 194,000 beds in 

the time of the survey. As shown in table III 

beds is 0.8 percentage points. Thus, by inter0.9 percentage points. 

tistics and could be prepared at a moderate cost, a 

number of approximations were required. As a result, 

the relative standard errors shown in figure A and the 

standard errors shown in table III should be interpreted 

as approximate rather than precise for any specific 

estimate. (The relative standard error of an estimate 

is obtained by dividing the standard error of an estimate 

by the estimate itself and is expressed as a percentage 

of the estimate.) 

The standard errors (and relative standard errors) 

shown in th’is appendix are not directly applicable to 

differences between two sample estimates. ‘lhe standard error of a difference is approximately the square 

root of the sum of the squares of each standard error 

considered separately. Although it is only a rough approximation in most other cases, this formula will represent the actual standard error quite accurately for the 

difference between separate and uncorrelated characteristics. 

25 
#Figure A- Approximate relative standards errors of estimated numbers of beds snd. residents 

shown in this report 

Size of Estimate 

,Illustration of use of figure A: There are an estimated 194,000 beds in personal-care-with- nursing homesirthe United Statesas shown iq table 1. The relative standard error of 194,000 

is approximately 2.2 percent (read from scale at left side of chart); the standard error of 

194,000 is 4,268 (2.2 percent of 194,000). 

26 
----- 

-- -- ------ 

APPENDIX II 

A. DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT 

Terms Relating to Establishments or Residents 

Institutions fol- the aged: 

This term refers to nursing and personal care 

homes and “hospitals” as defined below. 

Nursing and personal caye ho&es: 

This term refers to the three types of homesnursing care, personal-care-with-nursing, and 

personal care homes-derived from the classification scheme described in section B of this 

appendix. 

“Hospitals.“: 

This term refers to the following hospitals and 

units of hospitals: geriatric hospitals, chronic 

disease hospitals, chronic disease wards of general hospitals, and nursing-home units of general 

hospitals. A description of how hospitals and units 

of hospitals were classified is given in section 

B of this appendix. 

Nursing care: 

Nursing care is defined ,rs the provision of one 

or more of the following: 

Hypodermic injection 

Intravenous injection 

Taking of temperature, pulse, respiration, or 

blood pressure 

Application of dressings or bandages 

Bowel and bladder retraining 

Nasal feeding 

Catheterization 

Irrigation 

Oxygen therapy 

Full bed bath 

Enema 

Bed: 

For homes providing nursing or personal care, 

a bed is defined as one set up and regularly 

maintained for patients or residents. Beds maintained for staff and beds used exclusively for 

emergency services are excluded. Hospital beds 

are those regularly maintained (set up and staffed 

for use) for inpatients. Beds used exclusively for 

emergency services and bassinets for newborn 

infants are not included. 

Resident: 

A resident is defined for the purpose of RPS-1 as 

a person who has been formally admitted to but 

not discharged from an establishment, All such 

persons were included in the survey even though 

they were not physically present at the time of 

the survey. 

Public assistance: 

This term includes the following Federal assistance 

programs: Old-age Assistance, Aid to Permanently 

and Totally Disabled, Aid to the Blind, and Medical Assistance for the Aged. It also includes general 

welfare programs ‘of local or State governments. 

Demographic Terms 

Regions and States included in each region.-For 

the purpose of classifying homes and hospitals by 

geographic area, the States are grouped into regions. 

They correspond to those used by the Bureau of the 

Census and are as follows: 

Region States Included 

Northeast--------- Maine, New Hampshire, Vermont, 

Massachusetts, Rhode Island, 

Connecticut, New York, New 

Jersey, and Pennsylvania 

North Central Michigan, Ohio, Illinois, indiana, 

Wisconsin, Minnesota, Iowa, 

Missouri, North Dakota, South 

Dakota, Nebraska, and Kansas 

Sou&- Delaware, Maryland, District of 

Columbia, Virginia, West Virginia, 

North Carolina, South Carolina, 

Georgia, Florida, Kentucky, 

Tennessee, Alabama, Mississippi, 

Arkansas, Louisiana, Oklahoma, 

and Texas 

West _____________ Montana, Idaho, Wyoming, 

Colorado, New Mexico, Arizona, 

Utah, Nevada, Washington, Oregon, 

California, Hawaii, and Alaska 

27 
8. CLASSIFICATION OF ESTABLISHMENTS BY TYPE OF SERVICE AND OWNERSHIP 

1. Source of Data for Classifying Establishments 

The establishments in the RPS-1 were classified 

by type of service and type of ownership on the basis 

of information collected for the MFI. A brief description of the MFI is given in Appendix I; pertinent parts 

of the MFI questionnaire are reproduced in Appendix 

III. The MFI survey of establishments, whichcomposed 

the sampling frame for the RPS-1, was conducted 

during April-October 1962. A survey during April-June 

1962 included about 85 percent of the establishments. 

The remainder was surveyed during September and 

October 1962. Thus, the time interval between the MFI 

Survey and the RPS-1 was approximately 1 year. During this l-year interval, the type of ownership or type 

of service probably changed for some of the establishments. However, because of the short time period between the two surveys, any changes which may have 

occurred should have only a negligible effect on the 

distribution of establishments by either type of service or type of ownership. 

2. Criteria for Classifying Establishments 

by Type of Service 

The different types of homes for the aged have 

been classified according to the primary and predominant type of service provided to their residents. The 

criteria for classifying these homes are based on the 

following factors: 

The number of persons receiving nursing care 

during the week prior to the MFI survey. 

Whether or not medications and treatments are 

administered in accordance with physicians’ orders. 

Whether or not supervision over medications which 

may be self-administered is provided. 

The number of specified personal services routinely provided. These personal services, referred 

to as criterion personal services, include rub and 

massage; help with tub bath or shower; help with 

dressing, correspondence, or shopping; help with 

walking or getting about; and help with feeding. 

The presence or absence of nurses on the staff. 

On the basis of these factors three types of establishments are distinguished and defined as follows: 

Nursing care home.-An establishment is a nursing care home if nursing care is its primary and predominant functions. Those meeting the following criteria 

are classified as nursing care homes in this report: 

28 

One or more registered professional (RN’s) or licensed 

practical nurses (LPN’s) were employed 15 or more 

hours per week, and 50 percent or more of the residents 

received nursing care during the week prior to the 

MFI survey. 

Personal-care-wuith-nursing home--An establish,­

ment is a personal-care-with-nursing home if personal 

care is the primary and predominant function of the 

facility but some nursing care is also provided. The 

following criteria were used in classifying personalcare-with-nursing homes in this report: 

Some of the residents (less than 50 percent) 

received nursing care during the week prior to 

the MFI survey and one or more RN’s or LPN’s 

were employed 15 or more hours per week; or 

Some of the residents received nursing care 

during the week prior to the MFI Survey but 

no RN’s or LPN’s were on the staff; however, 

one or more of the following conditions were 

met: 

(1) Medications and treatments were administered in accordance withphysicians’ orders. ’ 

(2) Supervision over self-administered medications was provided. 

(3) Three or more of the criterion personal 

services were provided. 

Personal care home .-An establishment is a personal care home if it has a function to provide personal 

care but ordinarily not nursing care. Places in which 

any one of the following criteria are met are classified 

as personal care homes in this report: 

Medications and treatments were administered 

in accordance withphysicians’ orders; or supervision over medications which may be self-administered was provided, and no residents received nursing care during the week prior to 

the survey in the establishment. 

Three or more of the criterion personal services were routinely provided, and no residents 

received nursing care during the week prior to 

the survey in the establishment. 

Only one or two of the criterion personal services were routinely provided, there were no 

RN’s or LPN’s on the staff, and the conditions 

in the preceding paragraph a were not met except that nursing care may have been provided. 

Nursing care was provided to one or more residents during the week prior to the survey in the 

establishment, but, otherwise, the only service 
. . . . . . es No 

. . . . . . . . Yes No 

ik 

. . . . . . . . . No Yes 

PPPD B 

provided was room. and board. Either of the 

last two criteria (paragraphs c and d) defines 

a “domiciliary care home” which is one of the 

type-of-service classes used in stratifying the 

sampling frame for this survey. The domiciliary care homes are classed with personal 

care homes in this report since they also have 

a function to provide personal care. 

In the classification process, a criterion was considered as not having been met if the necessary information for that criterion was unknown. For instance, if 

the type of nursing staff was unknown for a particular 

place, it was considered as not having met the criterion 

of having one or more RN’s or LPN’s on the staff. Establishments indicating that some nursing care was 

provided (but not the number of persons to whom this 

care was provided) were considered as institutions providing nursing care to some, but less than 50 percent, 

of their residents. 

Table IVshows in detail the scheme for classifying 

establishments. 

Hospitals.- Included in this category are chronic 

disease and geriatric hospitals and chronic disease 

wards and nursing home units of general hospitals. In 

the MFI, the term “hospital” is not formally defined. 

For the purpose of the Inventory and this survey, an 

establishment is a “hospital” if the respondent in the 

MFI Survey said his facility was a hospital (see MFI 

questionnaire in Appendix III). Specialty hospitals were 

asked to indicate the specialty as geriatric, chronic disease, etc. General hospitals were asked the following 

questions: (1) Does this hospital maintain a special 

ward(s) set aside for the long-term treatment of patients with chronic disease? (Exclude tuberculosis, 

mental illness, alcoholism, or drug addiction), and 

(2) Does this hospital maintain a nursing home unit 

for patients requiring nursing care but not the full 

range of hospital services? The chronic disease wards 

and nursing home units included in this report are 

those maintained by hospitals which answered “yes” 

to these questions. 

Table IV. Criteria for classification of establishments 

Classification criteria 

Some but less 

than 50 percent None 

Percent of total 

residents who received 

ices offered? 

1+ None 

,.. es No 

. . . . . . es No alII 

l-l- None 

I I 

Yes No Ye6 No I I 

. . . . . . es No 

. . . . . . . . Yes No 

. . . . . . . . . No Yes 

PPPD B ik 

Legend: Nursing care home-----------------------N 

Personal-care-with-nursing home---------Pn

personal care home----------------------P 

Domiciliary care home-------------------D 

Boarding or rooming house(out of scope)-B 

-OOG29 
-- 

APPENDIX III 

A. QUESTIONNAIRE FOR THE RESIDENT PLACES SURVEY-l 

The following items show the exact content and 

wording of the questionnaire used in the RPS-1. The 

actual questionnaire was designed for an establishment 

as a unit and includes additional space for reports on 

all residents of an establishment. Such repetitive spaces 

are omitted in this illustration. 

Budget Bureau NO.6&R620-R1: AppmdExpires December 31.196 

CONFIDENTIAL - This informafion is collected under authority of Public Law 652 of the 84th Congress (70 Stat. 489; 

42 U.S.C. 305). Al1 information which would permit identification of an individual or of an esrablishmenr will be held 

strictly confidential, will be used only by persons engaged in and for the purposes of the surrey and will not be die 

closed or released to ocher persons or vscd for any other pvrpose (22 FR 1687). 

;I)PypS-Zo (I, nss*smsry. p,aam dmgs to allow corrsc* name an.3 ad&m.) 

U.S. DEPARTMENT OF COMMERCE BUREAU OF THE CENSUS *CTINC *s COLLECTlNC AGENT FOR THE 

U. S. NATIONAL HEALTH SURVEY 

Gentlemen: 

The U.S. National Health Survey of the Public Health Service, authorized 

by Public Law 652, 84th Congress, is conducting a survey of nursing homes, 

convalescent or rest homes, homes for the aged, chronic disease hospitals,

and other establishments in the United States whose primary function is 

to provide medical, nursing, personal or domiciliary care to the aged,

infirm, or chronically ill. This is one of a series of surveys mentioned 

in a recent inquiry to your establishment by the Bureau of the Census 

which is acting as the collecting agent for the U.S. National Health 

Survey. 

The purpose of the survey is to obtain much needed information on the 

health of residents in these establishments and facts related to their 

care. Please answer the questions on the inside of this form and return 

it as soon as possible preferably within the week. A self-addressed 

envelope which requires no postage has been provided for your conveni­ ence . 

The information will be given confidential treatment by the U.S. National 

Health Survey and the Bureau of the Census, and will be used for statistical purposes only. It will not be used for any regulatory, licensing 

or accreditation purposes; any published summary will be presented in 

such a manner that no individual establishment or person can be identified. 

Thank you for your cooperation. 

Sincerely yours, 

G&G 

Richard M. Scammon 

pirector 

Bureau of the Census 

30 
-- 

-- 

-- 

GENERAL INSTRUCTIONS FOR COMPLETING THE QUESTIONNAIRE 

Base your answers an records, as appropriate, when records are available. 

Step l-- Camplefe Part I, ESTABLISHMENT INFORMATION. 

These questions should be self-explanatory. The ward “esrablishmenr” 

refers to rhe facility providing service to residents or pstients, such as a 

hospital, nursing home, home far the aged, and so forth. The wards 

“resident or patient” are used interchangeably in rhis questionnaire. The 

people being cared for are usually referred to as *‘residents.” However, 

they are referred to as “patients” when this term seems more appropriate. 

Step 2.- Complete Part II, CENSUS OF RESIDENTS OR PATIENTS. 

List in Column (b) the name of l nch person (resident or patlent) who is 

currently an your register as a formal admission. (The number listed 

should be the same as shown for Part I, Quesrion 7.) (If rhl s is a general 

hospital, or some specialty hospital, except chronic disease and/or convalescent, geriatric, and rehabilitation, list only the patienrs or residents 

in your chronic disease ward and/or nursing home unit. All other establishments 

should list all of their patients or residents.) List rhe names in say order 

&at is mast convenient to you. If the names are not listed in alphaberical 

order or in sequence by some assigned number, such as admission number. 

please explain the order of the listing in rhe “Comments” zction on 

Page 4. 

Far each person listed, record rhe date he was last admltteJ to your 

establishment, his date of birth, sex, and race. You may wish to make 

these entries as you record the persons’ names in Column (b). If dare of 

last admission or date of birth is not known, record your best estimate of 

the date. 

Normally, the date of last admission refers to the dare of a,:mission to the 

nursing home, convalescent home, hospital, etc. However, if this is a general 

hospital with a chronic disease ward or a nursing home wiGthe date of lasr 

admission refers to the date of admission to the ward or nursing unir. If this 

is a chronic disease and/or convalescent, geriatric, or rehabilitation hospital 

and you maintain a nursing home unit, the date of last admission refers to the 

date of admission 10 tie nursing home unit or the hospital, which ever was first. 

Step 3 Complete Part Ill, HEALTH OF RESIDENTS OR PATIENTS. 

Some of the lines in Parr III are blocked out, while others pee not. For 

the lines not blocked oat (identified by a circled Iine number), make the 

qprapriale enrries in the colaams in Part III for rhe person whose name 

appearson that line in Parr II, Column (b). This information should be 

provided by the person best acquainted with the health of the residents 

in this establishment. 

Step 4 The names of persons entered on Port II are needed only as a means of 

identification in case there should be a question about an entry on the 

questionnaire when it is reviewed. If you prefer, you may tear off the strip 

on Part II which contains the names of patients. If you da tear off this part 

of the farm, please keep it in your files far at least 6 months. 

Step 5 Far convenience of contact in the event that questions concerning an entry do 

arise, the person completing the questionnairG ‘should enter his name and give 

his title or position, telephone number, and the date the form is completed on 

tie bottom of Port I. 

Step 6 . . After you have completed rhe questionnaire, return ic in the enclosed 

postage-free envelope. If the self-addressed envelope gets misplaced 

before the questionnaire can be completed, return the completed 

questionnaire to the Bureau of rhe Census, Jeffersonville, Indiana. 

Record any comments about the establishment or abaur individuals; on Page 4. 

31 
-- 

Part I - ESTABLISHMENT INFORMATION 

(NOTE: When the term “RESIDENT” is used in the questionnaire, it refers to resident e, patian+.) 

1. When did +his establishment begin accepting residents a+ its present address7 (o+ra ++m 

&lo *t Nret apmed AT THIS ..lmx?rss ae * nurdng home, EanPata*smr home. shmds dlaooao 

ho.pltal, etc., *ID” LWph Iha ov.mor.*lp 0, smtrd ha. a,nss shanpod hand,.). . . . . . . . . . . . . . . 

2 To provide P general pictwe of your admission policy: 

Do you accept the following h/pas of residents? (hark or) ‘*I%,” 01 %o’* lo, each Item.> 

m. M~lsr...................................................... 

b. Fsm~lsr.................................................... 

C. Bedfast patients. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

d. Mentally Ill patimntn (that is, diagnosed by a physician as mentally ill.). . . . . . . . . . . 

0. Do you accept persons of all ages, including childrsl? . . . . . . . . . . . . a . . . . . . . . 

(I) If “NC?’ what agas do you accept? (&far* (,I) 0.~13 boxon,yj . . . . . . . . . . . . . . . . . 

f. Do you accept persons who are recipients of Public A~sist~nre o, Welfare? 

(Thh indudes Old A@ .4eaia*enca. Aid to Psmme”*ly and rotdry D*a.lb+od, Aid to ,+I* 

Bll”d. MOdkd A..lbLMC. ,or the .4gcd. mid m,x.,at wollars.) . . . . . . . . . . . . . . . . . . . . . 

(1) How many residents do you h.ve who we on Public Assirtrmce o, Welfare?. . . . . . 

3. Do you provide nursing care b residents in you, establlrhmsnt? . . . . . . . . . . . . . . . . . . 

I 0 Re&e,ed Nurse, full time J 0 Licensed Practical Nurse, full time 

2 0 Registered Nurse, pa,+ time l 0 Licensed Practical Nurse, part time 

I 0 Neither Registered Nurse not Licensed Practical Nurse 

5. Are rhere one o, more nurses o, nwse’s aides ON DUTY 24 hours a day? . . . . . . . . . . . IlgYcr ZONO 

6. How 

whsthsr 

many 

or not 

beds 

they 

me 

mo 

rsgulorly 

I, use a, 

maintainad 

ths ,xs~cnf the. 

for residents? 

Exclude bsda 

(Include 

was., au 

ny 

at.{, 

beda 

or 

aat 

my 

up 

bsda 

for u-e 

uasd 

1 Number 1

sxsrualvoly +a dmarponcy sor”,oe.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

7. How many residents we currantly on you, register (II formal admissions, 

who have not bean dischqed? (Do not include awlaysoa ormo~rlotir~.~ . . . . . . . . . . 

I8. Of the rsrldsntr In this srtoblirhmsnt (Question 7, above) - Number I

I 8. Howmany slept hers last night? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I 

b. How many wc,e tamporwily awry last night In D hospital? (If this establishment Is 

I a hossl+al. how many residents wecc temmxarilv away last niaht in some other Number . _ 1

hospl;cl?)- *.................................................. 

C. How many wete temperarlly away lost night In soma place other than D Number 

horpltol?.................................................... 

9. How many admlsslons did you have during 19627. . . . . . . . . . . . . . . . . . . . . . . . . . . . Nub’, 

10. How many dlscharga. dld you have during 1962. excluding deathr7. . . . . . . . . . . . . . . . N”mb=t 

11. How many parsons died during 1962 whil e residents of this establishnmnt? (Include aI+ Number 

who did w*,+s 0” your rsp,stor am3n tbw** ramporrrrry aww h . hoapltd or .ome other PI.-.,. . . . 

12 A,e oII parsons odmlttsd to this establishment requwed +o be examined by a physician 

before or soon ufter odmisslon7. . . . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ’ 0 yea 2ONO 

(P., 13. Who+ 1. you, most frequent, you, high**+, and llmrtl) you, lower+ cho,ga’PER MONTH for lodging, me&, 

nursing ewe, and other personal ssrvlces? . . . . . . . . . . . (PC . . . . . . . . . . . rncdh> 

Number 14. How many persons a,* employed in thls esroblishment? (Include l 11pa!d apfopes, 

*ember. Of rel+plo”a odora. ax! mwm,. who Y.“.l+y w0r.k I.5 ho”,. or mo,. . ae.* In th,. set.b*fshmnl. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Name of person completing this farm Telephone No. and Ext. Dare completed 

Establisbmcoc Number 

32 
I Part II - CENSUS OF 

RESIDENTS OR PATIENTS I Part II - CENSUS OF RESIDENTS OR PATIENTS 

If pv wish you may darach and k-q 

thlr rtub of Pm-f II for your records. 

IF YOU DO TEAR OFF THIS STRIP, Enter Dot. of Enter resi- Enter Enter 

PLEASE RETAIN IT IN YOUR FILES Lost Admis- dear’s Dot. resident’s residera’s 

FOR AT LEAST 6 MONTHS. lion honth, .f Birth S.x Roe* 

day, yead (month, day, 

for each year) for each 

resident resident 

7, not Imom, M = Mde W = White. all., bw* f = Fern& NW = fl;;;C ..,h.,.) 

Port Ill - HEALTH OF RESlDENTS OR PATIENTS 

IMPORTANT: CamplOt* on. fine of Part 111 for l och p.rron /ISted On thora /in-r of Part II that m1. Idmntffied by q CIRCLED NUMBER. 

6ED STATUS I I I I 

(Except In bad for 

ordinary rest or deep) 

, 

4. 

33 
6. QUESTIONNAIRE 

The 

wording 

pertains 

the scope 

FOR THE MASTER FACILITY INVENTORY SURVEY 

following items show the exact content and 

of that part of the MFI questionnaire which 

to the classification of establishments within 

of the RPS-I. 

L DESCRIPTION OF ESTABLISHMENT. Pl ease read 811 of the clnsses liared below, then place sn “X” in the box opposite 

the class which best desctibcs this esnblisbment. 

a. HOSPITALS 

t 0 General hospit& . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . COMPLETE S.nton B on Peg. 2 

z f-J Specidcy hospits (I”lnol”d.. In-tllut*on. or horn.. Ior B. ment.lly l.M.llf~d) . . . . . . . COMPLETE S.tiion C on PaI. 2 

Note: If this is a huspltal systwn composed of a general hospital and a specialry hospita1, complete both 

Section B md Secrim C. If it is composed of more tbsn one specialty hospital, complere Section C 

for me of them and furnish the same btfotmstion for each of the orbers on a sepsnte sheer of paper. 

b. ESTABLISHMENTS WHICH PROVIDE NURSING, PERSONAL, OR DOMICILIARY CARI 

3 0 Nursing Home 

COMPLETE S.ctlon D on Parr. 3 

COMPLETE S.st1.n E 0” pow 3 

34 
! Swiion B . GENERAL HOSPITAL 

1. TofuI nvmkr of &ads ngulorly malntolnod (set up and staffed for usa) for fnpntlnt~. (In&& beda fn 

rdxmirs of the hospital such u wards or convalescent units. Exclude beds wed exclushcly for cmergency services and b.ssiners for newborn infants.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

2. Dow this hospltal .drnlt cblldnn only? t OYC‘ 2 0N.x 

3. On the orwag., how long dld potlm~ I l--J Less than 30 dmys stay In this bspltol during colador t 0 30 days or PM yam l%l? 

a. Number of physiciaw (including residents and interns), nurses md ahcr professional peraotmel, rrd 

rechaictn~..................................................................,.............. 

b. Number of all orher paid employees inclodins adminiscrat.ivc personnel, cl&cd and office rotors,

atmd.nr~, sad custodial wakers.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

C. Totdnumbcrofcmployeer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

. . mp*ncnr*.................................................................... 

7. Number of admissioae to this ward(s) during calendar year l%L . . . . . . . . . . . . . . . . . . . . 

6. Approrimare sren~c daily CCIISUS in this ward(s) during 

c~leod.~ye~r1961............................................................ 

0 0 Psychiuxic 

0 hknrd deficiency or recuduion 

2. Dow this hosplkl admit chlldnn o,dy? I I-JYrs z i-JNo 

3. Total nmbw of beds nguforly ~rmlntolnad (.n up and sWf.d br US*) for inpe,ia,~. (Erclvd~ beds used 

exclusively for emegency services and bw&ats &ox newborn infann.).. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

4. What was the number of inpotlwt admissions to lhe hospital during s~lmdor yar l%l? . . . . . . . . . . . . . . . . . 

5. What was the appmxlmae avemga dally cansus during &los&r ymr l%l? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

6. On the awmge, how long dld patlmts stay In this 1 0 Less Ibaa 30 dsys 

hospital during cslndor year 19617 P J-J3O&ysorlnae 

1 

7. Numbw of pafd l mployws. (Insluda proprietors, muu~ers, and all pold employees rho nsudly roll 15 haus 

or more . week in this eamblirbmenr.) 

a. Number of physicians (including rcsidinrs and interns), rnurses md o&r profeasioed personnel, 

~ndttchnickng........................................................................... 

b. Numkr of dl other paid employees including admhircmrive personnel, clericd and office workers, 

utcndmrs, urd custodid workera. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

5. Tot~lnumberofemployee................................................................... 

35 

I 
Section D - ESTABLISHMENT WHICH PROVIDES NURSING, PERSONAL, OR DOMICILIARY kARE 

NOTE, If the tcpozting establishment is I hospital which has s nursing bomc unit (“Yes” box checked fn Question 9, 

Section B a in Ouestion 8. Section CL the items in this section refer to char nursina home unit onlv. 

I. Total numb.? of bwds rqulnrly monntalnod for patl*n~ or nsldants. (Inslud~ any beds set up for use 

whether ot not they ate h use at the present rime. Exclud. beds used by stsff ot my beds used 

crclusiveiy for emergency set&es.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

!. Tot01 numbwof pwsons (patiwts w nsldontm) rho slopi in thim l stabllshnant last nigh+ (.x&ding 

.mployawond pmprlstor~)........................................................................ t 

I. Fx the purpose of this sntvey, the following list of set&es define “Nursing Can”: 

Nas.1 feedings Encmn Applic~rion of dtesshS8 

Carbererizatioras Hypodermic injections ot bw,dagcs 

Itrig*tions Intnrcnoru injections Bowel md bladder 

Oxygen therapy Tempcnrutc - pulse - rerpimtion retmining 

Full bed b.ths Blood presswe 

Du,hp th. pas, s.v.n d,,ys, bow many of tha PERSONS In Pwstla 2 ne*lwd “Nursing Can?‘: . . . . . . . III 

I. Which of ctn foIlmIng smisw an ROUTINELY provldwl? C’X” aI1 tial wwly) 

I 0 Stlqcrvirion .is provided over medications l 0 Help with tub barb ot shower rbrcb may be selC&&istered s 0 Help with dtes&S 

z 0 Medic+ms and tresrm+s UC -admini* 6 0 Help with cotrespondence ot shopping td,m accotd.ttcc mth pbyarcws’ 

7 0 Help ritb w=lkinS or get&g about 

I 0 Rub and m.ss.ge * 0 Help rich feediiS 

o 0 Nat tespwsible for pmviding any scnicem except mom and board 

I. Nunthor of paid l mployoae. (Include pmprietora, managers, and a11 pald employees rho usually work 

15 louts ot mote s week h this establishment.) 

cm. el”.n dwwtl I” Itern 54 .hO”ld b. tll. .Yln 0, *. Ill”“. .hom in n.m. .t*., 56.. .“d so., 

a. Number of registered professional muses.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

b. Number of licensed pmcricd muses. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

c. Number of all other pald employees fncluding pbysicisns, proprietors, managers, nuts& aider, 

otdedies. clerical md office workers, atccndsztrs, and custodial workers. . . . . . . . . . . . . . . . . . . . :. . . . . . . 

d. Total number of employees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

000 

* “. S. GOVERNMENT PRINTIN OFFICE : 1906 0 - 798-850 
OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publication No. 1000 

Series 1. 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. 

Reports number 1-4 

Series 2. 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. 

Reports number 1-13 

Series 3. 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. 

Reports number 1-4 

Series 4. 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. 

Reports number 1 and 2 

Series 10. Data From the Health Interview Survey .-Statistics on illness, accidental injuries, disability, use of 

hospital, medical, dental, and other services, and other health-related topics, based on data collected in 

a continuing national household interview survey. 

Reports number l-26 

Series 11. Data From the Health Examination Survey .-Statistics based on the direct examination, testing, and 

measurement of national samples of the population, including the medically defined prevalence of specific diseases, and distributions of the population with respect to various physical and physiological 

measurements. 

Reports number l-12 

Series 12. Data From the Health Records Survey. -Statistics from records of hospital discharges and statistics 

relating to the health characteristics of persons in institutions, and on hospital, medical, nursing, and 

personal care received, based on national samples of establishments providing these services and 

samples of the residents or patients. 

Reports number l-4 

Series 20. Data on mortality .-Various statistics on mortality other than as included in annual or monthly reportsspecial analyses by cause of death, age, and other demographic variables, also geographic and time 

series analyses. 

Reports number 1 

Series 21. Data on nutality, 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. 

Reports number l-8 

Series 22. Data From the National Natality and Mortality Surveys. - Statistms on characteristics of births and 

deaths not available from the vital records, based on 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. 

Reports number 1 

For a list of titles of reports published in these series, write to: National Center for Health Statistics 

U.S. Public Health Service 

Washington, D.C. 20201