NATIONAL CENTER Series 12 

For HEALTH STATISTICS I Number 5 

VITALand HEALTH STATISTICS 

DATA FROM THE NATIONAL HEALTH SURVEY 

Employeesin Nursing and 

PersonalCare Homes 

United States-May- June 1964 

Statistics on the number and types of employees in nursing 

and personal care homes by age and sex, hours worked per 

week, and ratio of residents to employees. Based on data 

collected from institutions during the period May-June 1964. 

Washington, D.C. September 1966 

U.S. DEPARTMENT OF 

HEALTH, EDUCATION, AND WELFARE Public Health Service 

John W. Gardner Wil liam H. Stewart 

Secretary Surgeon General 
Public Health Sorvicc Publication No. 1000-Scrics 12-No. 5 

For sale hy the Superintendent of Dorumcwts, U.S. Governmrnt Printing Office 

\Vnshington, D.C., 20402 - Price ::I) cents 
NATIONALCENTERFOR HEALTHSTATISTICS 

FORREST E. LINDER, PH. D., Director 

THEODORE D.wOOLSEY, Deputy Director 

OSWALD K. SAGEN, PH. D., Arsia.mt Director 

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

ALICE M.WATERHOUSE,M.D., Medical Advisor 

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

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

DIVISIONOF HEALTHRECORDSSTATISTICS 

MONROEG. SIRKEN,PH.D., Chiej 

E. Earl Bryant, Chief, institutional Population Survey Branch 

Milton C. Rossoff, Chief, Hospital Discharge Survey Branch 

Gordon F. Sutton, Chief, Vilal Records Surveys 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 12LNo. 5 

Library of Congress Catalog Card Number 66-61304 
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CONTENTS 

Page 

Intr&uction ____-_______________-------------------------------------- 1 

Background -------------c-----c------------------------------------ 1 

General Survey Design---------------------------------------------- 1 

Characteristics of the Staff in Nursing and Personal Care Homes-----------

J& Category-------------------

Age andSex--------------------------- -------_------__---_---------

Hours Worked per Week---------------------------------------------

Full-Time EquivalentStaff-------------------------------------------

Ratio of Residents to Staff -----------------_--------------------------

References----------------------------------------------------------- 10 

&wiled Tables------------------------------------------------------- 11 

Appendix 1. TechnicalNotes onMethods--------------------------------- 20 

SurveyDesign------------------------------------------------------ 20 

General Qualifications------ ___L_____ -_-- __c_____ __-___ -_---_--- 22 

Appendix II. 

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

Terms Relating to Staff _____c_________________ _____- ______----- 27 

Terms Relating to Homes or Residents---------------------------- 27 

B. Classification of Homes by Type of Service------------------------ 28 

#ppendh 111. Forms and Questionnaires---------------------------------

SYMBOLS 

Data not available _________- __________ 

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

Quantity zero ________________________ 

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

Figure does not meet standards of 

reliability or precision----------------­

. . . 

-

0.0 

* 

29 
IN THIS REPORT employees in nuvsing and personal care homes aye 

described in terms of the+ age and sex, job categories, houvs worked 

per week,@-time equivalent staff, andratio of residents to employees. 

The data aye based on a sample survey conducted during the spring of 

1964 of nursing homes and Yelated facilities, including geriatric hospitals. 

Nuvsing and personal care ho.mes employed an estimated 299,900 persons. Of this number 281,000 worked 15 OY more hours per week representing one for every two residents in these homes. 

Over half of the employees weYe nursing personnel, including 17,400 

registered n.urses (RN’s); 20,500 lice,nsed practical nurses (LPN’s); and 

113,800 nuxse’s aides. Also, about one-third of the 20,700 administrators 

were reported to be eilhev an RN, LPN, OY nurse’s aide. The vast majority of the remaining employees weye housekeeping, kitchen, and office workers. Professional zcoykers, other than nurses and administvators, were -few in number; an estimated 3,600persons were employed in 

such categories as plzysicians, dentists, the?*apists, dietitians, and social wovkevs. 

Only about 1 of 10 employees was male. Males were slightly older on 

the average tlzan females; medial2 ages were 48 years and 45 years, yespectitlels. The ages of nursing staff varied f??orn a median age of 42 

years Wfornz~rs~~~saides fo 48 years for RN’s and LPN’s. “Other PYOfessiojLal”and fecluaical sta.ff ulcre older with a median age of 52 years. 

In. gepzeral, employees ilz mlvsizg care homes were the youngest and in 

pevso?lal care JIOIIICS, the oldest. 

Almost one--fifth of the employees zooyked 15-34 hours pev week OY part 

time. Avozrud ofje-JlaLf of flze emploJ!ees wos*ked 35-40 hours per week, 

and nearly tlzree-fejztlzs, ol’er 40 JKXWSper week. Aboutoze-thivd of the 

RN’s xorked part fi)uLe rnld almost tJzyee- te&hs of “other professional” 

staff. Part-time RhT’s ukld “otlzer pYofessiona1” staff were used moye 

often ill ho,lzes pa-01Gding pvimarilj? nursing caye (nurs+ng care homes) 

than in othe)- tjjpes of Jzomes. 

In terms of both total uumbev and the ratio of employees to residents, 

theve were more employees i/z nursing care homes than in other types. 

In nursing cat-e homes there weye about two residents for each &?I- time 

eyzriuale& emploJlee. This is in comparison with about three residents 

pev employee in otJjer t_zlpesoflzomes. DatafovnuYsingstaff of all levels 

of skill show nuysi~zgcave homes employed about1 nurse oynuyse’s aide 

for every 3 residents, while in personal-cave-with-nursing homes and 

personal care homes tlze Yatio was 1 in 6 and 1 in 12, respectively. 
EMPLOYEESIN NURSING AND PERSONAL 

CARE HOMES 

Carl A. Taube, Division of Health Records Statistics 

INTRODUCTION 

Background 

The data presented in this report are based 

on the second of the institutional population 

surveys conducted by the Division of Health 

Records Statistics of the National Center for 

Health Statistics. The Institutional Population 

Survey is one part of the National Health Survey 

program, which provides comprehensive and 

current health statistics on the Nation’s population. In other parts of the program, statistics 

are collected about the noninstitutional population 

from personal interviews, physical examinations, 

and hospital records. A detailed description of 

the National Health Survey program has been 

published. i 

Both of the institutional population surveys 

which have been designated as “Resident Places 

Survey 1 and 3,” or RPS-1 and RPS-2, covered 

facilities providing nursing or personal care 

to the aged and chronically ill. RPS-1 was 

conducted during the spring of 1963 to collect 

statistics on the establishments’ admission polities, charges for care, admissions, discharges, 

and, in very general terms, health characteristics of residents or patients in the institutions. 

In addition to nursing and personal care homes, 

RPS-1 included mental hospitals, chronic disease 

and geriatric hospitals, and units of general 

hospitals which primarily provided care to the 

aged and chronically ill. Several reports on the 

results of RPS-1 have been published.s-5 

RPS-2, the survey on which this report is 

based, was conducted during May and June 1964. 

Although its scope was somewhat more limited 

than RPS-1, the statistics collected were more 

comprehensive. RPS-2 was even more directed 

toward the aged institutional population than 

RPS-1, including within its scopeonlynursing and 

personal care homes and geriatric hospitals. 

Detailed information was sought about the establishment itself, the residents or patients, 

and the employees. This included the availability of physicians’ and dentists’ services; the 

availability and utilization of beds; personal, 

demographic, and health data about residents, 

including the prevalence of chronic conditions 

and impairments; and certain information about 

employees. 

Data are presented in this report on the 

number and types of employees in nursing and 

personal care homes, the age and sex distribution 

of these employees, and the hours worked per 

week by the type of service provided in the home, 

the type of ownership, and size of the home. 

Subsequentreports in this publication series will 

present other data collected in RPS-2. 

General Survey Design 

The scope of the RPS-2 included all resident 

institutions in the United States which provide 

nursing or personal care to the aged or chronically ill. This includes nursing homes, convalescent homes, rest homes, and other similar 

types of places with three or more beds, as well 

1 
as geriatric hospitals. One criterion for inclusion 

in the survey is that an establishment must 

routinely provide some level of personal or 

nursing care. Thus, an establishment providing 

only room and board was not within the scope 

of the survey, even if it were a home for the aged. 

A “multiframe technique” was used in establishing the sampling frame of institutions for 

the RPS-2. Two frames were used: (1) theMaster 

Facility Inventory (MFI), comprising about 90-95 

percent of the nursing and personal care homes 

in the United States, and (2) a list of places 

within the scope of RPS-2. but not included in 

the MFI. This second list is derived from 

the Complement Survey, which is based on an area 

sample of the United States. A detailed description 

of the Master Facility Inventory and the Complement Survey has been published.” Further discussion of the sampling frame for RPS-2 appears 

in Appendix I of this report. 

The estimates presented in this report are 

based on a two-stage probability design consisting 

of a sample of 1,073 establishments found to be 

in operation at the time of the survey, a subsample 

of 10,560 residents or patients, and a subsample of 

11,848 employees who worked 15 or more hours 

per week in the sample establishments. Bureau of 

the Census interviewers made personalvisits to 

each of the homes to select the sample of residents 

and employees and to conduct the survey. Details 

of the sample design and survey procedures are 

described in Appendix I. Facsimiles of the 

questionnaires used in the survey are shown in 

Appendix III. 

Since the estimates derived from the survey 

are based on a sample rather than on all establishments 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 the estimate 

is a small number, or when the estimate is a percent or rate based on a small number in the 

denominator. Tables of approximate sampling 

errors and illustrations of their use are given in 

Appendix I. 

Definitions of certain terms used in this 

report may be found in Appendix II. Reference 

to these definitions is essential to the interpretation of data in the report. Special attention is 

called to the procedure for classifying institutions. The classification of establishments, 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 how it may be licensed by the State. 

CHARACTERISTICS OF THE STAFF 

IN NURSING AND PERSONAL 

CARE HOMES 

Survey results indicated that nursing dnd 

personal care homes in the United States employed 

about 299,900 persons in May-June 1964, including 

administrators, owners who worked in the establishment, members of religious orders, and 

all paid employees. Of these, 18,900 or about 

6 percent were working less than 15 hours a 

week. Only the total number of these employees 

was obtained since they were not considered within 

the scope of the survey. An estimated 281,000 

persons were employed 15 or more hours a week 

in nursing and personal care homes-about one 

for every two.residents in these homes. Table A 

shows the distribution of employees working 15 or 

more hours per week and the distributions of homes 

and residents in these homes by the primary type 

of service provided. As can be seen from this table, 

over half of these homes were nursing care homes 

(the primary and predominant service was nursing 

care), and these contained over two-thirds of the 

residents and about three-fourths of the staff. 

Nursing care homes were on the average larger 

than personal-care-with-nursing homes (personal 

care was the primary type of service, but some 

nursing care was provided), maintaining about 

44 beds on the average as compared with 31 beds 

in the personal-care-with-nursing homes. Bothof 

these service groups were considerably larger 

than the personal care homes, which maintained 

an average of 15 beds. Over four-fifths of the 

homes were operated under proprietary auspices 

and were smaller than homes operatedunder other 

forms of control. Further information on the 

distribution of nursing and personal care homes 

by type of service and ownership can be obtained 

from table 8. 

Job Category 

Employees working 15 or more hours aweek 

were classified as to job performed in the es2 
- ---- 

‘

Table A. Number of nursing and personal 

care homes, residents, and employees,by 

type of service: United States,May-June

1964 

Type of service 1 Homes 1 izz:, / ,$L,, 

Nursing care---- 9,350 373,300 210,100

Personal care 

with nursing--- 5,240 145,400 58,700

Personal care--- 2,810 35,300 12,300 

tablishment by the administrator or some other 

responsible respondent. During the interview, the 

administrator was given a card listing 15 job 

categories (Card B, Appendix III) and was asked, 

for each employee, the following question: “Which 

of the following job categories best fits the job 

which this employee does in this establishment?” 

In general this seems to have been a valid method 

of job classification. Comparison of the administrator’s assignment of job category with that 

provided independently by the employee himself 

was possible for some job categories and the 

correspondence was generally high. Further discussion of the classification of employees appears 

in Appendix I. 

Table B shows the distribution of employees 

by job category, as assigned by the administrator 

or other responsible respondent. Over half (56 

percent) of the total employees were classified as 

performing some level of nursing duties. ‘ibout 

17,400 or 6 percent were registered nurses (RN’s), 

including about 1,200 graduate nurses who were not 

registered, and about 20,500 or 7 percent were 

licensed practical nurses 

500 licensed vocational 

staff, constituting about 

staff, are referred to as 

report for convenience 

(LPN’s), including about 

nurses. Other nursing 

43 percent of the total 

“nurse’s aides” in this 

and also because the 

majority of the persons were in fact nurse’s aides. 

Practical nurses, student nurses, orderlies, and 

other supporting nursing staff are included in the 

“nurse’s aide” category. 

Table B. Number and percent distribution 

of employees in nursing and personal care 

homes, by job category: United States, 

May-June 1964 

Employees 

Job category Percent 

Number distribut ion 

All staff --__----_- 281.000 100.0 

Nursing staff-------- 158,450 56.4 

Registered nurses------ 17,400 6.2 

Licensed practical nurses- -__--__-__ 20,500 Nurse’s aides---------- 120,600 4::: 

Other professional and technical staff- 24,300 8.6 

Administrators---------

Physicians-------------

Dentists---------------

20,700

800

9; i-t:

* 

Occupational

therapists------------ 600 0.2 

Physical therapists---- Dietitians------------- 300 

900 25 

Social workers---------

Other staff------------

400 

600 2 

Other nonprofes­ sional staff-------- 98,300 35.0 

There were an estimated 20,700 administrators and assistant administrators in these 

homes. These admimstrators were asked if they 

performed any other jobs in the home in addition 

to their administrative duties. Over one-third 

stated that they also worked as an RN, LPN, 

or nurse’s aide, and over one-twentieth stated 

that they were working in some other professional 

capacity (table 7). Table B shows the estimated 

total employees in seven other professional and 

technical job categories; however, the sampling 

errors associated with these estimates are relatively high, ranging from 10 to 50 percent of the 

estimate itself. Despite this the data do give a 

rough estimate of the number of employees in 

these categories and for this reason they are 

presented. In the remainder of this report, these 

categories (physicians, dentists, occupational and 

3 
Table C. Number and percent distribution of nursing and other professional staff in 

nursing and personal care homes, by job category according to sex: United States, 

May-June 1964 

Sex 

Job category 

Both sexes Male Female 

I 

Number 

Total nursing and professional staff------- 182,800 11 16,700 1 166) 100 

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

Registered nurses--------------------------------

Licensed practical nurses------------------------

Nurse’s aides------------------------------------

Of-her professional staff------------------------­

physical therapists, dietitians, social workers, 

and other professional and technical staff) and the 

administrators are grouped together and referred 

to as “other professional staff.“This category and 

the RN, LPN, nurse’s aide, and other nonprofessional categories form the five groupings of job 

categories used in analysis and tables. Appendix 

II shows the job categories that are included in 

each of these groups. 

Age and Sex 

The nursing and other professional staff in 

nursing and personal care homes were predominantly women; only about 1 out of every 10 

employees was male. As shown in table C, men 

were employed primarily either as administrators, professional, or technical employees 

(48 percent), or as orderlies and nurse’s aides 

(50 percent). Men were in the minority, however, 

in each job category; they constituted only about 

7 percent of the nurse’s aide category and about 

33 percent of the other professional category. 

Males were slightly older on the average than 

females; the median age of males was 48 years 

as opposed to 45 years for females. 

The age of employees varied by job category 

ranging from a median of 42 years for nurse’s 

Percent distribution 

aides to 52 years for professional and technical 

staff. The median age for both registered nurses 

and licensed practical nurses was about 48 years 

(table 2). Registered nurses employed in nursing 

and personal care homes seem to be older than 

employed professional nurses in general; the 

median age of professional nurses in all fields of 

employment, as reported in another source, 7 

was about 39 years, more than 8 years younger 

on the average than the registered nurses in 

nursing and personal care homes. The median 

age (48 years) of licensed practical nurses, 

however, was about the same as that for employed 

LPN’s in general. No comparative data are 

available for the other types of nursing personnel. 

Tables 1 and 2 show the percent distribution 

of employees by age, according to the type of 

service and ownership of the home. The age of 

employees varied both by the type of service and 

by the type of ownership of the home. In general, 

employees in nursing care homes were the 

youngest and employees in personal care homes 

were oldest; employees in nonprofit homes were 

slightly older than those in proprietary or government-operated homes. The consistency of this 

pattern suggests that this might be true for all job 

categories; however, the differences for specific 

job categories were generally not statistically 

significant. 

4 
Hours Worked per Week 

As used in this report, hours worked per 

week means the number of hours an employee 

“usually works per week.” If a person’s regular 

work week was 40 hours, but he usually worked 

8 additional hours on an overtime basis, he was 

considered as working a 48-hour week. The 

distribution of employees by hours worked per 

week is shown in tables 3 and 4 by job category, 

according to type of service and type of ownership. The data on hours worked for administrators were not considered reliable and thus are 

excluded from this part of the analysis. Members 

of religious orders generally lived in the establishment and either were not able to state 

the number of hours worked per week or considered themselves on duty 24 hours a day. 

In addition, there were about 1,600 other persons 

in the sample who stated that they were unable to 

determine their work week or were on duty 24 

hours a day. These persons were generally 

relatives of the owner or family members working 

in family-operated homes. Over three-fourths of 

these persons were employed in homes with less 

than 25 beds, and 92 percent were in proprietary 

homes. For these persons, referred toas “unpaid 

employees ,‘I and for the members of religious 

orders, hours worked per week were not coded. 

They were grouped with employees working 400r 

more hours a week in the figures and are shown 

separately in tables 3 and 4. 

Part-time employees.- Nursing and personal 

care homes employed a large number of part-time 

employees. Of the estimated 260,300 employees 

(excluding administrators), about 18 percent 

worked 15-34 hours a week, or part time as defined 

in this report; about three-fifths of these worked 

less than 24 hours a week. The highestproportions 

of part-time employees were found in the professional categories, 34 percent for RN’s, 21 

percent for LPN’s, and 28 percent for other 

professional staff (table 3 andfig. 1). Employment 

on a part-time basis was also frequent for the 

nurse’s aides’ and other nonprofessional staff, 

however; 14 and 19 percent, respectively, worked 

part time for these two groups. 

The data suggest the hypothesis that parttime RN’s as well as “other professional” staff 

were used more often in nursing care homes 

PERCENT OF EMPLOYEES 

Job category 0 20 40 60 60 IOC 

Registered nurssr ,,........ 

Figure I. Percent distribution of employees in 

nursing and personal care homes,by hours worked 

per week according to job category. 

than in the other two service classes; however, 

because of the small number of professionalstaff 

in other than nursing care homes, comparisons 

with the other two service classes are generally 

not statistically significant. 

Only about one-sixteenth of the employees 

in government homes were employed on a parttime basis, as compared with about one-fifth in 

both proprietary and nonprofit homes. With the 

exception of the “other professional” staff, 

government homes employed relatively fewer 

part-time staff in each of the job category groups. 

About one- third of the “other professional” group 

in both government and proprietary homes and 

one-fifth in nonprofit homes were part-time 

employees. Other differences between ownership 

groups can be seen when specific job categories 

are considered. For example, about 40 percent 

of the RN’s in proprietary homes worked part time, 

as opposed to about 28 percent in nonprofit 

homes and 16 percent in government homes 

(table 4). 

Full-time employee&-About 82 percent of 

the 260,300 employees, excluding the adminis5 
trators, were employed 35 or more hours a week, 

or full time as defined in this report. Of those 

working full time, a large proportion, around 

three-eighths, worked more than 40 hours a week. 

While around one-half of the employees for each 

job category worked a 35-40-hour week, the 

proportion working over 40 hours a week varied 

by job category, depending on the proportion 

working part time. Only about 13 percent of the 

RN’s worked over 40 hours a week, but conversely, 

the highest proportion of part-time employment 

was found for the RN’s. About one-fourth of the 

LPN’s and other professional staff worked over 

40 hours a week, as compared with almost onethird for the nurse’s aides and other nonprofessiona! staff. It should be noted, however, 

that about 8 percent of the “other professional” 

group were members of religious orders or other 

unpaid employees and this undoubtedly affects 

the distribution by hours worked for this category. 

Over half of the employees in nursing care 

homes were employed 35-40 hours a week, as 

opposed to slightly over two-fifths in personalcare-with-nursing and personal care homes; 

however, there is some variation when specific 

job categories are compared. 

Almost four-fifths of all employees in government homes worked 35-40 hours a week (fig. 2), 

nearly twice the proportion in proprietary homes 

(44 percent). In the nonprofit homes about half 

worked 35-40 hours, but about 5 percent of 

the employees in these homes were classified 

as members of religious orders or other unpaid 

staff, as compared with 1 percent or less in the 

other two ownership classes. The proportion of 

employees working over 40 hours a week was 

highest in proprietary homes (36 percent) and 

lowest in government homes (14 percent). When 

specific job categories are compared by ownership groups, it is seen that for each category, 

except “other professional,” about four out of 

every five employees in government homes were 

employed 35-40 hours a week, a much higher 

proportion for each job category than in theother 

two ownership classes. However, considerable 

variation also appears for specific job categories 

when nonprofit and proprietary homes are compared. For example, in nonprofit homes only 

one-fourth of the “other professional” group, 

compared with one-half in proprietary homes, 

Type of PERCENT DISTRIBUTION 

ownership 0 

Proprkztory 

Nonprofit 

Government 

15-34 hours 35-40 hours 41 hours or more 

Figure 2. Percent distribution of employees in 

nursing and personal care homes,by hours worked 

per week according to type of ownership. 

worked 35-40 hours a week. It should also be 

noted that about 14 percent of the RN’s in nonprofit homes were classified as members of 

religious orders or other unpaid employeescompared with less than 1 percent in proprietary 

homes (table 4). 

Full-Time Equivalent Staff 

In this section the distribution of the employees in nursing and personal care homes is 

discussed in terms of the number of full-time 

equivalents. Two part-time employees are conventionally taken as equivalent to one full-time 

employee. In the case of these data, this seems 

a valid assumption; the average number of hours 

worked per week for part-time employees was 25, 

and for full-time employees, 48. By using the 

number of full-time equivalent employees rather 

than total employees, the variation between homes 

in the proportion of part-time staff is held constant. This does not control for the variation 

between homes in the proportion of employees 

working 41-48 or over 48 hours a week however. 

The distribution of the full- and part-time employees, and the full-time equivalent employees 

by job category according to the type of service and 

type of ownership of the home are shown in table 5. 

6 
Professional and technical staff excluding 

administrators composed only about 1 to 2 percent 

of the total staff in each type of service class 

and each ownership class. The ratio of nursing 

staff to nonprofessional staff varied considerably 

however. In nursing care homes for example, 

over two-thirds of the staff were nurses or nurse’s 

aides, and under one-third were nonprofessional. 

In personal care homes however, this ratio was 

reversed; about two-thirds of the staff were nonprofessional and only one-third were nurses or 

nurse’s aides (fig. 3). Proprietary homes had a 

larger proportion of nursing staff (70percent) than 

either nonprofit or government-operated homes, 

in which 43 and 55 percent, respectively, of the 

total staff were “nurses . ” 

As mentioned previously, the nursing staff 

was highly concentrated in the nursing care 

homes. When full-time equivalent employees are 

considered, this still holds. About 9 out of every 10 

RN’s and LPN’s, and about 8 out of every 10 

aides were employed in nursing care homes. 

Slightly above three out of four of the other professional employees excluding administrators 

were employed in nursing care homes. This 

conforms closely to the proportion of total 

employees in nursing care homes. 

Ratio of Residents to Staff 

This analysis employs the ratio of the number 

of residents to the number of full-time equivalent 

employees by the type of service and ownership 

classes and thus provides a crude measure ofthe 

workload as well as the availability of staff to 

provide care for residents, The resident-staff 

ratios have not been adjusted for the effect of 

actual staffing patterns in the home as reflected 

by the assignment of nursing staff to shifts. The 

effect of such an adjustment would be to increase 

the ratios and thus show a fewer number of staff 

on duty at a given time for care of the residents. 

However, since detailed information on staffing 

patterns was not sought, the analysis is restricted 

to the overall ratios of residents to staff. 

The number of residents for the serviceownership classes are shown in table 8. The 

number of full-time equivalent staff is shown in 

tables 5 and 6. In calculating the ratios of 

residents to nurses the administrators who stated 

w PERCENT DISTRIBUTION 

m 0 25 50 75 100 

Professional Nursing ?&off Nonprofessional 

and technical 

Figure 3. Percent distribution of full-time 

equivalent staff in nursing and personal care 

homes,, by job category according to type of 

service. 

that they also performed nursing duties were 

counted as full-time nurses. This allocation 

seemed reasonable since most of these nurseadministrators were employed in small homes and 

thus were likely to be working as a nurse much 

of the time. The number of administrators 

performing nursing duties is shown in table 7 by 

type of service and ownership. While these 

numbers are generally small and the sampling 

errors associated with them relatively large, they 

are presented so the reader may calculate rates 

excluding the administrator-nurses or perhaps 

including them, but as part time instead of full 

time. Counting the nurse-administrators increases the number of full-time equivalent 

“nurses” about 5 percent. The increase in RN’s 

and LPN’s is about 12 percent, and there is 

about a 2-percent increase in the number of 

nurse’s aides. Within the type of service and 

ownership classes the effect of including the 

nurse-administrators varies greatly. For example, for proprietary personal-care-withnursing homes, the increase in number of RN’s 

is over 25 percent as compared with about a 

6- and 11-percent increase, respectively, for 

nonprofit and government homes of the same 

service class. 

7 
RATIO OF RESIDENTS TO TOTAL STAFF 

0 I 2 3 4 5 7 I I I I I I 

Proprk3fory 

Nonprofit 

Personal core 

with nursing 

TOi 

“roprietary 

Nonprofit 

Government 

Personal care 1 

rota1 

Jroprletary 

Nonprofit 

Government 

Figure 4. Ratio of residents to total full-time 

equivalent staff in nursing and personal care 

homes, by type of service and type of ownership. 

Overall there were about two residents per 

employee in nursing and personal care homes 

(fig. 4). Nursing care homes had two or less 

residents per employee as opposed to roughly 

three residents per employee in the other two 

service classes. The data suggest that personal 

care homes have fewer employees relative to 

the number of residents than personal-care-withnursing homes. The differences in the ratios for 

these two service classes are consistent within 

each ownership class but are not statistically 

significant. 

For nursing care homes there was little 

variation in the ratio by ownership; governmentoperated homes had slightly fewer residents per 

employee than proprietary and nonprofit nursing 

care homes. For the other two service classes 

the patterns was reversed; government homes had 

Proprietary Nonprofit Government 

Figure 5. Ratio of residents tofull-time equivalent nurses in nursing and personal care homes, 

by type of ownership and size of home. 

more residents per employee than the other two 

ownership classes (fig. 4). 

Type of service and ownership accounted 

for most of the variation in the ratio of residents 

to employees. Some regional variations and 

variations by size of the home were present 

within the service-ownership classes but these 

differences were generally small and not statistically significant. 

Table D shows the ratio of residents per 

RN, LPN, and nurse’s aide for both type of 

service and type of ownership classes. These 

ratios generally reflect the concentration of 

nurses in the nursing care homes. However, 

while almost 9 out of every 10 RN’s and LPN’s 

were in nursing care homes, relative to the 

number of residents the ratios were high-26 

residents per RN and 21 residents per LP$J-
Table D. Ratio of residents to full-time equivalent nurses in nursing and personal 

care homes, by type of nurse according to type of service and type of ownership:

United States, May-June 1964 

Type of service and type of ownership 

All homes-----------------------------------

Type of service 

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

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

Type of ownership 

Proprietary----------- --------------------^_______ 

Nonprofit------------ --___----__-_-__------------- Government----------------------------------------

Type of nurse] 

Licensed Registered Nurse’s practical nurse aide nurse 

Ratio of residents to full-time 

equivalent nurses 

26 1 4 

71 I 2 I 7 

IAdministrators performing nursing duties are included in nursing staff. 

and higher still in personal-care-with-nursing and 

personal care homes. 

The differences observed in the ratio of residents to RN’s by ownership classes were not 

statistically significant. There were about 22 

residents per LPN in proprietary homes as 

opposed to about 37 and 38 in nonprofit and 

government homes, respectively. Nonprofit homes 

had the fewest aides relative to the number of 

residents and also the fewest total nurses of any 

type relative to the number of residents. As 

shown in table 6, there were 5.4 residents per 

“nurse” in nonprofit homes as opposed to 3.8 

Per “nurse” in government homes and 3.2 per 

“nurse” in proprietary homes. 

There were twice as many residents per 

“nurse” in personal-care-with-nursing homes as 

in nursing care homes, and twice as many in 

personal care homes as in personal-care-withnursing homes (table 6). This order of service 

classes in terms of the ratio of residents to 

nurses held within each ownershipclass, although 

the differences between the personal-care-withnursing and personal care homes were not always 

statistically significant. As before, regional and 

size variations within the service-ownership 

classes in the ratio of residents to nurses were 

present, but because of considerations of sample 

size, and because the major variation can be 

accounted for by the service-size classes, the 

data are presented only by the latter variables. 

Figure 5 gives some indication of the variation 

by size within the ownership classes in the 

relative number of nurses. 

9 
REFERENCES 

INational Center for Health Statistics: Origin, program, 

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

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

Health Service. Washington. U.S. GovernmentPrinting Office, 

Aug. 1963. 

‘National Center for Health Statistics: Institutions for the 

aged and chronically ill, United States, April-June 1963. Vital 

and Health Statistics. PHS Pub. No. 1000~Series 12-No. 1. 

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

Office, July 1965. 

3National Center for Health Statistics: Characteristics of 

residents in institutions for the aged and chronically ill, 

United States, April-June 1963. Vital and Health Stutistice. 

PHS Pub. No. 1000Series 12-No. 2. Public Health Service. 

Washington. U.S. Government Printing Office, Sept. 1965. 

$National Center for Health Statistics: Characteristics of 

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

Vital and Health Statistics. PHS Pub. No. 1000~Series 12-No. 

3. Public Health Service. Washington. U.S. Government Printing Office, Dec. 1965. 

‘National Center forHealthStatistics: Utilization of institutions for the aged and chronically ill, United States, AprilJune 1963. Vital and He&h Statistics. PHS Pub. No. 1000-

Series 12-No. 4. Public Health Service. Washington. U.S. 

Government Printing Office, Feb. 1966. 

‘National Center for Health Statistics: Development and 

maintenance of a national inventory of hospitals and institutions. Vital and Health Statistics. PHS Pub. No. 1000-

Series l-No. 3. Public Health Service. Washington. U.S. 

Government Printing Office, Feb. 1965. 

7Division of Public Health Methods: Industry and occupation data from the 1960 census, by State, by R. A. Prindle 

and M. Y. Pennell. HealthManpower Source Book, Section 17. 

PHS Pub. No. 263. Public Health Service. Washington. U.S. 

Government Printing Office, 1963. p. 29, table 15. 

000 

10 
Table 1. 

2, 

3. 

4. 

5. 

6. 

7. 

8. 

DETAILED TABLES 

Page 

Number and percent distribution of nursing staff and other professional employees in nursing and personal care homes, by age according to type of service and job 

cat-gory: United States, May-June 1964-------------------------------------------- 12 

Number and percent distribution of nursing staff and other professional employees

in nursing and personal care homes, by age according to type of ownership and job 

category: United States, May-June L964-------------------------------------------- 13

Number and percent distribution of employees in nursing and personal care homes,by

hours worked per week according to type of service and job category:United States, 

May-June 1964--------------------------------------------------------------------- 14

Number and percent distribution of employees in nursing and personal care homc,bg hours worked per week according to type of ownership and job category: - States, May-June 1964------------------------------------------------------------- 15

Number of employees and number of full-time equivalents in nursing and personal 

care homes, by type of ownership according to type of service and job category: United States, ~~sy-J~e 1964------------------------------------------------------ 16 

Number of total employees and total nursing staff, full-time equivalents, and the 

ratioof residents to total employees and to total nursing staff,by type of service 

and type of ownership: United States, May-June 1964------------------------------- 17 

Number of administrators in nursing and personal care homes by additional duties 

performed, type of service, and type of ownership: United States, May-June 1964--- 18 

Number of nursing and personal care homes, beds, and residents, by type of service 

and type of ownership: United States, May-June 1964------------------------------- 19 

11 
Table 1. Number and percent distribution of nursing staff and other professional employees in

nursing and personal care homes, by age according to type of service and job category: United 

States, May-June 1964 

- - Age of employee 

Type of service and All -1<edian

job category staff All 15-24 25-34 35-44 45-54 55-64 65+ age 

ages years years years years years years 1 

Percent distribution 

All homes*------------- 176,000 100.0 11.6 14.9 21.5 27.8 19.0 5.3 45 = - - - - - - - -

Registered nurses------------ 17,400 100.0 3.6 14.3 23.1 27.6 24.2 7.3 48 

Licensed practical nurses---- 20,500 100.0 7.0 13.1 20.4 29.5 22.2 7.8 48 

Other professional staff----- 24,300 100.0 0.8 6.1 18.0 34.7 27.5 12.9 52 

Nurse's aides'--------------- 113,800, lOO..O 15.9 17.2 22.2 26.0 15.8 2.9 42 

Nursing careI---------- 140,200 100.0 12.1 16.3 22.4 27.9 17.4 3.8 44 

Registered nurses------------ 15,200 100.0 3.8 15.1 23.9 27.7 23.2 6.4 47 

Licensed practical nurses---- 18,100 100.0 6.9 13.6 21.8 28.7 21.4 7.4 47 

Other professional staff----- 13,900 100.0 0.5 7.8 21.6 36.0 24.0 10.0 50 

Nurse's aidesl--------------- 92,900 100.0 16.3 18.3 22.4 26.6 14.6 1.8 41 

Personal care with 

nursing]-------------- 29,700 100.0 10.3 9.7 18.6 27.9 23.4 10.0 49 

Registered nurses------------ 2,100 100.0 2.2 8.6 17.7 27.2 31.1 13.1 52 

Licensed practical nurses---- 1,800 100.0 4.6 8.8 8.9 32.2 33.2 12.2 53 

Other professional staff----- 6,700 100.0 0.8 2.0 14.9 39.7 25.5 17.1 53 

Nurse's aides*--------------- 19,100 100.0 15.2 12.6 20.9 23.4 20.9 7.0 45 

Personal careI--------- 6,100 100.0 4.0 7.4 14.8 24.5 34.2 15.0 54 

Registered nurses------------ * * * k * ?< * -1 * 

Licensed practical nurses---- 600 100.0 17.0 9.8 10.9 45.8 12.2 4.3 * 

Other professional staff----- 3,700 100.0 1.5 6.7 10.1 20.8 44.4 16.4 57 

Nurse's aides'--------------- 1,800 100.0 5.2 8.4 26.1 25.5 19.7 15.2 49 

IExcludes the estimated 6,800 orderlies. Nurse's aides including orderlies are distributed by 

type of service in table 3. 

12 
-

Table 2. Number and percent distribution of nursing staff and other professional employees in

nursing and personal care homes, by age according to type of ownership and job category: United 

States; May-june 1964 

Age of employee 

Type of ownership and All Median job category staff All 15-24 25-34 35-44 45-54 55-64 65+ age 

ages years years years years years years 

Percent distribution 

All ownerships*-------- 176,000 100.0 11.6 14.9 21.5 27.8 19.0 5.3 145 - - - - = -

Registered nurses------------ 17,400 100.0 3.6 14.3 23.1 27.6 24.2 7.3 48 

Licensed practical nurses---- 20,500 100.0 7.0 13.1 20.4 29.5 22.2 7.8 48 

Other professional staff----- 24,300 100.0 0.8 6.1 18.0 34.7 27.5 2.9 52 

Nurse's aides'--------------- 113,800 100.0 15.9 17.2 22.2 26.0 15.8 2.9 42 

Proprietaryl----------- 123,400 100.0 12.4 15.1 22.6 27.5 17.7 4.7 44 -

Registered nurses------------ 11,100 100.0 3.7 15.9 25.6 26.2 22.0 5.6 46 

Licensed practical nurses---- 14,700 100.0 7.9 13.9 22.3 27.2 20.5 3.2 47 

Other professional staff----- 17,800 100.0 0.5 5.9 19.6 35.5 25.8 2.7 51 

Nurse's aidesI--------------- 79,800 100.0 17.0 17.2 23.0 26.0 14.8 200 41 

Nonprofitl------------- 28,900 100.0 10.1 12.8 16.5 26.7 24.6 9.4 48 -

Registered nurses------------ 3,700 100.0 2.8 9.8 18.4 26.8 29.6 2.6 52 

Licensed practical nurses---- 3,500 100.0 4.6 12.3 12.8 34.4 28.1 7.7 50 

Other professional staff----- 4,000 100.0 1.6 5.5 12.1 28.3 35.9 5.8 55 

Nurse's aides'--------------- 17,800 100.0 14.6 15.1 17.8 24.8 20.4 7.4 46 

Government 1---------__- 23.700 100.0 9.2 16.7 21.8 30.5 18.5 3.3 45 -

Registered nurses------------ 2,600 100.0 4.0 13.6 18.8 34.5 26.3 i.9 49 

Licensed practical nurses---- 2,300 100.0 4.8 9.2 19.8 36.9 24.3 i.0 49 

Other professional staff----- 2,500 100.0 1.1 8.1 16.6 39.2 26.5 3.5 51 

Nurse's aides'--------------- 16,200 100.0 11.9 19.6 23.4 27.5 15.2 !,3 42 

-

'Excludes an estimated 6,800 orderlies. Nurse's aides including orderlies are distributed by type of ownership in table 4. 

13 
Table 3. Number and percent distribution of employees in nursing and personal care homes,by hours 

worked per week according to type of service and job category: United States, May-June 1964 -

T Hours worked per week 

All Type of service and job category staff 

Total 

Percent distribution 

All homes'------------------------- 260,300 100.0 18.1 51.3 24.8 3.8 2.0 - - - - -

Registered nurses------------------------ 17,400 100.0 34.3 53.1 8.0 1.5 3.0 

Licensed practical nurses---------------- 20,500 100.0 21.2 53.8 19.8 4.1 1.2 

Other professional staffI---------------- 3,600 100.0 28.3 45.5 11.9 6.5 7.7 

Nurse's aides---------------------------- 120,600 100.0 14.3 53.2 28.6 3.2 0.6 

Nonprofessional staff-------------------- 98,300 100.0 18.9 48.3 24.7 4.7 3.4 

Nursing carel---------------------- 198,900 100.0 17.8 53.7 24.1 3.1 1.3 - - -

Registered nurses------------------------ 15,200 100.0 35.4 52.5 8.0 1.8 2.3 

Licensed practical nurses---------------- 18,100 100.0 21.7 53.8 19.9 3.9 0.7 

Other professional staff'---------------- 2,800 100.0 30.4 47.1 13.2 2.6 6.7 

Nurse's aides---------------------------- 98,400 100.0 13.6 55.2 28.1 2.6 0.4 

Nonprofessional staff-------------------- 64,400 100.0 18.4 52.0 23.5 4.0 2.1 

Personal care with nursingl-------- 52,700 100.0 19.2 43.8 27.2 6.0 3.9 - - -

Registered nurses------------------------ 2,100 100.0 26.9 58.0 7.0 - 8.1 

Licensed practical nurses---------------- 1,800 100.0 18.8 50.3 19.0 6.7 5.2 

Other professional staffl---------------- 800 100.0 23.3 43.7 6.6 14.2 12.2 

Nurse's aides---------------------------- 20,300 100.0 16.8 43.9 31.6 5.9 1.6 

Nonprofessional staff-------------------- 27,800 100.0 20.2 42.2 26.5 6.1 5.0 

Personal careI--------------------- 8,700 100.0 18.4 41.0 27.4 - - - 6.4 6.7 

Registered nurses------------------------ -k f ?< -2 >k f 9< 

Licensed practical nurses---------------- 600 100.0 11,3 63.3 21.5 2.0 2.0 

Other professional staffl---------------- Jx 9< t Y< * ?k 9c 

Nurse's aides---------------------------- 1,900 100.0 23.6 46.8 23.2 5.7 0.7 

Nonprofessional staff-------------------- 6,100 100.0 17.9 37.6 29.2 6.2 9.2 

- - -

'The estimated 20,700 administrators are excluded from this table. These employees are distributed by type of service in table 1. 

14 
Table 4. Number and pa?%%% 6irstrftxrti.m of employees in nursing and personal care homes,by hours 

worked per week according to type of ownership and job category: United States, May-June 1964 

Hours worked per week 

All Type of ownership and job category staff II Unpaid 

L”Cc&A hours 

I4 35-40 41-48 48+ or relihours hours hours gious

II order 

il I I I I 

Percent distribution 

All ownershipsI-------------------- 60,300 100.0 18.1 51.3 24.8 3.8 2.0 - - - - - -

Registered nurses------------------------ 17,400 100.0 34.3 53.1 8.0 1.5 3.0 

Licensed practical nurses---------------- 20,500 100.0 21.2 53.8 19.8 4.1 1.2 

Other professional staffl---------------- 3,600 100.0 28.3 45.5 11.9 6.5 7.7 

Nurse's aides---------------------------- 20,600 100.0 14.3 53.2 28.6 3.2 0.6 

Nonprofessional staff-------------------- 98,300 100.0 18.9 48.3 24.7 4.7 3.4 

Proprietary'----------------------- 56,400 100.0 20.6 43.6 30.0 4.6 1.2 

Registered nurses------------------------ 11,100 100.0 40.9 47.2 9.7 2.1 0.2 

Licensed practical nurses---------------- 14,700 100.0 25.5 46.9 22.7 4.8 0.2 

Other professional staffl---------------- 1,200 100.0 31.1 25.8 25.7 9.3 8.1 

Nurse's aides---------------------------- 83,000 100.0 16.0 46.0 33.8 3.9 0.3 

Nonprofessional staff-------------------- 46,400 100.0 22.2 37.8 30.4 6.3 3.3 

Nonprofitl------------------------- 61,400 100.0 20.0 51.1 21.1 2.6 5.2 

Registered nurses------------------------ 3,700 100.0 27.7 51.4 6.3 1.0 13.5 

Licensed practical nurses---------------- 3,500 100.0 15.4 61.6 14.2 2.6 6.2 

Other professional staffl---------------- 1,300 100.0 20.3 52.5 6.3 6.8 14.2 

Nurse's aides---------------------------- 19,000 100.0 15.9 57.7 22.0 1.4 3.0 

Nonprofessional staff-------------------- 33,900 100.0 21.9 46.3 23.5 3.2 5.0 

GovernmentI------------------------ 42,600 100.0 6.2 79.5 11.5 2.5 0.2 

Registered nurses------------------------ 2,600 100.0 16.0 80.5 3.5 

Licensed practical nurses---------------- 2,300 100.0 1.9 86.2 10.1 1.8 h 

Other professional staffl---------------- 1,100 100.0 34.8 57.3 4.4 3.5 

Nurse's aides---------------------------- 18,500 100.0 5.2 80.5 12.3 1.9 

Nonprofessional staff-------------------- 18,000 100.0 4.5 78.9 12.5 3.6 0.4 

'The estimated 20,700 administrators are excluded from this table. They are distributed by 

type of ownership in table 2. 

15 
Table 5. Number of employees and number of full-time equivalents in nursing and personal care

homes, by type of ownership according to type of service and job category: United States, May- June 1964 

Type of ownership 

Type of service and I job category All Propri- Non- Govern- A11 homes etary profit ment homes 

Full- and part-time employees Full-time equivalents 

All homes'--------- 260,300 156,400 61,400 42,600 236,800 140,300 55,300 41,300 -

Registered nurses-------- 17,400 11,100 3,700 2,600 14,400 8,800 3,200 2,400 

Licensed practical 

nurses------------------ 20,500 14,700 3,500 2,300 18,300 12,800 3,200 2,300 

Oi:th;fTrofessional 

-m-m----m-----__-_ 3,600 1,200 1,300 1,100 3,100 1,000 1,200 1,000 

Nurse's aides------------ 120,600 83,000 19,000 18,500 112,000 76,400 17,500 18,000 

Nonprofessional staff---- 98,300 46,400 33,900 18,000 89,000 41,200 30,100 17,600 

Nursing careI------ 198,900 132,900 30,100 35,900 181,200 119,200 27,200 34,800 

Registered nurses-------- 15,200 10,600 2,200 2,400 12;500 8,400 1,900 2,200 

Licensed practical 

nurses------------------ 18,100 14,000 2,100 2,000 16,100 12,200 1,900 2,000 

Other professional staffI------------------ 2,800 1,000 800 1,000 2,400 800 700 800 

Nurse's aides------------ 98,400 71,000 11,200 16,300 91,700 65,600 10,300 15,900 

Nonprofessional staff---- 64,400 36,300 13,900 14,200 58,500 32,200 12,400 13,800 

Personal care with nursingI---------- 52,700 18,600 28,800 5,300 47,700 16,700 25,800 5,200 

Registered nurses-------- 2,100 400 1,500 200 1,800 300 1,300 200 

Licensed practical 

nurses------------------ 1,800 600 1,100 200 1,600 500 1,000 200 

Other professional staff'------------------ 800 t 500 200 700 +r 400 * 

Nurse's aides------------ 20,300 10,800 7,700 1,800 18,600 9,700 7,100 1,800 

Nonprofessional staff---- 27,800 6,700 18,100 2,900 25,000 6,100 16,000 2,900 

Personal care'----- 8,700 4,900 2,400 1,400 7,900 4,400 2,200 1,300 

Registered nurses-------- 9< * * 4 9r -1s n i. 

Licensed practical 

nurses------------------ 600 200 300 ?< 500 200 300 I 

Other professional -2 t Jr ;k 9< ;'; 9< * staffl------------------

Nurse’s aides------------ 1,900 1,300 200 400 1,700 1,200 t 400 

Nonprofessional staff---- 6,100 3,300 1,900 900 5,600 3,000 1,700 900 

*The estimated 20,700 administrators are excluded from this table. The distribution of these 

administrators by type of service and type of ownership is shown in table 7. 

16 
Table 6. Number of total employees and total nursing staff, full-time equivalents and the ratio 

of residents to total employees and to total nursing staff, by type of service and type of 

ownership: United States, May-June 1964 

Total staff Nursing staff 

Type of ownership 

Full- and part-time1 Full- and part-time2 

All ownerships- 165,600 

Proprietary-------- 115,100 

Nonprofit __________ 26,700 

Government--------- 23,500 

Full-time equivalent1 Full-time equivalent2 

All ownershipsProprietary--------

Nonprofit----------

Government---------

Ratio of residents to full-time Ratio of residents to full-time 

equivalent staff equivalent nursing staff 

All ownerships- '-']I 1.9 1 2.7 ( 3.1 

I I 

Proprietary-------- *sl II 2.0 1 2.6 1 2.9 

Nonprofit---------- 2.3 II 1.9 2.6 3.0 

Government--------- 2.1 1.7 3.6 4.0 

IThe estimated 20,700 administrators are included as full-time employees. The distribution of 

administrators by type of service and type of ownership is shown in table 7. 

"An estimated 7,100 administrators who stated that they also performed nursing duties are included as full-time "nurses." The distribution of these administrators is shown in table 7. 

17 
Table 7. Number of administrators in nursing and personal care homes by additional duties per- formed, type of service, and type of ownership: United States, May-June 1964 

Administrators performing Administrators additional duties as: with no All

Type of service and type of ownership adminis- additional 

nursing or trators Other other profes- RN LPN Nurse's profes- aide sional duties sional 

All homes----------------------- 20,700 2,000 2,500 2,600 1,200 12,400 -

Proprietary--------------------------- 16,600 1,700 2,100 2,500 900 9,500 

Nonprofit----------------------------- 2,700 f 400 9< 200 2,000 

Government---------------------------- 1,400 200 -2 -2 -k 1,000 

Nursing care-------------------- 11,100 1,800 1,900 700 600 6,200 

Proprietary--------------------------- 9,600 1,600 1,800 700 500 5,000 

Nonprofit----------------------------- 800 ?c $< ;li ;tr 600 

Government---------------------------- 700 9< 9< Y< -2 500 

Personal care with nursing------ 6,000 1,300 400 3,600 

Proprietary--------------------------- 4,100 1,300 200 2,400 

Nonprofit----------------------------- 1,500 t Jx 1,000 

Government---------------------------- 300 ;ri 9< 200 

personal care------------------- 3,600 600 200 2,700 

Proprietary--------------------------- 2,900 500 200 2,100 

Nonprofit----------------------------- 400 * x 300 

Government---------------------------- 300 k 4 200 

18 
Table 8. Number of nursing and personal care homes, beds, and residents, by type of service and 

type of ownership: United States, May-June 1964 

Type of service and type of ownership Homes Beds Residents 

All homes------------------------------------ 17,400 618,900 554,000 

Proprietary---------------------------------------- 14,190 372,900 333,300 

Nonprofit------------------------------------------ 2,220 147,500 132,800 

Government----------------------------------------- 990 98,600 87,800 

Nursing care _____------__-------------------- 9,350 411,700 373,300 

8,170 285,200 258,700 

650 58,200 53,300 

530 68,300 61,300 

Personal care with nursing------------------- 5,240 163,800 145,400 

Proprietary---------------------------------------- 3,710 61,700 53,600 

Nonprofit------------------------------------------ 1,270 80,100 71,700 

Government----------------------------------------- 260 22,000 20,000 

personal care-------------------------------- 2,810 43,400 35,300 

Proprietary---------------------------------------- 2,310 25,900 21,000 

Nonprofit------------------------------------------ 300 9,200 7,800 

Government----------------------------------------- 200 8,300 6,500 

19 
APPENDIX I 

TECHNICAL NOTES ON METHODS 

Survey Design 

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

was conducted during May and June 1964 by the Division 

of Health Records Statistics in cooperation with the 

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

institutions in the United States which provide nursing 

or personal care to the aged and chronically ill, of 

their patients or residents, and of their employees. The 

institutions within the scope of the survey included 

such places as nursing homes, convalescent homes, rest 

homes, homes for the aged, other related facilities, 

and geriatric hospitals. To be eligible for the survey 

an establishment must have maintained three or more 

beds and must have provided some Ievel of nursing 

or personal care. The procedure for classifying establishments for the RPS-2 universe is described in Appendix II-B. 

This appendix presents a brief description of the 

survey design, general qualifications of data, and the 

reliability of estimates presented in this report. Succeeding appendixes are concerned with classification 

procedures. definitions, and questionnaires used in the 

survey for collecting information about employees. 

Sampling frame.- A “multiframe” technique was 

used in establishing the sampling universe for RPS-2. 

The principal frame was the Master Facility Inventory 

which contained the names, addresses, and descriptive 

information for about 90-95 percent of the nursing and 

personal care homes in the United States. Establishments not listed in the MFI were, theoretically, on 

another list referred to as the Complement Survey list. 

A description of the MFI and the Complement Survey 

has been published. 6 

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

Interview Survey. 1 In the Health Interview Survey, 

interviewers make visits each week to households 

located in probability samples of small segments ofthe 

United States. In addition to collecting information about 

the health of the household members, the interviewers 

are instructed to record the names and addresses 

of hospitals and institutions located wholly or partially 

within the specified areas. The Complement Survey 

list is composed of the establishments identified in 

these sample areas between January 1959 and July 

20 

1963 that were not listed in the MFI, and which were 

in business as of July 1, 1962. The Complement Survey 

sample for RPS-2 included four establishments representing an estimated total of about 800 such facilities 

in the United States not included in the Master Facility 

Inventory. 

Sample design. -The sample was a stratified twostage probability design; the first stage was a selection 

of establishments from the MFI and the Complement 

Survey, and the second stage a selection of employees 

and residents from registers of the sample establishments. In preparation for the first-stage sample selection, the MFI was divided into two groups on the basis 

of whether or not current information was available about 

the establishment. Group I was composed of establishments which had returned a questionnaire in a previous 

MFI survey. Group II contained places which were possibly within the scope of RPS-2, but were not confirmed 

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

not delivered by the post office because of insufficient 

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

hospitals, personal-care-with-nursing homes, andpersonal care homes. Group II was treatedasa fourth type 

of service stratum. Each of these four strata was further 

sorted into four bed size groups, producing 16 primary 

strata as shown in table I. Within each primary stratum 

the listing of establishments was ordered by type of 

ownership, State, and county. The sample of establishments was then selected systematically after a random 

start within each of the primary strata. 

Table I shows the distribution by primary strata of 

establishments in the MFI and in the sample, and the 

final disposition of the sample places with regard to 

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

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

and within scope of the survey. 

The second-stage sample selection of employees 

was carried out by Bureau of Census interviewers at 

the time of their visit to the establishments in accordance with specific instructions given for each sample 

establishment. After determining the total number of 

employees usually working 15 or more hours per week 

in the home, the names of all such employees were listed 

on a Staff Information and Control Record Form (HRS3b). The respondent was asked to view a list of job 
Table I. Distribution of institutions for- the aged in the Master Facility Inventory and in the 

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

to the RPS-2: United States 

Number of homes in sample 

Number In scope and 

Type of service and size of institution of 

in 

homes out of in business 

MFIl 

the Total scope or 

homes' out of Nonre­ business sponding

homes 

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

N-sing careO----------------------------- 8,155 634 37 8 589 

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

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

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

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

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

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

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

loo-299 beds------------------------------------ 345 103 1 102 

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

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

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

30-99 beds-------------------------------------- 402 32 1 31 

100-299 beds------------------------------------ 29 14 2 1 11 

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

2,772 73 54 19 

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

25-99 beds-------------------------------------- 185 15 12 3 

100-299 beds------------------------------------ 6 3 3 

300 beds and over __-_-______---_---------------- 3 3 2 1 

IThe universe for the RPS-2 sample consisted of the MFI and the Complement Survey. Included in 

the;RPS-2 sample were four homes from the Complement Survey. -Includes geriatric hospitals. 3Group II consists of those institutions assumed to be in scope of the RPS-2 survey but for 

which current data were not available. 

21 
titles on a flash card (Card B-“List of Selected Job 

Categories “-in Appendix III) and to indicate the category which best fits the job done in the home by each 

employee. For the purpose of stratifying employees 

by type of work, the job categories were grouped into 

three classes: “professional” (job categories l-10 on 

card B), “semiprofessional” (job category 11 on card 

B), and “nonprofessional” (job categories 12-16 on 

card B). All professional employees were identified in 

column (b) of HRS-3b, all semiprofessional in column 

(c), and all nonprofessional in column (d). Using predesignated sampling instructions that appeared at the 

head of each column, the interviewer then selected the 

sample of employees within each stratum. The total 

sample selected from establishments cooperating in the 

survey consisted of 11,832 employees. 

Survey procedures.- For the survey. the Bureau of 

the Census employed about 140 interviewers all of whom 

were regular interviewers in continuing sample surveys 

conducted by the Bureau. About half of them were 

employed in the Health Interview Survey, and abouthalf 

in other continuous surveys conducted by the Census 

Bureau. Since the interviewers were all well trained 

in general survey methodology. it was relatively easy 

to train them in the specific methods used in RPS-2. 

Briefly, their training consisted of home study materials 

and observation by the Census Regional Supervisor on 

the first interview assignment. 

The initial contact with an establishment was a 

letter signed by the Director ofthe Bureau of the Census. 

The letter (HRS-3f, Appendix III) notified each administrator about the survey, requested his cooperation, and 

stated that a representative would contact him for an 

appointment. The interviewer’s telephone call usually 

followed within 3 or 4 days. 

During the course of the interview, the interviewer 

collected data on the establishment, the residents, and 

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

information was collected both by personal interview 

and by means of a self-enumeration questionnaire. The 

respondent for the establishment questionnaire and the 

Staff Information and Control Record (HRS-3b) was 

usually the administrator or some other employee in 

the business office. The information requested on these 

forms was generally readily available either from 

records or personal knowledge of the respondent. However, the interviewer was instructed to encouragemaximum use of available records. 

After completing the Staff Information and Control 

Record for each sample employee, the interviewer partially completed a supplemental one-page staff questionnaire (HRS-3d) for each sample employee classified as 

professional or semiprofessional. This involved entering the employee’s name, certain identification information, and his job title such as “registered nurse” or 

“administrator.” These partially completed questionnaires were then distributed to the appropriate employees who were requested to complete the forms 

and return them to the interviewer, if possible. before 

she left the home. Those employees who could not complete the questionnaires before the interviewer left the 

home and those who were not on duty at the time of the 

interview were requested to mail the completed questionnaires within 5 days to a specified Census Bureau 

regional office. When questionnaires were not received 

within a week, a followup letter (Form HRS-3g in Appendix III) was mailed from the regional office. Those 

still not responding within 2 weeks of the followup 

letter were contacted by telephone. 

The Census regional offices also performed certain 

checks during the course of the survey to insure that 

the interviewers were conducting the survey according 

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

Washington office and made inquiries as necessary to 

obtain the missing information. 

The completed questionnaires were edited and 

coded by the National Center for Health Statistics and 

the data were processed on an electronic computer. This 

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

included matching with basic identifying information 

contained in the Master Facility Inventory, as well as 

carrying out internal edits and consistency checks to 

eliminate “impossib1.e” response and errors in editing, 

coding, or processing. 

General Qualifications 

Nonresponse and imputation of missing data.-The 

survey was conducted in 1,073 homes or about 89 percent of the original sample. About 7 percent of the 

sample places were found to be out of business and an 

additional 3 percent were found to be out of scope of 

the survey; that is, they did not provide either nursing 

or personal care to their residents or maintained fewer 

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

the sample refused to cooperate in the survey (table I). 

The response rate for the in-scope sample was 98.9 percent. 

Statistics presented in this report were adjusted for 

the failure of a home to respond by use of a separate 

nonresponse adjustment factor for each service-size 

stratum further stratified by three major ownership 

groups. This factor was the ratioof allin-scope sample 

homes in a stratum to the responding in-scope sample 

homes in the stratum. 

Data were also adjusted for nonresponse which resulted from the failure of a sample employee to complete 

a questionnaire or the failure to complete an item on 

the questionnaire. The procedure was to impute to employees for whom no data were obtained the characteristics of respondents in the same job category and type 

22 
of home. This nonresponse ranged from 0.4 percent 

for the type of job category to 8.9 percent for the age 

of employee. 

Interzjiezo process.--The accuracy of the data presented in this report depends on the accuracy of personnel and business records, and to some extent on the 

accuracy of the respondent’s replies based on his 

memory or willingness to provide correct answers. 

Also, there may be some measurement error in the 

data due to judgmental answers to questions. For 

example, there was some room for judgment in deciding 

which job category best described the type of work that 

an employee performed in the establishment. The magnitude of this type of error should be small for most 

employee types, however, since most of the job categories specified in the report are well defined by their 

title, e.g., physician, dentist,registerednurse, licensed 

practical nurse. and nurse’s aide. The types of jobs 

that are less well defined include dietitians or nutritionists, physical and occupational therapists, and 

social workers. 

It is possible to make a rough assessment of the 

validity of the administrator’s assignment of job category by comparing it with that indicated on the staff 

questionnaire by the employee himself. The employee’s 

assignment was based on his answer to the question, 

“which, if any, of the following degrees, diplomas, or 

licenses do you have?” Possible categories included 

registered nurse, licensed practical nurse, persons 

with a degree in home economics-members of the 

American Dietetic Association, among others. The 

administrator’s assignment was based on his judgment as to which of a number of listed job categories 

best fitted the job done by theemployee. Therefore, inconsistent answers were not necessarily inaccurate. 

Another factor which should be taken into consideration 

when making the comparison is that registration and 

licensure practice varies by State; for example, not all 

States require physical therapists to be registered. 

The correspondence between the administrator’s 

CIassification and the information provided by the 

employee was highest for RN’s; about 94 percent of 

those classified as RN’s by the administrator also reported on the self-enumeration form that they were 

registered. For LPN’s, about 88 percent confirmed 

the administrator’s classification on the self-enumeration form. For the physical and occupational therapists, about 42 percent and 22 percent, respectively, 

reported that they were registered; for the dietitians, 

19 percent reported that they held a degree in home 

economics, and for the social workers, 16 percent 

reported a degree in social work. However, over twothirds of the physical therapists and over three-fifths 

of the occupational therapists reported that they had 

taken special training or courses in their field, and 

over half of the persons classed as dietitians had 

taken courses in nutrition or food services. For those 

classed as social workers, about 37 percent had taken 

special courses in mental or social problems of the 

aged. 

Houndilzg of numbers.- Estimates relating to staff 

and residents have been rounded to the nearest hundred 

and homes to the nearest ten. For this reason detailed 

figures within tables do not always add to totals. Percents were calculated on the basis of original, unrounded figures and will not necessarily agree with 

percents which might be calculated from rounded data. 

Estimation procedure.-The statistics presented 

in this report are essentially the result of a ratio 

estimation technique. A first-stage adjustment factor 

R,i = B;IB; was determined for each noncertainty 

stratum of the sample design. Bi is the total number 

of beds for establishments in the ith stratum according to the MFI. Bi is the estimated number of beds 

for establishments in the ith 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. 

The second-stage ratio adjustment was included 

in the estimation of staff data for all primary strata. 

The adjustment factor, RZii = Eii/E,; was computed for 

each type of service-size strata, where RZii represents 

the second-stage adjustment factor for the ith strctllm, 

Eii is the total number of employees in thejth;ob 

category in the sample establishments for the ith atraturn, and E(i is the estimated number of emplojees in 

the jth job category in the sample establishments for 

the ithstratum. The purpose of this adjustment was to 

correct the sample for overrepresentation or underrepresentation of job categories in the particular samples selected within sample establishments. 

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

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

same schedules, instructions, and procedures. 

As in any survey, the results are also subject to 

reporting and processing errors and errors due tononresponse. To the extent possible, these types of errors 

were kept to a minimum by methods built into survey 

procedures. 

The sampling error (or standard error) of a statistic is inversely proportional to the square root of 

the number of observations in the sample. Thus, as 

the sample size increases, the standard error decreases. The standard error is primarily a measure 

of the variability that occurs by chance because only 

a sample, rather than the entire universe, is surveyed. 

As calculated for this report, the standard error also 

reflects part of the measurement error, but it does not 

23 
measure any systematic biases in the data. The chances 

are about two out of three that an estimate from the 

sample differs from the value which would be obtained 

from a complete census by less than the standard error. 

The chances are about 95 out of 100 that the difference 

is less than twice the standard error and about 99 out 

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

Relative standard errors of aggregates shown in this 

report can be determined from figure I of this appendix. The relative standard error of an estimate is 

obtained by dividing the standard error of the estimate 

by the estimate itself and is expressed as a percent 

of the estimate. An example of how to convert the 

relative error into a standard error is given with 

figure I. Standard errors of estimated percentages 

are shown in tables II and III. 

To determine the standard error of the ratio of 

residents to employees, of a median value, or of the 

difference between two statistics, the following rules 

may be used. 

Standard eYYor of ratio of residents to employees: 

(a) Determine from curve A, figure I, the relative 

standard error of the number of residents 

which composes the numerator of the ratio. 

Then determine the standard error of the 

denominator (number of employees) from curve 

A or curve B, as appropriate. 

(b) Subtract 1% times the product of the two relative 

standard errors from the sum of the squares of 

the two relative errors. The square root of this 

number approximates the relative standard 

error of the ratio of residents to employees. 

The standard error of the ratio is equal to the 

product of the ratio and the relative standard 

error. 

Cc) Example. Suppose the standard error of the 

ratio of the number of residents in nursing 

care homes to the number of registerednurses 

in nursing care homes is desired. 

373 000 R’ = + = -L = 24.5

15,200 

The relative error of 373,000 (from curve A) is 

0.008. 

The relative error of 15,200 (from curve B) is 

0.040. 

v,‘: = v.t + vyT - 1.5 v,. v,. 

= (.008j2 + (.040)* - (1.5) c.008) t.040) 

= .000064 t .0016 - .000480 

= .001184 

v,. = .034 

slla = ,034 x 24.5 = .83 

Standard e’Yyor of a median -The medians shown 

in this report were calculated from grouped data. 

Approximate standard errors for these estimated 

medians can be computed as follows: 

(a) Determine the standard error of a 50-percent 

characteristic whose denominator is equal to 

the estimated number of persons in the frequency distribution on which the median is 

based. For example, the median age of LPN’s 

in nursing care homes is 47 years. The estimated number of LPN’s in nursing care homes 

is 18,106. The standard error of a SO-percent 

characteristic whose base is 18,106 is shown 

in table II, by interpolation, to be 2.3 percentage points. 

0)) Apply this standard error to the cumulative 

frequency distribution to obtain the confidence 

interval around the median. The steps are as 

follows. For the above example, using the 95-

percent level of confidence, determine the 

points on the cumulative frequencydistribution 

corresponding to 45.4 percent (50 percent 

minus two standard errors) and 54.6 percent 

(50 percent plus two standard errors). These 

points are 8,220 (.454 x 18,106) and 9,886 

(.546 x 18,106). From table 2, determine the 

ages that correspond to these two points. They 

are 45.5 years and 48.7 years, respectively. 

Therefore, the confidence limit for the cstimated median age of 47 years is 45.5 - 48.7 

years at the 95-percent level of confidence. 

It is possible to investigate whether an observed 

difference between two estimated medians can be attributed to sampling error alone by obtaining the upper 

68-percent confidence limit, lJ;, of the smaller observed 

median, M; , and the lower 68-percent confidence limit, 

L;, of the larger median, M;. These limits may be 

found by using the method outlined above, but using 

one standard error instead of two. The square root of 

the sum of the squared differences between M;and U, 

and M; and L; is the standard error of the difference 

between M; and M;; that is, 

SCM,+,= VIM; - U’,? + CM; - L’,)’ 

For the purposes of this report any difference between 

M’, and M; greater than 2tS,. _ M, 1 has been considered a real difference. ’ * 

Standard eYYoY of a diffeerence between two estimates .-The standard error of a difference is approximately the square root of the sum of the squares of 

each standard error considered separately. This formula will represent the actual standard error quite 

accurately for the difference between separate and 

uncorrelated characteristics, although it is only a 

rough approximation in most other cases. 

24 
Table II. Approximate standard errors of percentages for estimated total employees,nurse's aides,

and other nonprofessional employees 

Estimated percent Base of percent

(number of employees) 

or 99 5 or 95 I 10 or 90 20 or 80 I 30 or 70 50 

Standard error expressed in percentage points 

16.4 18.8 20.5 

11.6 13.3 14.5

;:; E 2: 

4.2 4.6 

2:1 

z-i ;:; 1.8 . 

1.6 1.9 2.1 i*x E L’*z 

0:7 0:8 0:8 

Table III. Approximate standard errors of percentages for RN's, LPN's, and other professional employees 

Estimated percent Base of percent

(number of professional employees) 

1 or 99 5 or 95 10 or 90 20 or 80 30 or 70 50 

Standard error expressed in percentage points 

12.0 22.0 24.7 27.2 

:*; ,,““““““““““““““““““““““““““““““” 

1,000”““““““““““““““““““““““““““””” 

1,750------------------------------

2,500------------------------------

5,000------------------------------

7,500------------------------------

10,000”“““““““““““““““““““““““““”””” 

15,000------------------------------

20.000------------------------------ ->---

25,000 “““““““““““““““““““““““““““““” 

50,000------------------------------

13.7 15.8 17.0 

9.5 10.9 

4:3 7.7 8.7 

‘Z. 

;:2: 6.5 5.: 8.0 

:-; i:; 417 56:: 

1:3 2:4 z.3 32:: 

E

;:9’ f-7 

2.3 

f*i 

1:4 2; 1:9 

1.6 

0:5 tl:; ::: 1.2 

25 
Figure I. Approximate relative standard errors of aggregates. 

100.0 

80.0 

60.0 

40.0 

20.0 

10.0 

8.0 

6.0 

4.0 

2.0 

1.0 

0.8 

0.6 

0.4 

0.2 

0.1 

Size of Estimate 

ExamDle of use Of fi.Wre I: An estimate of 100,000 total employees has a relative standard error 

of 2.5 percent (read from scale at left side of figure). The estimate has a standard error of 

2,500 (2.5 percent of 100,000). 

-ooo26 
APPENDIX II 

A. DEFINITIONS OF CERTAIN 

Terms Relating to Staff 

Employee: 

An employee is defined as any paid worker, proprietor , or member of a religious order who 

usually worked 15 or more hours per week in the 

establishment. 

Full time or part time: 

Persons who usually worked 35 hours or more 

per week are designated “full time” in this report. 

Persons who usually worked 15-3-l hours per week 

are designated “part time.” 

Full-time equirjalent 

For the purposes of this report, two “part-time” 

employees are counted as equivalent to one “fulltime” employee. 

Job category: 

For purposes of analysis and tabular presentation, 

the job categories designated in the survey were 

condensed into five major groups as follows: 

1. Kegistered muses: includes registered professional nurses and graduate nurses. 

2. Licensed practical ~PSCS: includes licensed 

practical nurses and licensed vocational nurses. 

3. Nurse’s aides: includes practical nurses, 

nurse’s aides, student nurses. other supporting 

nursing staff, and orderlies unless notedotherwise. 

4. Other professional staff: includes physicians, 

dentists, occupational therapists, physical therapists, dietitians, social workers, other professional staff not included in the above positions, and administrators unless noted otherwise. 

5. Other nonprofessional staffi includes clerical, 

bookkeeping, or other office staff, food service 

personnel, and housekeeping personnel. 

TERMS USED IN THIS REPORT 

Terms Relating to Homes or Residents 

Bed: 

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. 

Hesideut: 

A resident is defined for the purpose of RPS-2 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. 

Nwsing care: 

Nursing care is defined for the purpose of this 

survey as the provision of one or more of the 

following: 

Taking of temperature-pulse-respiration or blood 

pressure 

Full bed bath 

Application of dressings or bandages 

Catheterization 

Intravenous injection 

Intramuscular injection 

Nasal feeding 

Irrigation 

Bowel and bladder retraining 

Hypodermic injection 

Oxygen therapy 

Enema 

Proprietary home: 

A home operated under private commercial ownership. 

Norzpprofithome: 

A home operated under voluntary or nonprofit 

auspices, including both church-related and nonchurch-related institutions. 

Government (operated) home: 

A home operated under Federal, State, or lodal 

Government auspices. 

27 
B. CLASSIFICATION OF HOMES BY TYPE OF SERVICE 

For purposes of stratification of the universe prior nursing care (see definition, AppendixII-A) durto selection of the sample, the homes on the MFI were ing the week prior to the survey in the home, 

classified as nursing care, personal-care-with-nursing, with an RN or LPN employed 15 or more hours 

personal care, or domiciliary care homes, The latter per week. In this report, geriatric hospitals 

two classes were combined to produce the three types are included with the nursing care homes. 

of service classes shown in table I, Appendix I. Details 2. A personal-care-with-nursing Ilome is defined 

of the classification procedure in the MFI have been as one in which either (a) over 50 percent of the 

published. 6 residents received nursing care duringthe week 

Due to the Z-year interval between the MFI survey prior to the survey. but there were no RN’s or 

and the RPS-2 survey, it was felt that, for producing LPN’s on the staff; or (b) some, but less than 

statistics by type of service from the RPS-2 survey, 50 percent, of the residents received nursing

the homes should be reclassified on the basis of the care during the week prior to the survey regardcurrent data collected in the survey. This classification less of the presence of RN’s or LPN’s on the 

procedure is essentially the same as the MFI scheme. staff. 

The three types of service classes delineated for RPS-2 

3. A personal caYe home is defined as one in are defined as follows: 

which residents routinely received personal

1. A nursing cat’s home is defined as one in which care, but no residents received nursing care 

50 percent or more of the residents received during the week prior to the survey. 

29 
r 

IAPPENDIX III 

FORMS AND QUESTIONNAIRES 

U.S. DEPARTMENT OF COMMERCE 

BUREAU OF THE CENSUS 

WASHINGTON. DC 20253 

-I 

-I 

Dear Administrator: 

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

United States Public Health Service, is conducting a nationwide survey 

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

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

purpose of this survey is to collect much needed statistical information 

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

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

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

health of our people. 

The purpose 

you that a 

establishment 

to his visit, 

convenient 

of this letter is to request your cooperation and to inform 

representative of the Bureau of the Census will visit your 

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

the Census representative will call you to arrange for a 

appointment time. 

All the information given to the Census representative will be kept

strictly confidential by the Public Health Service and the Bureau of 

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

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

Sincerely yours, 

G&G 

Richard M. Scammon 

Director 

Bureau of the Census 

29 
U.S. DEPARTMENT OF COMMERCE 

BUREAU OF-I-HE CENSUS 

Dear 

About a week ago the Bureau of the Census conducted a survey in the 

establishment in which you are employed to obtain informatjon on the work 

experience and education of certain profess%onal and semi-orofessional 

employees of the home. At that time we left a questionnaire for you to 

co.mplete and return to us. According to our records, the questionnaire 

has not been received. 

Another copy of the questionnaire is enclosed for your use if the other 

copy has been lost or misplaced. Please complete the questionnaire and 

mail it to the Bureau of the Census within 5 days. For your convenience, 

a self-addressed envelope which requires no postage is enclosed. 

If you have already returned the original questionnaire, please disregard 

this reminder. 

Thank you for your cooperation. 

GGSincerely yours, 

Richard M. Scammon 

Director 

Bureau of the Census 

Enclosures 

Please send completed 

form to: 

30 
Budget Bureau Ho. G&Rt%Q.RZ; Appmval Expues December 31. 1964 

CONFIDENTIAL - This mlommrion 1s collected for rhe U.S. Public Health Service under aurhoriry of Public Law 612 of the 84th Congress 

70 star. 489; 42 U.S.C. 305). All tnlorm~rmn which aould peonrt idcnuf~carmn of the tndtvrdual wll be held strictly confidenrid. will be 

wed only hy persons Engaged ,n and for rhc pwposcs of rhc survey. and a,11 nor be hsclosed or released m orhcrs for any other purposes 

22 FR 1687). 

U.S. NATIONAL HEALTH SURVEY 

ESTABLISHMENT QUESTIONNAIRE 

Number 

00. How many persons WOM in this estoblirhment? (Include owners who uork in the establishment 

as well as all paid employees and members of religious orders) 

b. HOW rmmy of those - (q. 10a) - persons usually work LESS than 15 hours o week in 

this establishment? 

(Subtract the answer to question IOb from the answer to question JOa 

and insert the difference in item IOc below) 

5. Now I need to list thenomes of the employees who usually work 15 hours or more par week in this 

establishment. 

Name of respondent(s) Telephone number and ext. 

Title or position Dare completed 

iCode 

f 

Comments 

I 

31 
-- 

------ 

------ ----- 

---- 

ORM FIRS-3b 

1-2.64, STAFF INFORMATION AND CONTROL RECORD 

What is his job here? (Enter number from Card 8) -_. 

Employees who work 15 or more bows a week in this esrnblishmenr 

(Enter Mr., Mrs., Miss, 

d or Dr., first initial 

5 and last name) 

: 

.9 

-I 

vs. OEPARTMENTOF COMMERCE.Esrab,isbmenr““mber BVREA”OF THE CENSUS 

INTERVIEWER 

Fill buff Swff Questionnaire 

form (Form HRS3d) for each 

sample employee in columns 

(b) and(c) only 

(Check one box for each sample employee eligible 

for staff form) 

b) (b) (cl Cd) (e) (9) k) 6) (i) (9 (k) 

1 

2 

2.. 

4 

5 

6 

7 

32 

Month 0 Completed at time of visit 

0 Form left 10 be mailed in ___---------_-__-_--__

Year Date recerved I” R. 0. 

Month 0 Completed a rime of visit 

0 Form left 1” bc mailed in -------~arer;F;iyey~n-Ryo~---- Year 

Month 0 Complcrcd at time of visit 

0 Form left f” bc mailed in ------------,-__-------

Year Date recexvcd I” R. 0. 

Monrb 0 C=mpl=r ed at time of visit 

0 Form left to be mailed in -------B-&-r~c-i-e~~“-R~~---- Year 

Month 0 Complctcd al time of visit 

0 Form left co be mailed in _----- Year - I5ZTCZiTJ 771-R. 0. 

Month c] Campleted at rime of visit 

n Form left to be mailed in 

Year bat;rXiY=JGX 0. 

Month 0 Completed at time of visit 

0 Farm left to be mailed in ---___ ------.--L--- Year Dale recclved 1” R. 0. 
-- 

Budget Bureau No. GE-RG20.RZ; Appro~l Expires December 31, ,964 

FORM HRS-3d CONFIDENTIAL - This information is collecrcd for the U.S. Public Health Service under ,3-31.6.1 aurhority of Public Law 652 of the 84th Congress (70 Srar. 489; 42 U.S.C. 305). All infor 

U.S. DEPARTMENT OF COMMERCE mation which would permit identification of rhc rndividul will be held strictly confiden- BVREAU OF THE CENSUS *CTINC AS COLLECTING *CENT FOR THE ifal. will be used only by persons engaged in and for :he pw~oscs of rhe survey. and will 

not be disclosed or released 10 orhers forany orher purposes (22 FR 1687). 

nmber b. Line number U.S. NATIONAL HEALTH SURVEY ‘- Esrablishmenr 

STAFF QUESTIONNAIRE c. Name of person 

I 

The U.S. National Health Survey of the cublic Health 

Service is conducting a nationwide survey 

homes, homes for the aged, and other related 

establishments. The purpose of the survey is 

certain information about the staff employed 

establishments as well as about the health of 

residents in the establishments. 

in nursing 

types of 

to obtain 

in these 

patients or 

who should fill this form 

I 

Since it takes only a few minutes to complete the questionnaire, we would very much ap reciate it if you will 

complete and mail the fotm within P c next 5 days. 

Your answers will be given confidential treatment by the 

U.S. National Health Surrey and the Bureau of the Census. 

The information will be used for statistical purposes only, 

and will be presented in such a manner that no individual 

person or establishment can be identified 

Thank you for your cooperation. 

k 

Please answer the questions on this questionnaire. When 

you have completed it, mail it to the Bureau of the Census 

in the postage-free, self-addressed envelope provided. 

1. How old ware you on your last birthdoy?. . . . . . . . . . . _ _ . . . . . . . _ _ . . . _ _ _ . . . . . . . . . _ . 

I

I

2. How many yews have you worked os a 

o-- in this establishment?. . . . . . . . . . . . . . . . . . _ . . . . . _ . . . 1 G and m.nlhr 1 

b-- in other nursing homes, homes for the aged, or related facilities? 

c-- in hospitals?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

(If your present job is in a hospital, do nor include the experience 

shown in quesrion 2a.l 

NOTE TO NURSES: Do not include special duty or private duty nursing. 

3. What is the highest grade you 

COMPLETED in school? t Elemenrary school . . . 1 2345678 

(Grade school) 

(Circle the highest grade completed) z High school.. . . . . . . 1 2 3 4 

3 College.. . . . . . . . . 1 2 3 4 5+ 

I

I 

4. Which, if any, of the following 

degrees, diplomas, or licenses I 0 Registered professional 7 0 Doctor of Dental Surgery 

do you hove? nurse (R.N.) or Dental Medicine 

(D.D.S. or D.M.D.) 

P 0 Licensed practical (Check al? boxes tbat apply) nurse (L.P.N.) 8 0 Physician (M.D. or D.O.) 

3 0 Degree in home 0 C Masrer of Social Welfare 

economics (M.S.W.) 

4 0 Member- American 

Dietetic Associarion 

I a Regisrered occupntional 

therapist 

6 0 Regisrered physical OR 

therapist I I 0 None of the above 

33 

L 
Card B 

LIST OF SELECTED JOB CATEGORIES 

WHICH OF THE FOLLOWING JOB CATEGORIES BEST 

FITS THE JOB WHICH THIS EMPLOYEE DOES IN THIS 

ESTABLISHMENT? 

1. 

2. 

3. 

4. 

5. 

6. 

7. 

8. 

9. 

10. 

Administrator 

Physician (M.D. or D.O.) 

Dentist 

Occupational Therapist 

Physical Therapist 

Dietitian or Nutritionist 

Social Worker 

Registered Professional Nurse 

Graduate Nurse, but not registered 

Licensed Practical Nurse 

11. Other nursing personnel (include, (a) practical 

nurse, (b) nurse’s aide, (c) student nurse, and 

(d) ocher supporting nursing staff) 

12. Orderly 

13. 

14. 

15. 

16. 

34 

Clerical, bookkeeping, or other office staff 

Food service personnel (cook, kitchen help, erc.) 

Housekeeping personnel (maid, maintenance man, 

etc.) 

Job other than those listed above (~kase describe 

employee’s duties) 

RESIDENT PLACES SURVEY - 2 

000 

fi “. S. GOVERNMENT PRINTING OFFICE : 1966 0 - 226-288 
Series 1. 

Series 2. 

Series 3. 

Series 4. 

Series 10. 

Series 11. 

Series 12. 

Series 20. 

Series 21. 

Series 22. 

OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publication No. 1000 

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

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

other material necessary for understanding the data. 

Reports number l-4 

Bata 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 l-18 

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 l-4 

Documents and committee repouts.-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 1-5 

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-32 

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, physiological, and 

psychological measurements. 

Reports number l-16 

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 1-5 

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 and 2 

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 i-9 

Data From the National Natulity and Mortality Surveys .-Statistics 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 and 2 

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

U.S. Public Health Service 

Washington, 13.C. 20201