NATIONAL CENTER Series 12 

For HEALTH STATISTICS I Number 6 

VITAL and HEALTH STATISTICS 

DATA FROM THE NATIONAL HEALTH SURVEY 

Employeesin Nursing and 

PersonalCare Homes: 

Number, W o rk Experience, 

Special Training, and Wages 

United States- May- June 1964 

Statistics on the number and types of employees and their 

total work experience in nursing and personal care homes and 

hospitals, length of current employment, special training, and 

wages. Based on data collected from employees of nursing 

and personal care homes during the period May-June 1964. 

Washington, D.C. January 1967 

U.S. DEPARTMENT OF Public Health Service 

HEALTH, EDUCATION, AND WELFARE William H. Stewart 

John W . Gardner Surgeon General 

Secretary 
Public Health Service Publication No. 1000~Series 12-No. 6 

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

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

FORREST E. LINDER, PH. D., Director 

THEODORE D. WOOLSEY, Deputy Dir.ector 

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

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

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

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

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

DONALD GREEN, Information Officer 

DIVISION OF HEALTH RECORDS STATISTICS 

MONROE G. SIRKEN, PH.D., Chiej 

JOHN MONROE, Assistant Chic/ 

PETER L. HURLEY, Chic/, Institutional Population Survey Branch 

MILTON C. ROS~FF, M.S., Chief, Hospital Discharge SUTV~Y Branch 

COOPERATIONOFTHEBUREAUOFTHECENSUS 

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 and collecting the data. 

Public Health Service.Publication No. 10004eries 12.No. 6 

Library of Congress Catalog Card Number 66-62091 
----------------------------- 

---- 

CONTENTS 

Page 

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

Background ________-_____-__-______________________----------------

General Survey Design and Qualifications 

Number and Types of Employees-------------------------------------

Number of Homes and Residents -_------ _-_____- -_____-_ -_- ______ 

Work Experience and Special Training----------------------------------- 3 

Work Experience--------------------------------------------------- 3 

Special Training---------------------------------------------------- 6 

Len@ of Current Employment _-____--_-________----------------------- 8 

Wages _____--__________--_------------------------------------------- 9 

12 

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

Appendix I. Technical Notes on Methods-------------------------------- 21 

Survey Design------------------------------------------------------ 21 

General Qualifications __----_-_-___ - ________________________________ 23 

Appendix II. 

A. Definitions of Certain Terms Used in This Report------------------ 28 

Terms Relating to Staff--------- _-______ -----_- ______ -_--- _______ 28 

Terms Relating to Homes or Residents---------------------------- 28 

B. Classification of Homes by Type of Service------------------------ 29 

AppendixIII. Forms andQuestionnaires--------------------------------- 30 
IN THIS REPORT employees of nursing and personal caye homes aye 

described in terms of their work experience in hospitals, nursing homes, 

and related facilities; special courses taken that relate to the caye of 

the aged OY chronically ill; and wages paid for a standard 40-hour week. 

These data, which aye based on a sample survey conducted during MayJune 1964, provide a general picture of the Levels of skill attained by 

employees and of turnover in personnel. 

Of the 176,000 employees classified asnurses, nurse’s aides, and other 

professionals, about one-fifth had less than 1 year of total experience 

and moye than one-half had worked Less than 5 years. Of the several job 

categories studied, registered nuzses (RN’s) had the most experience 

andnurse’s aides had the Least-medians of 11.1 and 2.5 years, respectively. Relatively few of the employees had taken a formal course under 

college sponsorship. The proportion was somewhat higher for short 

co-uyses, institutes, and workshops. For example, about 19 percent of 

the RN’s had taken a short c@uYse in mysing caye of the aged in comparison with 5 percent who had taken such a cowse under college sponsorship. 

There appeared to be a high turnover rate among employees. Nearly 

out of every 10 persons had beenin their current job fov Less than 1 year, 

and the median was only 1.7 years. Employees with previous experience 

hadbeenin their current job 1.4 years on the average as compared with 

their median total work experience of 7.4 years. 

Income was obtained in the survey for an estimated 255,200 employees 

working15 houvs OY moye per week which included all personnel except 

administrators and members of religious orders. The estimated median 

wages for a standard 40-hour week was $48. The Lowest wages weye 

paid to nuyse’s aides and the highest to other professional-with 

medians of $44 and $89 per week, respectively. 

SYMBOLS 

Data not available ________________________ __-

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

Quantity zero ____________________________ _ 

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

Figure does not meet standards of 

reliability or precision------------------ 1 

4 
EMPLOYEES IN NURSING AND PERSONAL 

CARE HOMES 

NUMBER, WORK EXPERIENCE, SPECIAL TRAINING, WAGES 

Carl A. Taube, and E. Earl Bryant 

INTRODUCTION 

Background 

The Division of Health Records Statistics, in 

cooperation with the U.S. Bureau of the Census, 

has conducted two national surveys of resident 

institutions which provide nursing or personal 

care to the aged or chronically ill. These surveys 

have been designated as Resident Places Survey 1 

and 2, or RPS-1 and RPS-2. RPS-1 wasconducted 

during the spring of 1963 to collect statistics on 

such things as the establishments’ admission 

policies, charges for care, numbers of admissions 

and discharges, and, in very general terms, the 

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 

provide care to the aged and chronically ill. 

Several reports on the results of RPS-1 have been 

published. 1-4 

RPS-2, the survey on which this report is 

based, was conducted during May and June 1964. 

The scope of RPS-2 was not as broad as that of 

RPS-1 in that all hospitals except geriatric were 

excluded; however, the statistics collected were 

more comprehensive and covered more subjects. 

Detailed information was obtained about the establishment itself, the residents, and theemployees. 

The questionnaires included such topics as the 

availability of physicians’ and dentists’ services; 

bed capacity; number of discharges; personal, 

demographic, and health characteristics of residents, including the prevalence of chronic diseases 

and impairments; and certain items of information 

about employees. This is the second report to be 

published on the findings of RPS-2. The first 

report provided data on the number and types of 

employees in nursing and personal care homes by 

age and sex, hours worked per week, and the 

ratio of residents to employees.’ The primary 

emphasis in this report is on work experience 

of the employees, special training relating to care 

of the aged and chronically ill, and wages. Subsequent reports will present other data collected in 

RPS-2. 

General Survey Design and Qualifications 

The scope of RPS-2 included the class of 

resident institutions generally referred to as 

nursing homes and related facilities and, inaddition, geriatric hospitals. To be included in the 

universe (sampling frame), such establishments 

must have maintained at least three beds and 

routinely provided some level of nursing or 

personal care. Thus, a home providing only room 

and board to its residents was not eligible for the 

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

The sampling frame for RPS-2 consisted of 

two lists: (1) the Master Facility Inventory (MFI), 

which contained the names and addresses of about 

90-95 percent of the nursing and personal care 

homes in the United States; and (2) an area sample 

list composed of a probability sample of places 

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

h4FI. This second list was derived from a procedure called the Complement Survey, which is 

1 
based on a complete canvass of small segments 

of the United States. A detailed description of the 

Master Facility Inventory and the Complement 

Survey has been published.6 Further discussion 

of the sampling frame for RPS-2 appears in 

Appendix I of this report. 

The estimates presented it, 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 sample of 

11,848 employees who worked 15 hours or more 

per week in the sample establishments, and a 

sample of 10,560 residents or patients. Bureau 

of the Census interviewers made personal visits 

to each of the homes to select samples of residents 

and employees and to conduct the survey. Details 

about the sample design, survey procedures, and 

other technical notes are given in Appendix I. 

Since the estimates derived from the survey 

are based on a sample rather than on all employees of nursing and personal care homes, the 

estimates are subject to sampling variability. The 

sampling errors for most of the estimates shown 

in the report are relatively small. Caution should 

be taken, however, in interpretation when the 

estimate is a small number or when the estimate 

is a percent 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 establishments; 

the classification of establishments is based on 

the type of service provided to residents rather 

than on what the place may be called or how it may 

be licensed. Also a review of the questionnaires 

and related material shown in Appendix III should 

be helpful in understanding the data. 

Number and Types of Employees 

At the time of the survey in 1964, tllere were 

an estimated 299,900 persons employed in 17,400 

nursing and personal care homes in the United 

States. These employees were serving an estimated 554,000 residents or patients. Of the 

299,900 employees, 281,000 were reported as 

usually working 15 hours or more a week. It is 

this group on which this report is based. Those 

working less than 15 hours per week were not 

within the scope of the survey. 

The employees working 15 hours or more 

were classified by the administrator or some 

other responsible respondent according to the jobs 

they performed in the establishment. During the 

interview, the. administrator was given a card 

listing 16 job categories (see Card B in Appendix III) and was asked, for each employee, the 

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 reliable method of job classification. By 

comparing the administrator’s assignment of 

certain job categories with those provided independently by the employees themselves, it was 

found that the correspondence was generally 

high. This comparison is discussed inAppendix1. 

For purposes of analysis, employees are 

classified into five groups: registered nurses 

(RN’s), licensed practical nurses (LPN’s), nurse’s 

aides, other professional, and other nonprofessional employees. None of the groups is completely 

homogeneous in terms of the level of skill that 

might be implied by the name of the job category. 

For example, 1,200 of the 17,400 RN’s were 

graduate nurses who were not registered; 500 

of the 20,500 LPN’s were reported to be licensed 

vocational nurses, The term “nurse’s aide” refers 

to a number of different types of jobs; in addition 

to employees reported in the survey as nurse’s 

aides, the vast majority of the group, other 

supporting nursing staff are included such as 

student nurses, practical (unlicensed) nurses, and 

orderlies. Of the 24,300 other professional employees, 20,700 were reported to be administrators or assistant administrators. Of the 

other job categories which constitute this group 

there were an estimated 900 dietitians, 800 

physicians, 600 occupational therapists, 400 social 

workers, 300 physical therapists, and 600 other 

professional or technical employees. 

An important fact to consider when interpreting the statistics on the availability of nurses is 

the number of administrators who also are nurses, 

In the survey administrators were asked if they 

performed any other specific jobs in the home in 

addition to their administrative duties. Over onethird reported that they also worked as an RN, 

LPN, or as a nurse’s aide and 5 percent worked 

2 
‘Table A. Number and percent distribution of nursing and personal care homes, residents, 

and nursing staff and other professional employees, by type of service according to 

job category: United States, May-June 1964 

Employees 

Type of service Homes Resi- Nursing staff Other staff 

dents All 

staff 

LPN Nurse’s Pro- Nonpr oRN fes- fes­ aides’ sional sional 

Number 

All homes---- 17,400 1 554,000 1281,000 11 17,400 120,500 1120,600 124,300 1 98,200 

Percent distribz-i:ion 

All types---- 100 100 100 100 100 100 100 100 

Nursing care-----

Personal care 

54 68 75 88 88 82 57 66 

with nursing----

Personal care----

30 

16 

26 

6 

21 

4 

12 9 

3 

17 

2 f E 

28 

6 

‘Orderlies are counted with nurse’s aides. 

in some other professional capacity. Details about 

other jobs performed by administrators are given 

in another report.7 In this analysis they are 

counted only as administrators. 

Number of Homes and Residents 

In order to better understand the information 

about employees, it should be helpful to relate 

the distribution of employees to the number and 

types of homes in which they work and the 

number of residents or patients they serve. 

Such comparative data are shown in table A. 

Nursing care homes comprised the majority 

of several types of institutions and were the 

largest. On the average, nursing care homes maintained 44 beds as opposed to 3 1 beds for personalcare-with-nursing homes and 15 beds for personal 

care homes. This size differential can be seen by 

comparing the distribution of residents with the 

distribution of homes (table A). 

About 8 out of every 10 homes wereoperated 

under proprietary auspices. For the remainder 

there were about two nonprofit homes for each 

government operated facility. Eighty-seven percent of the nursing care homes were proprietary 

in comparison with 82 percent of the personal 

care homes and 71 percent of the personal-carewith-nursing homes. 

WORK EXPERIENCE 

AND SPECIAL TRAINING 

To projlide a basis for evaluating employees’ 

training in care of the aged and chronically ill, 

information was collected on their work experience and on any special education they had 

received. Since the primary concern was with the 

training of employees who provide direct patient 

care, the questionnaire pertaining to total work 

esperience and special education was completed 

only by nurses, nurse’s aides, and other professional employees. Thus nonprofessional employees are not included in this part of the report. 

Work Experience 

Data on work experience have two important 

qualifications. They refer only to the type of job 

held by the employee at the time of the survey 

3 
Table B. Median age of nursing staff and 

per sona 1 care homes, by length of work 

May-June 1964 

Job category 

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

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

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

Other professional staff-----------------------­

and are limited to experience in hospitals, nursing 

homes, homes for the aged, and related facilities, 

On this basis, the median total experience for 

all nursing and professional employees was 4.1 

years. About one-fifth of the employees had 

worked less than 1 year, while two-fifths had 

worked 5 years or more, Distributions of employees by length of work experience are shown in 

tables l-3 according to the primary type of service 

provided, type of ownership of the establishment, 

age of employees, and job category. 

By job category the median length of experience ranged from a high of 11.l years for 

RN’s to a low of 2.5 years for nurse’s aides. 

For LPN’s and other professional staff the median 

was 7.9 and 8.7 years, respectively. 

There is little if any evidence that the employees in one type of home had more experience 

than those in another type. Although the median 

length of employment appears to be slightly 

longer for employees in personal care homes than 

for employees in nursing care homes, the difference is not statistically significant (table 1). 

On the other hand, there does seem to be some 

association between type of ownership and length 

of experience. The median experience of employees in nonprofit and government-sponsored 

homes was 4.5 years compared with 3.9 years in 

proprietary homes (table 2). The primary reason 

for this difference is that nurse’s aides and LPN’s 

had more work experience in government andnonprofit homes than did those in proprietary homes. 

For RN’s the median w,as 11 years for each type 

4 

other professional employees in nursing and 

experience and job category: United States, 

Length of work experience All 

staff 

Under l-4 5-9 lo+ 

1 year years years years 

Median age 

2; if ii 2: z3” 

42 48 

53 52 

of ownership. Professional employees (other than 

nurses) in proprietary homes, however, hadmore 

experience than those in homes of other types of 

ownership. 

In general, the length of experience in a 

specified type of job increases with age of the 

employee (table 3), but relative to the age 

span, the increase is small. The median years 

of total work experience ranged from 1.1 years 

for employees under 25 years of age to 10.2 

for those 65 and over. In the intermediate age / 

group 25-64, which contains over 80 percent 

of the employees, the median length of experience 

was only about 5 years. Two facts are apparent. 

Although many of the employees had extensive 

experience in caring for the aged, a large proportion of them did not. For example, in the age 

group 45-64, about one-third of the employees had 

worked less than 3 years in hospitals andnursing 

homes; the proportion with less than 3 years experience was much higher for nurse’s aides than 

for nurses and other professional personnel. 

For these latter vocations, however, the proportion was substantial (about 10 to 15 percent). 

The second fact to be noted is that a large 

proportion of the employees were middle age 

or older; more than half were 45 years or older. 

As shown in table B, the median age by job 

category ranged from 42 for nurse’s aides to 

53 for other professionals; the median age of 

both RN’s and LPN’s was 49. The table clearly 

indicates the mature age at which many of the 

employees began working in their respective 
Table C. Number and percent distribution of nursing staff and other professional employees, by length of current employment according to status of prior experience and 

job category: United States, May-June 1964 

Length of current employment 

Status of prior experience and Median job category All years 

staff 

No prior experience Percent distribution 

All employees--------------------- 82,000 23 

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

Licensed practical nurses--------------- Nurse’s aides---------------------------

Other professional staff----------------

Prior experience 

All employees---------------------

Registered noses-----------------------

Licensed practical nurses--------------- Nurse’s aides---------------------------

Other professional staff---------------­

job categories. For example, the median age of 

RN’s with less than 5 years’ experience was 41, 

and for other professional staff it was about 50. 

Almost one-half of the total employees had 

no work experience prior to their current job. 

By type of job, the proportion without prior experience was highest for nurse’s aides and other 

professional staff (53 percent) (fig. 1 and table C). 

Although substantially lower, the proportion of 

RN’s and LPN’s with no prior work experience 

was also high; about one-sixth of the RN’s and onefourth of the LPN’s had no previous work experience as nurses in other nursing homes or 

hospitals. This, of course, does not necessarily 

mean that people without previous work experience 

were not just as experienced as those who had 

worked in other nursing homes or hospitals. It 

may be seen from table C that about one-fourth 

of the employees without prior experience had 

worked 5 years or more in their current jobs. 

It should be noted, however, that the median 

years of total work experience was only 1.8 

years for employees without prior experience. 

This compares with 7.4 years of total work exPERCENT DISTRIBUTION 

~ ; :O 4” 6,D “,O IO; 

cotsqory 

Figure I. Percent distribution of employees in 

nursing and personal care homes,by whether they 

had prior experienceinanother home or hospital 

according to job category. 

240-480 0 - 67 - 2 

1.8 
15 r 14 

t 

12 c 

II -

IO -

9-

s­

?-

6-

5-

4c 

3 

2 

0I 

VrA- - _ All employees 

_ _ _ Employees with prior experience 

Employees without prior experien 

4.6 

All nursing Registered Licensed 

and other nurses practical 

professional nurses 

staff 

JOB CATEGORY 

Figure 2. Median years of total work experience in nursing homes, personal care homes, and hospitals, 

by whether or not employee had prior experience in another home or hospital and job category. 

perience for people with previous work ex- Special Training 

perience in another similar or related establishment (fig. 2). Such a comparison for RN’s is even In addition to information about work exmore striking, 2.2 years for those without previous perience, nursing staff and other professional 

experience and 12.9 years for those with previous employees were asked if they had taken certain 

experience. courses relating to care of the aged or chronically 

6 
Table D. Percent of nursing staff and other professional employees who had attended 

special courses, by job category and type of course: United States, May-June 1964 

Job category 

Type of course 

Nursing home administration 

Accredited course------------------------------------

Short course, institute, or workshop-----------------

Nursing care of the aged 

Accredited course------------------------------------

Short course, institute, or workshop-----------------

Medical or dental care for the aged 

Accredited course------------------------------------

Short course, institute, or workshop-----------------

Mental or social problems of the aged or 

chronically ill 

Accredited course -----------__-----------------------

Short course, institute, or workshop-----------------

Physical therapy or rehabilitation 

Accredited course -----C-__--r-------C___CL___________ 

Short course, institute, or workshop-----------------

Occupational therapy 

Accredited course --__-----C-------LL-_-------C-L----------

Short course, institute, or workshop-----------------

Nutrition or food services 

Accredited course --c-_-c-----_-----c-__cc__r_________ 

Short course, institute, or workshop-----------------

Percent who attended a course 

0.7 0.3 

6.2 2.0 

5.1 1.2 

19.2 267:: 17.0 

2.0 

7.5 

4.8 4.3 

11.9 15.3 

1Z 

ii:; 

0.8 

143:; 3.1 

ill, including accredited courses sponsored by 

universities and colleges as well as short courses, 

institutes, and workshops. The responses to this 

question are summarized in table D. 

Relatively few of the employees had taken 

any of the specified accredited courses; the 

proportions ranged from a high of about 6 percent 

to a low of less than 1 percent for a specific 

type of course. Short courses, however, were 

much more frequently attended. 

Of the seven types of courses shown in table D, 

the one for nursing care of the aged was attended 

by more employees in each job category than any 

of the others. Nearly one-fifth of the nurse’s aides 

and RN’s and one-fourth of the LPN’s and other 

professionals had taken a short course innursing 

care of the aged. Almost as well attended were 

courses in mental or social problems of the aged 

or chronically ill, physical therapy or rehabilitation, and in nutrition or food services. 

7 
Some employees took both an accredited 

course and a short course in the same subject. 

As a result they were counted twice for the 

subject- once for the accredited course and once 

for the short course. However, only a small 

proportion of the employees fell in this category. 

For nursing staff categories the figure varied 

from 0 to about 0.5 percent; for other professionals it was only slightly larger. 

A note of caution in interpreting the data 

in table D seems advisable since there is some 

evidence that the question about special education 

was not always interpreted alike by all respondents. One of the major points of confusion was 

whether a course taken as part of a degree program in a university (or a hospital in the case of 

nurse’s training) should be reported as an accredited course. Some reported such courses and 

it is likely that others who had taken courses did 

not report them. The effect of this problem on the 

estimates is not known. 

The data reported about short courses or 

workshops are probably more accurate than that 

about college training. The mos! noticeable point 

of confusion for a respondent seemed to be 

whether or not to include correspondence courses, 

television courses, and in-service training. When 

it was known that a course or training was given 

through these media, the course or training was 

not counted. 

LENGTH OF CURRENT EMPLOYMENT 

Nursing and personal care homes are reportedly confronted with problems of recruiting 

qualified personnel andmaintaining adequatestaff. 

One indication of the problem of turnover is the 

length of current employment-defined in this 

report as the time interval between the date 

the employee began working in the establishment 

and the date of the survey in that establishment. 

Survey results indicate that almost 2 out 

of every 5 employees in nursing and personal 

care homes had been in their present job less 

than 1 year, and a high proportion prevailed for 

each job category except other professional 

(table 4). The percent of workers employed in 

their current jobs for less than 1 year was 

44 percent for nurse’s aides, 37 percent for RN’s, 

PERCENT DISTRIBUTION 

0 20 40 60 80 IOC 

I I I I I I 

Job 

category 

Registered

““rSeS 

Licensed 

practical

““rSeS 

LENGTH OF CURRENT EMPLOYMENT 

Figure 3. Percent distribution of employees in 

nursing and personal care homes, by length of 

current employment according to job category. 

and 35 percent for LPN’s. Apparently, turnover 

was much less among other professional staff; 

only 11 percent had been in their current job 

for less than 1 year, while over half of them had 

worked 5 years or more. This is in comparison 

with about one-fifth of the RN’s, one-fourth of 

LPN’s, andone-eighth of the nurse’s aides working 

5 years or more (fig. 3). The median length of 

current employment for other professional staff 

was 5.8 years, which was more than three times 

as long as that for RN’s and LPN’s and over 4 

times as long as that for nurse’s aides. It should 

be noted, however, that the larger figure for 

other professionals is influenced by the employment longevity of administrators, many of whom 

are owners of proprietary homes. 

The length of time that a person had worked 

in a home was related to whether or not he had 

previously worked some other place; 33 percent 

of those with no prior experience had been employed less than 1 year in their current job 

as opposed to 43 percent of those with prior ex-­

perience (table C). For both RN’s and other 

a 
professionals there was no significant difference 

between those with prior experience and those with 

no prior experience in terms of either the percent 

employed less than 1 year or the median length 

of current employment. For both LPN’s and 

nurse’s aides, however, the proportion working 

less than 1 year was higher for those with prior 

experience than for those who had not previously 

been employed in another nursing home or 

hospital. 

Apparently, turnover was higher in homes 

providing nursing care than in homes providing 

only personal care (table 4). In both nursing care 

homes and personal-care-with-nursing homes 

about 4 out of every 10 employees had been in 

their present job less than a year. By comparison, about one-fourth of the employees in personal 

care homes had been on the job less than 1 year. 

These comparisons are somewhat deceptive, 

however, because as the level of skill provided 

in the homes decreases the size decreases and 

also because the administrators constitute a 

higher proportion of the total staff. Consequently, 

the low turnover rate for administrators has a 

greater effect on the overall rate. If nursing 

personnel alone are compared by type of service 

classes, it is seen that there are no statistically 

significant differences in the proportion employed 

less than 1 year. 

In general, the turnover rate appears to have 

been highest for proprietary homes, slightly less 

for nonprofit homes, and least for governmentoperated facilities (table 5). The most pronounced 

differences by type of ownership were observed 

for LPN’s; about 4 out of every 10 in proprietary 

homes had worked less than a year in their 

current job as compared with 3 out of every 10 

in nonprofit homes and 2 out of every 10 in 

government homes, The medians for the three 

types of homes in the order stated were 1.7, 

2.6, and 3.6 years. A similar pattern was observed 

for nurse’s aides, but the differences were not 

as great. For RN’s, however, little if any difference existed by type of ownership, except that 

RN’s in government homes were possibly somewhat more stable than those in other types of 

ownership. For other professionals a reverse 

pattern is shown in table 5; those working in 

proprietary homes had been in their current 

jobs longer than those in other types. This 

is undoubtedly influenced by the large proportion 

of such proprietary employees who were owners 

as well as administrators of the homes. 

WAGES 

In this section data are presented on the 

wages or salary of employees in nursing and 

personal care homes. Wages or salary was 

defined in the survey as the employee’s usual 

gross wages before any deductions had beenmade 

for income tax, social security, and before other 

deductions. Wage data are presented for alltypes 

of employees with the exception of administrators 

and members of religious orders. Administrators 

are excluded because of the high rate of nonresponse (30 percent) to the questions relating 

to wages and hours worked. In order to make 

meaningful comparisons between groups of employees, wages were standardized for all staff 

to a 40-hour week which, incidentally, was the 

median hours worked per week for all types of 

employees. 

The median weekly salary of employees working a standard 40-hour week was $48, ranging 

from a low of $44 for nurse’s aides to a high of $89 

for other professionals. The median salary for 

RN’s was about as high ($87) as that for other 

professionals, and was $25 per week higher than 

for LPN’s (table 6). The mean income was about 

the same as the median for employees in each 

job category except “other professional,” where 

the mean was $110 (table F). 

There was a wide range of salaries paid to 

persons in each job category and thus a substantial overlap between distributions by salary 

levels of employees. For example, some nurse’s 

aides earned as much or more than some RN’s, 

and a relatively large proportion of the LPN’s 

had salaries similar to both RN’s and nurse’s 

aides. Although some of the variation was caused 

by sampling and measurement errors, most of it 

probably reflects the true situation. This is 

supported by a survey of nursing homes conducted 

in 1965 by the U.S. Department of Labor which 

produced similar results. 7 

Little comparable data are available on the 

wages of employees in other types of medical 

facilities. The data that are available suggest that 

the salary levels of nurses in nursing and 

9 
Table E. Percent of nursing staff and other professional employees in nursing and personal care homes receiving room and/or board, by type of service and job category:

United States, May-June 1964 

Type of service 

Job category ’ 

All employees------------------------

Registered nuTses--------------------------

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

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

Other professional staff-------------------

Other nonprofessional staff---------------­

‘Administrators and members of religious 

personal care homes are not very different from 

those in other types of medical facilities. Results 

from a survey conducted in mid-1963 of nurses 

in non-Federal short-term hospitals in metropolitan areas indicated that the average weekly 

salary for RN’s was $90.50; for LPN’s it was 

$64.50; and for nurse’s aides it was $54.50.8 With 

the possible exception of nurse’s aides, the 

differences in salary could be attributed to the 

higher salaries generally paid in metropolitan 

areas and to the exclusion of hospitals with less 

than 100 beds from the hospital study. 

Median weekly salary varied slightly 

by type of service provided in the home. The 

data suggest that employees in nursing care homes 

have higher salaries than those in personal care 

homes with or without nursing. The overall 

median salary was $49 for nursing care homes 

as opposed to about $42 for the other types of 

homes. When the median weekly wage is compared 

for each job category separately, this pattern 

seems to be true for each class of employee. 

However, the differences by type of service class 

are statistically significant only for other nonprofessional staff. 

All Nursing Personal care 

homes care with nursing 

Percent receiving room and/or 

51 46 69 

39 36 61 

45 43 61 

50 47 64 

59 45 79 

56 48 70 

orders are excluded. 

Personal 

care 

board 

72 

62 

55 

76 

76 

L 

These salary differentials are related to 

pay-in-kind, measured in the survey in terms 

of the provision of room and/or board for employees. For those job categories for which the 

median salary decreases with the level of skill 

provided in the home, the percentage of employees 

receiving room and/or board increases. For 

example, the median wage in personal care homes 

for other nonprofessional staff was about $39, 

or $9 less than in nursing care homes (table 6). 

However, about three-fourths of the other professional employees in personal care homes were 

receiving room and/or board as opposed to about 

one-half of the nonprofessional employees in 

nursing care homes (table E). 

Wages also varied by type of ownership 

(table 7). The highest salaries were paid by 

government homes; this was true for each job 

category with the possible exception of RN’s, 

where the difference was not statistically significant. Between proprietary and nonprofit homes the 

wage differential was small for each job category, 

except other professionals-the overall indication 

being that employees of nonprofit homes received 

a slightly higher salary. Other professionals em10 
Table F. Mean weekly income of nursing staff and other professional employees in 

nursing and personal care homes, by length of work experience and job category:

United States, May-June 1964 

I Length of work experience 

1 

Job category1 

Total lJnder 1 1 - 4 5 - 9 lo+

year years years years 

Mean weekly income 

All employees-------------------------------- $51 $42 $47 $53 $67 i 

Registered nurses---------------------------------- 86 80 84 85 87 

Licensed practical noses-------------------------- 60 63 60 59 60 

Nurse’s aides-------------------------------------- 43 39 42 45 50 

Other professional staff--------------------------- 110 74 94 97 139 

'Administrators and members of religious orders are excluded. 

ployed in nonprofit homes received a significantly 

higher salary, $86 per week as compared with $62 

per week in proprietary homes. 

One would expect a person’s wages to be 

related to his work experience. and this is partially 

supported by the data shown in table F. The 

mean salary for all employees with less than 1 

year’s experience was $42, increasing to $47 for 

employees with 1-4 years’ experience, $52 for 

employees with 5-9 years’ experience, and $67 

for those with experience of 10 years or more. 

The relation between amount of experience and 

average salary holds true for each job category 

except LPN’s. For LPN’s there was no significant 

change in average salary with increasing work 

experience. 

11 
REFERENCES 

‘National Center for Health Statistics: Institutions for the 

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

Vital and Health Statistics. PHS Pub. No. lOOO-Series 12-

No. 1. Public Health Service. Washington. U.S. Government 

Printing Office, July 1965. 

2National Center for Health Statistics: Characteristics of 

residents in institutions for the aged and chronically ill, 

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

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

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

3National Center for Health Statistics: Characteristics of 

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

Vital and Health Statistics. PHS Pub. No. IOOO-Series 12-

No. 3. Public Health Service. Washington. U.S. Government Printing Office, Dec. 1965. 

4National Center for Health Statistics: Utilization of institutions for the aged and chronically ill, United States, 

April-June 1963. Vita2 and Health Statistics. PHS Pub. No. 

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

U.S. Government Printing Office, Feb. 1966. 

5National Center for Health Statistics: Employees in nursing and personal care homes, United States, May-June 1964. 

Vital and He&h Statistics. PHS Pub. No. lOOO-Series 12-

No. 5. PublicHealth Service. Washington. U.S. Government 

Printing Office, Sept. 1966. 

‘National Center for Health Statistics: Development and 

maintenance of a national inventory of hospitals and institutions. Vital and HealthStatistics. PHSPub. No. lOOO-Series 

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

‘Wage and Hour and Public Contracts Divisions: Nursing 

Ilomes and Related Facilities, A study to evaluate the feusibil%ty of e&ending minimum wage and oveptime protection under 

the Fair Labor Standards Act, U.S. Department of Labor, Jan. 

1966. 

8:4merican Nurses’ Association: Facts About Nursing, A 

statistical summary. New York, 1965. 

‘National Center for Health Statistics: Health Survey procedure, concepts, questionnaire development, and definitions 

in the Health Interview Survey. Vita2 and Health Statistics. 

PHS Pub. No. 100bSeries l-No. 2. Public Health Service. 

Washington. U.S. Government Printing Office, May 1964. 

000 

12 
DETAILED TABLES 

Page 

Table 1. Number and percent distribution ofnursing staff and other professional employees in nursing and personal care homes, by length of work experience according to 

type of service and job category: United States, May-June 1964------------------ 14 

2. Number and percent distributionofnursing staff and other professional employees in nursing and personal care homes, by length of work experience according to 

type of ownership and job category: United States, May-June 1964---------------- 15 

3. Number and percent distributionofnursing staff and other professional employees in nursing and personal care homes,by length of work experience according to age of employee and job category: United States, May-June 1964---------------------- 16 

4. Number and percent distributionof nursing staff and other professional employees

in nursing and personal care homes, by length of current employment according to 

type of service and job category: United States, May-June 1964------------------ 17 

5. Number and percent distribution ofnursing staff and other professional employees in nursing and personal care homes, by length of current employment according to 

type of ownership and job category: United States, May-June 1964---------------- 18 

6. Number and percent distribution ofnursing staff and other professional employees in nursing and personal care homes, by standardized weekly income according to 

type of service and job category: United States, May-June 1964------------------ 19 

7. Number and percent distributionofnursing staff and other professional employees

in nursing and personal care homes, by standardized weekly income according to 

type of ownership and job category: United States, May-June 1964---------------- 20 

13 
Table 1. Number and percent distribution of nursing staff and other professional employees in nursing and per­ sonal care homes, by length of work experience according to type of service and job category: United States, May-June 1964 

Length of work experience 

Type of service and All ledian job category' staff rears Total 

Percent distribution 

All homes----------- 176,000 10.9 I 8.4 13.8 9.2 14.0 20.3 16.9 6.4 4.1 - - - - - - -

'Registered nurses--------- 17,400 100.0 4.0 3.1 4.3 4.1 10.8 20.0 32.4 21.3 11.1 Licensed practical *uT*e*------------------- 20,500 100.0 8.0 11.7 26.8 31.4 Nurse's aides------------- 113,800 100.0 1z 1::: 17.9 1E 15.6 17.8 10.0 ::i ::; Other profes­ sional staff------------- 24,300 100.0 4.0 2.3 6.3 6.1 11.2 27.0 26.2 16.9 8.7 

Nursing care-------- 140,200 100.0 11.1 8.3 14.4 9.4 14.1 19.8 17.1 5.7 4.0 

Registered nurses--------- 15,200 100.0 4.2 3.0 4.5 4.3 11.3 20.1 32.1 20.6 10.8 Licensed practical *uT*e*------------------- 18,100 100.0 2.7 6.0 11.5 25.8 32.0 8.0 Nurse's aides------------- 92,900 100.0 257 11.3 1::: 11.3 15.7 17.7 10.0 ::: 2.5 Other profes­ sional *I--ff------------- 13,900 100.0 3.0 1.6 7.1 6.3 10.5 25.6 29.3 16.6 9.2 

Personal care with nursing------------ 29.700 100.0 10.0 9.9 12.5 8.5 14.1 20.4 16.0 8.6 4.3 

Registered nurses--------- 2,100 100.0 1.7 3.8 3.0 2.9 7.7 20.4 34.6 25.9 13.0 Licensed practical nurse*------------------- 1,800 100.0 2.4 31.5 30.1 8.1 8.1 Nurse’s aides------------- 19,100 100.0 13.9 182::1% 1x 1::: 17.2 10.0 2.9 2.6 ’ Other profes6,700 100.0 3.5 4.5 3.8 4.3 14.4 26.4 23.5 19.6 a.7 ’ 

Personal care------- 6.100 100.0 11.4 3.5 5.6 9.3 11.3 31.9 16.3 10.7 6.4. 

Registered nurses--------- 100 100.0 -'c -‘< ;‘t << t >‘? +< t 4 

Licensed mactical 

600 100.0 " B .k A >‘< ?< A 

I 

Nurse’s aides------------- 1,800 100.0 17.4 10.; 3.0 13.1 14.5 25.2 10.0 6.3 ::z I Other sionai profes- staff------------- 3,700 100.0 8.9 0.7 7.9 8.6 7.9 33.6 19.5 12.9 7.4 

'Excludes an estimated 6,800 orderlies for whom years of work experience was not available. 

14 
> 

Table 2. Number and percent distribution of nursing staff and other professional employees in nursing and personal care homes, by length of work experience according to type of ownership and job category: United States,

May-June 1964 - - Length of work experience 

Type of ownership and All Iedian

job category' staff Total Under 6 6 months 1 2 3-4 5-9 10-19 20+ Tears 

months to 1 year year years years years years years 1

J 

Percent distribution 

All homes--------s-m 176.000 100 .o 10.9 I a.4 13.8 I 9.2 14.0 20.3 1 16.9 6.4 4.1 

Registered nurses--------- 17,400 100.0 10.8 20.0 32.4 21.3 11.1 

Licensed practical *uses------------------- 20,5oo 100.0 11.7 26.8 31.4 7.6 Nq~rse's aides------------- 113,800 100.0 15.6 17.8 10.0 1.6 :-z Other professiunal staff-- 24,300 100.0 11.2 27.0 26.2 16.9 817 

Proprietary--------- 123,400 100.0 13.6 19.9 16.7 6.1 3.9 

Registered nurses--------- 11,lOO 100.0 11.2 -4la.7 35.1 18.6 11.0 

Licensed practical nurses--~---------------- 100.0 11.4 26.7 30.5 6.9 Nurse’s aides------------- 100.0 1L?: 1E 15.1 16.7 z-2 

Other professional staff-- 100.0 5:2 5:3 10.3 29.1 2% 1::: 911 

Nonprofit----------- 28,900 100.0 13.2 8.9 14.2 22.3 16.0 7.9 4.5 

Registered nurses--------- 3, 700 100.0 2.0 3.1 5.1 5.6 9.6 21.1 28.0 25.6 11.2 

Licensed practical nurses------------------- 3,5100 100.0 5.4 11.4 26.9 32.6 a.5 Nurse's aides------------- 17,8110 100.0 1% 1;::

.1 

17.6 1::'; 16.0 21.4 z Other professional staff-- 4,000 100.0 2:1 7.6 9.4 11.8 23.2 2;:: 1318 62:; 

Government---------- 23, 700 100.0 8.b 7.7 t ! 3 . ; 7.9 16.2 t 20.4 19.4 5.9 4.5 

Registered nurses--------- 2,600 100.0 2.2 3.7 11.0 26.5 11.3 

Licensed practical nllrses------------------- 2,3110 100.0 14.3 a.9 Nurse's aides------------- 16,200 100.0 l?? 102.: 17.5 

Other professional staff-- 2,sfloo 100.0 6:l 1:4 14.9 1::: 

'Excludes 6,800 orderlies for ,xhom years of work experience was not available. 

15 
Table 3. Number and percent distribution of nursing staff and other professional employees in nursing and per­ sonal care homes, by length of work experience according to age of employee and job category: United States, i$ay-June 1964 - Length of work experience 

Age of employee and All -E4edian job category' staff pars Total Under 6 6 months 1 2 3-4 5-9 10-19 20+ 7 

months to 1 year year years years years years years 

Percent distribution 1 

176,000 100.0 10.9 8.4 13.8 9.2 14.0 20.3 16.9 6.4 4.1 - -

Registered 

Nurse's aides-------------

Other professional staff--

113,800 

24,300 

100.0 

100.0 

1::'; 

4.0 

11:s 

2.3 

17:9 

6.3 

11:3 

6.1 

15.6 

11.2 

17.8 10.0 

27.0 26.2 

1:6 

16.9 

::; 

a.7 

Under 25 years------ 20,300 100.0 29.4 18.8 29.0 10.4 9.7 2.8 0.0 1.1 

Registered nurses--------- Licensed practical nurses- Nurse's aides-------------

Other professional staff--

600 

1,400

18,100

200 

100.0 

100.0 

100.0 

100.0 

18.7 

16.3 

30.6 

49.7 

28.9 

4.6 

19.6 

16.8 

19.3 

27.4 

29.5 

19.5 

21.5 

19.9 

9.3 

7.6 

10.1 

26.1 

a.4 

5.9 

965 

216 

0.; 

is: 

1:o4 

25-44 years--------- 64,100 100.0 10.9 8.9 14.8 10.0 17.0 21.1 15.8 1.4 3.6 

Registered nurses--------- Licensed practical nurses- Nurse's aides-------------

Other professional staff--

6,500

6,900

44,900

5,900 

100.0 

100.0 

100.0 

100.0 

?87 

13:4 

6.0 

f-: 

1115 

2.5 

l?: 

17:4 

9.7 

2;

11:7 

8.0 

15.6 

13.7 

17.8 

15.5 

25.8 37.6 

31.4 27.5 

17.7 

30.3 2::; 

5.1 

i?'Q

318 

22 

62:: 

45-64 years ---____. __ 82.300 100.0 7.1 6.2 10.3 a.7 13.4 23.5 20.9 9.8 5.9 

Registered nurses--------- Licensed practical nurses- 9,000

10,600 

100.0 

100.0 t-1/ z 3.0 

9: G-2 

18.6 32.9 

25.3 37.1 

29.6 

11.9 

13.8 

nurses--------- 17,400 100.0 4.0 ?: 2: E?A11.7 26.8 31.4 2:.: 

10.8 20.0 32.4 11.1

Licensed practical nurses- 20,500 100.0 

Nurse's aides------------- 47,600 100.0 9:s 8:s 144.: 11:s 16:s 22.8 13.0 2.8 E Other professional staff-- 15,100 100.0 2.9 2.3 6:0 5.9 10.0 27.4 27.2 i8.4 9:2 

65 years and over--- 9,300 100.0 4.8 2.0 4.0 5.2 8.7 24.7 26.5 24.1 10.2 

Registered nurses--------- 1,300 100.0 10.0 18.0 55.0 20.9 Licensed practical nurses- 1,600 100.0 0':: 0.8 32.; 38.6 12.6 10.3 Nurse's aides------------- 3,300 100.o 10.3 z-82 29:o 24.0 6.9 Other professional staff-- 3,200 100.0 2'2 0.8 9:3 20.6 26.5 35.1 1% 

'Excludes an estimated 6,800 orderlies for whom age and years of work experience were not available. 

16 
Table 4. Number and percent distribution of nursing staff and other professional employees in nursing and per­ sonal care homes, by length of current employment according to type of service and job category: United states,

May-June 1964 

-

Length nf current cmploymrnt 

All Type of service and job category staff Hedian 

Total Under 6 6 months 1 2 3-4 5-9 10+ years 

months to 1 veal- year pears years years years 

f 

Percent distribution T All homes------------------ 182,800 -

100.0 - 23.6 __~ 14.6 - 17.9 10.3 12.6 13.5 7.5 1.7 - - -

Licensed practical nurses-------- Nurse's aides'-------------------

Other professional staff---------

20,500

120,600

24,300 

100.0 

100.0 

100.0 

21.3 

27.9 

6.3 

13.7 

16.5 

5.0 

15.8 

19.5 

10.5 

10.9 

10.7 

8.9 :4-';14:6 

13.7 

10.3 

29.5 

1:.: 

314 

25.2 

1.9 

::i 

Nursing care homes--------- 145,700 100.0 '4.2 14.7 18.5 10.8 12.5 12.5 6.8 1.6 

Registered nllrses----------------

Licensed practical nurses-------- Nurse's aides'-------------------

Other professional staff---------

15,200

18,100

98,400

13,900 

100.0 

100.0 

100.0 

100.0 

21.5 

22.1 

27.7 

5.7 

:x 

16:6 

4.4 

19.8 

16.7 

19.7 

10.7 

1Z 

11:1 

10.8 

14.1 

13.h 

11.5 

15.9 

:4*: 

1o:o 

"7.9 

Z-2 

3:3 

24.7 

::;

::5’ 

Personal care with nursing- 30,900 100.0 21.7 15.2 16.7 8.1 13.6 15.3 9.3 1.8 

Registered nllrses---------------- 17,400 100.0 21.2 15.3 19.4 8.5 14.2 13.2 1.7 

Licensed practical nurses-------- Nurse's aides'-------------------

Other professional staff---------

1,800 100.0 

20,300 100.0 

6,700 100.0 

13.7 

28.3 

5.3 

22.8 

16.3 

7.h 

10.2 

:;:; 

13.1 

68:: 

19.3 

lL.6 

14.6 

15.1 

10.9 

LB.' 

2-i 

27:s 

$2 

i:: 

Personal cart-------------- 6,200 100.0 19.1 8.1 9.1 7.5 11.2 29.3 15.7 &.l 

Registered nurses---------------- Licensed practical nurses-------- Nurse's aides'-------------------

Other professiona staff---------

100 100.0 

600 100.0 

1,900 100.0 

3,700 100.0 

k 

20.8 

33.3 

10.6 

* 

2L.O 

13.8 

2.9 

* 

4.7 

9.2 

9.9 

<? 

9.8 

7.8 

7.1 

>k 

24.5 

10.9 

9.6 

f: 

5.0 

19.7 

38.0 

>k 

11.3 

5.3 

22.0 

* 

-‘; 

1.3 

6.3 

'Orderlies arc counted with nu::se's aides. 

Registered nurses---------------- 2,100 100.0 17.8 22.4 17.0 5.6 15.0 16.2 6.1 

17 
----- 10.2 

Table 5. Number and percent distribution of nursing staff and other professional employees in nursing and per­ sonal care homes. bv length of current employment according to type of ownership and job category: United 

States, May-June'l96ic -

Length of current employment 

Type of ownership and All Median 

job category staff Total Under 6 6 months 1 2 3-4 5-9 lo+ years 

months to 1 year year years years years years 

Percent distribution 

Al1 homes------------------- 182,800 -

100.0 23.6 14.6 Z

17.9 10.3 -

12.6 -

Registered nurses----------------- 17,400 100.0 21.2 15.3 19.4 14.2 13.2 8.1 1.7 

Licensed practical nurses--------- 20,500 100.0 21.3 13.7 15.8 lE.59 14.4 13.7 

Nurse's aides'--------------- 120,600 100.0 27.9 16.5 19.5 10:7 11.7 10.3 3.4 :*;

Other professional staff---------- 24,300 100.0 6.3 5.0 10.5 8.9 14.6 29.5 25.2 518 

Proprietary----------------- 126,600 100.0 25.6 14.4 18.0 10.2 12.0 12.6 7.2 1 1.6 

Registered nurses----------------- 11,100 100.0 23.0 13.7 20.6 8.4 15.0 11.9 

Licensed practical nurses--------- 14,700 100.0 24.4 13.9 17.1 10.2 14.0 11.7 

Nurse's 

Other professional staff---------- 17,800 100.0 6.3 2.9 8.8 7.9 15.1 3;:: 

Nonprofit------------------- 30,200 100.0 19.9 16.0 16.9 10.3 14.5 

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

Licensed practical nurses--------- Nurse's aidesl--------------------

Other professional staff----------

3,700

3,500

19,000

4,000 

100.0 

100.0 

100.0 

100.0 

14.5 

24.0 

5.1 

18.5 

16.3 

15.9 

13.7 

20.1 

11.7 l?Li 

18.5 

10.5 1% 

12.9 

17.3 

14.3 

14.7 

14.4 

15.1 

12.7 

23.0 

151:; 

2::; 

1.6 

2.6 

i:: 

Government------------------ 26,000 100.0 18.3 / 13.8 18.6 10.4 13.6 16.5 

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

Licensed practical nurses--------- Nurse's aides'--------------------

Other professional staff----------

2,600

1,300

18,500

2,500 

100.0 

100.0 

100.0 

100.0 

15.2 

12.1 

20.9 

8.7 

17.7 

1E 

518 

E-2 E 

19:4 10:3 

22.2 10.9 

12.6 

12.2 

14.3 

10.6 

17.3 

24.7 

14.4 

23.7 

aidesl-------------------- 83,000 100.0 30.3 17.0 19.8 11.0 10.5 

'Orderlies are counted with nurse's aides. 

18 
67 

02 

Table 6. Number and percent distribution of nursing staff and other professional employees in nursing and per­ sonal care homes, by standardized weekly income according to type of service and job category: Llnited States,

May-June 1964 

Standardized weekly income (40 hours) 

Type of service and job All Yedian 

category1 staff Total U;d;r $40- $50- $gH&- $70- $80- $90- $loo- sllo+ income 

4 49 59 79 89 99 109 

Percent distribution 

Al1 homes---------------- 255,200 100.0 33.1 21.3 zIzz=z4.2 2.3 1.6 2.2 $48 - - zY=zzzz20.4 9.9 5.0 

Registered nurses-------------- 16,900 100.0 7.3 14.4 22.5 17.0 14.4 

Licensed practical nurses------ 20,200 100.0 2: 15:: ,$f 27.6 13.4 Nurse's aides------------------ 119,800 100.0 40.1 2s:o 22:j: Z E E

Other professional staff------- 3,400 100.0 4.6 11.4 68-z 2: 36:9 

Other nonprofessional. staff---- 94,900 100.0 E 22.2 20.4 8:5 4:6 I:: ::; 1.8 

Nursing care------------- 196.400 100.0 30.1 21.3 21.2 10.7 5.5 4.6 2.5 1.8 2.3 - Registered nurses-------------- 14,900 100.0 4.4 4.1 6.9 13.6 22.8 17.0 13.4 14.7 

Licensed practical nurses------ 18,000 100.0 12.6 22.1 28.2 13.8 LO.1 3.8 Nurse's aides------------------ 98,000 100.0 15.2 23.6 9.0 E 0.7 0.5 2: 2: 

Other professional staff------- 2,600 100.0 4.7 10.1 8:s 37:3 

Other nonprofessional---------- 63,000 100.0 22.4 21.8 ;:i: 5:5 5:; 1:6 1.6 1.9 

Personal care with 

nursing----------------- 50,700 100.0 43.0 21.1 17.9 7.6 3.5 2.7 1.6 0.8 1.8 

Registered nurses-------------- 1,900 100.0 4.8 4.6 9.6 ZO.5 21.3 17.7 6.2 11.8 

Licensed practical nurses------ 1,700 100.0 10.9 7.0 2; 26.0 -2.0 3.0 3.3 2.3 2.6 Nurse's aides------------------ 20,000 100.0 50.5 23.3 xi:2 6.9 1.5 

Other professional staff------- 700 100.0 21.5 17.4 2.: 2'1 38.9 

Other nonprofessional staff---- 26,400 100.0 42.7 24:; 19.2 ::; ::: 213 1:4 1.5 

Personal care------------ 8,100 LOO.0 44.1 23.3 14.9 6.5 1.1 2.6 3.0 2.5 1.1 

Registered nurses-------------- 100 100.0 :‘t ::- ;:- cc ;.< ;.? -‘: 9’ 

Licensed practical nurses------ 500 100.0 29.9 29.2 11.9 4.7 7.1 4.9 Nurse's aides------------------ - Other professional staff-------

1,900 100.0 31.3 -:; 24.4 7’; 

2.7 4 1.5

Q ;.< 3.5;*< 5.9

100 100.0 -‘< 4

Other nonprofessional staff---- 5,500 100.0 20.4 10.5 6.9 2.0 3.1 2.7 1.4 1.4 

'Excludes administrators and members of religious orders. 

19 
-- 

Table 7. Number and percent distribution of nursing staff and other professional employees in nursing and per­ sonal care homes, by standardized weekly income according to type of ownership and job category: United States,

May-June 1964 

Standardized weekly income (40 hours) 

Type of ownership and job All (edian 

category' staff 

Total Under $40- income 

$40 49 

Percent distribution 

All homes -_--- - _____--- 255,200 100.0 33.1 21.3 20.4 9.9 5.0 4.2 2.3 1.6 2.2 $48 -

Registered nurses-------------- 16,900 100.0 14.4 22.5 17.0 14.4 

~urse's aides------------------

Other professional staff-------

Other nonprofessional staff----

119,800 

3,400 

94,900 

100.0 

100.0 

100.0 

40:1 

12.5 

35.6 

25:0 2214 

11.4 

2;:; 20.4 

i:; 

. 

i:; 

;:i 

i:: 

E 

517 

1.6 

22 

3619 

1.8 

44 

:69 

Proprietary-------------- 154,400 100.0 38.1 21.8 19.7 9.3 3.5 3.2 1.7 45 

Registered nurses-------------- Licensed practical nurses------ Nurse’s aides------------------

Other professional staff-------

Other nonprofessional staff----

11,000 

14,700 

82,800 

1,100 

44,800 

100.0 

100.0 

100.0 

100.0 

100.0 

2.2 

25:l 

10.9 

23.2 

13.2 

13.3 

103'; 

2:8 

23.1 

p:; 

1:9 

15.2 

2: 

28' 

13.2 

:*: 

14:6 

1.0 

8.5 

61 

41 

62 

43 

Nonprofit---------------- 58,200 100.0 32.2 22.3 8.7 4.8 3.5 2.6 2.1 48 

Licensed practical nurses------ 20,200 100.0 3 1t-: 24'02 2::: 13.4 :: 

Registered nurses-------------- 3,200 100.0 4.6 19.1 16.6 25.9 

Licensed practical nurses------ 3,300 100.0 62-i19.1 2s2.z 2::: 11.5 6.9 Nurse's aides------------------ 18,500 100.0 3712 26.1 25:5 1.8 i:; Other professional staff------- 1,100 100.0 16.9 12.9 ;:p i-03 

Other nonprofessional staff---- 32,200 100.0 35.4 232:; 22.7 I:: 3:1 ::: 

Government--------------- 42,500 100.0 16.5 18.3 19.8 13.8 10.4 8.7 4.3 3.2 

Registered nurses-------------- 2,600 100.0 13.7 18.7 22.2 93 

Licensed practical nurses------ 2,300 100.0 :s 2-t 22.4 10.8 1.9 Nurse's aides------------------ 18,500 100.0 18:5 23:5 25.1 :; ’ 

Other professional staff------- 1,100 100.0 is: 60.; Other nonprofessional staff---- 18,000 100.0 192:: 18.4 183:04 3:9 4.4 % 

'Administrators and members of religious orders are excluded. 

I 
APPENDIX I 

TECHNICAL NOTES ON METHODS 

Survey Design 

Gene&.-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 providing nursing 

or personal care to the aged and chronically ill, of 

their patients or residents. and of their employees. 

The institutions within the scope of the survey included 

such places as nursing homes. convalescent homes, 

rest homes, homes for the aged, other related facilities, 

and geriatric hospitals. To be eligible for the surve! 

an establishment must have maintained three beds 

or more and must have provided some level of nursing 

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

Appendix II-B. 

This appendix presents a brief description of the 

survey design, general qualifications of the data, and 

the reliability of estimates presented in this report. 

Succeeding appendixes are concerned with classification 

procedures, definitions, and questionnaires used in 

the survey for collecting information about employees. 

Sampling frawm-A “multiframe” technique was 

used in establishing the sampling universe for RPS-2. 

The principal frame was the Master Facility Inventory 

(MFI) which contained the names, addresses, and 

descriptive information for about 90-95 percent of the 

nursing and personal care homes in the United States. 

Establishments not listed in the MFI were. theoretically, 

on another list referred to as the Complement Survey. 

A description of the MFI and the Complement Survey 

has been published.” 

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

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

visits each week to households located in probability 

samples of small segments of the United States. In 

addition to collecting information about the health of the 

household members, the interviewers are instructed to 

record the names and addresses of hospitals and institutions located 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 1968 which were not listed in 

the MFI but which were in business as of July 1. 1962. 

The Complement Survey sample for RPS-2 included four 

establishments representing an estimated total of about 

800 such facilities in the United States not included 

in the Master Facility Inventory. 

Sample desigx-The sample design was a stratified, two-stage probability design; the first stage was 

a selection of establishments from the MFI and the 

Complement Survey, and the second stage was a 

selection of employees and residents from registers 

of the sample establishments. In preparation for the 

first-stage sample selection, the MFI was divided into 

two groups on the basis of whether or not current 

information was available about the establishment. 

Group I was composed of establishments which had 

returned a questionnaire in a previous h4FI survey. 

Group II contained places which were possibly within 

the scope of RPS-2 but which were notconfirmed in the 

MFI survey, e.g., nonresponses and questionnaires not 

delivered by the Post Office because of insufficient 

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

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

the h4FI and in the sample by primary strata and the 

final disposition of the sample places with regard 

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

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

business and within the scope of the survey. 

The second-stage sample selection of employees 

was carried out by Bureau of the 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 hours or 

more per week in the home, the names of all such 

21 
Table I. Distribution of institutions for the aged in the Master Facility Inventory and in the 

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

to the RPS-2: United States 

Number of homes in sample 

Number In scope and 

out Type of service and size of institution of 

in 

homes 

Total scope 

of 

or 

in business 

the 

MFI' inomesl out of 

business Nonre- Responding sponding homes homes 

All types--------------------------------- 19,520 ,201 116 12 1.073 

Nursing care2----------------------------- 8,155 634 37 8 589 

Under 30 beds----------------------------------- 4,400 179 21 5 153 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

1 The universe for the RPS-2 sample consisted of the MPI and the Complement Survey. Included in 

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

21ncludes geriatric hospitals. 

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

which current data were not available. 

22 
employees were listed on a Staff Information and 

Control Record Form (HRS-3b). The respondent was 

asked to view a list of job 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 staff stratum. The total sample 

selected from establishments cooperating in the surrey 

consisted of 11,832 employees. 

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

survey. All were experienced in the continuing surveys 

conducted by the Bureau of the Census; about half 

were employed in the Health Interview Surveyone of the major programs of the National Center for 

Health Statistics-and about half in other surveys. 

Since the interviewers were well trained in general 

survey methodology, it was relatively easy to train 

them in the specific methods used in RPS-2. Brietly, 

their training consisted of home study materials and 

observation by the Census Regional Supervisor on the 

first interview assignment. 

The initial contact with an establishment was a 

letter signed by the Director of the Bureau of the 

Census. The letter (HRS-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 -i days. 

During the course of the interview, the interviewer 

collected data about the establishment, the residents. 

and the employees. The establishment and resident 

information was obtained by personal interview, and 

the staff information was collected 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 

encourage maximum 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 suchds “registered 

nurse” or “administrator.” These partially completed 

questionnaires were then distributed to the appropriate 

employees who were requested to complete the forms 

and, if possible, return them to the interviewer 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 Bureau 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 Washin+m office and m.ade inquiries as necessary 

to obtain 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 hlaster Facility Inventory as 

well as carrying out internal edits and consistent] 

checks to eliminate “impossible” response errors in 

editing, coding. or processing. 

General Qualifications 

Norrr-espouse und irtiputafiorl of vzissixg data.-The 

survey was conducted in 1,073 homes, or about 89 

percent of the original sample. About - 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 they maintained 

fewer than three beds. Only 12 homes. or about I 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 statified by three major ownership 

groups. This factor was the ratio of all in-scope sample 

homes in a stratum to the responding in-scope sample 

homes in the stratum. 

Data were also adjusted for nonresponse which 

resulted from the failure of a sample employee to 

complete a questionnaire or the failure to complete 

23 
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 of home. Thus nonresponse ranged 

from 0.4 percent for the type of job category to 8.9 

percent for age of employee. 

Intervielv 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 because some answers to questions may have been 

provided on the basis of judgment. 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 dc, 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 the employee. 

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 vary by State; 

for example, not all States require physical therapists 

to be registered. 

The correspondence between the administrator’s 

classification 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 nurses. For LPN’s about 88 percent confirmed the administrator’s classification on the selfenumeration 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 

two-thirds of the physical therapists and over threefifths 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. About 37 

percent of those classed as social workers had taken 

special courses in mental or social problems of the 

aged. 

Rounding 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 using the 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 tb.e result of a ratio estimation technique. A first-stage adjustment factor R,,=Bi/Bf 

was determined for each noncertainty stratum of the 

sample design. Bi is the total number of beds for 

establishments in the jth stratum according to the 

MFI. B’i is the estimated number of beds for establishments in the jth stratum; it is obtainedthrough a simple 

inflation of the MFI data for sample establishments in 

the jth 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’ii was computed 

for each type of service-size strata, where Rzij represents the second-stage adjustment factor for the ith 

stratum, Eii is the total number of employees in the 

i th job category in the sample establishments for the 

jth stratum and Elii is the estimated number of 

employees in the jth job category in the sample establishments for the itb stratum. 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 estimates.-since statistics presented in this report are based on a sample, they will 

differ somewhat from figures that would have been 

obtained if a complete census had been taken using 

the same schedules, instructions, and procedures. 

As in any survey, the results are also subject to 

reporting and processing errors and errors due to 

nonresponse. To the extent possible, these types of 

errors were kept to a minimum by methods built into 

survey procedures. 

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

the number of observations in the sample. Thus, as 

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

the variability that occurs by chance because only a 

sample rather than the entire universe is surveyed. 

24 
Figure I. Approximate relative standard errors of aggregates, 

100.0 

60.0 

60.0 

Use curve A, B, or C as follows: 

40.0 

's,and "other professional." 

20.0 

3

V 

u 10.0 

iti 8.0 

m 6.0 

a

t;( 4.0 

2 

: 2.0 

4 

3 Ii.: 

2 0.6 

0.4 

Size of Estimate 

ample of use of fime I: An estimate of 100,000 total employees has a relative standard error 

2.5 percent (for curve A, read from scale at left side of figure). The estimate has a standard error of 2,500 (2.5 percent of 100,000).

As calculated for this report, the standard error also 

reflects part of the measurement error, but it does not 

measure any systematic biases in the data. The chances 

are about two out of three that an esrimate 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 Iess 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 anJ ij esprcssed as 

a percent of the estimate. An esampleof how to convert 

the relative error into a standard eiroI' is give11 with 

figure I. Standard errors of estimated percentages are 

shown in tables II and III. 

To determine the standard error of a median value, 

or of the difference between two statistics. the following 

rules may be used. 

Standurd ewor of a nzediajz.-The medians shown 

in this report were calculated from grouped data. 

Approximate confidence intervals 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 salary of 

nurse’s aides in nursing care homes is $45. 

The estimated number of nurse’s aides 

in nursing care homes is 98,000 (table 6). 

The standard error of a 50-percent characteristic whose base is 98,000 is shown in 

table II to be approximately 1.5 percentage 

points. 

(bj 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 frequency distribution 

corresponding to 47 percent (50 minus two 

standard errorsj and 53 percent (50 plus 

25 
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) 

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

Standard error expressed in percentage points 

z-93 12.3 16.4 

11.6 

18.8 

13.3 

20.5 

14.5 

4:o 9: 7.3 

2.8 3:9 5.2 i:: 69:: 

2.0 3.7 4.2 4.6 

1.4 2.6 3.0 

2.4 2: 

::: ::; 2.1 213 

1.6 2.1 

2'6 1.5 

i::: 

2;

0:7 ii:: 

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 

15.9 22.0 24.7 27.2 i-2 10.0 13.7 15.8 17.0 

2:8 9.5 10.9 11.5 

2.2 29' 7.7 8.7 9.4 

6.5 

::i 5-Y E 68.: 

3:1 24 417 5:1 

2: 2.2 3.3 3.6 

0:6 1.8 S:Z 2.7 2.9 

2.0 2.3 2.6 

22 2: 

0:4 X :*7 :*; 

0.3 2: 1:5 1:6 

0.2 0:7 b:S 1.1 1.2 -

26 
two standard errors). These points are 46,060 

(0.47 x 9S,OOO) and 51,940 (0.53 s 9S,OOO). 

From table 6 determine the incomes that 

correspond to these points. They are $43.5 

$45.9 at the W-percent level of confidence. 

It is possible to investip.ate whether an observed 

difference between two estimated medians can be 

attributed to sampling error alone by obtaining the 

upper 6S-percent confidence limit. U;, of the smaller 

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

limits may be found by using themethodoutlined above, 

but by using one standard error instead of two. The 

square root of the sum of the squared differences between M’, and V’ and 

error of the difference 

SCM’, - M’?)= hM’, 

For the purposes of this 

M ‘2 and L’, is the standard 

between M’, and M’,; that is 

- V’,)’ + (M’: -L’,)’ 

report any difference between 

M’, and M ‘2 :reater than 2 (SM., _ M,2) is considered 

statistically significant. 

standard evoY of a diffeerence between two estirnates.- The standard error of a difference is appcosimately 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 approsimation in most other cases. 

000 

27 
APPENDIX II 

A. DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT 

Terms Relating to Staff 

Employee: 

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

usually worked 15 hours or more per week in the 

establishment. 

FULLtime OYpart time: 

Persons who usually worked 35 hours or more 

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

Persons who usually worked 15-34 hours per week 

are designated “part time.” 

Lengtlz of current employment: 

The time interval between the date the survey was 

conducted in an establishment and the date an 

employee first came to work in the establishment 

is considered the length of current employment. 

Work experience: 

For this report work experience is employment 

in the type of position currently held and any 

previous employment in the same type of position 

in other nursing homes or related facilities or in 

hospitals. 

Wages oy salary: 

Wages or salary is defined as the employee’s 

usual gross wages or salary for a specified pay 

period before any deductions have been made 

for income tax, bonds, health insurance, social 

security, and other deductions. 

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. Registered 1zuyses: includes registered professional nurses and graduate nurses. 

2. Licensed practical %uzuTses: includes licensed 

practical nurses andlicensedvocationalnurses. 

3. Nurse’s aides: includes practical nurses, 

nurse’s aides, student nurses, other supporting 

nursing staff, and orderlies unless noted otherwise. 

4. Other professional staff: includes physicians, 

dentists, occupational therapists, physical therapists, dietitians, social workers, other pro28 

fessional staff not included in the above positions, and administrators unless noted otherwise. 

5. Other nonprofessional staf$ includes cleric& 

bookkeeping, or other office staff, food service 

personnel, and housekeeping personnel. 

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 cscluded. 

Resident: 

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. 

Nursing 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 

Pyopvietary home: 

A home operated under privatecommercialownership. 

Nonpvofit kome: 

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 local 

Government auspices. 
B. CLASSIFICATION OF HOMES BY TYPE OF SERVICE 

For purposes of stratification of the universe prior nursing care (serdefinition. XppendixII-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 hours or more 

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-mrsing Izollre 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 2-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 delineatedfor RPS-2 

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

which residents routinely received personal

1. A nursi?zg caYe honle 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 
APPENDIX III 

FORMS AND QUESTIONNAIRES 

U.S.DEPARTMENT 

BUREAU OFT-HE 

WASH I NGTON, 

r 

IDear Administrator: 

OF COMMERCE 

CENSUS 

DC. 20233 

1 

-J 

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&L 

Richard M. Scammon 

Director 

Bureau of the Census 

30 
U.S. DEPARTMENT OF COMMERCE 

*UREA” OFl-I-E CENSUS 

Dear 

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

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

experience and education of certain professional and semi-nrofessional 

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

complete 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. 

GLSincerely yours, 

Richard M. Scammon 

Director 

Bureau of the Census 

Enclosures 

Please send completed

form to: 

31 
Budget Bureau No. GB-RG20.R2; Appmval Expires December 31, 1964 

‘CONFIDENTIAL - This inform&an is coilecrcd for rhe U.S. Public Healrh Service under authority of Public Law 652 of the 84th Congress 

(70 Star. 489: 42 U.S.C. 305). All informarion which would permit identification of rhe individual will be held strictly confidential. will be 

used only by persons engaged in and for the purposes of the survey, and till nor be disclosed a released to others for any other purposes 

(22 FR 1687). 

FORM HRS-30 (verily nema and e&trees and me*e any n*c*.9eary corrsotlons~ ka.L.91, 

U.K. DEPARTMENT OF COMMERCE 

BUREAU OF THE CENSUS 

ACT’ING .4K COLLECTING AGENT FOR THE 

U.S. NATIONAL HEALTH SURVEY 

ESTABLISHMENT QUESTIONNAIRE 

Number 

10a. How many persons work in this establishment? (Include owners who work in rhe establishment 

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

b. How many of these - (9. 10a) - persons usually work LESS than 15 hours D week in 

this sstoblishment? 

(Subtract the answer to question IOb from the answer to question 1Oa 

and insert the difference in item 10~ below) 

1 

C. Now I need to list thenomes of the employees who usually work 15 hours 01 mws per weak in this 

establishment. 

Name of respondent(s) Telephone number and exr. 

Title or position Date completed 

i Code 

I 

I 

32 
U.S.DEPARTMENTOF COMMERCE&rrb,ishmc”r “umhr r

:I0~7RS-3b STAFF INFORMATION AND CONTROL RECORD BUREAUOE THE CENSUS 

When 

did he (lost)

stoti 

y$g 

establish. 

men,? 

INTERVIEWER 

form (Form HRS3d) for each sample employee in columns 

(b) and fc) only 

(Check one box for each sample employee eligible for staff form) 

33 
-- 

Budget Bureau No. GE-RGZO.R2; Approval Expires December 31, 1964 

CONFIDENTIAL - This inform&an is collecicd for rhe U.S. Public Health Service under 

aurhoriry of Public Law 652 of the 84th Congress (70 Star. 489; 42 U.S.C. 305). All infor 

marinn which would petmir idcnrificaiion of rhe individual will he held strictly confidential, will be used only by persons engaged ih and for rhe purposes of the survey, and will 

not be disclosed or released 10 others fof nny other puposes (22 FR 1687). 

U.S. NATIONAL HEALTH SURVEY a. Establishment number b. Line number 

I STAFF QUESTIONNAIRE C. Name of person who should fill this form 

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

Service is conducting a nationwide survey 

names, 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 

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. 

I. How old were you on your lost birthday?. . . . 

Since it takes only a few minutes to complete the qucstionnaire, we would very much ap r&ate it if you will 

complete and mail the form within t K e next 5 days. 

Your answers will be given confidential treatment by the 

U.S. National Health Survey 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 OI establishment can be identified. 

Thank you for your cooperation. 

. _ . . _ . . . . _ . . . . . . . . . . . . . 1 

Number of -

2. How many years have you worked as o 

a - - in this establishment?. . . . . . . . . . . . / Yeers and XT% 

b - - in other nursing homes, homes for the aged, or related facilities? 1 Yeers and mDnNIs 

c-- in hospitals?. . . . . . . . . . . . . . . . . . . . . . . . . ysars and Gzz 

(If your present job is in a hospital, do nor include the experience shown in quesrion 2~) 

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

3. What is the highest grade you 

COMPLETED in school? , Elementary school . . . 1 2345678 

(Grade school) . 

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

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

4. Which, if any, of the following 

degrees, diplomas, or licenses I 0 

do you have? 

(Check all boxes that apply) z c] 

3 n 

a n 

s a 

6 m 

34 

Registered professional nurse (R.N.) 

Licensed practical 

nurse (L.P.N.) 

Degree in home 

economics 

Member - American 

Diereric Adsociacion 

Registered occupnrional 

therapist 

Registered physical therapist 

7 n Doctor of Denral Surgery or Dental Medicine 

(D.D.S. or DAD.) 

B 0 Physician (M.D. or D.O.) 

3 17, Master of Social Welfare 

(M.S.\V.) 

OR 

I I n None of the above 
1 

2 

3 

4 

5 

6 

7 

5. Have you taken any of the courses listed below? 

For each course that you have raken, please indicate by checking the appropriate column,

whether the course was “accredired under college or university sponsorship” or whether it was a “short course, institute, or workshop.” 

Accredited course sbon course, under college or institute or university sponsorship workshop (b) Cc) 

Nursing home administration 

Nursing care of the aged or chronically ill 

Medical or dental care of the aged or chronically ill 

Mental or social problems of the aged or chronically ill 

I Physical therapy or rehabilicacion I I 

Occupational therapy 

Nutrition or food services 

35 
LIST OF SELECTED JOB CATEGORIES 

t 

WHICHOFTHEFOLLOWINGJOBCATEGORIi%SBEST 

FITSTHEJOBWHICHTHISEMPLOYEEDOESINTHIS 

ESTABLISHMENT? 

1. Administrator 

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

3. Dentist 

4. Occupational Therapist 

5. Physical Therapist 

6. Dietitian or Nutritionist 

7. Social Worker 

8. Registered Professional Nurse 

9. Graduate Nurse, but not registered 

10. Licensed Practical Nurse 

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

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

(d) other supporting nursing staff) 

12. Orderly 

13. Clerical, b&kkeeping, or other office staff 

14. Food service personnel (cook, kitchen help, etc.) 

15. Housekeeping personnel (maid, mainrenance man, 

etc.) 

16. Job other than those listed above (~knso describe 

empioyer’r dutirs) 

RESIDENT PLACES SURVEY - 2 

“. S GOVERNMENT PRINTING OFFICE : 1967 0 - 240-480 36 
Series 1. 

Series 2. 

Series 3. 

Series 4. 

Series 10. 

Series 11. 

Series 12. 

Series 13. 

Series 20. 

Series 21. 

Series 22. 

OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publication No. 1000 

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

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

and other material necessary for understanding the data. 

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

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

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

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

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

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

and death certificates. 

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

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

in a continuing national household interview survey. 

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

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

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

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

universe of persons. 

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

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

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

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

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

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

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

and time series analyses. 

Data on natatity, marriage, anddivorce. -Various statistics onnatality, marriage, and divorce other 

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

geographic and time series analyses, studies of fertility. 

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

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

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

life, characteristics of pregnancy, etc. 

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

National Center for Health Statistics 

U.S. Public Health Service 

Washington, D.C. 20201