Data from the Series 12 

NATIONAL HEALTH SURVEY Number47 

Services and Activities 

Offered to 

Nursing Home Residents 

UnitedStates- 1968 

Statistics on rehabilitative serviceqrecreational activities, 

and arrangements for physician services provided to 

nursing home residents, by type of nursing service and 

bed size of home and number of employees. Based on 

data collected from April through September 1968. 

DHEW Publication No. (HSM) 73-1702 

U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE 

Public Health Service 

Health Services and Mental Health Administration 

National Center for Health Statistics 

Rockville, Md., December 1972 
Vital and Hdth Statistics-Series 1.Z0~. 17 
NATIONAL CENTER FOR HEALTH STATISTICS 

THEODORE D. WOOLSEY, Director 

EDWARD B. PERRIN, Ph.D., Deputy Director 

PHILIP S. LAWRENCE, Sc.D., Associate Director 

OSWALD K. SAGEN, Ph.D., Assistant Director for Health Statistics Development 

WALT R. SIMMONS, M.A., Assistant Director for Research and Scientific Devebpment 

JOHN JHANLON, M.D., Medical Advisor 

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

EDWARD E. MINTY, Executive Officer 

ALICE HAYWOOD, Information Officer 

DlVlSlON OF HEALTH RESOURCES STATISTICS 

SIEGFRIED A. HOERMANN, Director 

PETER L. HURLEY, Deputy Director 

HENRY S. MOUNT, Chief, Health Manpower Statistics Branch 

G. GLORIA HOLLIS, Chief, Heakh Facilities Statistics Branch 

WILLIAM F. STEWART, Chief, Family Pkznning Statistics Branch 

GRACE K. WHITE, Chief, Hospital Discharge Survey Branch 

COOPERATION OF THE BUREAU OF THE CENSUS 

Under the legislation establishing the National Health Survey, the Public Health Service 

is authorized to use, insofar as possible, the services or facilities of other Federal, State, 

or private agencies. 

In accordance with specifications established by the National Center for Health 

Statistics, the Bureau of the Census, under a contractual arrangemenz,.participated in 

planning the survey and collecting the data. 

Vital and Health Statistics-Series 1Z-No. 17 

DHEW Publication No. (HSM) 73-1702 

Library of Congress Catalog C&d Number 72-600214 
------------------------------------------------------------ 

--------------------------------------------- 

------------------------------------------------- 

------------------------------------------------------------- 

CONTENTS 

Introduction --_--__----__---_-_---------------------------------------

Rehabilitative Services --__----_---_----__-____________________--------

Homes 

Residents and Staff ---_----_-__--__--______________________---------

Outpatient Care Clinics 

Arrangements for Physician Services -_--_--_-_---_--_-_----------------

Homes ___-_----_--------_-____ ---------r--r-----------------------

Staff ------___----_-__-_-_______________I____-------------- --M-s-wRecreational Activities --_--------__----_--________________ -B-m--------

Homes -_-----_--_----_-_------------------------------------------

Residents and Staff 

Summary 

References --_-_------------------------------------------------------

List of Detailed Tables -----_-------____-------------------------------

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

General -------_--_--_---------------------------------------------

Universe -----_-----------_--------- -_-_---------------------------

Data Collection and Processing --------------------------------------

Appendix II. Qualifications of the Data---------------------------------

General Qualifications ---_--_-------_--_--____________________------

Time Interval Between Establishing the Universe and Conducting the 

Survey -_-------------_-------------------------------------------

Weighting Procedure ----------_-_-_-__-----------------------------

Rounding of Numbers -_------------------____________________-------

Nonresponse and Imputation of Missing Data-_-_-_--------------------

Appendix III. Definitions of Certain Terms Used in This Report-----------

Terms Relating to Homes or Residents --_-_-----__-----___-----------

Terms Relating to Programs or Treatments -_-__-----_----_-___------

Page 

1 

7 

8 

8 

8 

10 

10 

11 

12 

14 

25 

25 

25 

25 

27 

27 

27 

27 

28 

28 

30 

30 

30 

iii 
- - - 

-- 

CONTENTS-Con. 

Page 

Appendix IV. Classification of Nursing Homes by Type of Service--------- 31 

Appendix V. Forms Used in the Survey--_--_______---_----------------- 33 

1968 Nursing Home Questionnaire -_---__---_-_----------------------- 33 

Definition Sheet----------------~----------------------------------- 37 

Fail-Edit Questionnaire ----------___-------------------------------- 38 

1967 MFI Nursing Home Questionnaire ---__---_-------_---___________ 40 

SYMBOLS 

Data not available- __l____-___^l_-----_____l____l 

Category not appficable ______-_____-_-_------- - . . .

Quantity zero ______- __________-_____ - _____-____-- -

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

Figure does not meet standards of 

r&abifity or pre&ion _-_-__ ____ - ---_-- * 

Data suppressed to comply with 

ConfidentiaIity requirements---------------- # 

iv 
SERVICESAND ACTIVITIES OFFEREDTO 

NURSING HOME RESIDENTS 

Alvin Simocco, Divtkion of Health Resources Statistics 

BACKGROUND 

Data presented in this report were collected 

in the 1968 Nursing Home Survey, which was a 

survey of “all” the nursing homes in the United 

States. (Nursing homes were defined as resident 

institutions which provided nursing or personal 

care and maintained three beds or more for 

patients.) This survey of 18,185 nursing homes 

was conducted during April-September 1968 and 

collected selected data on the homes, such as 

number of residents, admissions, anddischarges; 

admission policies; monthly charges for care; 

number and kinds of employees; and medical and 

recreational services offered. 

This survey did not collect data on approximately 1,355 homes which opened during the lyear interval between establishing the universe 

and conducting the survey. However, basic information on these homes (such as type of service, ownership, and size) was collected in 1969. 

Using this information, the data collected in the 

1968 survey were weighted to account for the 

existence of these newly opened homes. Thus 

figures presented in this report reflect information for “all” 19,533 nursing homes in operation in the United States in 1968. (See appendix 

II for further discussion of the survey universe 

and weighting procedures.) 

The 1968 Nursing Home Survey was the third 

in a series of ad hoc surveys of long-term health 

care facilities. Resident Places Survey-l, the first 

of these surveys, was conducted during April-June 

1963 and collected data on nursing homes, chronic 

disease and geriatric hospitals, andnursing home 

units and chronic disease wards of general and 

mental hospitals. Some of the data from this 

earlier survey will be compared in this report 

with the data from the 1968 Nursing Home Survey. Further findings of Resident Places Survey-l, as well as a description of its design and 

methodology, may be found in several previously 

published reports.im5 Resident Places Survey-2, 

which was conducted during May-June 1964, is 

the second of these ad hoc surveys and concentrated mainly on nursing homes and geriatric 

hospitals. This second survey collected more 

detailed information about each institution, its 

residents, and its employees.6-14Resident Places 

Surveys-l and -2 and the 1968 Nursing Home 

Survey are all part of the National Health Survey 

prOgMIl? 

This report presents data on the services 

and activities offered to residents of nursing 

homes. Other reports from this survey present 

data on monthly charges for care,16employees,17 

and admission policies of the homes.i* (A brief 

comparison of the 1968 summary data and data 

collected in 1963 has also been published.)lg 

In order to better interpret the data presented in this report, the reader should review 

the background material presented in the appendixes. This background material includes information on the survey design and procedures 

(appendix I), general qualifications of the data, 

weighting, and imputation procedures (appendix 

II), definitions of terms (appendix III), classification of institutions by type of nursing service (appendix IV), and forms used in the survey 

(appendix V). Data in this report relate to questions 8-11 and 19 of the 1968 Nursing Home Survey form, shown in appendix V. 

1 
INTRODUCTION 

With advances in medicine and the resultant 

improvement in quality of health care in the 

United States, more and more Americans are 

reaching and passing the age of 65. As a result, 

more and more attention is being focused on the 

problems faced by this older portion of our population. These problems are basically twofold: 

l Physical-increasing loss of sight, hearing, and mobility. 

l Emotional-feeling unwanted, useless, and 

alone; lacking a feeling of well-being. 

Hospitals are equipped to handle most of the 

physical problems encountered by older people 

but are not equipped to handle their emotional 

problems. In a sense, nursing homes have been 

delegated this responsibility. Whereas originally 

their sole functions were to provide food, shelter, and health care to their residents, the current trend calls for nursing homes to provide 

recreational and rehabilitative services as well. 

In an article for the Jou~nd ofRehabilitation, Suzanne Harsanyi sums it up this way: 

Present-day statistics show that a good 

number of our agedpopulation do reach a stage 

when seeking a protective setting (in other 

words, institutionalization) is necessary. To 

meet this need without further damaging the 

individuals, I would like to see institutions 

set up with the whole personality in mind, 

while treating a specific illness and helping 

contain special disabilities, yet allowing 

other capacities to function at full potential.20 

Whether or not our institutions actually do 

this is an open question. As noted in another 

article: 

The aging person is in a stage of life characterized by physical, psychological, and 

social deterioration, to which long-term 

institutional confinement with its monotony 

contributes. It is also the stage when there 

is a rapid succession of losses-of family, 

friends, work, and social identity. The fear 

of death and lack of future are ever present. 

The feelings of abandonment by family and 

community are real when the person is confined to an institutioma 

There have been many studies andevenmore 

theories dealing with the problems faced by older 

people. One very popular theory, called the activity theory, states that “non-activity and nonuse of physical and mental capacities will eventually result in atrophy. Also, boredom and confinement in an unchanging restricted environment 

quickly results in deterioration of behavior and 

increasing abnormal mental conditions. Conversely, continued activity is essential to good 

adjustment in old age,“22 Studies have indeed 

shown that the more a patient engages in activity, the better his morale. 

This report presents statistics on the availability of rehabilitative andrecreational programs 

in nursing homes in 1968. The data were collected 

for the National Center for Health Statistics 

(NCHS) in a mail survey of all nursing and 

related care homes in the United States during 

April-September 1968. Though the statistics do 

not show how many residents had a feeling of 

well-being, they do show how many nursing homes 

offered programs which help to create such a 

feeling. 

REHABILITATIVE SERVICES 

Homes 

There were 19,533 nursing homes in the 

United States in 1968. These homes offered a 

wide variety of nursing care to their patients, 

ranging from highly skilled nursing services to 

the bare minimum of personal services. Accordingly, they have been divided into three groups: 

(1) nursing care (NC) homes-those providing 

a high degree of nursing care, (2) personal care 

with nursing (PCN) homes-those providing some 

nursing care, and (3) personal care (PC)homesthose providing primarily personal care. (See 

appendix I for a more detailed explanation of the 

classification of nursing homes.) Table A shows 

the distribution of these homes by bed capacity. 

More than half (58 percent) w.ere NC homes and 

most (88 percent) had fewer than 100 beds.These 

a

Reprinted with permissionof the NationalAssociation 

of Social Workers, from SOCIAL WORK, Vol. 14, No. 2 

(April 1969).“l 

2 
two facts should be kept in mind as further comparisons are made. 

Table 1, which is an expanded version of 

table A, indicates the extent to which nursing 

homes offered rehabilitation programs on the 

premises. Rehabilitation programs areprograms 

such as physical therapy, occupational therapy, 

and speech and hearing therapy. The table shows 

6,278 nursing homes-just 32 percent of all the 

nursing homes in the country-providing rehabilitative services. Looking at this positively, 

however, the 408,145 residents of these homes 

represented more than half of the 813,335 total 

residents in all nursing homes (table 2). In adTable A. Number of nursing homes, by type of service and bed size: United States, 1968 

[Subtotals do not necessarily add to totals 

because of roukling] 

Type of service and bed size Nur s ing homes 

All types of service--- 19,533 

Less than 25 beds------------ 7,839 25-49 beds-------------------

50-99 beds _--_--------------- p;;; 

100 beds or .more------------- 2 1438 

Nursing care----------- 11,299 

Less than 25 beds------------ 2,366 25-49 beds------------------- 3,741 50-99 beds------------------- 3,324 100 beds or more------------- 1,868 

Personal care with nursing--------------- 3,877 

Less than 25 beds ------------ 1,819 25-49 beds------------------- 875 

50-99 beds------------ _____ -_ 657

100 beds or more------------- 527 

Personal care---------- 4,357 

Less than 25 beds------------ 3,654 25-49 beds------------------- 513 50-99 beds------------------- 147

100 beds or more------------- 43 

dition, one would expect only a few of the PC 

homes to offer such services since they provide 

only a minimum of care to their patients. Likewise, not many of the PCN homes would be expected to have rehabilitative services since they 

provide only limited nursing care. This is verified in table 3. Only 7 percent of the PC homes 

and 19 percent of the PCN homesofferedrehabilitation programs. On the other hand, 46 percent 

of NC homes provided rehabilitation programs. 

This percent, though much higher than the other 

two, still appears very low. A check of the residents in these NC homes showed that 59 percent 

of the NC residents (i.e., over 350,000 out of 

about 600,000) were in homes that provided rehabilitation programs. 

Size of the home appears to be an important 

factor in determining whether rehabilitation services were offered. The average number of residents in homes providing no rehabilitation programs was 31; the average number in homes 

with rehabilitation programs was 65. The larger 

the bed size of the home, the more likely it was 

that the home provided rehabilitation programs. 

As table 3 shows, only 14 percent of the homes 

with less than 25 bedshad rehabilitation programs, 

but as the bed sizes got larger, so did the percent 

of homes offering these programs. In fact, 67 

percent of all nursing homes having 100 beds or 

more offered rehabilitation programs. For NC 

homes the trend was the same but with slightly 

higher percentages (ranging from 25 to 75 percent). 

As mentioned earlier, there are three major 

types of rehabilitative services-physical therapy, occupational therapy, and speech and hearing therapy. All other such services have been 

grouped into the category “other therapy.” Physical therapy was offered in more nursing homes 

(5,582) than any of the other kinds of rehabilitation programs. Occupational therapy foliowed, 

with 3,479 nursing homes having such programs. 

Next came speech and hearing therapy, offered 

in 1,909 homes, and other therapy programs, 

which were offered in 523 homes (table 1). 

Table B offers a quick look at how many programs were available within individual facilities. 

Of the 6,278 nursing homes that offered rehabilitation programs, 2,727 (43 percent) offered just 

one program, 2,092 (33 percent) offered two pro3 
Table B. Number and percent distribution of nursing homes by number of rehabilitation 

programs, according to type of service: United States, 1968 

Type of service 

All types of

service----------

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

Personal care with 

nursing----------------

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

All types of

service ____ 

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

Personal care with 

nursing----------------

Personal care----------­

[Subtotals do not necessarily add to totals because of rounding] 

Homes with Homes with Homes with Homes with Homes with 

rehabili- all four three two reha- one rehatation rehabili- rehabilitation tation bilitation bilitation 

programs programs programs programs program 

qq 

321 

- -____ 100.0 

100.0 

100.0 

100.0 

Number 

7 61 229 

Percent distribution 

3.3 19.9 33.3 43.4 

3.6 22.0 33.8 40.6 

11.3 36.3 51.1 

7.2 19.0 71.3 

dents were actually receiving rehabilitation services. What this means, then, is that on any given 

day more than 250,000 residents werenotreceiving rehabilitation services even though they resided in nursing homes which offered them. 

One explanation for this could be that these 

people had no need for rehabilitative services. 

It is also possible that over the course of a 

month or a year every resident would have received these services. However, it appears more 

likely that only a small fraction of the nursing 

home resident population were participating in 

rehabilitation programs. The very fact that over 

405,000 were in nursing homes which did not 

even offer these services is a good indication of 

this. 

A look at table C will show how many residents were receiving each of the various types of 

rehabilitative services. -The table shows about 

64,500 residents receiving physical therapy, 

77,000 receiving occupational therapy, 6,500 receiving speech and hearing therapy, and 12,000 

receiving other types of therapy. (Again, some 

grams, 1,252 (20 percent) offered three, and 206 

(3 percent) offered all four types. Percentagewise, NC homes (59 percent) were more likely 

to have multiple programs than PCN (49 percent) 

or PC (29 percent) homes. 

Residents and Staff 

How many residents were actually using 

these services? 

Table C indicates that of the 408,145 residents in nursing homes with rehabilitation programs, only 159,960 were using these services at 

the time of the survey. (The actual wording of the 

question was “LAST MONTH, what was the AVERAGE DAILY number of patients receiving these 

services?” Responses were for each of the four 

types of rehabilitation programs.) As indicated 

above, many nursing homes offered more than 

one rehabilitation program; hence it was very 

likely that at the time of the survey some residents were ‘participating in more than one rehabilitation program. In terms of actual people, 

therefore, somewhat less than the 159,960 resi4 
--- --- ----- 

Table C. Number of nursin homes offering rehabilitation programs, residents in these

homegand residents rece ‘i ving rehabilitation therapy, by type of rehabilitation program and type of service: United States, 1968 

[Subtotals do not necessarily add to totals because of rounding] 

Nursing homes 

offering rehabilitation 

programs 

Residents in 

Residents in the8 e homes 

rgceiving these homes rehabilitation 

therapy 

408,145 159,960 

377,841 64,527 

332,981 57,768 42,235 5,670 2,626 1,088 

255,400 76,931 

220,592 793159 32,114

3,094 1;576 

142,411 6,452 

132,080 5,757 9,250

1,081 51;; 

34,135 12,051 

32,382 10,330 4,883 1,190 870 531 

Type of rehabilitation program and type of service 

Homes with rehabilitation 

programs----r-----------------

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

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

Homes with physical rehabilitation----------------

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

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

Homes with occupational rehabrlitation----------------

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

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

Homes with speech/hearing rehabilitation----------------

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

Personal with nursing 

6,278 

5,203

754

321 

5,582 

4,812 

% 

3,479 

2 9;;; 

173 

1,909 

1,715 

2: 

523 

411 

fit 

care personal care------------------------

Homes with other rehabilitation programs---------------

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

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

residents may have been participating in more 

than one program, so these numbers do not 

represent separate and distinct individuals.) 

Hence, occupational therapy is the program most 

often used by nursing home residents. Physical 

therapy, although offered in more homes (5,582 

homes compared to 3,479 offering occupational 

therapy) and having many more residents in these 

homes (377,841 residents compared to 255,800 

in homes offering occupational therapy), was used 

by fewer residents than occupational therapy. 

Table C also indicates that only 64,527 

(17 percent) of the residents in those homes that 

provided physical therapy actzually received it; 

5 
------------- 

-- 

in those homes that provided occupational therapy, 

76,931, or 30 percent, of their patients received 

it; and in those homes that provided speech and 

hearing therapy, 6,452 (5 percent) of their residents received it. (Because of the diversity of the 

other therapy category, such a statement relating to residents’ use of other therapy would be 

meaningless.) 

A high percentage of nursing homes providing rehabilitation programs did not have a fulltime or part-time therapist on the staff (table 

D) . In the 5,582 homes providing physical therapy, 

2,349 (42 percent) had neither a full- or parttime physical therapist nor a full- or part-time 

physical therapist assistant on the staff. In the 

3,479 homes providing occupational therapy, 1,391 

(40 percent) had neither a full- or part-time 

occupational therapist nor a full- or part-time 

occupational therapist assistant on the staff. 

And in the 1,909 homes providing speech and 

hearing therapy, 1,009 (53 percent) had neither 

a full-time nor part-time speech therapist on 

the staff. It can only be presumed that those 

homes which had no therapists on the staff had 

arrangements outside the facility for these servTable D. Number of nursing homes, by type ice: United 

[Subtotah do not necessarily 

Type of arrangement for therapy 

All types of arrangements 

Physical therapy --------_--c-------_--------

Physical therapy and a physical therapist’ 

Occupational therapy------------------------

Occupational therapy and an occupational

therapist2---------------------------------

Speech/hearing therapy----------------------

Speech/hearing therapy and a speech

therapist3---------------------------------

IFull- or part-time physical therapist %ull- part-time occupational therapist physical therapist 

or or occupational therapist assistant. 

3Full- or part-time speech therapist (a speech therapist also handles hearing theram4 . 

ices or had contracts with people not on the staff 

to provide them. 

Although not discussed here, two more tables 

dealing with residents are included with the detailed tables. Table 4 lists by State thenumber of 

nursing homes and residents for each of the four 

wpes of rehabilitation programs. Table 5 gives 

by State the number of nursing homes offering 

rehabilitation programs, the number of residents 

in these homes, the number of residents receiving rehabilitation therapy, and also the number 

of homes offering no rehabilitation programs with 

the number of residents in these homes. 

Outpatient Care Clinics 

Another question that this report attempts to 

answer is how many of the homes that did not 

have a rehabilitation program of their own had 

access to outpatient care clinics such as physical 

therapy clinics, diagnostic clinics, and medical 

clinics. 

Table 6 indicates there were 10,445 nursing 

homes where residents did not use outpatient 

care clinics, which left 9,088 homes where residents did. More importantly, however, table 7 

of arrangement for therapy and type of servStates, 1968 

add to totals becauseof rounding] 

II Type of service 

homes I Personal I 

3,877 4,357 

589 181 

278 27 

430 173 

211 

140 z: 

42 10 

or assistant. 

6 
shows that 7,978 homes offered no rehabilitation 

programs and did not use outpatient care clinics. 

That is 41 percent of all nursing homes in the 

country. Stating this another way, only 59percent 

of the nursing homes in 1968 either provided rehabilitative services for their residents or provided their residents with the use of outpatient 

care clinics for such services. 

Table 6 also specifies the number of homes 

using each of the various types of clinics. Medical outpatient clinics were easily the most often 

used, with 7,023, or 77 percent, of the homes 

that used clinics using medical clinics. Diagkstic 

clinics were the next most often used (4,549 

homes), followed by physical therapy clinics 

(2,793 homes), and other outpatient clinics (1,442 

homes). 

It is obvious from these numbers that many 

homes used several types of clinics. Table 8 

points out for each State and region how ‘many 

homes used only physical therapy clinics, only 

diagnostic clinics, only medical clinics, only 

other outpatient clinics, more than one type of 

clinic, and no clinics. Comparing the totals in 

this table with the totals in table 7 (which gives 

the number of homes without rehabilitation programs that used these clinics), it can be seen 

that most nursing homes where patients used 

outpatient care clinics did not offer rehabilitation programs. (This was true in 5,278 of the 

9,088 such homes.) 

Tables 6 and 7 also point out the fact that it 

was mostly the small nursing homes which offered neither rehabilitation programs nor theuse 

of outpatient care clinics. Of the 7,839 homes 

having less than 25 beds, 4,546 (58 percent) 

offered neither of these services. On the other 

hand, only 348 out of the 2,438 homes having 100 

beds or more (14percent)offeredneither service. 

Only in the area of physical therapy can a 

direct comparison be made between rehabilitation programs and outpatient care clinics. Table 

E shows that 888 nursing homes offered both 

physical therapy programs and the use of physical therapy outpatient clinics; 4,694 homes offered 

just the physical therapy programs; and 1,905 

homes offered just the use of a physical therapy 

outpatient clikc. Thus the total number of homes 

offering either or both of these important services was 7,487, only 38 percent of the nursing 

homes in the country. 

ARRANGEMENTS FOR 

PHYSICIAN SERVICES 

In addition to offering rehabilitative services, 

an important area for a nursing home is the type 

of arrangement it provides for physician services. A survey conducted by the National Center 

for Health Statistics in 1964 covered the area of 

physician arrangements, and a report has been 

written on the findings.14 This section discloses 

Table E. Number of nursing homes, by type of service and type of arrangement for phys­ ical therapy: United States, 1968 

All Type of arrangement for physical therapy homes 

All types of arrangements------------- 19,533 

Physical therapy programs (no clinics)------ 4,694 

Physical therapy clinics (no programs)------ 1,905 

Both programs and clinics------------------- 888 

Neither programs nor clinics---------------- 12,046 

-

Type of service 

I I 

Personal 

Nurs ing care Personal 

care with care 

nur s ing 

~ 

11,299 3,877 4,357 

4,085 468 141 

1,236 340 329 

727 121 40 

5,251 2,948 3,847 1 I 

7 
the findings of the 1968 survey and offers a brief 

comparison between its results and those of the 

previous survey. 

There are four basic types of arrangements: 

i Employment of a full-time physician. 

l Arrangement for a physician to come to the 

home at regular intervals. 

l Arrangement for a physician to come to the 

home when needed but not at regular intervals. 

l Arrangement for a physician to givemedical care to the residents in his office. 

Homes 

The majority (54 percent) of the 19,533 

nursing homes serving 813,335 residents in 1968 

arranged to have a physician come to the home 

when he was needed (tables 9 and 10). The next 

most common arrangement was to have a physician visit the home at regular intervals; this was 

done by 34 percent of the homes. Approximately 

7 percent employed a full-time physician, and 

2 percent arranged for office visits. The remaining 3 percent of the homes madenoarrangements for physician services. 

Virtually all of the homes, therefore, had arranged for physician services, but most of the 

arrangements dealt with treating the patient after 

he became ill. Only those homes which had a 

full-time staff physician (7 percent) or those which 

had arranged for a physician to visit regularly 

(34 percent), offered the chance of preventing 

the illness from occurring in the first place. 

However, table 10 also shows that these 

percentages did not apply to the large (100 beds 

or more) nursing homes. Nearly half (47 percent) of these homes arranged for a physician 

to visit the home regularly; about 15 percent 

employed a full-time physician; and an additional 

33 percent arranged for a physician to come 

when needed. 

Staff 

NC homes, as would be expected, tended to 

have more of their number employing full-time 

physicians than did PCN or PC homes (table 10). 

NC homes also had a higher percentage with arrangements for physicians to visit at regular intervals. The vast majority (73 percent) of the 

PC homes, on the other hand, arranged for physicians to come only when needed. Table 9 gives 

the number of residents in these homes by the 

type of arrangement.

Table F indicates for each type of arrangement the level of skill of the nurse in charge and 

on duty in the nursing home. In homes having the 

more intensive types of coverage (either a fulltime physician or a regular visiting physician), 

over 85 percent had a registered nurse (RN) or a 

licensed practical nurse (LPN)’ working full- or 

part-time. In homes which arranged for a physician to come when needed, most had RN’s or 

LPN’s but 20 percent were under the supervision 

of persons who were not even nurse’s aides.This 

same statement applies in homes with no arrangements for physician services. In,homes with arrangements for office visits only, however, onehalf were under the supervision of someonebelow 

the level of a nurse% aide. In fact, only 31 percent of these homes employed a full- or part-time 

RN or LPN-by far the lowest such percentage 

of any of the arrangements. 

Comparing the above results With the 1964 

figures indicates that the most noticeable difference occurred in the homes having no arrangements (table H). In 1964, 11.4 percent of the 

homes had no arrangements for physician services, whereas in 1968 the figure was only 2.8 

percent. It appears that most of this difference 

was made up by the increase in the percent of 

homes which had arrangements for physician 

visits when needed. This lype of arrangement increased from 44.9 percent of the homes in 1964 

to 53.9 percent in 1968. 

RECREATIONAL ACTIVITIES 

As mentioned in the Introduction, recreational activities have a role of importance in 

nursing homes. Merely helping older people with 

their physical problems is not enough. They need 

to be stimulated and entertained; otherwise, they 

rapidly lose interest in living. 

Dr. Erich Fromm asks these questions: “How 

can you help to make him [the older person] more 

alive than he has ever been, rather than feeling 

less alive? . . . How do you arouse a more active 

interest?” He offers this answer: 

. . . the older person, like the younger, should 

try to become more responsive to the world 
--------- --- 

Table F. Number and percent distribution of nursing homes by level of nurse in charge

and on duty, according to arrangements for physician services: United States, 1968 

[Subtotals do not necessarily add to totals because of rounding] 

Arrangements for physician services 

Level of nurse 

in charge on duty 

Number 

All levels _---_------ 1,459 6,622 10,520 384 548 

Full-time ~--------------- 366 1,440 1,266 20 125 

Part-time ~--------------- 610 3,208 3,445 53 173 

Jj’ull-time LPN-------------- 151 593 

Part-t-me LPN-------------- 119 614 ‘I% 2’: ;57 Full-time nurse’s aide----- 117 359 1:318 68 62 

Part-time

$‘ull-tj.me other------------ 2,105 195 1079 

Percent distribution 

All levels----------- 100 1 100 1 100 1 

Full-time 

Part-time 

RN---------------

~--------------- 3’: 22 3’5 11 

Full-time LPN-------------- 10 7 

nurse’s aide----- 8: 337: 191 

Part-time LPN--------------

Full-time nurse’s aide----- 1: 

8 

5 

99 1’; 13 158 1:

Part-time nurse’s aide----- 1 18 1 2 1 1 

Full-time other 15 I 6 I 6 20 50 , 20 

around him . . .The older person must learn Personnel tend to think of recreation as a 

how recreation can become re-creation-a “nice” service to offer the client. It is usunew capacity to be creative-and for this he ally an afterthought, and emphasis is on 

does not need to be a painter or a poet or “Where shall we have it? What space do we 

anything; all he needs to be is alive and that need?” Rarely is it conceived as an integral 

means to be truly and generally interested service in the rehabilitation process, Often 

in the world.“” it is only a limited program of activities 

In an article in the Journal of Rehabilitation, directed by a well-meaning staff member who 

Avedon suggests that nursing home personnel has other primary responsibilities. “Visible” 

could help their residents in this area. “They activities are frequently used by administra­

[personnel] can stimulate the client so that he tion primarily as a public relations tool?* 

improves his general health and appearance and 

minimizes atypical appearance and behavior so 

he is more readily accepted in social situations.“z4 Statistics in this section reflect answers to 

Such action by nursing home personnel couldhelp the following question in the 1968 survey: “Which 

to make these older people feel alive and take a of the following recreational activities do you 

more active interest in the world. have for patients?” The categories were: arts 

This is usually not done, however. As Avedon and crafts program, planned social activities, 

says: trips to concerts, plays, etc., other, none. 

9 
Planned social activities included such events as 

parties, games, dancing, and sing-alongs. Arts 

and crafts included sewing, crocheting, painting, 

writing, etc. Even if a nursing home indicated 

that it provided several of these activities, it 

would be impossible to determine the extent of 

its recreational program. As stated above by 

Avedon, it is often only a limited program of 

activities. Even so, a limited program is far better than none at all. 

Homes 

Of the 19,533 nursing homes, 15,443 (79percent) offered some form of recreational activities to their residents. As would be expected, 

most of the homes that offered such activities 

were NC homes and, in addition, were homes with 

over 2.5beds (table 11). 

Nevertheless, one cannot overlook the 4,090 

nursing homes which apparently did not offer 

their residents any recreational programs. Equally important is the fact that included in this 

number are 460 homes which had 50-99 beds and 

134 homes which had 100 beds or more, showing 

that there were quite a few large nursing homes 

that had no recreational programs. Table 11 also 

indicates that many of these were NC homes, 

which suggests that these homes were providing 

extensive care toward the physical well-being 

of their residents but little care, if any, towards 

their emotional well-being. 

In the 15,443 homes which offered recreational activities, over 91 percent (14,056 homes) 

provided planned social activities, 50 percent 

(7,585 homes) provided arts and crafts, 33 percent (4,989 homes) provided trips to such events 

as movies, concerts, and plays, and 39 percent 

(6,082 homes) offered other activities (table 12). 

From these figures it can be seen that the most 

frequently offered recreational programs were 

parties, games, andother social activities, whereas trips to concerts, plays, movies, etc., were 

the least offered forms of recreation. There 

could be several reasons for this. One might be 

that the residents preferred social activities 

because they were physically unable to make 

trips or unable to see or hear the performances 

if they did go. Other reasons could be a lack of 

theaters near the nursing home or a lack of 

transportation. 

Considering the discussion at the beginning 

of this section, however, two additional explanations are possible. First, many of the older residents might be extremely self-conscious about 

their appearance and behavior andmight, because 

of this, be unwilling to venture outside the nursing 

home. 

The second explanation deals directly with 

Avedon’s article concerning nursing home personnel’s attitude towards recreational activities. 

If it is true that recreation “is usually an afterthought, and emphasis is on Where shall we 

have it? What space do we need?“12*then the 

above percentages can be interpreted another 

way. Social activities (parties, games, etc.) take 

a minimal amount of the personnel’s time and 

require very little space and even less material. 

An arts and crafts program requires more of 

the personnel’s time, extra space, and considerably more material. Offering trips to concerts, 

plays, or movies requires even more-organizing the trip, helping the residents prepare for it, 

and transporting them to and from the theater 

(not to mention the expenses involved). Looking. 

at the figures from this viewpoint, it is little 

wonder that in those homes which provided 

recreational activities, 91 percent provided social 

activities, 50 percent provided arts and crafts, 

and only 33 percent provided trips. 

Residents and Staff 

There were 715,751 residents-88 percent of 

the entire nursing home resident population-in 

the 15,443 nursing homes that provided recreational activities (table 13). Stated another way, 

only 12 percent of the residents in nursing homes 

were in homes that offered no recreation. Residents in NC homes were even more fortunate, 

since only 8 percent of them were in homes 

without recreation programs. 

In addition, 82 percent of all the residents in 

nursing homes were in homes providing planned 

social activities, while 58 percent were in homes 

offering recreation in the form of arts and crafts. 

On the other hand, only 35 percent of the nursing 

home residents were in homes which provided 

trips to concerts, movies, plays, etc. 

There were a total of 1,771 full-time and 

3,046 part-time recreational therapists working 

10 
in nursing homes in 1968. These 4,817 specialists were employed in 3,293 nursing homes (tables 

13 and G). In other words, even in those homes 

which offered recreational programs, only 21 

percent employed a recreational therapist. Table 

G also shows that 1,846 of these 3,293 homes had 

only part-time therapists available. Even the 

larger nursing homes tended not to employ recreational therapists. Of the 2,438 homes with 

100 beds or more, only 1,075 (44 percent) had 

either a full-. or part-time therapist employed 

(table G). 

Table G. Number of nursingihomes with full- or 

part-time recreational therapists by type of

service and bed size of home: United States, 1968 

[Subtotalsdo not necessarily addto totals because of rounding]

Homes with

recreational 

Type of service and All therapists 

bed size of home homes 

Full- Parttime1 time' 

All types of homes_--____-_-- 19,533 1,447 1,846 

Less than 25 beds------ 7,839 209 25-49 beds------------- 2:; 496 50-99 be&------------- 2EZ 487 708

100 beds or more------- 2:438 642 433 

Nursing care----- 11,299 1,205 1,540 

Less than 25 beds------ 121 25-49 be&.------------- 337:: 2% 431 50-99 be&,------------- 3:324 436 634

100 beds or more------- 1,868 539 353 

Personal care

with nursing---- 3,877 192 219 

Less than 25 beds------ 1,819 41 25-49 be&------------- 875 2 50-99 beds------------- 657 42 2

100 beds or more------- 527 97 75 

Personal care---- 4,357 50 87 

Less than 25 beds------ 3,654 28 46 25-49 be&-------------

50-99 be&-------------

100 beds or more-------

2:

43 

1:

6 

f 

4

: 

IMight also have part-time recreational

thesapists. Have no full-time recreational therapists. 

These figures seem to indicate one of two 

things. Either nursing home administrators were 

not seeking the professional help of recreational 

therapists or there were not enough recreational 

therapists available. At the present time there is 

no accurate means of determining how many 

recreational therapists there are in the United 

States; hence both explanations can be considered. 

Table H. Number and percent distribution 

of nursing homes by type of arrangement for physician services: United States, 1964 and 1968 

[Subtotals do not necessarilyadd to totals 

becauseof rounding] 

Arrangements for 

physician services 

Number of homes-­

Arrangements for 

physician services 

All arrangementsFull-time physician---- Regular visits---------

Visits when needed-----

Office visits----------

None------------------­

'Estimated figure. 

1968 1964 -I-- 19,533 17,4001 

Percent 

distribution 

100.0 

3:‘: 

44:9 

19:: 

SUMMARY 

“Today’s society with its forced retirement 

rules leaves little room to put tousethe accumulated wisdom of the aged.“25 This statement, 

taken from Harsanyi’s article, is evenmoreprofound when one realizes that retirement is often 

followed by institutionalization. When the in&.­

tution is a nursing home, what becomes of these 

aged people? Are they sufficiently motivated and 

actively encouraged to pursue their interests despite their age and surroundings? 

Findings of the 1968 Nursing Home Survey 

indicate that most homes did not provide such 

motivation and encouragement, for to provide 

these, a nursing home would have to offer its 

11 
residents adequate medical, rehabilitative, and 

recreational services, The medical services 

promote and the rehabilitative services restore 

physical well-being, while the recreational services promote and restore emotional well-being. 

Unfortunately, few nursing homes offered all 

three services and many offered just one. Medical and rehabilitative services, the type of 

services usually attributed to nursing homes, 

were sometimes missing and many times lacking, as the following statistics show, 

l Of the 19,533 nursing homes in 1968, only 

7 percent had a full-time staff physician, 

and only 34 percent arranged for a physician to visit at regular intervals. 

l Only 32 percent of the nursing homes offered rehabilitative services. 

l Of the 813,335 residents in nursinghomes, 

half were in homes not providing rehabilitative services. 

l Of the 408,145 residents in the homes which 

did offer rehabilitation, the average daily 

number that actually used the services was 

159,960. 

l Some of the homes (5,278) that did not offer rehabilitation programs sent their residents to outpatient care clinics instead. 

Most of them (7,978) did not. 

Depression in old age often is not recognized, 

Nevertheless, the importance of depressiqn in the 

chronologically old cannot be overestimated, It is 

common, disabling, and painfuL2’ Recreational 

activities can alleviate this depression. However, 

the study found the following: 

* 4,090 nursing homes offerednorecreational programs. 

l Although 15,443 nursing homes (79 percent) 

offered’ recreational activities, the more 

extensive activities, arts/crafts and trips, 

were offered in only7,585and4,989homes, 

respectively. 

l In homes that offered recreational activities, only 21 percent employed a recreational therapist. 

REFERENCES 

‘National Center for Health Statistics: Design and methodology for a national survey of nursing homes. Vital and Health 

Statistics. PHS Pub. No. 1000Series l-No. 7. Public Health 

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

1968. 

2National 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. 

3National Center for Health Statistics: Characteristics of 

residents in institutions for the aged and chronically ill, United 

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

No. lOOO-Series 12-No. 2. Public Health Service. Washington. 

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

4National Center for Health Statistics: Characteristics of 

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

Vital and Health Statistics. PHS Pub. No. lOOO-Series 12-No. 3. 

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

Office, Dec. 1965. 

5National Center for Health Statistics: Utilization of 

institutions for the aged and chronically ill, United States, 

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

lOOO-Series 12-No. 4. Pubjic Health Service. Washington. U.S. 

Government Printing Office, Feb. 1966. 

6National Center for Health Statistics: Employees in nursing and personal care homes, United States, May-June 1964. 

Vital and Health Statistics. PHS Pub. No. lOOO-Series 1%No. 5. 

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

Office, Sept. 1966. 

7National Center for Health Statistics: Employees in nursing and personal care homes: number, work experience, special 

training, and wages, United States, May-June 1964. Vital and 

Health Statistics. PHS Pub. No. 1000Series 12-No. 6. Public 

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

Jan.1967. 

*National Center for Health Statistics: Chronic illness 

among residents of nursing and personal care homes, United 

States, May-June 1964. Vital and He&k Statistics. PHS Pub. 

No. 1000Series 12-No. 7. Public Health Service. Washington. 

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

9National Center for Health Statistics: Prevalence of 

chronic conditions and impairments among residents of nursing 

and personal care homes, United States, May-June 1964. Vital 

and Health Statistics. PHS Pub. No. 1000~Series 12-No. 8. 

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

Office, July 1967. 

lONational Center for Health Statistics: Charges for care 

in institutions for the aged and chronically ill, United States, 

May-June 1964. Vital and Healtk Statistics. PHS Pub. No, 

12 
lOOO-Series 12-No. 9. Public Health Service. Washington. U.S. 

Government Printing Office, Aug. 1967. 

1lNational Center for Health Statistics: Nursing and 

personal care services received by residents of nursing and 

personal care homes, United States, May-June 1964. Vitaal and 

Health Statistics. PHS Pub. No. lOOO-Series12-No. 10. Public 

*Health Service. Washington. U.S. Government Printing Office, 

Sept. 1968. 

12National Center for Health Statistics: Use of special 

aids in homes for the aged and chronically ill, United States, 

May-June 1964. Vital and Health Statistics. PHS Pub. No. 

lOOO-Series12-No. 11. Public Health Service. Washington. U.S. 

Government Printing Office, Dec. 1968. 

IsNational Center for Health Statistics: Marital status and 

living arrangements before admission to nursing and personal 

care homes, United States, May-June 1964. Vital and Health 

Sk&tics. PHS Pub. No. lOOO-Series12-No. 12. Public Health 

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

1969. 

14National Center for Health Statistics: Arrangements for 

physician services to residents in nursing and personal care 

homes, United States, May-June 1964. Vital and Health Statistics. PHS Pub. No. lOOO-Series 12-No. 13. Public Health 

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

1970. 

IsNational Center for Health Statistics: Origin, program, 

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

He&h Statistics. PHS Pub. No. lOOO-Series l-No. 1. Public 

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

Apr. 1965. 

16National Center for Health Statistics: Charges for care 

in nursing homes, United States, April-September 1968. Vital 

and Health Statistics. Series 12-No. 14. DHEW Pub. No. 

(HSM)72-1037. Washington. U.S. Government Printing Office, 

May 1972. 

*TNational Center for Health Statistics: Employees in 

nursing homes, United States, April-September 1968. Vital and 

Health Statistics. Series 12-No. 15. DHEW Pub. No. 

(HSM)73-1700. Washington. U.S. Government Printing Office, 

1972. 

IsNational Center for Health Statistics: Nursing homes, 

their admission policies, admissions, and discharges, United 

States, April-September 1968. Vital and Health Statistics. 

Series 12-No. 16. DJXEW Pub. No. (HSM)73-1701. Washington. 

U.S. Government Printing Office, 1972. 

19National Center for Health Statistics: Comparison of 

selected characteristics of institutions for the aged, United 

States, 1963 and 1968. Monthly Vital Statistics Report. Vol. 

20, No. 1, Supplement. Rockviie, Md. Public Health Service, 

Apr. 15, 1971. 

ZOHarsanyi, Suzanne L.: Social attitudes regarding aging 

as a disability. Journal of Rehabilitation 36(6):24-27, 

Nov.-Dec. 1970. p. 27. 

ZlGiordano, Joseph L. and Grace: An activities program 

in a home for the aged in the Vugin Islands. ~o~ourrzal of the 

National Association of Social Ivo’orkers 14(2):61-66, Apr. 

1969. p. 63. 

22Stein, Thomas A.: The need and approach to recreation 

services with older persons. Therapeutic Recreation Journal 

2(2):3-10, Apr.-June 1968. p. 5. 

23Erich Fromm, Ph.D., “Psychological Problems of 

Aging,” Proceedings of the Fourth Annual Governor’s Conference on Aging, May 7, 1965, P. 9-16, New York State Office 

for the Aging, 855 Central Avenue, Albany, New York 12206. 

24Avedon, Elliott M.: Recreation, responsibility, and the 

rehabilitation process. Journal of Rehabilitation 35(1):28-29, 

Jan.-Feb. 1969. p. 29. 

25Harsanyi, op. cit., p. 25. 

26Goldfarb, Alvin I.: Masked depression in the old. Am. 

J.Psychotherapy 21(4):791-796, Oct. 1967. 

27Nationd Center for Health Statistics: Development and 

maintenance of a national inventory of hospitals and institutions. Vi’ital and Health Statistics. PHS Pub.No. 

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

Government Printing Office, Feb. 1965. 

28National Center for Health Statistics: Design and 

methodology of the 1967 Master Facility Inventory Survey. 

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

l-No. 9. Public Health Service. Washington. U.S. Government 

Printing Office, Jan. 197 1. 

29Nationd Center for Health Statistics: The Agency 

Reporting System for maintaining the nationa inventory of 

hospitals and institutions. Vitual and Health Statistics. PHS 

Pub. No. lOOO-Series l-No. 6. Washington. U.S. Government Printing Office, Apr. 1968. 

000 

13 
LIST OF DETAILED TABLES 

Page 

Table 1. Number of nursing homes, by typeofrehabilitation program provided, type of service, and bed size: United States, 1968 ,,,,,,,,,,,-,,,,,,,,---------~------------- 15 

2. Number of nursing home residents, by type of rehabilitation program provided by home, type of service, and bed size; United States, 1968------------------;------ 15 

3. Percent distributions of nursing homes and residents in these homes by whether or 

not rehabilitation programs are provided, according to type of service and bed size: United States, 1968-----------------------------------------------~---~---- .16 

4. Number of homes and residents in these homes, by type of rehabilitation programs provided and State: United States, 1968-------------------------------------~---- 17

5. Number of nursing homes, residents in these homes, and residents in these homes 

receiving therapy, by whether or not rehabilitation programs are kffered: United 

States and each State, 1968 _--------------_--_----------------------------------- 18 

6. Numberofnursing homes using outpatient clinics, by type of clinic, type of service, and bed size: United States, 1968 ----L--------_----------------------------- 19 

7. IVEEn;,of nursing homes without rehabilitation programs, by use of outpatient 

, type of servxe, and bed size: United States, 1968---------------------- 20 

8. Numberofnursing homes whose residents used outpatient clinics,bytypeof clinic, region, and State: United States, 1968----------------------------------c-------- 21 

9. Number of residents in nursing homes, by arrangements for physician services and 

type of service provided by home: United States, 1968---------------------------- 22 

10; Number and percent distributionofnursing homesbyarrangements forphysician services, according to type of service provided by home and bed size; 'U&ted States,

1968 ----------------------,------------------------------------------------------- 22 

11. Number and percent distributions of nursing homes and residents in homes with and 

without recreational activities, accordingtotype of service and bed size: United States, 1968--------------------------------------------------------------------- 23

12. Number of nursing homes, by type of recreational activity provided, type of service, and bed size: United States, 1968------------------------------------------- 24

13. Number of residents and recreational therapists in nursing homes, by type of recreational activity providedinhome, type of service, and bed size: United States, 1968----------------------------------------------------------------------------- 24

14 
----- 

-- 

-- 

Table 1. Number of nursing homes, by type of rehabilitation program provided, type of service, and bed size: 

United States, 1968 

[Subtot& do not necessarilyadd to totals becauseof rounding] -

Ii Type of rehabilitation program provided 

hY 

program 

Physical

therapy 

Occupa- Speech/ tional hearing therapy therapy 

Other 

All types of service-------------- 19,533 6,278 5,582 3,479 1,909 523 13,256 

Less than 25 beds-----------------------

25-49 beds------------------------------

50-99 beds------------------------------

100 beds or more------------------------

7,839

5,129 

xi' . 

1,068 

1,551 

x::J 

804 

1,370

1,849

1,558 

f;3: 1,161

1,120 

12 

155 

162 

6,771 

3,578 

2,110 

797 

N-sing care---------------------- 11,299 5,203 4,812 2,877 1,715 411 6,096 

Less than 25 beds-----------------------

25-49 beds------------------------------

50-99 beds ------------------_-- --_-

100 beds 01: more------------------------

2,366 

3,741 

3,324 

1,868 

583 

1,379 

% > 

508 

1,249 

m> 

120 

362 

635 

598 

35 

1E 

139 

1,783 

2,362 

1,yy 

Personal care with nursing-------- 3,877 754 589 140 68 3,123 

Less than 25 beds-----------------------

25-49 beds------------------------------

50-99 beds------------------------------

100 beds or more------------------------

1,819 

875 

657 

527 

215 

142 

158 

240 

145 

106 

124 

215 

2 

26 

55 

25 

it 

22 

1,604 

733 

499 

287 

Type of service and bed size All homes 

Personal care--------------------- 4,357 321 181 54 43 4,037 

Less than 25 beds----------------------- 3,654 269 151 40 35 3,385 25-49 beds----- -__-- -_-- __--_-- - __-- -___ 513 31 16

SO-99 be&-----------_--b---h--- _----_-- 17 12 $ 2 1%

100 beds or more----------------- -__-_- % 4 2 2 1 39 

Table 2. Number of nursing home residents, by type of rehabilitation program provided by home, type of service,

and bed size: United States, 1968 

T program therapy therapy hearing

therapy 

Other 

All types of service-------------- 813,335 408,145 64,527 76,931 6,452 12,051 405,190 

Less than 25 beds-----------------------

25-49 beds------------------------------

50-99 beds------------------------------

100 beds or more------------------------

89,914

162,452 

245,637 

315,332 

x3 

125:245 

216,577 

5,042 

7,923 

xs , 

3,636 

8,660 

x57:, 

580 

739 

2,299 

2,834 

738 

13'::; 

6:174 

75,209 

Ex394 

9a:755 

Nursing care---------------------- 593,622 353,066 57,768 67,019 5,757 10,330 240,556 

Less than 25 beds-----------------------

2549 beds------------------------------

50-99 beds------------------------------

100 beds or more------------------------

34,736 

120,382 

199,634 

238,871 

9,084 

46,082 

114,776 

183,123 

3,721 

7,186 

18,657 

28,205 

3'93% 

23:050 

34,681 

355 

691 

2,143 

2,568 

313 

13% 

5:391 

25,652 

74,300

84,858 

55,748 

Personal care with nursing-------- 159,013 50,040 5,670 8,335 573 1,190 108,974 

Less than 25 beds-----------------------

25-49 beds------------------------------

50-99 beds------------------------------

100 beds or more------------------------

21,670 

27,415 

E%t, 

2,754 

4,594 

9,555

33,136 

604 

630 

976 

3,460 

719 

1,011

1,818 

4,787 

120 

1% 

261 

150 

148 

131 

761 

18,916

22,821

28,669 

38,568 

Personal care--------------------- 60,699 5,039 1,088 1,576 122 531 55,660 

[Subtotals

-

do not necesstily add to tot& becauseof rounding] -

lr Type of rehabilitation program provided 

- All -I- Type of service and bed size residents 

bY Physical , 

"Z%i Speech/ 

Less than 25 beds----------------------- 33.508 2,866 73.7 986 106 275 30,642 2549 beds------------------------------ 14,655 107 291 61 13,714 50-99 beds -------_--_---_---__---------- 7,780 2; z 6,865 100 beds or more------------------------ 4,756 317 Y: 280; 6 2: 4,439 

15 
-------------------------- 

-------------------------- 

--------------------------------- 

----- ---------------------- 

-------------------------- 

Table 3. Percent distributions of nursing homes and residents inthese homes by whether 

or not rehabilitation programs are provided, according to type of service and bed 

size: United States, 1968 

[Subtotals do not necessarily add to totals becauseof rounding] 

Type of service and bed size 

All types of service-----------------

Less than 25 beds--------------------------

25-49 beds------------------ ____ -___-_- ____ 

50-99 beds -------------------_------------- 100 be& or more---------------------------

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

Less than 25 beds------------~------------­

25.49 beds---------------------------------

50-99 beds------------------------- ________ 

100 be& or more---------------------------

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

Less than 25 beds 

25-49 beds -----------------L---------------

50-99 beds ------c----------_---------------

100 beds or more -----------------_---------

personal care------------------------

Less than 25 beds

25-49 beds---------------------- --,- - ______ - SO-99 be&------------ ____ ---_- ____ -___-___ 100 be& or more-------------------- ____ -__ 

Percent distribution of homes 

100 32 68 

100 

100 3: 

100 49 

100 67 

100 46 

100 

100 3”;

100 55 

100 75 

100 19 

100 

100 ii 

100 

100 22 

100 7 

100 7 

100 6 

100 12 

100 9 

Percent distribution of residents 

All types of service-----------------

Less than 25 beds--------------------------

25-49 beds

50-99 beds---------------------------------

100 be& or more---------------------------

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

Less than 25 beds--------------------------

25-49 beds------------------- ______ -_-_-_-_ 

50-99 beds---------------------------------

100 be& or more 

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

Less than 25 beds

25-49 be& --__- ______ --_--__--__--_--__-_-- 50-99 beds ____ -__- ____ -_-- _________ -__--__- 100 be& or more--------------------------­

personal care------------------------

Less than 25 beds--------------------------

25-49 beds-------------------------- _______ 

50-99 be& -_----_--_-----------------------

100 be& 01: more---------------------------

100 50 

100 16 

100 32 

100 

100 

100 59 

100 26 

100 

100 

100 

100 31 

100 13 

100 

100 $57 100 46 

100 8 

100 

100 E 

100 12 

100 7 

16 

50 
-- 

---- ------------- 

-- - -- 

Table 4. Number of homes and residents in these homes, by type of rehabilitation programs provided and State: 

United States, 1968 

[Subtotalsdo not necessarilyadd to totals becauseof rounding] -

Lesidents Residents Homes .n homes with with with Homes in homes with i n homes

residents Homes in homes Homes Residents 

with State All with with vccupa- occupa- speech/ speech/ other With omes physical physical :ional tional hearing hearing other therapy therapy :herapy therapy therapy therapy :herapy therapy 

United States--- .9,533 64,527 3,479 76,931 1,909 6.452 523 12,051 

Alabama--------------- 161

4 42; 14# 296 

11 

6 27 Alaska----------------

Arizona--------------- 244 1; zi Arkansas-------------- 1:; 3% ii 395 California------------ 2,956 7,213 600 11,031 41: 1,396 

col,,ra&, m---------v- 177 x2 56 1,410 293 

Connecticut----------- 368 '133 2 1,024 219' 

Delaware-------------- 33 175 

District of Columbia-- 142 21 169 ;

Florida--------------- 338: 1,920 76 1,366 519 

Georgia--------------- 210 L$f 46 892 

Hawaii---------------- 16 i88 

Idaho 2 166 238f 

Illinois-------------- 953 %9 1;; 5,707 8:: 

Indiana--------------- 479 3 1,014 189 

Iowa- -e--w ---mm _---me- 752 1,162 1,300 30 165 

Kansas---------------- 482 865 1,392 12 232 

Kentucky-------------- 300 207 

Louisiana------------- 204 ‘;5s: 672 1: 

60 

Maine----------------- 285 478 301 16 2: 

Maryland-------------- 203 1,326 1,553 154 

Massachusetts--------- 982 4,857 2:: 4,554 12: Michigan-------------- 524 118 3,062 g Minnesota------------- 512 x2; 117 4,105 Mississippi----------- 108 '165 8 123 

2 

2 5 

MQso~--------------- 452 1,443 24 350 Montana--------------- 180 Nebraska-------------- 2885 465 1: :z Nevada---------------. 23 1 -

New Hampshire--------- 137 2;: e 

Ne" Jersey-----------. 516 2,166 104 7; 343 

New M~ico------------ 201

New york ------_---- - -. 1,;Gi 997; 3050 17: 1,;;; North Carolina-------- 43 

North Dakota---------- 94 420 20 

li 

2 38 

Ohio-_----- --mm_ -em--. 1,172 3,702 71 

Oklahoma-------------. '678 1,493 2i E:: 

&eg~-------------. %Z 1,550 433 

Pennsylvania---------. 810 1% 4,;;; 1:: 1,163 

Rhode Island---------- 177 17 11 19 

South Carolina-------- 319 313 10

4 

31 

South Dakota---------- 139:: 270

Tennessee------------- 220 $97 320 

Texas----------------- 2,013 1,;~; ii 31168 

Utah------------------ % 351 108 

Vermont -e--m _--- - 118 232 166 9

Virginia-------------- 542 2 567

Washington------------ 43: 1,101 72 1,7g 412 

West Virginia--------- 127 

Wisconsin------------- 2,204 1452 4,09$ Wyoming--------------- 11 # 

#Data suppressed to comply with confidentiality requirements. 

17 
Table 5. Number of nursing homes, residents in these homes, and residents in these homes receiving therapy, by whether or not rehabilitation programs are offered: United States and each State, 1968 

[Subtotals do not necessarilyadd to totals becauseof rounding] 

Yomes with Cesidents Residents Homes with Xesidents 

State rehabili- in these receiving tation bilitation

no reha- in these 

programs homes therapy programs homes 

United States----------------------- 6.278 408,145 159,961 13,256 405,190 

Alabama-----------------------------------

Alaska------------------------------------

Arizona----------------------------------­

,Arkansas----------------------------------

California--------------------------------

Colorado----------------------------------

ConneCTicut-------------------------------

Delaware----------------------------------

District of Columbia----------------------

Florida-~---------------------------------

Georgia-----------------------------------

Hawaii------------------------------------

Idaho-----------------------------------~-

Illinois----------------------------------

Indiana-----------------------------------

Iowa--------------------------------------

Kansas------------------------------------

Kenfucky----------------------,------------

Louisiana---------------------------------

Maine-------------------------------------

Maryland '-_________________________________ 

Massachusetts-----------------------------

Michigan----------------------------------

Minnesota---------------------------------

Mississippi--------------------------;----

Missouri----------------------------------

Montana-----------------------------------

Nebraska----------------------------------

Nevada------------------------------------

New Hampshire----------;------------------

New Jersey--------------------------------

New Mexico--------------------------------

New York----------------------------------

North Carolina----------------- _______ -___ 

North Dakota------------------------------

Ohio--------------------------------------

Oklahoma----------------------------------

Oregon-------------------------------------

Pennsylvania-----------------------------­

mode Island------------------------------

South Carolina----------------------------

South Dakota------------------------------

Tennessee---------------------------------

Texas-------------------------------------

Utah--------------------------------------

Vermont-----------------------------------

Virginia----------------------------------

Washington--------------------------------

West Virginia-----------------------------

Wisconsin---------------------------------

Wyoming-----------------------------------

49 3,211: 761 112 5,973

# # B #

2,113 722 1,663

:56 2,057 835 1% 8,915

893 47,583 20,794 2,063 32,874 

6,429 2,784

11,111 3,243

320 

t;: 339 

10,979 4,027 

6,614

855 

1,593

9;;; , 

9,976 2,754

5,935 2,553

3,500 736 

1,132 2% t 896

7,186

3:: 21,231

204 

:zzt 

'798 

1l.a 

E2 

8,918

1,377

3,978

288 

3,663

483 

1,204

166 

32 1,439 415 

180 12, ;;; 5,;;; 

4:: 

105 

24 

39,685 

4%Q 

16,752

1,186

, 1,130

2; 3;; 7,392

3,202

71041 3,005 28,236 10,;;; 2,313 

2,264

1,906

3,045

16,443

1,907 

1,115 

3g'%

'697 

15,258

# 

100 

187 z;:

'442 

5': 

178 z:::, 

5,072 '2 ,531

1,363 6:: 

370 :E:fs, 

572 17,163

10,526 "25: 

149 xt 

220 3:300 

110 3,412

17,152 ‘3;: 11,747 361 y;; 89 , 

334 13,737

1,604 2:: 7,;;;

1:: 2,352 

3i26 

622 

565 

70 

787 

283 IX 

193 6:482 

17,932

'is; 2,585 

60 

$3 

90 

1,488 

?E 

1:43a 

11,041

B 

i/Data suppressed to comply with confidentiality requirements. 

18 
---------------- 

Table 6. Number of nursing homes using outpatient clinics, by type of clinic, type of 

. service, and bed size: United States, 1968 

[Subtotals do not necessarily add to totals because of rounding1

-

Type of service and,bed size All lr 

homes Physical

therapy Diagnostic %edical Other None 

All types of service------- 19,533 2,793 4,549 7,023 1,442 10,445 

Less than 25 be&---------------- 7,839 783 968 2,293 361 5,019 

25-49 beds----------------------- 5,129 843 1,250 1,899 319 2,668 

50-99 beds----------------------- 4,128 699 1,291 1,706 383 1,863 

100 be& or more----------------- 2,438 468 1,040 1,125 379 896 

Nursing car---------------- 11,299 1,963 3,364 4,499 1,013 5,259 

Type of outpatient clinic used 

Less than 25 beds 2,3,66 363 428 741 125 1,386 

25-49 beds----------------------- 3,741 700 1,047 1,497 250 1,777 

50-99 beds --------_---_---_------ 3,324 565 1,080 1,393 334 1,437 

100 beds or more----------------- 1,868 334 810 868 305 659 

Personal care with nursing- 3,877 461 709 1,259 232 2,334 

Less than 25 be&---------------- 1,819 133 173 499 82 1,222 

25-49 be&------------ ____ -___--- 875 93 135 257 38 560 

50-99 beds----------------------- 657 111 181 260 42 337 

100 be& or more---- _-- _---- _---- 527 124 220 243 69 215 

personal care-------------- 4,357 369 476 1,266 198 2,852 

Less than 25 be&---------------- 3,654 287 367 1,053 155 2,411 

25-49 beds----------------------- 513 49 69 146 31 330 

50-99 beds----------------------- 147 22 30 53 7 89 

100 beds or more----------------- 43 10 10 14 4 22 

19 
Table 7. Number of nursing homes without rehabilitation programs, by use of outpati,ent.. clinics, type of service, and bed size: United States, 1968 

[Subtotalsdo not necessarily addto totalsbecause of rounding]

Type of outpatient clinic used 

All Phvn - ---,- Type of service and bed size homes ical Diag- Med- Othe-‘I 

I @---- I ther- nostic ical None’ 3G” 

apy only only oqly e!?a1 

only 

Homes without rehabilitation programs 

All types of service------- 13.256 361 191 1,891 257 2,578 7,978 

Less than 25 be&---------------- 6,771 140 1,018 135 

25-49 beds----------------------- ;i;:; 111 %09

50-99 beds----------------------- :7 607

100 be& 01: more----------------- '797 3: 4;;

71 14 312 

Nursing car---------------- 6,096 250 118 831 113 1,577 3,207 

Less than 25 be&----------------

25-49 beds-----------------------

50-99 beds-----------------------

100 beds 01: more-----------------

1,783

2,362

1,480

470 

68 

;3"

26 

31 

10 

219 

353 

213 

46 

2:: 

29 

9 

330 

612 

449 

187 

1,105

1,212

697 

193 

Personal care with nursing- 3,123 44 40 432 55 510 2,043 

Less than 25 beds --_----------_-- 25-49 beds-----------------------

50-99 beds-----------------------

100 beds or more-----------------

1,604

733 

% 

20 

;

7 

18 

9 

57 

'E 

2 

E 

z 

152 

115 

130 

113 

1,135

494

280 

134 

personal care-------------- 4,037 68 33 629 88 491 

Less than 25 be&---------------- 3,;;; 51: 8

25 552 

I:,

2 

377 

25-49 beds-----------------------

50-99 beds----------------------- 130 51: 139 

100 be& or more----------------- 39 2' 3 1 11 

20 
-- 

--- ----- -- -- --- 

Table 8. Number of nursing homes whose residents used outpatient clinics, by type of clinic, region, and

State: United States, 1968 

[Subtotalsdo not necessarilyaddtototals becauseof rounding] -

ll- Type of outpatient clinic used 

Area All

homes Physical Diagnostic Medical Other therapy Several None

United States---------------

Northeast--------;------------

Connecticut-----------------------

Maine-----------------------------

Massachusetts---------------------

New Hampshire---------------------

New Jersey------------------------

New York--------------------------

Pennsylvania----------------------

Rhode Island----------------------

Vermont---------------------------

North Central-----------------

Illinois--------------------------

Indiana--------------------------­

only only only OdY 

19,533 562 580 2,693 512 4,741 10,445 

4,479 160 196 404 154 1,169 2,396 

468: 

982 

137

516 

1,087 810 

177

118 

6,333 184 179 876 165 1,449 3,480 

Iowa- __-_ --__---__-__- --__ --__---.. 

Kansas----------------------------

Michigan--------------------------

Minnesota-------------------------

Missouri--------------------------

Nebraska--------------------------

North Dakota----------------------

Ohio-----------------------------­

south Dakota----------------------

Wisconsin-------------------------

South-------------------------

Alabama-------- ____ __..__ --___---

Arkansas--------------------------

Delaware--------------------------

District of Columbia-------------- Florida---------------------------

Georgia---------------------------

Kentucky--------------------------

Louisiana-------------------------

Maryland ----------_---__---------- Mississippi.------------------------

North Carolina--------------------

Oklahoma-------------------------­

south Carolina--------------------

Tennessee-------------------------

Texas-----------------------------

Virginia--------------------------

West Virginia---------------------

West-------------------------- 98 

Alaska----------------------------

Arizona---------------------------

California------------------------

Colorado--------------------------

Hawaii----------------------------

Idaho-----------------------------

Montana---------------------------

Nevada----------------------------

New Mexico------------------------

Oregon----------------------------

Utah------------------------------

Washington------------------------

Wyoming -mmm -., mm - - - -

#Data suppressed to comply with confidentiality requirements, 

21 
----------------- 

----------------------- 

-- 

---- -- 

5 

Table 9. Number of residents in nursing homes, by arrangements for physician services and type of service provided by home: United States, 1968 

[Subtotals do not necessarilyadd to totalsbecauseof rounding] 

Arrangements for physician services 

provided by home arrangements Full-time 

physician Regular Visits when 

visits needed 

Office 

visits None 

Number of residents 

All types of homes--------- 813,335 100,915 339,730 343,625 6,667 22,399 

Nursing care --__ 

Personal care with nursing------- persona1 care-------------------- %% 

60:699 

81,846

16,381

2,687 

257,760 233,988

70,134 67,715 11,836 41,921 

3,060

1,436

2,170 

16,968 

9% 

Type of service All 

, 

Table 10. Number and percent distribution of nursing homes by arrangements for physician services, according to type of service provided by home and bed size: United States, 1968 

[Subtotalsdo not necessarilyadd to totalsbecauseof rounding] -

Arrangements for physician services 

by home and bed size srrrangements Full-time 

physician Regular Visits when visits needed 

Office 

visits NO*=5 

I Number of homes 

All types of homes--------- 19,533 1,459 6,622 548 

Less than 25 be& --v--m a--m-w --a- 7,839 25-49 beds 5,129 50-99 beds _--_--_- --m------------ 4,128 100 be& or more----------------- 2,438 

386 

369 

328 

376 

1,536

2,267

1,663

1,156 

Type of service provided All 

Nursing car---------------- 11,299 1,053 4,735 5,129 76 

Less than 25 be&------------- 2,366 167 776 1,330 23

25-49 beds ------_----------_----- 290 1,745 50-99 be&-- --__ -mm_--- -------mm xii 283 1,;;; 1,605 :79

100 be& or more----------------- 1:868 312 1,;;; 7 

Personal care with nursing- 3,877 236 1,256 2,224 89 71 

Less than 25 beds-- --m-m- a -----mm 1,;;; 281 35 25-49 be& _-_____----_----___ --mm 420 1,354 376 t; 9 50-99 be& _---_-_- - -___ -___---_ 657 2% 5

100 beds or mope----------------- 527 26" 2 

Less than 25 be&----------------

25-49 beds--- --__ m---m--- --__ -m-m 50-99 be,& _---_-------_---------- 100 beds or more-----------------

3,654 

2: 

43 

136 

26 

7 

to738 

33 

17 

2,686

362 

;?I 

199 

14 

1 

154 

3’ 

5 

Percent distribution 

All types of homes--------- 100 7 541 2 3 

Less than 25 be& --_- - --_---_- 25-49 beds _-_-___r - ---_- - --_-_-_- 50-99 b.&s--- ___-_---_- - --__- -mm 100 beds or ,,,ore-e-m _--- m-m 

100 

100 

100 

100 

5 

;

15 

3 

: 

4 

@ Nursing care-----------..--- 100 9 

personal care-------------- 4,357 170 631 3,167 220 170 

Less than 25 be&,---------------- 100

25-49 beds----------------------- 100 ;: =,0-99 beds----------------------- 100 

100 beds 01 more----------------- 100 1; 

Personal care with nursing- 100 6 32 

Less than 25 be&------------ 100 2

25-49 beds---_--_-----_---------_ 100 2

50-99 be& ----_-_-----_-----__--- 2"

100 be& or more----------------- :ooi 1; 3 

Personal care-------------- 100 4 4 

Less than 25 be&------------- 100 4 25-49 beds _------------------_--- 100 s 50-99 beds-----_-----------_---- 100 : 100 beds ,,r more----------------- 100 1'2 

22 
-- 

Table 11. Number and percent distributions of nursing homes and residents in homes, with and without recreational activities, according to type of service and bed size: United States, 1968 

[Subtotals do not necessarily add to totals because of rounding] 

Homes with any Residents in Homes with no Residents in Type of service and bed size recreational these homes recreational these homes activities activities 

Number 

All types of service--------- 15,443 715,751 4,090 97,584 

Less than 25 beds------------------ 65,184 2,481 25-49 be&------------- ____ -_-__h__ 22:: 132,965 1,015 50-99 beds------------------------- 3:668 219,859 460 100 be& or more------------------- 2,304 297,743 134 

Nursing care----------------- 9,800 544,602 1,498 

Less than 25 beds------------------ 1,796 27,198 570 25-49 be&------------ _____ ______ 3,172 203,593 50-99 beds------------------------- 183,651 ::09 100 be& 01 more------------------- 9% 3 230,160 79

50-99 

Personal care with nursing--- 2,757 129,032 1,120 29,981 

Less than 25 beds-~----------------

25-49 beds-------------------------

50-99 be& _______ -----_-__--- ______ 100 b&s or more-------------------

14,232

19,744 

2%, 

678 

263 

133 

46 

5% 

7:249 

7,623 

personal care---------------- 2,886 42,117 1,472 18,583 

Less than 25 be& --_--_-_----_-_--- 25-49 beds------------------------- 2,421 330 23,754

9,628 1,233 183 9,754

5,028 be&------ ____ --_------ ______ 101 47 100 be& or more------------------- 34 2% 9 z;; , ,

Percent distribution 

All types of service--------- 79 88 21 12 

Less than 25 beds------------------ 73

25-49 beds------------------------- t:

50-99 beds---i--------------------- 89 8

100 be& or more------------------- 95 94 

Nursing care----------------- 87 92 13 8 

Less than 25 be& -----__---------_- 78 24

25-49 beds------------------- ______ 15 50-99 beds------------------------- 8

100 beds or more------------------- 4 

Personal care with nursing--- 71 81 29 

Less than 25 beds------------------ 63 25-&9 beds-----------------'-- ______ ;; SO-99 beds------------------- ______ ~~ 81

100 beds or more------------------- 41 89 

personal care-------i-------- 66 69 

Less than 25 beds------------------

25-49 beds------------------------- 28 2 50-99 beds----- ____________ - _______ 69 67 100 be& or more------------------- 79 74 

23 
------- 

Table 12. Number of nursing homes, by type of recreational activity provided, type of service, and bed size: 

United States, 1968 

[Subtotals do not necessarily addto totalsbecauseof rounding]

= -

T Recreational activities provided 

- All Type of service and bed size homes Any Arts/ Planned 

social Trips Other None activity crafts activities 

All types of service------------- 19,533 15,443 7,585 14,056 4,989 6,082 4,090 -

Less than 25 beds---------------------- 7,839 1,536 1,549 2,109 2,481 25-49 beds------------- -_______________ 5,129 ?E 1,879 

“;‘%:: 1,140 1,511 1,015 50-99 beds----------------------------- 31668 2,339 3:432 1,175 1,430 100 beds 01: more---- --__ -__-_- _________ 4% > 2,304 1,831 2,187 1,125 1,032 4%

Nursing care--------------------- 11,299 9,800 5,598 9,025 2,948 3,751 1,498 

Less than 25 beds---------------------- 2,366 1,796 647 1,571 661 25 -49 beds --__ ---__------- _____________ 3,741 3,172 1,503 z1 1,147 % 50-99 beds----------------------------- 3,324 1,981 2::; 897 1,163 280 100 beds or more----------------------- 1,868 2% I 1,467 1:703 797 780 79

Personal care with nursing------- 3,877 2,757 1,180 2,541 1,075 1,193 1,120 

Less than 25 beds---------------------- 1,819 1,141 289 1,024 317 506 678 25-49 beds---------------- _____________ 875 612 575 202 231 263 50-99'beds----------- ---------_-_-_____ 657 524 3% 242 221 133 100 beds or more-------- __-____ - _______ 527 481 344 it39 315 235 46 

Personal care-------------------- 4,357 2,886 807 2,490 965 1,138 1,472 

Less than 25 beds---------------------- 3,654 2,421 600 2,061 790 942 1,233 25-49 beds--------- ---___. __-__________ 513 330 136 305 127 

50-99 beds--- m------ _______ - ____---__-_ 147 101 l253 % 100 beds 01: more----------------------- 43 34 2 % 253 17 9 

Table 13. Number of residents and recreational therapists in nursing homes, by type of recreational activity pro­ vided in home, type of service, and bed size: United States, 1968 

[Subtotals do not necessarilyadd to totals becauseofroundind 

= 

Residents Recreational 

therapists P~11 homes Recreational activities provided in home 

Type of service and bed size 0Lth rec- I :eational 

Ictivities 

Any Arts/ Planned Full- Partsocial Trips Other time time activity crafts activities : 

Number 

All types of service------- 15,443 715,751 469,524 669,696 287.956 294.553 1,771 3,046 -

Less than 25 be&---------------- 5,358 65,184 21,087 57,836 18,775 25,170 25-49 beds----------------------- 4,114 132,965 63,112 122,864 37,420 $2 % 50-99 beds----------------------- 3,668 219,859 144,106 71,839 %";i 533 1,197 100 beds or more----------------- 2,304 297,743 241,219 %% , 159,922 135:397 816 751 

Less than 25 beds----------------

25-49 beds------------- __________ 

50-99 beds ______-________________

100 beds or more-----------------

1,796

3,172

3,044

1,789 

27,198

103,593

183,651

230,160 

10,417

51,088

122,461

192,051 

24,078

95,293

172,668 

219,712 

i~%Z 

55:162 

114,390 

9,835 

x";

100:636 

i4i 

693 

Wf 

Personal care with nursing- 2,757 129,032 77,581 120,151 69,178 59,840 245 390 

Less than 25 beds----------------

25-49 beds-----------------------

50-99 beds-----------------------

100 beds or more-----------------

1,141

612 

524

481 

14,232

19,744 

30,974

64,082 

3,921

7,909

la,824

46,927 

12,974

18,645

29,072

59,460 

3,930

6,596

14,605

44,048 

6,133

7,660

13,166

32,882 

i: 

154 

55 

1604

165 

personal care-------------- 2,886 42,117 15,926 37,792 15,331 17,236 81 176 

Nursing care--------------- 9,800 544,602 376,017 511,753 203,446 217,478 2,481 

Less than 25 beds - ________ 2,421 y; 6,750 20,784 7,904 9,202 48 102 25-49 beds ______-________________ 330 4,115 8,926 3,870 3,964 44 SO-99 beds _-e-_-m - --_-----_______ 101 51234 2,821 2,072 2,189 1'16 100 beds 01: more----------- ----_- 34 3,501 2,241 1,485 1,880 .6 i28 

24 
APPENDIX I 

TECHNICAL NOTES ON THE SURVEY DESIGN 

AND PROCEDURES 

General 

The 1968 Nursing Home Survey included “all” 

resident institutions in the United States which provide nursing or personal care to the aged, infirm, or 

chronically ill. The survey was directed toward the 

aged institutional population; however, all people who 

were residents of institutions within the scope of the 

survey were included regardless of age. The survey, 

conducted during April-September 1968, included 18,185 

nursing homes, convalescent homes, rest homes, homes 

for the aged, and other related facilities. It did not 

include 1,355 homes which opened in the year prior 

to the survey. As discussed in appendix II, special 

weighting procedures were applied to the data to account for the existence of these homes. Resident institutions included in the survey were those which 

maintained at least three beds and provided some type 

of nursing service. (See appendix IV for the procedure 

used to classify these institutions by type of nursing 

service.) 

This appendix describes the survey design and 

procedures for the 1968 Nursing Home Survey. Succeeding appendixes present general qualifications of the 

data and the weighting procedure to account for the 

existence of newly opened homes (appendix II), definitions of terms (appendix III), classification of institutions by type of nursing service (appendix IV), and 

forms used in the survey (appendix V). 

Universe 

The universe for the 1968 Nursing Home Survey 

consisted of all institutions classified as nursing homes 

in the 1967 Survey of the Master Facility Inventory 

(MFI). A detailed description of how the MFI was 

developed, its content, maintenance plans, and a procedure for assessing the completeness of its coverage 

has been published.a7y28The MFI includes the names, 

,addresses, and certain descriptive information about 

%llf’ hospitals and resident institutions in the United 

States. It was originally developed by collating a large 

NOTE: The list of references follows the text. 

number of published and unpublished lists of establishments and surveying these establishments by mail 

to obtain information on their nature and status of 

business. 

Since the Ml?1 serves as a sampling frame for institutions within the scope of the various health facilities surveys, it is imperative that it be kept as current 

as possible. To aid in accomplishing this purpose, a 

mechanism known as the Agency Reporting System 

(ARS) has been developed to provide information on 

new institutions. This information is incorporated in 

the MFI at regular intervals. A reportonthe origin and 

development of the ARS has been published.2g 

Data Collection and Processing 

Data for this survey were collected, primarily by 

mail, by the Wolf Research and Development Corporation, under contract to the National Center for Health 

Statistics. In addition to the original mailing, followup 

procedures consisted of three regular first-class 

mailings, each approximately 3 weeks after the prior 

mailing, and a final certified mailing. Before the certified mailing, U.S. Bureau of the Census interviewers 

made personal visits to apprordmately 400 of the 

largest nursing homes which had not responded. (These 

400 homes were not included in the certified followup.) 

Of ‘those nonresponding homes left after the certified 

mailing, a sample of 2,000 homes, stratified by bed 

size and type of service, was selected for telephone 

followup. 

Approximately 22 percent of the 18,185 homes in 

scope of the survey responded to the original mailing. 

The three additional first-class mailings added 39 percent, and the certified mailing plus theCensuspersona1 

interviews added another 19 percent. Telephonefollowup and late mail returns brought the total response to 

87 percent. Of the 2,375 nonresponding homes, the 

majority had less than 25 beds (table I). Nonresponse 

decreased as bed size increased. 

The Wolf Corporation hand-edited and coded the 

completed questionnaires in accordance with specifications established by the Center. If the returnedquestionnaire did not contain data for certain key items, a 

25 
------------ 

------------------- 

Table I. Number and percent distributions of nursing homes by response status and bed 

size: United States, April-September 1968 

[Subtotals do not necessarily add to totals because of rounding] 

Questionnaires

mailed 

Bed size Questionnaires Questionnaires

returned not returned 

Number 

of homes Total 

Percent distribution 

All homes-------------- 18,185 100 87 1 13

=====I 

Less than 25 beds 7,778 

25 49 b&s 4,719 

50-99 be& ____-_-_-__--_-___- 3,935 

100 beds or more------------- 1,753 -

further mail inquiry was made specifically for these 

items. Approximately 10 percent of the returned questionniares did not pass editing criteria for oneor more 

key items and required this “fail-edit” mailing. 

After the edited and coded data.were recorded on 

magnetic tape, the staff of the Health Facilities Statistics Branch of the Division of Health Resources 

000 

26 11 23 t 3 

22 20 2 

10 9 1 

Statistics processed the data on the Center’s electronic computer. Processing included matching each 

institution with basic identifying information contained 

in the 1967 MFI Survey as well ascarrying out internal 

edits and consistency checks to eliminate “impossible” 

responses and errors in editing, coding, or processing. 

26 
APPENDIX II 

QUALIFICATIONS 

General Qualifications 

Certain qualifications should be kept in mind regarding the MFI, which was the universe for the 1968 

Nursing Home Survey. The data in this report can be 

no more representative of nursing homes in the United 

States than the universe upon which the survey was 

based. The 1967 MFI Survey included approximately 89 

percent of the nursing homes in the United States. Indications are that places not on theMF1 were relatively 

small, possibly no more than half as large on the 

average as those listed. 

Special attention is called to the procedure for 

classifying institutions described in appendix IV. Classification of nursing homes, i.e., homes for the aged, 

rest homes, and related types of places, was based on 

the type of service provided in the home rather than on 

State licensure laws or on what the home may call itself. This criterion for classification was chosen in the 

absence of any commonly accepted definition of nursing 

homes or other institutions of this type. 

Since the 1968 Nursing Home Survey was a census 

of “all” nursing homes in the United States, the data 

presented in this report are not subject to sampling 

variability. However, the data are subject to reporting 

and measurement errors. The accuracy of the data 

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 report correct answers. 

In an attempt to keep measurement errors to a 

minimum, the questionnaire was made as self-explanatory as possible. Not only were definitions and explanations included as part of each question, but a separate Definition Sheet regarding staff was enclosed. 

Time Interval Between Establishing the Universe 

and Conducting the Survey 

The time interval between the 1967 MFI Survey 

(April-October 1967), in which the universe of nursing 

homes was established, and the 1968 Nursing Home 

Survey (April-September 1968) was 1 year. Basic 

classification data collected in the 1967 MFI Survey 

OF THE DATA 

were not collected in the 1968 Nursing Home Survey. 

Instead, the 1968 data were assumed to be the same as 

the 1967 data, which were used to classify thehomes. 

Thus the classification of institutions for the 1968Nursing Home Survey was based on type of service and 

type of ownership information collected in the 1967 

MFI Survey. 

During this l-year interval the type of ownership 

and type of service probably changed for some of the 

institutions. Because of the short timeperiod, however, 

any changes which may have occurred should have only 

a negligible effect on the distribution of institutions by 

either type of service or type of ownership. 

During the l-year interval between establishing the 

universe and conducting the 1968 survey, 399 nursing 

homes closed and 1,355 nursing homes openedfor business. The nursing homes which opened for business 

were not included in the 1968 survey because of a time 

lag in receiving the names and addresses ofnew homes 

from the Agency Reporting System, the mechanism 

which updates the MFI mailing list. Data from the 1968 

survey were weighted to account for the existence of 

these newly opened homes even though they were not 

included in the survey. 

Weighting Procedure 

The 1968 data were weighted to account for the 

existence of 1,355 newly opened homes according to 

three basic variables: type of service (nursing care, 

personal care with nursing, personal care), type of 

ownership (proprietary, church and other nonprofit, 

government), and number of beds (less than 25 beds, 

25 to 49 beds, 50 to 99 beds, 100 beds or more). In 

all, there were 36 combinations of these variables, or 

36 weighting classes. The number of homes which 

opened during the l-year interval between establishing 

the universe and conducting the 1968 survey was tallied 

for each of the 36 weighting classes from data collected 

in the 1969 MFI Survey. Percent distributions of these 

1,355 new homes based on the 1969 data are presented 

according to type of ownership and bed size (table II) 

and type of service (table III). The majority of new 

nursing homes (79 percent) were proprietary-owned. 
Table II. Percent distribution of nursing homes Table III. Percent distribution of nursing

opened for business between April-October homes opened for business between April-Octoership and bed size: United States

1967 and April-September 1968,by type of own- ber 1967 and April-September 1968, by type of

service: Uniteh State‘s 

[Subtotals do not necessarilyadd to totals becauseof rounding] [Subtotals do not necessarilyadd to totals becauseof rounding] -

Nursing homes 

opened for 

Type of ownership >usiness~-between

and bed size April-October

1967 and April- September 1968 

Number 

Total homes------------ 1,355 

Percent 

distribution 

All types of ownership- 100.0 

Proprietary-------------- 78.9 

Less than 25 beds------------ 31.4 25-49 beds------------------- 12.3

50-99 beds------------------- 22.3 

100 beds or more------------- 12.9 

Church and other nonprofit--------------- 14.1 

Less than 25 beds------------

25-49 beds------------------- ?2 50-99 beds--------------- ____ 100 beds or more------------- 2:: 

Government--------------- 6.9 

Less than 25 beds ------------ 3.4 25-49 beds--------- _____ --___ 50-99 beds------------------- i-2

100 beds or more------------- 0:8 

The majority (72 percent) also were those providing 

nursing care, the highest level of nursing service. The 

largest bed-size group (37 percent) was the category 

of less than 25 beds. 

The weight for each weighting class was calculated 

according to the following formula: 

x0 

w, =lt- , 

yc 

where 

W =weight 

c = weighting class 

X = number of newly opened homes 

Y = number of homes in scope of the 1968 survey 

Weights were assigned to each nursing home according 

to its weighting class. Then the 1968 survey information 

Type of service 

Total homes------------

All types of service---

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

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

Nursing homes 

opened for 

business between 

April-October

1967 and April- September 1968 

Number 

1,355 

Percent 

distribution 

100.0 

E 

15:8 

was weighted by multiplying the weight times the data, 

Thus data in this report represent information for “all” 

nursing homes in existence in the UnitedStatesin 1968. 

Rounding of Numbers 

All data were calculated to the nearest hundredth 

because the weights were carried to this level of accuracy. After calculations were performed, the data 

were rounded to the nearest whole number, Because 

of this rounding, figures in the tables may not add to 

the totals. 

Nonresponse and Imputation of Missing Data 

Of the 18,858 institutions comprising the universe 

of nursing homes, 673 were found to be either out of 

business, out of scope, or duplicates, leaving 18,185 

homes in scope of the survey. A total of 2,375 nursing 

homes, or 13 percent, refused to respond to the survey 

after all followup procedures were completed, Additional 

information on the response rate is presented in table 

I of appendix I. 

Statistics in this report were adjusted for nonresponse for an entire institution by using classification data collected in the 1967 MFI Survey for that 

particular nursing home and imputing all items, When 

nursing homes did not return a questionnaire or returned a questionnaire with items left blank, the items 

were imputed in one of four ways, A “no” response 

was assigned to blanks in the following items: minimum age for admission, admission physical, yearly 

physical, availability of recreation therapy or out28 
patient therapy, If the missing data for a particular

home had been collected in the 1967MFI Survey, they 

were used. The items imputedin this waywere number 

of full-time registered nurses, number of full-time 

licensed practical nurses, and number of residents. 

If the missing items hadnot beencollected in the 1967 

MFI Survey, data were usedfrom the precedingquestionnaire from another nursing homehavingthe same 

type of service (nursing care,personal care with nursing, or personal care) and bed-size group (less than 

25 beds, 25-49 beds, 50-99 beds, 100 bedsor more),

Items imputed this way were number of employeesin 

selected occupations (excluding full-time registered 

nurses and licensed practical nurses), charges for 

care, physician arrangements to visit patients, and 

000 

level of skill of the nurse in charge on eachshift. In a 

similar type of imputation, data were used from the 

preceding questionnaire from a home with the same 

type of service, bed-size group, and type of ownership,

Items imputed in this way were number of admissions 

number of discharges, andnumber of deaths. 

For items related to patient census, special imputation tables were used which gave the ratio of the 

item to the patient census by type of service andbedsize group or by type of ownership.These items were 

number of discharges, number of deaths, number of 

male and female patients, number of patients receiving

rehabilitation services, andnumber of patients receiving medical assistancebenefits. 

29 
APPENDIX III 

DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT 

Terms Relating to Homes or Residents 

Nuysi?q home.-This term refers to all institutions within the scope of the 1968Nursing Home Survey. 

It includes nursing homes, convalescent homes, homes 

for the aged, and related institutions which provide 

nursing care to the aged or chronically illand maintain 

three beds or more. 

Type of service. -The classification of nursing 

institutions according to type of service is describedin 

appendix IV. 

Type of ownership. -Institutions are classified by 

type of ownership into the following categories: 

Proprietary institution-an institutionoperatedunder private commercial ownership. 

Church orother nonprofit institution-an institution operated under voluntary or nonprofit auspices. This classification includes both churchrelated and other nonprofit institutions. 

Government institution-an institution operated under Federal, State, or local government auspices. 

Bed.-Any bed set up and regularly maintained for 

use by a resident or patient, whether or not the bed 

was in use at the ‘time of the survey, is included. Beds 

-oooused by staff or any beds used for emergency services 

only are excluded. 

Resident .-A resident, or patient, is any person 

who has been formalIy admitted to the home and is currently on its register. Included are residents temporarily away, for instance in a short-stay hospital or 

visiting with friends or relatives, but whose beds are 

maintained for them in the home. 

Terms Relating to Programs or Treatments 

Rehabilitation.-Rehabilitation is the process of 

restoring a resident to a state of physical and mental 

health through treatment and training. 

Physical therapy.-Physical therapy is the treatment of disease, injury, etc., by physical means rather 

than with drugs. Included in the category are treatments 

by massage, infrared or ultraviolet light, electrotherapy, hydrotherapy, heat, or exercise. 

Occupational therapy.-Occupational therapy is the 

treatment of mental and physical ailments by work 

designed to divert the mind or correct .a particular 

physical defect, or creative activity prescribed for its 

effect in promoting recovery or rehabilitation. 

Rem&ion.-Recreation is refreshment of bodyor 

mind by some form of play, amusement, or relaxation. 

30 
APPENDIX IV 

CLASSIFICATION OF NURSING HOMES BY TYPE OF SERVICE 

Institutions in the 1968 Nursing.Home Survey are 

classified by type of service as nursing care, personal 

care with nursing, or personal care homes according 

to data collected in the 1967 Master Facility Inventory 

Survey (MFI). (A brief description of the MFI is gfyen 

in appendix I and pertinent parts of the 1967 MFI Survey questionnaire are reproduced in appendix V.) The 

classification scheme for type of service is based on 

four criteria. 

1. The number of persons receiving nursing care 

during the week prior to survey. Nursing care 

is defined as the provision of one or more of 

the following services: 

Taking 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 

2. The presence or absence of nurses on the staff. 

3. Whether or not the institution provides administration of medications or supervisionover self. 

administered medications. 

4. Assistance in a certain number of activitiesfor 

daily living. These include rub and massage; 

help with tub bath or shower; help with dressing, correspondence, or shopping; help with 

walking or getting about; and help with eating. 

The three classes of nursing homes by type of service 

were defined as follows: 

Nursing care home 

l Fifty percent or more of the residents received 

nursing care during the week prior to the survey. 

a At least one full-time (35 or more hours per week) 

registered nurse (HN) or licensed practical nurse 

(LPN) was employed. 

Persoml care with nursing home 

a Some, but less than 50 percent, of the residents 

received nursing care during the week prior to the 

survey. 

l At least one full-time RN or LPN was employed. 

or 

l Some of the residents received nursing care during the week prior to the survey. 

l No full-time RN or LPN was employed. 

a The institution either 

Provided adminstration of medicines or supervision 

over self-administered medicines. 

or 

Provided assistance with three or more activities 

for daily living. 

Persoml care home 

a Some of the residents received nursing care during the week prior to the survey. 

a No full-time RN or LPN was employed. 

a The institution did not provide administration of 

medicines or supervision over self-administered 

medicines. 

l The institution provided assistance with one or two 

activities for daily living. 

or 

a None of the residents received nursing care during the week prior to the survey. 

a At least one full-time RN or LPN was employed. 

l The institution either 

31 
Provided administration of medicines or super- Institutions which provided adsitttance with one or 

vision over self-adminiotered medicines. two activities for daily living or offered room and 

or board as the only service were clac;sified QS out of 

scope of the 1968 Nursing Home Survey. 

Provided assistance with three or more activities Table IV shows in detail the scheme for clasaifyfor daily living. ing institutions according to type of service. 

Table IV. Classification of institutions by type of service: 1968 Nursing Home Survey 

Classification variables 

Percent of total residents who received nursing care during the week prior to day of survey 

Number of registered or licensed practical nurses 

Does the institution provide: (a) Administration of medicine or treatments 

according to doctor's orders 

(b) Su{e~;;;on over s%f-administered 

Does the institution offer assistance with three activities or more for daily living? 

Does the institution offer assistance with one or two activities for daily living? 

Does the institution offer room and/or board as ii3 only service? 

Institution' 

'NC-Nursimz care home 

Pen-Personal care with nursing home 

PC-Personal care home 

D-Domiciliary care home (out of scope) B-Boarding or rooming house (out of scope) 

Classification criteria 

50 percent or more Some but less than None 50 percent I 

1+ T None 1+ None ot 

. . . Yes 

- -

. . . . . . ; NO 

-

. . . . . . . . . Yes No No 

-

. . . . . . . . . . . . YeS Yes 

- - -. 

NC Pen PC" PC D Pcnl Pcnl Pcnl PC D 1 PC 1 PC D 

- - f 

-ooo32 
APPENDIX V 

FORMS USED IN THE SURVEY 

1968 NURSING HOME QUESTIONNAIRE 

8”OOET8UREAU NO. 68.36#017 

APPROVAL EXPIRES 8.3143 

U.S. DEPARTMENT OF HEALTH, 

EDUCATION AN0 WELFARE 

PUBLIC HEALTH SERVICE 

NATIONAL CENTER FOR HEALTH 

STATISTICS 

WASHINGTON, OX. 

20201 

NURSING AND PERSONAL CARE 

FACILITIES SURVEY 

March 1968 

I 

Dear Sir: 

The National Center for Health Statistics (NCHS) of the U.S. 

Public Health Service is conducting a survey of all resident facilities providing nursing and personal care to obtain basic data on 

their policies, services and staff. This program is being conducted 

as a part of the U. S. National Health Survey. This information will 

be used to compile statistics on the number and kinds of such facilities in the United States. These statistics will be used to meet 

the needs of Congress, State legislatures, Federal, regional and local 

health planners, national health associations, and many others who 

plan and provide health services to the aged. We wish to assure you 

that any information which permits the identification of your facility 

will be held strictly confidential, will be used solely by persons 

engaged in, and only for the purposes of the survey and will not be 

disclosed or released to other persons or for any other reason. 

Enclosed is a report from an earlier survey which we hope you 

will find informative. You can receive other publications by using 

the enclosed order blank and returning it, along with the completed 

questionnaire, in the postage-paid envelope. We would appreciate 

your cooperation in completing this questionnaire within one week. 

Thank you. 

Sincerely yours, 

---@-% 

Theodore D. Woolsey 

Director, 

National Center for Health 

statistics 

33 

I 
-

GENERAL INSTRUCTIONSFOR COMPLETING(1UESTIONNAIRE 

r a, ANSWERALL QlJESTlONS, plac. Defiitions and inrkuctionr are &II with the qucrtionl when needed. 1 b. INCLUDE IN THIS REPORTinformation for the facility named in the mniling label qr for it8 NCCUIO~ if the 

name or owner hr,s changed. Include infonnatin for ONE FAclLITy ONLY, but report for the ENTIRE faci- I tity, indudlng any nlb.titr. I 

c RETURN THE c0MPf.E~ QUPSTIONNAIRE in the part&aid mvelopc pmvided, to: 

Ndlond Chta for He&b Stdstica, P.O. Box 348. Bladrmbmg,bfar#and 20710. 

A.. OWNERSt#‘.OF FACILITY -

1. When did this facility first begin its operation at 

TM-S ADDRESS? ‘IGive the date it firot opened

this addreee ae a nursing home, 

eta., even though the ownership

since charged, and the opeoific

different.) 

2. liow many times has tho owncrehip

changed bands since it was first 

address? 

at 

convatoscent home, or oontrot may hove 

services may now be 

of this facility

opened at this 

3. When did this facility first begin its operation

under its PHESSNT OWNBRSliIP? 

B. ADMISSIONPOLICY_._ 

As a general policy, do you accept the following t/.fark tx) “YSS” or “No” for each item.) 

D, Bedfast patients . . . . . . . . . . . . . . . . . . . . . . . . . . 

b. Post surgical recovery patients . . . . . . . . ..a 

C. Patients trAnsferred from psychiatric facilities (such a8 mental hoe&tat CJP 

clinic, eta.) ................ . ............ d. Mentally retarded patients ................ e. Parsons with: 

(1) Hcart disease ........................ (2) 111 effects of a stroke .............. (3) Diabetes ............................. (4) Fractured hips ....................... (5) Crippling arthritis .................. (6) cancer ....................... . ....... 17) Blindneqs ............ ..% ............. (8) Alcoholism ........................... (9) Mental illness (that is. diagnosed by a physician (18 mentalZy ilt, not 

eenile OF mentatly retarded) ......... 

. 5. What is the minimum age for admittance into this 

facility? 

6. What is your most frequent, your highest, and 

lowest charge month for lodging, meals, 

types of persons? 

(1 

your per

nursing care. and other personal services? 

8. 

7. Arc 

by a 

1.0 

a. 

Intthl Paymant,Ll‘b care p,sn 

If you do not make monthly charges, cl 

please check the appropriate box. 

otnsr o3mcIfYl~~ I q 

all persons admitted 

rhc 

to this facility required to be examined r-’ physician within month prior to or after admissioll? I

L--l Ye57 2. 0 No (Skip to 81 

Patlant'r Psnonal PhYs1clan I 

Which of the following types of physi- cian usually performs the admitting HOIPItaIstall PhYsIcIan

cxnminntion for most patients?

(Chock ONE ho= Only.) stat, phyllCla" Of this fadw # 

34 
--- 

---.. ---- ,-L . SIX" LL;ci

8. Does a physician give a routine physical examination V” ND 

to all patients at least annually after admission? ..:...........-+ 

9. Which of the following recreational activities do you have 83 

for patients? (.\lurl; (S) 1111thut UPPI!.) 

Art, md crafrl prugrml . . . . . . . . . . . . . . . . 

Planned wci;ll activilic. (such as birthday purlits. card gnmrs. etc.) . . 

Trips to cunccrt,.play,,etc. . . . . . . . . . . . . . . . 

Other (Specify) . . . . . . . . . . 

Sonc. . . . . . . . . . . . . . . . . . . . . . . B 

11D. Does this facility provide professional rehabilitation services at this address? r-1 

I 

Yes 07 No cl (Skip to 11) L-J 

a. Which of the following do you b. LAST MONTH, what “as the AVERAGE 

pro~ide?(Jlurk (X) oN that DAILY number of patients receiving 

apply. these services? 

Physical rhnapy . . . . . . . . . . 

ocmptiod rImspy . . . . . . . . . 

Spcrchmdhmi~thm~ . . . . . . . 

b 0th (Specify) . . . . El 

1 1. Do your patients use any services of out-patient care clinics? 

‘ 1 Yes f-J 7 No q (Skip to 12) L--J I 

1 Fzg?zZf B a- Check the types of services your patients use..... 

ID. PATIENT TURNOVER AND CHARACTERISTICS 

1:2. How many admissions did you have during 1967? 

a. how many of the admissions during 1967 were from: TOId 

(1) Mental hospitals..................... 

(2) General hospitals.................... 

(3) Other hospitals...................... 

(4) Patient’s home....................... 

(5) Another nursing home................. 

(6) Other places (Specify) 

B 

1:3. How many discharges did you have during 1967, Numkr =od 

excluding deaths? 

a. How many of these patients discharged were Number El

admitted during 1967? 

11i. How many persons died during 1967 while patients of 

this facility? (Include all who died while on your register.) I Number I 

I! 5. What was your patient census last night? (Include Males 

all patients, eoen though they mny havr been fcmporarily 

way; exclude employees and proprietors.) , Femalea 

TOtd I H 

l( i. Do you participate in any of the Federal or State public assistance 

or medical assistance programs? (This includes Old Age Assistance, Aid lo the 

Blind, Aid to the Pcrmonentlyond Totally Disabled, Aid to I;nmifirs with Dependent 

Children. Aledicaid (XIX). or Alcdicare (Title X WI).) 

:--’ I 

I.--: 

1.0 Yes 2. 0 No (Skip to 17) 7 a. How many patients are currently receiving Public Assistance 

or Medical Assistance? (Include all prognzms EXCEPT bkdicnrc.) 

b. For how many patients are you NOW RECEIVING Medicare 

(Part A) payments? 

c. For how many patients are you NOT NOW receiving Medicare (Part 

A) payments because they have exhausted their benefit rights? El 

NUlUba 

35 
Yes 

17. Is there at least one Registered Nune (RN)- (rhar is, on the premircs and rourinely serving rhe 

patients) for PyEBy shift7 r-7 vcsn (Skip to 19) @cl (Answer 18) LA 

IO. PIcue check chc box chrr bdhtcs the level of skill of the “chqe nunc” who is ON DUTY (that ia, on the 

prcmire~ and routinely sewinS the patients) for each shift (If you do not have all of the shifts indicated below,

plcuccheck rhe “No such shift” box ncxI to the particular column.) 

I Shift No. 1 1 Shift No. 2, 0 No such thifr 1 Shift No. 3 q No such shift1 

a.= RN a. 0 RN P. 0 RN 

b. 0 LPN b. 0 LPN b. 0 LPN 

C. 0 Nune’r Aide E. u Nune’a Aide c. a Nur,e’r Aide 

d. 0 other (spq-y), d. 0 Other (specifu)- d. 0 Other (specrfu~­

19. coca chir facility employ a full-time staff physician for the NO 

cl (Skip to 194 

care of rhe pncicncr? . . . . . . . . . . . . : . . . . . . . . . . . . . . 

I Yes l-l I r 

How many are employed7

TII Number 

a. Dots this facility have an 

I

I 

At reguh interJaIl cl (Skip to 20) 

arrangement with a physician 

m come to this facility? When needed. but NOT at (skip to 20) 

(Murk IX), one 0nry.j . . . . . . . . . . . , . regular intenalr 

INeither of the above cl 

b. goes this facility have an arrangement with a 

in 

physician 

HISoffice 

(0 give 

I . 

medical 

. . . 

cue 

. . . 

to 

. 

the 

. . 

parienrs 

. . . . . . . . . . . . . . . . . , , . . No q 

20. Pleaseenter rhe number of full-rime and par-rime employees in this facility. (FulGtime maws 35 or more 

hours II week.) Counr each employee only once. in the occupation at which he spends most of his time. Also 

include all members of religious organizarions who contribute rhcir services. @ease con.4 the enclosed va to determinethe appropriatec&.ssif~ation of personnel.) 

Dietitian Medial Social Worker 

Regirtcrcd Occupational Therapist 

Other Occupational Thempius 

and Assistant, 

Adminiltntion) 

Qualified Pbvsiul Therapists Kitchen workers, lw,dty, howe. 

keeping and maintenance 

Plwsiol Therapist Assistant wrmnnd 

- All other pmonnel (wch ,I 

chauffeur. file clerk. elc.) 

TOTAL 1 1 1 TOTAL ( 1 J 

Name of penon completing this form Dae of Canpk~lon 

Tirlr Phone number of this tcilRv 

36 
DEFINITION SHEET 

DEFINITIONS OF EMPLOYEES 

Professional and Technical Nursing Personnel 

1. Registered nurse - a graduate of a State-approved school of professional nursing who is 

currently licensed as a registered nurse (R.N.) or is awaiting licensure to practice in 

your State; i.e., a recent graduate of a school of professional nursing, or a graduate 

nurse licensed in another State who recently moved to your State. 

2. Licensed practical/vocational nurse - a graduate of a State-approved school of practical nursing who is currently licensed as a licensed practical or vocational nurse (L.P.N. or 

L.V.N.) or awaiting licensure to practice, or an individual granted a license by waiver 

on the basis of experience or endorsement rather than upon completion of a prescribed 

course of study. 

3. Nursing aide, orderly, and attendant - one who assists the nursing staff by performing routine duties in caring for patients, under the direct supervision of professional or 

practical nurses. 

Other Professional and Technical Personnel 

4. 

5. 

6. 

7. 

8. 

9. 

10. 

11. 

12. 

13. 

14. 

Dietitian - one who plans nutritionally adequate menus, including modified diets, and 

supervises the preparation and service of meals for patients and personnel. Report & 

those dietitians who meet the educational qualifications of the American Dietetic 

Association. 

Occupational therapist - one who selects and directs physical, educational, social, and 

daily living activities designed to meet specific needs of mentally or physically disabled patients. 

Occupational therapy assistants - those who work under the supervision of the occupa­ tional therapist. Duties may include instructing patients in manual and creative arts 

and making special orthopedic devices such as splints and braces. 

Physical therapist - (report only those registered by the American Physical Therapy Association.) 

Physical therapy assistants - (report all other persons engaged in physical therapy service.) 

Recreation therapist - one who develops programs involving sports, crafts, trips, and 

music for rehabilitation and restoration of patients. 

Registered medical records librarian - (report only those registered by the American 

Association of Medical Records Librarians.) 

Other medical records librarians and technicians - (report all other persons engaged in 

medical records work.) 

Medical social worker - one who is professionally trained in a school of social work or 

who is "agency-trained" (as in public welfare departments) or is qualifted by related 

experience and who is capable of making a social evaluation of patients situations and 

of identifying social problems requiring service. 

Speech therapist - one who applies skills to help handicaeped persons speak in as normal 

a fashion as possible and understand the speech of others. 

All other professional and technical personnel - (include all other professional and 

technical personnel not reported in categories 1 to 13. Include also those individuals 

serving as Administrators.) 

37 
FAIL-EDIT QUESTIONNAIRE 

1 

U.S. DEPARTMENT OF HEALTH 

EOUCATION AN0 WELFARE 

PUBLIC HEALTH SERVICE 

NATIONAL CENTER FOR HEALTH 

STATISTICS 

WASHINGTON, OX. 

20201 

NURSING AND PERSONAL CARE 

FACILITIES SURVEY 

June 1968 

Dear Sir: 

Thank you for your cooperation during our earlier telephone 

conversation regarding the National Center for Health Statistics’ 

survey of all resident facilities providing nursing and 

care. The abbreviated questionnaire to which we referred 

conversation is on the back of this letter. It deals with 

on the numbers of patients admitted and discharged from 

and the number of people you employ. Also,in cooperation 

personal 

in our 

statistics 

your facility 

with the 

Veterans Administration, we are conducting a census of all male 

veteran patients. Please complete both forms within one veek and 

return them 

We wish 

identification 

will be used 

of the survey 

sons or for 

in the enclosed postage-paid envelope. 

to assure 

of your 

solely by 

and will 

any other 

you that any information which permits the 

facility will be held strictly confidential, 

persons engaged in, and only for the purposes 

not be disclosed or released to other perreason. 

We greatly appreciate your cooperation ln.this survey. 

Sincerely yours, 

Theodore 0. WoolseyDirector, 

National Center for Health 

statistics 
~ow many admissions did you have during 1967? 

a. How many of the admissions during 1967 were from: 

(11 Mental hospitals . . . . . . . . . . . . . . . . . . . . . . 

(2) General hospitals . . . . . . . . . . . . . . . . . . . . . 

(3) Other hospitals . . . . . . . . . . . . . . . . . . . . . . . 

(4) Patient's home . . . . . . . . . . . . . . . . . . . . . . . . 

(5) Another nursing home . . . . . . . . . . . . . . . . . . 

(6) Other places (Specify) El Number 

How many discharges did you have during 1967, excluding deaths? 

a. How many of these patients discharged were admitted during 1967? 

How many persons died during 1967 while patients of 

this facility? (Include a32 who died while on your

FeQieter.) 

What was your patient census last night? (Include

all patients, even though they may have been 

temporarily away; exclude employees and proprie­ tori.) 

TOtd 

or medical assistance Db you participate in any of the Federal or State public assistance programs? (l’his includes Old Age Assistance, 

Aid to the Blind, Aid to the Permanentty and TotaZly Dieabted, Aid 

to pamitioa with Dependent Children, Medicaid (XIX), OF Medicare 

(iit XVIII). )

1.q Yes7 2.0 No (Skip to 6) 

a. How many atients are currently receiving Public Assistance or Medica P Assistance? (Include all programs EXCEPT Medicare.) 

b. For how many patients are you NOWRECEIVING Medicare 

(Part A) payments? 

c. For how many patients are you NOT NOWreceiving Medicare (Part A) payments because they have exhausted their benefit rights? NU&X 

6. Please enter the number of full-time and part-time employees in this facility. (PuZt-time meane 3.5 OF mope hours a week.1 Count each employee only once, in 

the occupation at which

organizations 

he spends most of his time. Also include all members 

of religious who contribute their services. f~tease consult the 

enoloeed Definition of Employees to determine the appropriate classification of 

versonnet. 1 

Medicd Social Worker 

speechTherapist 

All other professional and technical 

Penonnd (include Administration) 

kitchen workers, laundry. house­ - keeping and maintmnnce perso~el 

- A,, other personnel (such as chauffeur. file clerk, etc.) 

TOTAL TOTAL 

Name of person completing this form Date of Completion 

Title Phone number of this facility 

L-i 
1967 MFI NURSING HOME QUESTIONNAIRE 

Dear Sir: 

Tbe Sational Center for Health Statistics (NCHS) of the U.S. Public Health Service is assembling an up-todate list of all facilities in the United States which provide some kind of medical, nursing, personal, domiciliary 

or custodial care. 

This rogram is bein conducted as B part of the U.S. Setional Health Surve authorized by Public Law 652,

84th e ongress. The ‘e urea” of the Census has been requested to act aa co1r”ecting agent for the WHS in, 

compiling the list. 

The purpose of this survey, in which you ace being asked to is to obtain current information, such as number of beds, staff size, and types of services 

will be used to compile statistics on the number end 

Sections A and B of this form request verification,of the name and address of the facility, type of service, ty e of orvnership, staff size and capacit Section C asks for additional information which is needed for detaile % 

statistics on otbercharacteristics or the facility. All information provided in Section C will be accorded 

confidential treatment by the Bureau of the Census and tbc Public Health Service and the statistics will be 

presented in such a manner that no individual facility CM be identified. 

For this purpose we are requesting tbat you complete tbisquestionnaire for your facility and return it within 

five days in the enclosed postage-paid envelope. The questionnaire is very brief and should take only a few 

minutes to complete. 

Thank you for your cooperation. 

Sincerely yours, 

A. Ross Eckler 

Director 

Bureeu of the Census 

I Section A - IDENTIFICATION OF FACILITY 

Please refer to the maililig label above, then make all additions and corrections according to the questions

below. Detailed identification information is needed to prevent duplicate listings and to assure that your

facility is properly represented in our files. /Please &pe or print) 

Is the NAME shown in the label above Correct name of facility if differen; from above 01 correct for your facility? 

lC3 Yes 

zC3 %--Please line through name’in label 

and enter correct name -

02 Is your facility know” by any othw NAMES(S)? o’ber “ameS Of yc”r faci1ity 

I [] Yes--Please gice other name(s)- -------------c----------

2[3 so 

Is the address shown in tha lobal above the 

correct mailing address for your facility? 

So-Please give complete address /or 

1 , 

40 

I 
GENERAL INSTRUCTIONS FOR COMPLETING QUESTIONNAIRE 

o. Includs in this rsport information for the facility named in the mailing label or for its successor if the 

name or owner has than cd. Include information for on. facility only, but report for the sntirs facility

including infirmaries anf other subunits. 

b. Due to name and address changes, duplicate listings in our file, or other reasons, you may have been 

sent more then one questionnaire under different names or addresses. If you r*ceiv* mar* than on* 

form for the same facility, complete on. only and return all otherswith the notation “Completed and 

rerurned under . . . (give name of facility on completed form).” 

C. Answw all questions, please. Definitions and special instroctions are given with the questions when 

needed. 

d. R*turn thr compl*trd qu*stionnoir* in the ostage paid envelope provided, to: Jeffersonville Census 

Operations Office, 1201 East 10th Street, ! effersonville, Indiana 47130. 

S*ction B - CLISSIFICATION INFORMATION 

PI*os* plot* on “X”‘ir only ONE box forth* typ* PI*os* road ALL of th* following, tb*n ch*ck 

3 

6 of organization operating your facility. The type 0

7 

th* ONE term which b*st d*scrib*s your facility. 

of organization legally responsible for the opera- Ckeck one only tion of the facility. Check only OAR no 0 Nursing Home 

110 State u 0 Convalescent Home 

~20 Rest Home 

120 County IIS0 Home for the Aged 

84 0 Boarding Home for the Aged 

4-J City Stare-Local r.oq Home for Crippled Children 

Govemmenr ra 0 Home for Needy 

740 City - Counry m 0 Home for Incurables 

II 0 Home for the Mentally Retarded 

150 SD0 Other - Please describe 7 

-----------------. 

Do*s your facility s*rv*: Check only one 

II 0 Ansed Forces 11 Primarily children (under 21) 

* q Primarily adults (21 or over)

180 Veterans Administration s 0 Both children and adults 

40 Other age limitation - sPecilv 

7 

-_------_--------. aon Church related 

Door your facility s*rv*: Check only one 

210 Nonprofit corporation t I-J %slcs only 

20 Females only 

so Both males and females 

~30 Individual What is the TOTAL NUMBER OF BEDS r~ularly 

maintoinod for poti*nts or r*sid*nts? 

Include 011 beds set up and staffedfor use whethe 24q Partnership or not they ore in use ot the present time. Do NO’ 

include beds used by staff or owners and beds 

used exclusively for emergency services. 

Total beds 

Section C - INFORMATION FOR STATISTICAL USE ONLY 

1, What is th* total NUMBER OF PERSONS (pati*nts 0

13 Which of th* following s*rvic*s CM* ROUTINELY 

3 or r*sid*ntr), who stoy*din yourfocility lastnight? provid*d? Check all that apply. 

Do NOT include employees or owners. 

Number of prraons 10 Supervision is provided over medications 

which may be self-administered 

2 0 &dicar ions end treatments are administered in accordance with physicians 

3 PERSONS in question 11 &*iv*d “Nursing Core”? 

Consider that o person received “Nursing Lore” 

if he received o”y of the following services: 

a[7 

40 

Rub and “Wssage 

Help with tub bath or shower 

50 Help with dressing 

During the post s*v*n days how meny of th* orders 

Nasal feeding Tempera~re-pulse- 6 0 Help with correspondence or shopping Catheterization rrspirarion 

Irrigation Blood pressure r 0 Help with walking or getting about 

Ox gen therapy Application of dressing 8 0 Help with eating Fuyl bed bath or bandage 

Enema Bowel and bladder 

Hypodermic injecdon retraining OR 

Intravenous injection 

90 Notre sp a nsl‘bl e for providing any service 

Number of persons except room and hoard - /If tkis box is 

checked no other box skouZd be ckccked 

in question 13.1 

41 
Section C - INFORMATION FOR STATISTICAL USE ONLY (Continued) 

gh W at is th’c total number of full-time personnel on the 16 Doer the owner of this facility own 01 operate any 

payroll of this facility? Full-time personnel ore 0 related or similar facility providing inpatient sarvica 

those who usually work 35 hours or more per week. which is NOT included in this report?

Include owners, monogers, ond members of religious For example, another facility of the type listed in 

orders who work full-time whether on the payroll or question 7 or o hospital, or other institution. 

not. Do noinclude t volunteers, private duty nurses, 

ond port-time employees. I Yes 20 No+Go to 17

TOTAL full-time personnel P 

Please provide the followiitg in&nation for all 

other facilities owned. Use the “Comments” sectio 

if additional space is needed or attach o separate 

Of the above personnel, how many arc: listing when available. 

Name of facifiry 

a. Licensed registered 

““rse8. . . . . . . . . Type of facility 

b. Licensed ractical or Address -Number and street vocationa P nurses. . 

5 What is the NAME of the person, corporation, or City I other organization which owns this facility? 

Name State i ZIP code 

i 

ame of person completing this form 1 Date 

I 

Title 

~OMZIENTS - General comments we invited as well as comments on specific items. 

Q U. S. GOVERNMENT PRINTING OFFICE : 1973 516-2OW30 

42 
VITAL AND HEALTH STATISTICS PUBLICATION SERIES 

Formerly tiblic Health Service Publication No. 1000 

Series 1. Programs and collection procedures. -Reports which describe the general programs of the National 

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

and other material necessary for understanding the data. 

Series 2. Data evaluation and methods research. -Studies of new statistical methodology including: expeli.. 

mental 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. 

Series 3. Analvtical studies.-Reports presenting analytical or interpretive studies basedon vital and health 

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

Series 4. Documents and committee reports .-Final reports of major committees concerned with vital and 

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

birth and death certificates. 

Series 10. Data from the Health Interview Survev.- Statistics on illness, accidental injuries, disability, use 

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

collected in a continuing national household interview survey. 

Series 11. Data from the Health Examination Survey. -Data from direct examination, testing, and measurement of national samples of the civilian, noninstitutional 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 v+thout 

reference to an explicit finite universe of persons. 

Series 12. Data from the Institutional Population Surveys -Statistics relating to the health characteristics of 

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

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

Series 13. 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. 

Series 14. Data on health resources: manpower and facilities.-Statistics on the numbers, geographic disrribution, and characteristics of health resources including physicians, dentists, nurses, other health 

occupations, hospitals, nursing homes, and outpatient facilities. 

Series 20. Data on mortality. -Various statistics on mortality other than as included in regular annual or 

monthly reports- special analyses by cause of death, age, and other demographic variables, also 

geographic and time series analyses. 

Series 21. Data on natality, marriage, and divorce.- Various statistics on natality, marriage, and divorce 

other than as included in regular annual or monthly reports--special analyses by demographic 

variables, also geographic and time series analyses, studies of fertility. 

Series 22. Data from the National Natality and Mortality Surveys.- Statistics on chai-acterisdcs of births 

and deaths not available from the vital records, based on sample surveys stemming from these 

records, including such topics as mortality by socioeconomic class, hospital experience in the 

last year of life, medical care during pregnancy, health insurance coverage, etc. 

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

National Center for liealth Statistics 

Public Health Service, HSMHA 

Rockville, Md. 20852