NATIONAL CENTER Series 12 

For HEALTH STATISTICS I Number 10 

VITAL and HEALTH STATISTICS 

DATA FROM THE NATIONAL HEALTH SURVEY 

Nursing and Personal 

Care Services 

Receivedby Residentsof 

Nursing and Personal Care Homes 

UnitedStates-May-June1964 

Statistics on nursing and personal care services, selected chronic 

conditions and impairments, time interval since resident last saw 

doctor, mobility status, length of stay, nurse or nurse’s aide on 

duty, supervisory nurse, type of care provided at time of admission, 

primary type of service, and ownership in nursing and personal care 

homes. Based on data collected during the period May-June 1964. 

Washington, D. C. September 1968 

U.S. DEPARTMENT OF 

HEALTH, EDUCATION, AND WELFARE Public Health Service 

Wilbur J. Cohen William H. Stewart 

Secretary Surgeon General 
Public Health Service Publication No. lOOO-Series 21.No. 16 

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

Washington, D.C ,, 20402 - Price 40 cents 
NATIONAL CENTER FOR HEALTH STATISTICS 

THEODORED. WOOLSEY,D~WC~OT 

PHILIP S. LAWRENCE, Sc.D., Associate Di7ector 

OSWALD K. SAGEN, PH.D.,, A ssistant Director for Health Statistics Development 

WALT R. SIMMONS, M.A., Assistant Director /or Research and Scientific Development 

ALICE M. WATERHOUSE, M.D., Medical Consultant 

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

MARGERY R. CUNNINGHAM, lnformafion Olficer 

DIVISION OF HEALTH RESOURCES STATISTICS 

SIEGFRIED A. HOERMANN, Director 

JOlIN MONROE, hf.&, Assistant Director 

PETER L. HURLEY, Chic/, Health Facilities Statistics Branch 

JACQUELlNI< GLEASON, Chief, Health Manpower Statistics Rranch 

E1)Y’I’HE A. GRAY, M A., Chief. Hospital Discharge Survey Branch 

COOPERATION OF THE BUREAU OF THE CENSUS 

In accordance with specifications cstahlished by the 

Sationnl Health Survey, the Bureau of the census, undctr a 

contractual agreement, participated in the design and stllcction of the sampl(l, and carried out the first stage of tho field 

intcarvic\ving and cCrtain parts of the statistical processing. 

Public Health Service Publication No. 1000~Series 12-Ho. 10 

Library o/ Congress Catalog Card Number 68-60076 
-------- 

CONTENTS 

Introduction -----_----------_-----------------------------------------

Selected Findings ________________________________________-------------

Sour-e and Qualifications of Data ___________ _____________________________ 

Level of Nursing and personal Care _____________________________________ 

Age and Sex of Resident---------------------------------------------

Number of Chronic Conditions and Time Interval Since Last Saw Doctor---

Selected Chronic Conditions and Impairments--------------------------

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

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

Type of Nursing Supervision ________________________________________-

Primary Type of Service ando~ership _______________________ 

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

Specific Types of Nursing and Personal CareServices---------------------

Age and Sex of Resident---------------------------------------------

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

Number of Chronic Conditions and Impairments------------------------

Detailed Tables --__-_--------_---_------------------------------------

Appendix I. 

A. Technical Notes on Survey Design _________________________________ 

B. General Qualifications ________________________________________---

Appendix II. 

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

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

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

D. Basic List of Diagnostic Categories Reported for Residents in Nursing 

and personal Care Homes----------------------------------------

Appendix III. Resident Questionnaire and Other Survey Forms-------------

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IN THIS REPORT Ye&dents of nuvsi~ and personal caYe homes ave 

described by level of care given to them in tevms of the& health and 

Yelated chavactevistics, and certain health services which they yeceived. 

The Resident Places Survey (RPS-2) of the Nation’s nursing and pevsonal care homes determined which nursing OY pwsonal caye services 

weye being provided for the Yesidents of these homes. These services 

wme pouped into levels of cave fov the purpose of indicating the intensiveness of caye a Yesident Yeceived. 

A moye intensive level of caye was provided to groups of residents at 

the older ages, and women generally Yequived a bighev level of care 

than men. 

As limitation of mobility increased, lavgev proportions of Tresidentsyeceived some level of nursing caye and conversely smaller pyopovtions 

received personal caye. The percents of floups of residents Yeceiving 

some level of nursing care generally decreased as length of stay increased. 

Fairly high levels of care weve yequived for some specific chronic conditions such as cavdiovasculav conditions, rheumatism and avthvitis, 

and advanced senility. 

Ooe~ two-thirds of the residents Yeceived some level of nursing caye 

in homes in which either a yegisteved nurse (RN) OYlicensed practical 

nurse (LPN) was the supevvisovy nurse cornpaved with about two-fifths 

of the Yesidents in homes in which neither an RN ?WYan LPN was supevvisor. Homes with 24-hour-a-day nuvsiw sevvice provided higher 

levels of nuvsin~ cave than homes which pYo,uidedfewer hours of nuvsing service. 

According to geographic region, the South had the largest pyopovtion of 

residents Yeceiving nursing cave (68 pevcent) and the West the lowest 

(52 pevcent). The South had the lowest proportions of residents yeceiving either pevsonul caye OYnone of the services. 

The proportions of Yesidents receiving a specific nursing OYpevsonul 

cave service increased as the number of chronic conditions and impairments increased. This increase was generally found move often fov 

the six personal caye sevvices than for the 13 nuvsing care services. 

Of the 19 nuysing OYpersonal caye services in which theve weve sex 

diffeeventials, theve was a preponderance of females ovey males at 

almost all age levels. 

SYMBOLS 

Data not available ________________________ ___ 

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

Quantity zero ____________________________ _ 

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

Figure does not meet standards of * reliability or precision------------------
NURSING AND PERSONAL CARE SERVICES 

RECEIVED BY RESIDENTS OF NURSING AND 

PERSONAL CARE HOMES 

Roy Morgan, Division of Health Resources Statistics 

INTRODUCTiON 

The data in this report are basedonthe findings of a sample survey of institutions in the 

United States which provide nursing or personal 

care to the aged and chronically ill. The survey, 

referred to as Resident Places Survey-2, was 

conducted during May and June of 1964 by the 

Division of Health Records Statistics in coeperation with the U.S. Bureau of the Census.The survey estimated that 554,000 persons were residents 

or patients in the 17,400 nursing or personal care 

homes in the Nation during the period May-June 

1964. At the time of the survey, these residents 

were receiving a variety of nursing and personal 

care services. The survey questionnaire asked 

which of the 13 nursing care services and six 

personal care services each resident was receiving (Card F, Appendix III). These 19 services 

were grouped into levels designed to indicate the 

intensiveness of care by a procedure described 

in Appendix II. 

SELECTED FINDINGS 

Residents were fairly evenly distributed 

among the three major levels of care. Slightly 

more residents received the intensive level of 

care (31 percent) than the levels of other nursing 

care (29 percent) and personal care (27 percent). 

A greater proportion of females than males were 

given intensive nursing care, while larger proportions of males received other nursing care, 

personal care, and neither nursing nor personal 

care. Age was directly related to the intensity 

of care with a more intensive level provided at 

the older ages. 

There was a relationship between specific 

chronic conditions and level of care since some 

of the conditions-cardiovascular conditions, advanced senility, and arthritis and rheumatismrequired fairly high levels of care. 

As the degree of mobility limitation increased, the intensity of the level of care increased. Intensive nursing care was received by 

73 percent of those residents who were limited 

to their beds,37 percent who were room limited, 

and 18 percent who had no restriction of mobility. 

The intensity of nursing care decreased with 

increasing length of stay. The proportions of 

residents under intensive nursing care and under 

other nursing care generally decreased as the 

length of stay increased. Similarly, proportions 

of residents receiving neither personal nor nursing care increased as their length of stay increased. 

The higher the level of care, the more complete was the coverage of nursing service. Homes 

with 24-hour nursing service provided higher 

levels of nursing care than homes providing fewer 

hours of nursing service. The intensity of the 

level of care was related to the type of supervisory nurse. In homes with either an RN or an 

LPN as supervisor, over two-thirds of the residents were given some nursing care. Nursing 

care was given to two-fifths of the residents in 

1 
homes where neither an RN nor an LPN was 

supervisor. 

There was a relationship between the type 

of care a resident received when he was admitted 

to a home and the level of care he was receiving 

when the survey was conducted. The predominant 

level of care given to residents in a home generally corresponded to the primary type of service of the home. One of the four levels of nursing care was received by 75 percent of residents 

in nursing care homes. In personal-care-withnursing homes, 32 percent received some level 

of nursing care and 38 percent, personal care. 

Some 93 percent of the residents in personal care 

homes were given personal care or none of the 

services. The South Region had the largest proportion of residents receiving some level of nursing care (68 percent) and the West the lowest 

(52 percent). Percentage distributions by level 

of nursing care were similar for the Northeast 

and North Central Regions. 

Although there was little sex and age difference in the proportions of males and females 

receiving the 19 selected nursing and personal 

care services, the services for which there was 

a difference showed a preponderance of females 

over males at almost all age levels. 

As one might expect, the proportions of residents receiving a specific service increased 

with the number of chronic conditions and impairments. This was the case with the six personal care services and was true to a lesser 

extent of the 13 nursing care services. 

When the residents were classified according 

to their mobility status, a higher proportion of 

the more restricted groups (bed and room limited) received more nursing and personal care 

services than those with no limitation. 

SOURCE AND QUALIFICATIONS 

OF DATA 

The scope of the Resident Places Survey 

(RPS-2) included such institutional establishments as nursing homes, homes for the aged,and 

similar types of places, as well as geriatric 

hospitals. Two basic criteria for including an 

establishment in the survey were (1) it must 

routinely provide some level of nursing or personal care and (2) it must maintain three or 

more beds for residents or patients. Thus homes 

providing only room and board to aged people 

were not within the scope of the survey. 

RPS-2 was a multiple purpose survey, collecting statistics about establishments, the residents or patients living in the establishments, 

and the employees of the establishments. Reports 

have been published on the number and types of 

employees; l on their work experience, special 

training, and wages;2 and on chronic illness of 

residents as reflected by the number of chronic 

conditions and impairments.3j4 This report describes the relationship of nursing and personal 

care services to characteristics of residents, 

to aspects of the health of the residents, and to 

classification of establishment variables. 

In order to properly interpret the statistics 

presented in this report, one should become 

familiar with the material in the appendixes. 

Appendix I gives a general description of the 

survey, the sampling frame used, the sample 

design, and the survey procedure. Imputation 

procedures, estimation technique, and sampling 

variation are also discussed. Tables and charts 

of standard errors are provided with illustrations 

of their use. Definitions of terms, the procedure 

for classifying establishments, rules for diagnostic coding, and the list of diagnostic categories 

are shown in Appendix II. Facsimiles of questionnaires and forms used in the survey are shown 

in Appendix III. 

It is important to note that classification of 

the establishments is based on the typeof service 

provided in the home and on the availability of 

nursing staff, rather than on what the home is 

called or how it is licensed by the State. 

The principal variables in this report are 

related to two questions on the resident questionnaire in Appendix III. These questions asked about 

the nursing and personal care services which a 

resident had received during the previous 7 days 

and at the time he was admitted to the home. These 

nursing and personal care services are listed in 

detail in item 17 of the questionnaire and Card F 

of Appendix III. To aid in analysis, these nursing 

and personal care services have been grouped 

into levels of nursing care and personal care. 

This procedure is described in Appendix II. 

The data on chronic conditions and impairments were obtained from proxy respondents 

2 
such as nurses or other personnel available in 

the homes who were considered to be the persons 

best acquainted with the health of the residents. 

Respondents reported conditions for each sample 

person on the basis of their personal knowledge, 

supplemented by medical records. All conditions 

reported for a person were recorded on the questionnaire, and all such conditions were coded and 

tabulated for this analysis. It should be pointed 

out, however, that every chronic condition or 

impairment a person had may not have been 

reported, since the question contained only certain ones that were specifically requested. Those 

asked about, listed in Appendis III, were the ones 

thought to be most relevant to this population. 

In general, the International Classification 

of Diseases’ was used in coding conditions. 

supplemented by a special procedure for classifying impairments. The list of conditions and 

impairments and the rules used in the coding 

process appear in Appendis II. This report 

does not attempt to compare residents on the 

basis of the specific combination of chronic 

conditions and impairments they might have 

had. Conditions are treated separately, and individual conditions are related to other characteristics of the individual. 

LEVEL OF NURSING AND 

PERSONAL CARE 

Age and Sex of Resident 

A higher level of care (intensive care and 

other nursing cart) was rec:.uired at older ages 

(fig. 1). ,\ direct relationship was seen between 

a+ :InLi intenAve nursing c3re. increasing from 

2.5 percent of the residents under 6.5 years to 

37 percent of the residents over age 85. About 

one-fourth of the residents under age 65received 

other nursing care services while somewhat 

higher proportions of the older age groups received this level of care. Of those residents receiving personal care, there were generally 

smaller proportions in the older age groups. 

However, this does not mean that older people 

did not receive personal care services because 

these categories are mutually esclusive and residents are classified according to the highest 

level of care received. Therefore many of the 

older resicients who are classified as receiving 

PERCENT DISTRIBUTION 

0 25 50 75 100 I I 8-i-I 

Age -

All ages 

Under65 years 

65- 74 years 

Neither nursing nursing nor personoI 

Figure I. Percent distribution of residents of 

nursing and personal care homes, by level of 

patient care according to age. 

nursing care are probably also receiving personal 

care services. Just as the older age groups 

received higher levels of care, there was an 

inverse relationship between increasing age and 

the proportions of age groups receiving none 

of these levels of care. 

hlen generally required less intensive levels 

of care than women; there were higher proportions 

of men receiving other nursing care, personal 

care, and none of the levels of care (table A and 

fig. 2). About one-fourth of male residents required inten.i;ive nursing care while over onethird of female residents were given such care. 

Not only was there a greater proportion of 

females than of males receiving intensive nursing care, but the excess of females over males 

was found in all age groups. Data by age and 

sex are presented in table 1 by more detailed 

levels of care. 

Number of Chronic Conditions and Time 

Interval Since Last Saw Doctor 

Figures for the average number of conditions 

hy age are given in a previous rep0rt.a in which 

the relationship of increasing number of condi3 
Table A. Number and percent distribution of residents of nursing and personal care

homes, by level of patient care according to sex: United States, May-June 1964 

Number 

Sex of 

residents 

PERCENT DISTRIEUTIDN 

0 20 40 60 80 

Neither nursing nor persona1 

Figure 2. Percent distribution of residents of 

nursing and personal care homes, by age and sex 

according to level of patient care. 

Level of patient care 

tions with advancing age and a concomitant relationship of an increase in the level of patient 

care with an increase in the number of chronic 

conditions and impairments are described. 

The number of chronic conditions and the 

interval since the resident last saw a doctor 

are discussed in this section in order to show how 

they relate to the level of patient care. As the 

number of conditions increased, there was an 

increase in the frequency of doctor visits and 

the proportion of those patients who had seen a 

physician during the last 3 months versus those 

who had not (table R). 

For each level of care, there were also increasing proportions of residents who had seen 

a doctor in the past 3 months as the number of 

conditions increased, except for less intensive 

care where the proportions remained relatively 

constant. Generally, when it had been more than 

3 months since a resident had seen a doctor, the 

proportions of such residents in each level of 

care decreased as the number of conditions increased. This decrease also applies to the 

situation in which the resident had not seen a 

doctor. As might be expected, fewer residents 

receiving only personal care or no service 

had seen a doctor during the last 3 months than 

residents receiving some nursing care. However, 

the differences within nursing care levels were 

slight. This in general was also true for the 

various number-of-condition categories. 
Table B. Percent distribution of residents of nursing and personal care homes, by number of chronic conditions and impairments and time interval since last saw doctor 

according to level of patient care: United States, May-June 1964 

Level of patient care 

Number of chronic 

conditions and time All 

interval since last levels 

saw doctor -+ 

All conditions--- 100.0 100.0 

Under 3 months---------

3 months or over-------

74.6 

21.1 

83.9 

13.9 

Doctor not seen-------- 4.3 2.2 

No conditions---- 100.0 

Under 3 months--------- 49.1 

3 months or over------- 32.2 

Doctor not seen-------- 18.7 

5 conditions----- 100.0 -1 100.0 

Under 3 months--------- 83.4 87.3 

3 months or over------- 15.5 12.1 

Doctor 

1-2 conditions--- 100.0 100.0 

Under 3 months--------- 79.9 

3 months or over------- 18.0 

Doctor not seen-------- 2.1 

3-4 conditions--- 100.0 100.0 

Under 3 months--------- 78.2 82.7 

3 months or over------- 19.0 13.5 

Doctor not seen-------- 2.8 3.8 

not seen-------- I 1.1 0.6 

Selected Chronic Conditions and Impairments 

The data on chronic conditions and impairments which were collected through use of interview cards D and E shown in Appendix III were 

classified according to a scheme described in 

Section C of Appendix II. Table 2 presents data 

on 35 conditions by the level of care the patient was 

given. Nine of the 35 conditions and impairments 

are presented in table C. As can be seen, the 

rates for residents with certain conditions were 

lower for patients in each succeeding lower level 

Percent distribution 

100.0 100.0 1 100.0 1 100.0 1 100.0 

81.8 88.6 79.7 / 68.6 53.7 

15.7 10.7 ‘I-; 26.6 33.9 

2.5 0.7 / . ~ I 4.8 12.4 

100.0 100.0 / 100.0 100.0 100.0 

t 

54.4 100.0 i 70.5 

36.7 - / 19.3 

8.9 - 10.2 11.7 22.6 

100.0 100.0, 100.0 I 100.0 100.0 

77.7 t 66.7 53.2 

17.6 27.8 34.2 

4.7 5 . 5 12.6 

100.0 100.0 100.0 100.0 / 100.0 

t 82.5 88.8 81.0 70.6 I 61.8 

15.6 10.6 16.1 25.4 / 34.0 

1.9 0.6 2.9 ~ 4.0 ~ 4.2 

.oo.o 100.0 ~ 100.0 100.0 i 100.0 

84.7 88.0 72.7 78.6 

14.0 11.5 25.0 21.4 

1.3 0.5 2.3 

of care. This fact emphasizes the possibility 

that the more debilitating conditions generally 

require higher levels of care. 

The two most prevalent conditions werevascular lesions affecting the central nervous system, 

with a rate of 340 per 1.000 residents, and diseases of the heart, with a rate of 283. As seen 

in table C, the rate of vascular lesions affecting 

the central nervous system was 516 for residents receiving intensive nursing care, 370 for 

other nursing care, 236 for personal care, and 

75 for none of these services. Residents receiv5 
ing intensive nursing care had diseases of the 

heart at a rate of 326 per 1,000 residents; the 

rate for those under other nursing care was 361. 

Diseases of the heart were reported for 224per 

1,000 residents under personal care and 133 

per 1,000 residents receiving no nursing or personal care services. 

The rate for arthritis and rheumatism for 

all residents was 221 per 1,000, ranging from 

252 for residents under intensive nursing care 

to 172 for those receiving no nursing or personal 

care services. The overall rate of residents with 

advanced senility was 218, with a range from 

314 per 1,000 residents under intensive nursing 

care to 28 per 1,000 residents receiving no services. This would indicate that advanced senility 

is one of those conditions requiring fairly high 

levels of care. A similar case appears for paralysis or palsy due to stroke, a condition which 

was reported for 120 of 1,000 residents; the 

range of rates reveals a high of 230for residents 

under intensive nursing care and a low of 27 

for residents receiving 

for visual impairments 

dents. with the highest 

intensive nursing care 

for those receiving no 

no services. The rate 

was 121 per 1,000 resirate (166) for those under 

and the lowest rate (42) 

services. 

Hearing impairments for all residents showed 

a rate of 188 per 1,000, but the range in rates 

by level of care was not as wide as that for most 

other conditions in table C. Residents under 

intensive nursing care had a rate of hearing 

impairments of 211 per 1,000 and this rate decreased as the level of care decreased to a rate 

of 147 per 1,000 for residents receiving none of 

the services. Malignant neoplasms was in the 

lower third by size of rate of the 35 selected 

chronic conditions and impairments presented in 

table 2. The rate was 33 per 1,000 for all residents. Malignant neoplasms was reported for 49 

per 1,000 residents under intensive nursing care, 

decreasing by intensity of care to 16 per 1,000 

residents receiving none of the services. 

Table C. Number of residents and rate of specified chronic conditions and impairments 

per 1,000 residents of nursing and personal care homes, by level of patient care: 

United States, May-June 1964 

-n Level of patient care 

Chronic conditions and impairments 1”‘lsI,...,,; 

Number of residents 

All residents------------------ 554,000 I[ 171,800 1158,800 1 148,800 1 74,600 

Rate per 1,000 residents in specified

level of care 

Malignant neoplasms------------------ 33.3 48.7 36.9 20.4 1509

Advanced senility-----.-------------- 218.4 313.6 233.5 187.9 27.7 

Vascular lesions affecting central 

nervous system---------------------- 339.5 515.5 235.8 75.4 

Diseases of the heart---------------- 282.6 325.9 SK 224.0 133.0 

Arthritis and rheumatism------------- 220.8 252.0 234: 9 194.2 171.9 Visual impairments------------------- 120.5 165.7 114.0 114.5 42.2

Hearing impairments------------------ 187.6 210.6 196.2 172.2 147.0 

Paralysis or palsy due to stroke----- 120.3 229.5 101.4 61.3 26.5 

Impairments of limbs, back, or trunk- 135.8 180.1 129.3 !124.5 70.1 --.__ 

6 
Table D. Number and percent distribution of residents of nursing and personal care 

homes, by level of patient care according to sex and mobility status: United States, 

May-June 1964 

Level of patient care 

Sex and mobility status of

Number All Neither 

Other Personal nursing residents levels 

Intensive nursing personal II I I I 

Percent distribution 

Both sexes---------- 554,000 100.0 28.7 26.9 13.5 ___-

Bed limited--------------- 92,200 100.0 73.1 17.3

Room limited-------------- 116,900 100.0 33.2 2x E 

Neither------------------- 344,900 100.0 z-2. 30.1 32:4 19:8 

Male---------------- 193,800 100.0 25.2 30.1 28.7 15.9 __- -

Bed limited--------------- 29,300 100.0 68.5 18.9 11.7 0.9

Room limited-------------- 33,100 100.0 29.8 40.8

Neither------------------- 131,400 100.0 14.4 30.0 z . 24:; 

Female-------------- 360,200 100.0 34.2 27.9 25.9 12.1 

Bed limited--------------- 62,900 100.0 75.2 16.6 0.9

Room limited-------------- 83,800 100.0 40.4 30.2 2E

Neither------------------- 213,400 100.0 19.6 30.3 31:8 12:83 

-

Mobility Status just to walk, shop, or visit with friends or relatives and so forth?” Residents who were routinely 

Previous reports have shown that as age taken out of the room in a wheelchair for most 

increases the resident’s mobility decreases, and of the day were considered neither bed nor room 

that as the number of chronic conditions in- limited and thus were included in this last group. 

creases, bed and room limitation increase.E’.ti The Data on level of care by ses and mohilit! 

level of nursing care is also related to the degree *tXus are presented in table D. In this report 

of mobility limitation. 17ersons classified as bed limited were not inThe respondent was asked the following ques- cluded in the group which was classified as room 

tions about the resident: “Does he stay in bed all limited. The important aspect of comparison 

or most of the day?” “Does he stay in his own between the two groups is the degree of health 

room all or mot+ of the day?” and “Does he go as reflected by the degree of limitation. 

off the premises lust to walk, shop, or visit with A direct relationship between bed limitation 

friends or relatives and so forth?” The residents and level of care is seen in table D. Among those 

for whom “yes” was checked for the question residents who were bed limited. 73 percent re­

“Does he stay in bed all or most of the day?” are ceived intensive nursing care; 17 percent, other 

defined as being bed limited. Those for whom nursing care; 9 percent, personal care; and 1 

“yes” was checked for “Does he stay in his room percent, none of these services. The same charall or most of the day?” are defined as room acteristic of increasing proportions of residents 

limited. The remaining residents are defined as in each succeedingly higher level of care occurred 

neither bed nor room limited if “yes” or “no” for residents who were room limited, although 

was checked for “Does he go off the premises the relationship was not as strong as for bed7 
limited residents. There was no particular pattern by level of care for residents who had 

neither bed nor room limitation. Their proportions were about the same for those receiving 

other nursing care and personal care, and for 

those receiving intensive care and none of the 

services. 

Length of Stay 

In this report, length of stay refers to the 

interval of time between the date of admission 

to the home and the date of the survey. Lengthof-stay statistics represent only the most recent 

stay for a resident with multiple admissions 

and do not represent the total length of stay in 

the homes. 

Generally, the greater the length of stay, 

the smaller the proportion of residents receiving 

some level of nursing care, decreasing from 66 

to 47 percent, and conversely the greater the 

proportion of residents receiving none of the 

services, increasing from 9 to 23 percent (fig. 3). 

Of residents who had been in a nursing or personal care home less than 1 year, 35 percent 

received intensive nursing care, while there 

was a decrease to 23 percent for those residents 

who had been in the home 5 years or more. For 

residents who had been in the home less than 2 

years, there were increasing proportions of 

residents in each succeedingly higher level of 

care. For lengths of stay of 2 or more years 

these increases were not consistent across all 

four levels of care. 

Although it might appear that residents are 

neglected as their length of stay increases, data 

comparing the care the resident received at the 

time he was admitted to the home with the care 

he received at the time of the survey indicate that a 

resident continues to receive generally the same 

level of care which he received at admission 

(table E). Item 13 of the RPS-2 questionnaire 

asked what kind of care a resident received when 

admitted to the home-primarily nursing care, 

primarily personal care, or room and board 

only. These three types of care are defined in 

Appendix II. For the group which received primarily personal care at admission the largest 

portion was still receiving personal care at the 

time of the survey, and this proportion had no 

PERCENT DISTRIBUTION 

0 25 50 75 100 

I I # I , Length of 

SIOY -

Total 

Under I year 

I to 2 years 

2 to 3 years 

3 to 5 yeors 

Intensive m Personal 

Other nursing 

Figure 3. Percent distribution of residents of 

nursing and personal care homes, by level of 

patient care according to length of stay. 

direct relationship with length of stay. The largest 

portion of residents who had received room and 

board at admission were not receiving any of the 

nursing or personal care services at the time 

of the survey, and again there was no direct 

relationship between the proportions and the 

length of stay. In the group which received 

primarily nursing care at admission there was 

little change in the proportions of residents by 

level of care as length of stay increased up to 

3 years; for lengths of stay of 3 years or longer 

there was a slight shift of residents from the 

level of nursing care to that of personal care. 

Type of Nursing Supervision 

As could be expected, there weredifferences 

by level of care according to whether there was 

8 
Table E. Number and percent distribution of residents of nursing and personal care 

homes, by level of patient care according to type of care received when admitted to 

home ar,d length of stay: United States, May-June 1964 

Level of patient care 

Type of care received when admitted Number All of Neither and length of stay residents ievels 

Nursing Personal nutmeg 

1 personal 

Percent distribution 

Primarily nursing care--------- 322,400 100.0 79.8 19.0 1.3 

Under 1 year------------------------- 123,000 100.0 17.6

1 to 2 years------------------------- 71,300 100.0 ix 17.7

2 to 3 years------------------------- 44,100 100.0 80:3 18.3

3 to 5 years------------------------- 44,000 100.0 77.6 20.9

5 years and over--------------------- 40,100 100.0 72.8 23.9 

Primarily personal care-------- 97,600 100.0 42.9 46.9 10.1 

Under 1 year-------------------------

1 to 2 years-------------------------

2 to 3 years-------------------------

3 to 5 years-------------------------

5 years and over---------------------

31,000

20,200

15,000

15,400

16,000 

100.0 

100.0 

100.0 

100.0 

100.0 

42.4 

43.1 

47.1 

41.5 

41.3 

48.6 

48.3 

44.3 

48.3 

43.1 

i$p 

10:3 

15.6 

Room and board only------------ 134,000 100.0 23.5 31.3 45.2 

Under 1 year-------------------------

i to 2 years-------------------------

2 to 3 years-------------------------

3 to 5 years-------------------------

5 years and over---------------------

30,200

21,500

17,100

23,100

42,100 

100.0 

100.0 

100.0 

100.0 

100.0 

25.0 

20.8 

24.1 

20.4 

25.2 

30.8 

32.7 

25.6 

36.5 

30.3 

44.2 

46.5 

50.3 

43.1 

44.4 

a nurse or a nurses' aide on duty 24 hours a day 

in a home. In homes providing 24-hour nursing 

service, two-thirds of the residents required 

some level of nursing care (table F). In contrast, 

only one-third of the residents in homes providing 

nursing service less than 24 hours a day received 

some level of nursing care. The proportion of 

residents receiving personal care in homes with 

24-hour nursing service was half that (24 percent) 

of the proportion in homes providing nursing service less than 24 hours a day (47 percent). In homes 

in which there was no nursing care the residents 

were almost equally distributed between personal 

care (49 percent) and none of the services (51 percent). 

A slight relationship existed between levelof 

care and the type of supervisory nurse. In homes 

in which a registered nurse was the supervisory 

nurse, about 66 percent of the residents received 

some level of nursing care with 24 percent receiving personal care and 11 percent receiving 

neither nursing nor personal care (fig. 4). Almost. 

the same distribution of residents by level of 

care appeared in homes which had a licensed 

practical nurse as supervisor. Some 41 percent 

of the residents in homes with neither an RN 

nor an LPN as the supervisory nurse were receiving some level of nursing care, and an equal 

proportion were receiving personal care. Data by 

the detailed levels of care are in table 3. 

9 
Primary Type of Service and Ownership 

In the RPS-2, the nursing and personal care 

homes were classified as either nursing care 

homes, personal care homes with nursing care, 

or personal care homes, according to the primary 

type of service provided for residents. In all types 

of homes 60 percent of the residents received 

some level of nursing care. The distribution of 

residents receiving the more intensive levels 

of care varied by type of home. Forty percent 

of residents in nursing homes received intensive 

nursing care and 36 percent were under other 

nursing care (fig. 5). Some 21 percent of nursing 

home residents were on a personal care basis. 

Residents in personal care homes with nursing 

service were principally on a personal care 

basis (38 percent), with a sizable proportion 

receiving some level of nursing care (32 percent). 

The level of care is fairly well indicated by 

the primary type of service. This was particularly evident for residents of personal care 

homes, 46 percent of whom were receiving personal care and only 7 percent of whom were receiving some level of nursing care. There was a 

marked distribution of residents who received 

no care which ranged from 4 percent in nursing 

care homes to 30 percent of those in personal 

care homes with nursing and 51 percent in personal care homes. 

PERCENT DISTRIBUTION 

0 25 50 75 100 Type of supervisory i-1 

u 

Total 

Registered nurse 

Licensed 

practical nurse 

Neither 

Intensive /ig-@J Personal 

Other nursing 

Figure 9. Percent distribution of residents of 

nursing and personal care homes, by level of 

patient care according to type of supervisory 

nurse. 

Table F. Number and percent distribution of residents of nursing and personal care 

homes, by level of patient care according to 24-hour nursing service: United States, 

May-June 1964 -

24-hour nursing Number 

of service residents 

All types----------- 554,000 

Nurse or nurse's aide on 

duty 24 hours------------ 490,800

Nurse or nurse's aide on 

duty less than 24 hours-- 30,200

No nursing care----------- 32,900 

Level of patient care 

All 

levels Neither 

Other Personal nutmeg 

personal 

I I I 

Percent distribution 

100.0 31.0 28.7 26.9 13.5 

100.0 34.2 31.2 24.2 10.4 

100.0 13.3 18.6 46.5 21.6 

100.0 . . . . . . 48.8 51.2 

Intensive nursing 

10 
100 

I 

All types 

Nursing care 

Personal care 

wilh nursing 

@g Personal 

Other nursing 

Figure 5. Percent distribution of residents of 

nursing and personal care homes, by level of 

patient care according to primary type of 

service. 

Level of care was somewhat related to the 

type of ownership. Figure 6 shows that in homes 

operated by a proprietor the proprtion of residents under intensive nursing care (40 percent) 

was over twice that in nonprofit homes (15 percent) and was considerably greater than in homes 

under other ownership (22 percent). Thirty percent of residents in proprietary homes received 

other nursing care, as did residents in homes 

under ownership other than proprietary or nonprofit. In nonprofit homes, 23 percent of the 

residents were under other nursing care. 

In nonprofit homes and in homes under 

. “other” ownership, three-tenths of the residents 

received personal care, while the proportion of 

residents under this care in proprietary homes 

was one-fourth. Nonprofit homes had the largest 

proportion of residents (three-tenths) receiving 

none of the levels of care, while almost one-fifth 

were in homes under ownership other than proprietary or nonprofit. 

Geographic Region 

Two-thirds of all residents of nursing and 

personal care homes were in the Northeast and 

North Central Regions (table 4). These two regions were similarly distributed according to 

the proportions of residents receiving the four 

levels of care, and the distributions were very 

close to the distribution for all regions (table G). 

The South Region is notable in its high proportion of residents receiving some level of nursing 

care (68 percent) compared with the proportions 

for the Northeast andNorth Central Regions (about 

60 percent) and that of the West (52 percent). The 

South had the lowest proportion of residents under 

personal care (22 percent) and receiving none of 

the services (11 percent). The West had the highest proportion of those receiving personal care 

(30 percent) and none of the services (18percent). 

PERCENT DlSTRlBlJTlON 

0 25 50 75 100 Type of I I I I I ownership 

All types 

Proprietary 

Nonprofit 

Olhar 

Intensive &g Persanol 

Other nursing 

Figure 6. Percent distribution of residents of 

nursing and personal care homes, by level of 

patient care according to type of ownership. 

11 
Table G. Number and percent distribution of residents of nursing and personal care 

homes, by level of patient care according to geographic region: United States,

May-June 1964 

I II Level of patient care 

Number 

Geographic region residents levels of 

*11 -

I 

All regions---------

Northeast-----------------

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

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

West----------------------

SPECIFIC TYPES OF NURSING AND 

PERSONAL CARE SERVICES 

The respondent was asked, “During the past 

7 days which of these services did this resident 

(patient) receive?” A list of nursing and personal 

care services (as contained in Card F, Appendix 

III) was then shown to the respondent. Each service mentioned by the respondent was checked on 

the questionnaire. The services ranged from 

intensive nursing care services to personal care 

services. The preceding part of this report described these services as grouped into broad 

levels of care. For the convenience of description, 

only selected nursing and personal care services 

are described in this section; detailed percent 

distributions for all 19 of the services are found 

in tables 5, 6, and 7. 

Table 5 indicates that the proportions of all 

residents receiving a specific personal care 

service ranged from a low of 21 percent who 

received help with eating to a high of 70 percent 

for those who were administered medications 

or treatments. Similarly, for all residents receiving nursing care services, there was a wide 

range, from a low of less than 1 percent each for 

oxygen therapy, intravenous injection, and nasal 

Percent distribution 

feeding to a high of 37 percent for temperature, 

pulse, and respiration readings. 

Age and Sex of Resident 

Generally, for most of the nursing and personal care services, the proportions of males 

who received these services did not differ greatly 

from the proportions of females. 

The seven services with the greatest differences by sex are shown in table H. Four of the 

services were in the nursing care category, and 

three, were personal care; there was also a noservice-received category. At all age levels more 

females than males required the services listed in 

table H with the possible exception of the administration of medications and hypodermic injection. 

About seven-tenths of females at all age levels 

received medications, while there was a direct 

relationship between the proportion of males receiving this service and age. The proportion increased with age from 58 percent for thoseunder 

65 years to 72 percent for those 85 years and 

over. Similarly, the difference between the proportion of males and females receiving hypodermic injections was not as outstanding as other 

services. 

12 
Among males under age 65, 1-I percent received help with eating; there was some increase 

with age to about 19 percent for the males who 

were over 75 years of age. About 20 percent of 

the females under 85 required this service, with 

a higher proportion (26 percent) found for those 

85 years and over. About one-fifth of the males 

received a special diet compared with one-fourth 

of the females. There was no direct relationship 

between this service and increasing age. Of 

those residents in the 65-74 age group, slightly 

higher proportions were given a special diet 

than those in other age groups for both males 

and females. 

A higher proportion of residents in the age 

groups 75 years and over received enemas than 

those in the age groups under 75, and for each 

age group there were somewhat higher proportions of females than males receiving this service. 

The greatest difference in proportions by 

sex and age occurred in the rub and massage 

service. Some 48 percent of the females received 

this service, while the corresponding proportion 

of males was 38 percent. As age increased, so 

did the proportions of males given the rub and 

massage service, increasing from 26 percent 

for those under 65 to 44 percent for those over 

85 years. This direct rela.tionship was not so 

dramatic in the female residents by age level, 

since approximately 45 percent of females in 

the three lower age groups received the rub and 

massage service as compared with 54 percent 

of those females 85 years and over. 

A full bed bath was given to males in proportions increasing with age, from 16 percent of 

those under 65 to 24 percent of those residents 

85 years and over. About 28 percent of females 

in each of the three lower age groups had full 

bed baths, while the proportion of females 85 

and over was 36 percent. 

Over one-fourth of the male residents under 

65 received none of the nursing and personal care 

services. This proportion decreased with increasing age to one-tenth of those 85 years and 

over. Proportions of females not receiving any 

of the services were not directly related to age. 

About 10 percent of the females in the age groups 

under 65 years and 85 years andover received 

no services; the proportion of those in the two 

intermediate age groups was 13 percent. 

13 
Mobility Status 

There was a general correlation between 

mobility status and the proportion of residents 

receiving the 19 nursing and personal care services. As limitation of mobility increased from 

neither bed nor room limitation to room and 

finally bed limitation, the proportion of residents 

receiving each of the 19 services increased, 

except for help with tub bath or shower (table 6). 

This relationship held for males and for females, 

with the proportions for both, by mobility status, 

about the same for most services, Where there 

was a difference, the percentages were higher 

for females. 

The proportions of residents who were given 

medication or treatment were higher by limitation of mobility than for any of the other services 

(table 6). The range was from 63 percent for 

those residents with neither bed nor room limitation to 87 percent for those who were bed 

limited (fig. 7). Help with dressing was another 

personal care service in which there were large 

proportions of residents, ranging from 47 percent 

of those with no limitation of mobility to 86 percent of those who were bed limited. More roomlimited residents (65 percent) required help with 

tub bath or shower than those with neither room 

nor bed limitation (59 percent). The fact that only 

two-fifths of those who were bed limited required 

this service could be accounted for by the likelihood that they generally received full bed baths. 

Readings for temperature, pulse, and respiration were received by more residents than any 

other nursing care service, ranging from 30percent of those with neither bed nor room limitation 

to 59 percent of those who were bed limited (fig. 7). 

The nursing service of blood pressure readings 

was administered to 24 percent of those residents 

with no mobility limitation and to 31 percent and 

42 percent, respectively, of those who were 

room and bed limited. Of those residents who 

were bed limited, only 1 percent received none 

of the services, and 5 percent of those who were 

room limited received none of the services. 

Twenty percent of the residents who wereneither 

bed nor room limited received none of the nursing or personal care services. 

Help with dressing Help with tub both or shower 

100 100 

5 5 

E 50 8 50 

% P 

0 0 

Administration of Temperature. pulse, and 

medications or treatment respiration 

Blood pressure None of the services 

Bed limitation Room limitation Neither 

Figure 7. Percent of residents of nursing and 

personal care homes, by selected nursing and 

personal care services and mobility status. 

Number of Chronic Conditions and 

Impairments 

As the specified number of chronic conditions 

increased from none to five and over, there was 

a concomitant increase in proportions of residents receiving a specific service. This was 

particularly true of the six personal care services and was generally true of most of the 13 

14 

I 
nursing care services (table 7). Five services Administration of are analyzed in this section (fig. 8). 100 Help with dressing 100 edications or treatment 

The most dramatic increase as conditions 

increased was in the personal care services; 70.7 

administration of medications especially showed I­ tsuch an increase. Of the residents with no condi- = 50 = 50 

P tions, about one-tenth received this service. kli 

2 

Almost six-tenths of those with one or two conditions were administered medications or treatment; these proportions increased to eight-tenths 0 0 

of those with three or four conditions and almost 

nine-tenths of those with five or more conditions. Temperature, . pulse, Bowel and bladder 

Residents who had help with dressing, shav- and respiration retraining 

ing, or care of hair had a similar sharp increasing relationship of proportions. Nine percent of 

those with no conditions received this service 

compared with 46 percent of those with one or 

two conditions. The percents of those residents 

with three or four conditions and five or more 

conditions were 67 and 79 percent, respectively. 0 

The nursing care service of temperaturepulse-respiration readings was received by 8 None of the 

percent of the residents with no conditions, 28 Blood pressure services 

percent with one or two conditions, 41 percent 

with three or four conditions, and 53 percent I 67.3 

with five or more conditions. Similar distribu- :: 

tions were seen for blood pressure readings, % 50 

varying in increasing proportions from 4 percent of those with no conditions to 43 percent 20.0 

of those with five or more conditions. 6.5 3. I 

: 

0 0 Ita- >;:.x>:.: -. “.* The proportion of residents receiving bowel 

and bladder retraining was somewhat lower than 

in other services; there was an increase from No conditions 

3 percent for those with one or two conditions 

to 15 percent of those with five or more conditions. Of the residents with no reported conditions, none of the sample cases received bowel 

or bladder retraining, 

Some 67 percent of residents with no condi- Figure 8. Percent of residents of nursing and 

personal care homes, by selected nursing and tions received none of the nursing and personal personal care services and specified number of 

care services. The figure for those with one or chronic conditions and impairments. 

two conditions was 20 percent; for those with 

three or four conditions and five or more conditions, the proportions were 7 and 3 percent, 

respectively. 

15 

I 
REFERENCES 

‘National 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 12-No. 

5. Public Health Service. Washington. U.S. Government Printing Office, Sept. 1966. 

2National 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. 1000~Series 12-No. 6. 

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

Office, Jan. 1967. 

3National Center for Health Statistics: Chronic illness 

among residents of nursing and personal care homes, United 

States, May-June 1964. Vital and Health Statistics. PHS Pub. 

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

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

4National 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. 

‘World Health Organization: Manual of the International 

Statistical Classification of Diseases, Injuties, and Causes 

of Death, Based on the Recommendations of the Seventh Revision Conference, 1955. Geneva, Switzerland, 1957. 

6National Center for Health Statistics: Characteristics of 

residents in institutions for the aged and chronically ill, 

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

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

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

7National Center for Health Statistics. Development and 

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

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

Printing Office, Feb. 1965. 

‘National Center for Health Statistics: Origin, program, 

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

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

HealthService. Washington. U.S. Government Printing Office, 

Aug. 1963. 

‘National Center for Health Statistics: MedicaZ Coding 

Manual and the Short Index. NHS-HIS-1000. Public Health 

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

000 

16 
DETAILED TABLES 

Page 

Table 1. Number and percent distribution of residents of nursing and personal care homes,

by level of patient care according to sex and age: United States, May-June 1964- 18 

2. Number of residents and rate of selected chronic conditions and impairments per 1,000 residents in nursing and personal care homes, by level of patient care: 

United States, May-June 1964---------------------------------------------------- 19 

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

by level of patient care according to type of supervisory nurse and 24-hour 

nursing coverage: United States, May-June 1964---------------------------------- 20 

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

by level of patient care according to geographic region and primary type of 

service: Unit-d Stat-s, May-June 1964------------------------------------------- 21 

5. Number and percent of residents of nursing and personal care homes, by specific nursing and personal care services, sex, and age: United States, May-June 1964-- 22 

6. Number and percent of residents of nursing and personal care homes, by specific nursing and personal care services, sex, and mobility status: United States 

my-June 1964------------------------------------------------------------------~ 24 

7. Number and percent of residents of nursing and personal care homes by specific

nursing and personal care services and specified number of chronic conditions 

and impairments: United States, &y-June 1964----------------------------------- 26 

17 
Table 1. Number and percent distribution of residents of nursing and personal care homes, by level of patient care according to sex and age: United States, May-June 1964 

Number 

Sex and age of 

residents 

Both sexes Percent distribution 

All ages- 554,000 100.0 3.8 27.2 7.0 21.7 26.9 13.5 

Under 65 years- 66,200 100.0 3.7 21.5 5.9 18.4 31.4 19.1 

65-74 years---- 104,500 100.0 3.6 24.6 8.0 22.2 26.3 15.4 

75-84 years---- 230,900 100.0 4.0 26.3 7.7 21.7 27.2 13.2 

85+ years------ 152,400 100.0 3.7 32.8 5.7 22.9 24.8 10.1 

Male 

All ages- 193,800 100.0 4.1 21.0 6.8 23.3 28.7 15.9 

Under 65 years- 36,200 100.0 2.9 15.7 5.9 17.0 32.3 26.1 

65-74 years---- 40,400 100.0 3.4 20.5 7.8 22.7 27.8 17.8 

75-84 years---- 74,100 100.0 4.6 22.4 7.8 24.7 27.2 13.4 

85+ years------ 43,100 100.0 5.1 23.8 4.9 26.8 29.4. 10.0 

Female 

All ages- 360,200 30.5 7.0 20.8 25.9 12.1 

Under 65 years- 30,000 28.5 5.7 20.0 30.4 10.6 j 

65-74 years---- 64,000 27.2 8.1 21.8 25.3 13.8 

75-84 years---- 156,800 28.1 7.6 20.2 27.2 13.1 

85-F years------ 109,300 36.4 6.0 21.3 23.1 10.1 

I 

18 
Table 2. Number of residents and rate of selected chronic conditions and impairments per 1,000 residents in nursing and personal care homes, by level of patient care: United States, May-June

1964 

II Level of patient care 

Chronic conditions All and Bed bath, Neither 

impairments I levels 

Intensive excluding in~~~~ive Routine Personal f:zl 

intensive 

Number of residents 

All residents------ 554,000 11 21,100 ( 150,700 1 38,600 1120,200) 148,800 1 74,600 

Rate per 1,000 residents in specified level of care 

Malignant neoplasms------ 33.3 38.0 50.2 60.5 29.4 20.4 15.9 Benign and unspecified 

neoplasms--------------- 16.3 13.6 24.7 11.6 Asthma------------------- 55.0 29.9 35.0 37.0 $f Diabetes mellitus-------- 105.3 86.9 216.4 68.1

Advanced senility-------- Senility, not psychotic--

‘E ‘E ‘25 ‘X 

;;:; 

Other mental disorders--- 154:7 146:9 17217 201:o 192: 6 Vascular lesions affect-­

ing central nervous 

system------------------ 339.5 497.1 518.0 325.0 384.9 235.8 75.4 Parkinson's disease------ 22.6 31.2 37.5 14.3 18.8 19.8 

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

Chronic diseases of the21.1 31.1 20.1 16.9 17.8 29.3 1;:; 

eye--------------------- 62.5 60.0 57.2 98.8 57.6 68.7 50.5 Diseases of the heart---- 282.6 348.9 322.7 387.1 352.4 224.0 133.0 Hypertension, without 

mention of heart-------- 63.3 50.5 37.5 74.6 81.4 62.2 86.2 General arteriosclerosis- 78.5 75.5 82.1 80.3 85.4 72.4 Varicose veins----------- 32.0 E 30.0 90.8 35.1 16.3 22.0 Hemorrhoids-------------- 38.2 7714 43.9 62.2 45.4 24.2 19.3 Bronchitis and emphysema- 40.2 75.3 38.2 60.0 47.3 30.1 32.9 Sinus and other 

respiratory conditions-- 19.4 38.8 14.8 23.7 26.3 14.3 20.5 Ulcer of stomach and

duodenum---------------- 17.6 21.1 14.1 26.2 24.4 13.1 17.5 Hernia of abdominal 

cavity------------------ 35.5 66.7 28.2 55.1 41.2 30.1 32.5 Other chronic conditions 

of the digestive system- 124.4 220.6 158.2 170.8 137.6 85.6 60.7 Diseases of urinary 

system------------------ 58.2 149.6 95.5 54.9 50.4 32.9 21.8 Diseases of prostate and other male genital organs------------------ 30.0 85.5 32.1 42.1 32.2 21.1 18.2 Arthritis and rheumatism- 220.8 273.2 249.1 222.4 171.9 Fracture femur (old)----- 31.1 59.6 51.2 '2: . 29.1 %-: . 7.6 All other chronic , conditions-------------- 148.7 277.6 168.6 257.8 121.4 124.2 108.0 Visual impairment: inability to read newspaper with glasses------ 120.5 166.5 165.6 125.8 110.3 42.2 Other visual impairments- 60.2 45.8 48.1 113.0 65.0 ‘% 62.0 Hearing impainnents------ 187.6 222.0 209.0 201.2 194.6 172:2 147.0 

b Speech impairments, all 

types------------------- 98.6 166.0 166.4 81.7 89.4 68.8 25.3 Paralysis or palsy due 

to stroke--------------- 120.3 157.9 239.6 81.8 107.7 61.3 26.5 Paralysis or palsy due 

to other causes--------- 46.9 59.2 76.9 46.8 37.3 36.3 19.3 Absence, major extremities------------- 20.9 9.3 29.8 28.9 19.7 18.3 8.8 Impairments of limbs,

back, or trunk---------- 135.8 167.5 181.9 128.9 129.4 124.5 70.1 All other impairments---- 13.7 14.3 12.6 29.9 14.5 12.4 8.5 -

19 
Table 3. Number and percent distribution of residents of nursing and personal care homes, by level of

patient care according to type of supervisory nurse and 24-hour nursing coverage: United States, May- June 1964 

Level of patient care 

Type of supervisory Number All 

nursing coverage residents levels 

Intensive excluding inkEEzive Rputine intensive 

Personal n"iEpg 

personal 

Percent distribution 

All types--------- 554,000 100.0 27.2 7.0 21.7 26.9 13.5 

Nursing 24 hours-----

Nursing under 24 490,800 100.0 29.9 7.5 23.7 24.2 10.4 

nurse and 24-hour of Bed bath, Neither 

hours--------------- 30,200 100.0 12.6 5.3 13.4 46.5 21.6

No nursing care------ 32,900 100.0 . . . . . . . . . 48.8 51.2 

29.5 23.1 23.6 

Nursing 24 hours-----

Nursing under 24 hours---------------

356,300 

6,500 

100.0 

100.0 

5.0 

0.8 

29.7 

21.3 

8.3 

6.8 

23.4 

7.0 

23.2 

44.4 

10.5 

19.8 

Licensed practical nurse------------ 107,000 100.0 2.5 30.4 6.5 26.9 24.6 9.1 

Nursing 24 hours-----

Nursing under 24 hours---------------

99,600 

7,500 

100.0 

100.0 

2.6 

1.4 

31.4 

17.9 

6.2 

10.6 

27.6 

18.2 

23.3 

41.9 

9.0 

10.0 

Neither registered 

nursenor licensed

practical nurse-- 51,200 100.0 1.5 21.5 3.5 14.7 40.9 17.9 

Nursing 24 hours-----

Nursing under 24 hours---------------

34,900 

16,300 

100.0 

100.0 

2.0 

0.4 

28.4 

6.7 

4.1 

2.2 

15.2 

13.7 

37.0 

49.4 

13.4 

27.7 

Registered nurse-- 362,800 100.0 

==8.2 I==10.7 

No nursing care--- 32,900 100.0 -I . . . . . . , . . . . . . 48.8 51.2 -; 

20 
Table 4. Number and percent distribution of residents of nursing and personal care homes, by level of 

patient care according to geographic region and primary type of service: United States, May-June 1964 -

II Level of patient care 

All 

levels Bed bath, Neither 

Intensive excluding in~~~~ive Routine Personal n"i:Fg intensive 

Geographic region Number 

and primary type of 

of service residents 

personal 

13.5 

3.9 

29.2 

51.2 

12.5 

3.8 

z-2 . 

21.0 : 27.1 13.6 

27.8 20.4 3.7 

11.4 1 36.5 25.6 . . . 47.4 52.6 

29.6 21.7 10.5 

34.2 16.6 3.5 

19.8 33.5 26.5 . . . / 51.0 49.0 

18.0 

5.0 

36.2 

40.0 

21 

Percent distribution 

t 100.0 3.8 27.2 7.0 

100.0 5.0 34.8 8.2 

100.0 1.7 14.1 5.5 

100.0 . . . . . . . . . 

100.0 2.2 31.4 7.7 

100.0 2.7 39.2 8.4 

100.0 1.3 11.7 7.5 

100.0 . . . . . . . . . 

100.0 4.4 26.2 7.7 

100.0 5.9 32.3 9.8 

100.0 2.0 19.3 5.1 

100.0 . . . . . . . . . 

100.0 2.3 31.1 4.7 

100.0 2.6 37.6 5.6 

100.0 1.9 15.8 2.6 

100.0 . . . . . . . . . 

100.0 6.9 17.8 6.4 

100.0 11.0 27.2 7.3 

100.0 1.2 5.0 6.2 

100.0 . . . . . . . . . 

All regions----

Nursing care---------

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

Personal care--------

Northeast------

Nursing care---------

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

North Central-­

Nursing care---------

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

Personal care--------

South---------

Nursing care---------

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

Personal care--------

West-----------

Nursing care---------

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

Personal care--------

554,000 

373,300 

145,400

35,300 

158,300 

117,600 

x:tI 

203,000 

127,800 

61,500

13,700 

100,400 

73,200 

23,600

3,600 

92,300 

54,800 

30,500

7,000 
Table 5. Number and percent of residents of nursing and personal care homes, by specific nursing

and personal care services, sex, and age: United States, May-June 1964 

All Nursing and personal care services ages 85 years and over 

Both sexes Number of residents 

All residents-------------------------------- 554,ooo1( 66,200 ( 104,500 j 230,900 \ 152,400 

Personal care services Percent of residents 

Help with dressing, shaving, or care of hair------- 59.0 50.9 54.7 58.3 66.5 

Help with tub bath or shower----------------------- 57.1 50.0 56.3 58.4 59.0 

Help with eating----------------------------------- 20.6 17.6 18.5 20.4 23.6 

Rub and massage------------------------------------ 44.3 35.4 40.9 43.7 51.4 

Administration of medications or treatment--------- 70.1 63.8 68.4 70.7 73.2 

Special diet--------------------------------------- 22.9 19.6 25.6 23.0 22.4 

Nursing care services 

Application of special dressings or bandages------- 5.7 6.9 6.3, 5.6 5.1 

Temperature, pulse, and respiration---------------- 36.9 30.5 35.6 36.7 41.0 

Full bed bath-------------------------------------- 27.2 21.5 24.6 26.3 32.8 

Enema---------------------------------------------- 15.6 11.9 13.7 16.6 17.0 

Catheterization------------------------------------ 4.1 3.8 4.1 4.2 4.1 

Bowel and bladder retraining----------------------- 6.6 5.3 6.2 6.3 7.8 

Blood pressure -_-_-___-_---_---_-_----------------- 28.5 22.5 28.8 29.2 29.9 

Irrigation----------------------------------------- 3.1 3.5 2.8 3.1 3.2 

Oxygen therapy------------------------------------- 0.6 0.5 0.6 0.6 0.5 

Hypodermic injection------------------------------- 5.7 5.2 5.1 6.0 5.8 

Intravenous injection------------------------------ 0.3 0.2 0.3 0.3 0.2 

Intramuscular injection-;-------------------------- 6.0 4.5 6.4 6.1 6.1 

Nasal feeding-------------------------------------- 0.2 0.5 0.3 0.1 0.1 

None of above-------------------------------------- 13.5 19.1 15.4 13.2 10.1 

Male Number of residents 

Al1 residents-------------------------------- 193,800 ( 36,200 40,400 74,100 43,100 

Personal care services Percent of residents 

Help with dressing, shaving, or care of hair------- 57.8 45.2 55.0 61.1 63.5 

Help with tub bath or shower----------------------- 57.4 45.6 53.5 61.9 63.4 

Help with eating----------------------------------- 17.8 13.9 17.2 19.4 18.9 

Rub and massage------------------------------------ 38.0 26.4 35.8 41.3 44.0 

Administration of medications or treatment--------- 67.5 57.5 65.3 70.9 72.1 

Special diet--------------------------------------- 20.0 15.3 22.7 21.3 19.3 

See note at end of table. 

22 
Table 5. Number and percent of residents of nursing and personal care homes, by specific nursing and personal care services, sex, and age: United States, May-June 1964-Con. 

Nursing and personal care services 

Male-Con. 

Nursing care services 

Application of special dressings or bandages-------

Temperature, pulse, and respiration----------------

Full bed bath-------------------------------------­

&-p~---------------- -_-__---__-_---____-----------

Catheterization------------------------------------

Bowel and bladder retraining-----------------------

Blood pressure -_-__-___-__________-----------------

Irrigation-----------------------------------------

Oxygen therapy ------------_-_----------------------

Hypodermic injection ------_-______--____-----------

Intravenous injection------------------------------

Intr-~scular injection----------------------------

Nasal feeding------------------i---------------------

None of above--------------------------------------

Female 

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

Personal care services 

Help with dressing, shaving, or care of hair-------

Help with tub bath or shower-----------------------

Help with eating-----------------------------------

Rub and massage ------_-___-________----------------

Administration of medications or treatment---------

Special diet---------------------------------------

Nursing care services 

Application of special dressings or bandages-------

Temperature, pulse, and respiration----------------

Full bed bath--------------------------------------

Enema----------------------------------------------

Catheterization------------------------------------

Bowel and bladder retraining-----------------------

Blood pressure-------------------------------------

Irrigation -------_------_--------------------------

Oxygen therapy-------------------------------------

Hypodermic injection-------------------------------

Intravenous injection------------------------------

Intra~scular injection----------------------------

Nasal feeding--------------------------------------

None of above--------------------------------------

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

Percent of residents 

5.9 6.7 5.9 6.4 4.5 

36.0 26.8 35.1 38.9 39.4 

21.0 15.7 20.5 22.4 23.8 

12.9 9.0 10.2 15.7 13.7 

3.9 3.0 3.5 4.3 4.2 

5.9 3.9 4.9 6.3 8.0 

27.3 20.8 28.9 29.4 27.6 

3.3 3.2 3.1 3.0 4.0 

0.9 0.8 0.7 1.2 0.8 

4.7 4.3 3.7 4.9 5.4 

0.4 0.3 0.5 0.3 0.4 

4.8 4.1 4.9 4.9 5.0 

0.2 0.6 0.4 0.1 

15.9 26.1 17.8 13.4 10.0 

Number of residents 

360,200 I( 30,000 1 64,OOOl 156,800 1 109,300 

Percent of residents 

59.6 57.8 54;z 57.0 66.8 

57.0 55.2 58.1 56.7 57.3 

22.1 22.1 19.r 20.8 25.5 

47.7 46.2 44.c 44.9 54.3 

71.5 71.4 70.: 70.6 73.6 

24.5 24.6 27.: 23.8 23.6 

5.6 7.0 6.5 5.2 5.3 

37.5 35.0 35.9 35.7 41.6 

30.5 28.5 27.2 28.1 36.4 

17.1 15.4 15.9 17.1 18.2 

4.3 4.8 4.6 4.2 4.1 

6.9 7.1 7.0 6.4 7.7 

29.1 24.6 28.8 29.0 30.8 

3.0 3.9 2.6 3.1 2.9 

0.4 0.2 0.5 0.4 0.4 

6.2 6.2 5.9 6.5 6.0 

0.2 0.2 0.3 0.2 

6.6 5.1 7.3 6.7 6.5 

0.2 0.5 0.2 0.2 0.1 

12.1 10.6 13.8 13.1 10.1

JNOTE: Because residents may receive more than one service, the columns of percents do not add 

to 100 percent. 

23 
Table 6. Number and percent of residents of nursing and personal care homes, by specific nursing and personal care services, sex, and mobility status: United States, May-June 1964 

All levels

Nursing and personal care services of Neither

mobility 

Both sexes Number of residents 

All residents------------------------------- 554,000 /I 92,200 1 116,900 1 

Personal care services 

Help with dressing, shaving, or care of hair------

Help with tub bath or shower----------------------

Help with eating----------------------------------

Rub and massage-----------------------------------

Administration of medications or treatment--------

Special diet--------------------------------------

Nursing care services 

Application of special dressings or bandages------

Temperature, pulse, and respiration---------------

Full bed bath-------------------------------------

Enema---------------------------------------------

Catheterization-----------------------------------

Bowel and bladder retraining----------------------

Blood press~e------------------------------------

Irrigation----------------------------------------

Oxygen therapy------------------------------------

Hypodermic injection------------------------------

Intravenous injection-----------------------------

Intramuscular injection---------------------------

Nasal feeding-------------------------------------

None of above-------------------------------------

Male 

Percent of residents 

59.0 85.8 73.0 

57.1 41.1 65.2 

20.6 55.6 25.1 

44.3 77.4 52.7 

70.1 86.8 78.8 

22.9 37.8 25.8 

5.7 12.2 6.6 

36.9 59.2 40.7 

27.2 69.4 32.2 

15.6 37.6 16.4 

4.1 14.5 3.2 

6.6 12.8 8.2 

28.5 41.8 30.6 

3.1 10.1 2.8 

0.6 1.5 0.6 

5.7 10.8 5.6 

0.3 1.1 0.1 

6.0 10.6 6.5 

0.2 0.9 0.2 

13.5 0.9 4.6 

Number of residents 

All residents------------------------------- 193,800 /) 29,300 ( 33,100 1 

Personal care services Percent of residents 

Help with dressing, shaving, or care of hair------ 57.8 90.8 74.8 

Help with tub bath or shower---------------------- 57.4 45.3 71.0 

Help with eating---------------------------------- 17.8 54.0 24.2 

Rub and massage----------------------------------- 38.0 72.1 48.2 

Administration of medications or treatment-------- 67.5 86.4 77.9 

Special diet-------------------------------------- 20.0 35.8 24.7 

344,900 

47.0 

58.7 

9.7 

3206 

62.7 

17.9 

3.7 

29.7 

14.2 

9.5 

1.7 

4.4 , 

24.2 i 

1.3 

0.3 

4.3 

0.1 : 

4.5 

0.0 

19.8 

131,400 

46.2 

56.7 

8.1 

27.8 

60.6 I 

15.3 

See note at end of table. 

24 
Table 6. Number and percent of residents of nursing and personal care homes, by specific nursing

and personal care services, sex, and mobility status: United States, May-June 1964-Con.

-

Nursing and personal care services of

L411 levels Bed Room Neither 

mobility limitation limitation 

Male-Con. 

Nursing care services Percent of residents 

Application of special dressings or bandages------ 5.9 10.7 9.3 

Temperature, pulse, and respiration--------------- 36.0 63.2 42.1 

Full bed bath------------------------------------- 21.0 64.0 24.2 

Enema--------------------------------------------- 12.9 32.9 14.8 

Catheterization----------------------------------- 3.9 15.5 2.4 

Bowel and bladder retraining---------------------- 5.9 11.2 7.5 

Blood pressure -_--_--_----_--__-_----------------- 27.3 43.4 32.5 

Irrigation---------------------------------------- 3.3 13.0 3.0 

Oxygen therapy------------------------------------ 0.9 2.1 0.7 

Hypodermic injection---- -_-----___---____-_-^_____ 4.7 8.4 4.9 

Intravenous injection----------------------------- 0.4 1.9 

Intramuscular injection--------------------------- 4.8 9.1 6.1 

Nasal feeding------------------------------------- 0.2 1.2 0.1 

None of above------------------------------------- 15.9 0.9 4.3 

Female Number of residents 

4.0 

28.3 

10.7 

7.9 

1.6 

4.4 

22.4 

1.1 

0.7 

3.8 

0.1 

3.5 

22.2 

213,400 

47.6 

60.0 

10.6 

35.5 

64.0 

19.5 

3.5 

30.5 

16.4 

10.4 

1.7 

4.4 

25.4 

1.5 

0.1 

4.6 

0.1 

5.2 

0.0 

18.3 

All residents------------------------------- 360,200 11 62,900 1 83,800 I- 1

Personal care services Percent of residents 

Help with dressing, shaving, or care of hair------ 59.6 83.5 

Help with tub bath or shower---------------------- 57.0 39.1 

Help with eating---------------------------------- 22.1 56.4 

Rub and massage----------------------------------- 47.7 79.8 

Administration of medications or treatment-------- 71.5 87.0 

Special diet-------------------------------------- 24.5 38.8 

Nursing care services 

Application of special dressings or bandages------ 5.6 12.9 

Temperature, pulse, and respiration---------------

Full bed bath-------------------------------------

Enema---------------------------------------------

Catheterization-----------------------------------

Bowel and bladder retraining----------------------

Blood pressure--------- ---_----------__-----------

Irrigation----------------------------------------

Oxygen therapy------------------------------------

Hypodermic injection------------------------------

Intravenous injection-----------------------------

Intramuscular injection---------------------------

Nasal feeding-------------------------------------

None of above-------------------------------------

37.5 57.4 

30.5 71.8 

17.1 39.8 

4.3 13.9 

6.9 13.5 

29.1 41.1 

3.0 8.8 

0.4 1.2 

6.2 11.9 

0.2 0.7 

6.6 11.3 

0.2 0.8 

12.1 0.9 

72.3 

62.8 

25.5 

54.5 

79.2 

26.2 

5.6 

40.1 

35.2 

17.0 

3.5 

8.5 

29.8 

2.7 

0.5 

5.9 

0.1 

6.6 

0.2 

4.8 

NOTE: Because residents may receive more than one service, the columns of percents do not add 

to 100 percent. 

25 
Table 7. Number and percent of residents cf nursing and personal care homes, by specific nursing and personal care services and specified number of chronic conditions and impairments: United 

States, May-June 1964 

All No 1-2 3-4 5 or more Nursing and personal care services conditions ~1 

conditions conditions conditions conditions 

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

Personal care services 

Help with dressing, shaving, or 

care of hair-----------------------

Help with tub bath or shower--------

Help with eating--------------------

Rub and massage---------------------

Administration of medications or 

treatment--------------------------

Special diet------------------------

Nursing care services 

Application of special dressings or bandages------------------------

Temperature, pulse, and respirationFull bed bath-----------------------

Enema-------------------------------

Catheterization---------------------

Bowel and bladder retraining--------

Blood pressure----------------------

Irrigation--------------------------

Oxygen therapy----------------------

Hypodermic injection----------------

Intravenous injection---------------

Intramuscular injection-------------

Nasal feeding-----------------------

None of above-----------------------

1~~~~ ~ 

Number of residents 

554,000 II 20,400 221,700.L-.-z?Il?!o I 110,700 

Percent of residents 

59.0 9.1 46.2 67.3 78.7 

57,l 20.9 53.6 62.2 61.7 

20.6 0.7 11.5 24.5 35.2 

44.3 7.4 31.4 51.4 64.0 

70.1 10.9 58.6 79.1 87.9 

22.9 2.3 12.9 26.9 39.7 

5.7 0.5 3.2 6.9 9.7 

36.9 7.7 28.0 41.1 52.7 

27.2 2.7 17.8 31.6 42.7 

15.6 8.2 18.1 28.8 

4.1 2.1 4.6 8.2 

6.6 2.5 6.9 15.3 

28.5 3.5 19.2 33.1 43.2 

3.1 1.4 3.9 5.7 

0.6 0.4 0.6 1.0 

5.7 3.1 6.2 10.9 

0.3 0.1 0.4 0.5 

6.0 0.7 3.6 6.5 10.7 

0.2 0.2 0.2 0.2 

13.5 67.3 20.0 6.5 3.1 

-

NOTE: Because residents may receive more than one service, the columns of percents do not add 

to 100 percent. 

26 
APPENDIX I 

A. TECHNICAL NOTES ON SURVEY DESIGN 

GenevaZ.-The Xeside~ir Piaces Survey-2 (RPS-2) 

was conducted during May and June 1964 by the Division of Health Records St?tiseics in (cooperation with 

the U.S. Bureau of the Census. It ~~1,sa survey of resideiit institutions i-1 ithe United States which providenursing or personal care to the aged and chronically ill, of 

their patients or residents, and of their employees. The 

institutions within the scope of the survey included such 

places as nursing homes, convalescent homes, rest 

homes, homes for the aged, orher related facilities, and 

geriatric hospitals. To be eligible for the survey an 

establishment must have maintained three or more beds 

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

II-B. 

This appendix presents a brief description of the 

survey design, general qualifications of the data, and 

the reliability of estimates presented in this report. 

Succeeding appendixes are concerned with classification 

procedures, definitions, and questionnaires used in the 

survey for collecting information about residents, 

chronic conditions, employees, and services. 

Sampling frame.- A “multiframe” technique was 

used in establishing the sampling universe for RPS-2. 

The principal frame was the Master Facility Inventory 

(MFI), which contained the names, addresses, and 

descriptive information for about 90-95 percent of the 

nursing and personal care homes in the United States. 

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

Survey list. A description of the MFI and the Complement Survey has been published. i 

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

Interview Survey.b In the Health Interview Survey, 

interviewers make visits each week to households 

located in probability samples of small segments of the 

United States. In addition to collecting information 

about the health of the household members, the interviewers are instructed to record the names and addresses of hospitals and institutions located wholly or 

partially within the specified areas. The Complement 

Survey list is composed of the establishments identified 

in these sample areas between January 1959 and July 

1963 which were not listed in the MFI and which were 

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

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

the United States. 

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

a selection of establishments from the MFI and the 

Complement Survey; the second stage, a selection of 

employees and residents from registers of the sample 

establishments. In preparation for the first-stage 

sample selection, the MFI was divided into two groups 

on the basis of whether current information was available about the establishment. Group I was composed of 

establishments which had returned a questionnaire 

in a previous MFI survey. Group II contained places 

which were possibly within the scope of RPS-2 but were 

not confirmed in the MFI survey, e.g., nonresponses and 

questionnaires not delivered by the post office because 

of insufficient address. Group I was then sorted into 

three type-of-service strata: nursing care homes, including geriatric hospitals; personal care homes with 

nursing; and personal care homes. Group II was treated 

as a fourth type-of-service stratum. Each of these 

four strata was further sorted into four bed-size groups, 

producing 16 primary strata, as shown in table I. Within 

each primary stratum the listing of establishments was 

ordered by type of ownership, State, and county. The 

sample of establishments was then selected systematically after a random start within each of the primary 

strata. 

Table 1 shows the distribution by primary strata 

of establishments in the MFI and in the sample and 

shows the final disposition of the sample places with 

regard to their response and in-scope status. Of the 

1,201 homes originally selected, 1,085 were found to 

be in business and within the scope of the survey. 

The second-stage sample selection of residents 

was carried out by Bureau of the Census interviewers 

in accordance with specific instructions given for each 

sample establishment as contained in the Resident 

Questionnaire (HRS-3c, Appendix III). All the residents 

on the register of the establishment on the day of the 

survey were listed on the Establishment Questionnaire 

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

27 
- ------------- ----- 

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

RPS-2 sample,by response status to the RPS-2 and by primary strata (type of service and size of 

institution): United States 

Number of homes in the sample 

In-scope and 

Type of service and size Number of 

out of in business 

of institution homes in 

the MFIl Total scope or 

homes1 out of Nonrehomes homes 

All types----------------------.-------- 19,520 1,201 116 12 1,073 

Nursing care9----------~----_----------- 8,155 634 37 8 589 

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

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

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

300 be& or more----------------------------- 60 60 2 58 

business sponding lesponding 

Personal care with nursing------------- 4,972 381 12 2 367 

under 30 beds-------------------------------- 3,168 128 10 1 117 ' 

30-99 be&.- _-_------------ 1,423 114 1 1 112 

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

300 be& or more----------------------------- 36 36 36 ' 

personal care-------------------------- 3,621 113 13 2 98 

under 30 beds-------------------------------- 3,187 64 11 53 1

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

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

300 be& or more----------------------------- 3 3 3 'r 

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

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

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

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

300 beds or more----------------------------- 3 3 2 1 r 

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

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

'Included geriatric hospitals. I 

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

which current data were not available. 

28 
numbers of predetermined sample lines for each home 

(e.g., every seventh line). The first three sample designations were entered on the questionnaire worksheet, 

and the interviewer entered the remaining predetermined numbers until the last selected number exceeded 

the total number now on the register. The name of the 

sample resident (patient) was entered opposite the 

sample designation number. For each sample resident 

a questionnaire was completed by the interviewer from 

information furnished by the respondent. The total 

sample selected from establishments cooperating in the 

survey consisted of 10,560 residents. 

Survey procedure.- The Bureau of the Census 

employed about 140 of their regular interviewers for 

the survey. All were experienced in the continuing 

surveys conducted by the Bureau of the Census; about 

half were employed in the Health Interview Survey, 

one of the major programs of the National Center for 

Health Statistics, and about half in other surveys. Since 

the interviewers were well trained in general survey 

methodology, it was relatively easy to train them in the 

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

consisted of home study materials and observation by 

the Census Regional Supervisor on the first interview 

assignment. 

The initial contact with an establishment was a 

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

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

stated that a representative would contact him for an 

appointment. The interviewer’s telephone call usually 

followed within 3 or 4 days. 

During the course of the interview, the interviewer 

collected data on the establishment, the resident, and 

B. GENERAL 

Nonresponse and imputation of missing data.-The 

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

sample places were found to be out of business, and an 

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

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

personal care to their residents or maintained fewer 

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

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

The response rate for the in-scope sample was 98.9 

percent. 

Statistics in this report were adjusted for the failure of a home to respond by use of a separate nonresponse adjustment factor for each service-size stratum 

further stratified by three major ownership groups. This 

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

information was collected by personal interview and by 

means of a self-enumeration questionnaire. The respondent for the Resident (Patient) Questionnaire (HRS3c) was a member of the staff who had close contact 

with the resident, thus having firsthand knowledge of 

the resident’s health condition. This was usually a nurse 

who was responsible for the individual sample resident. 

One nurse might have completed questionnaires for all 

residents in a small home, or shared the responsibility 

in a large home. The interviewer was instructed to 

encourage maximum use of records by the respondent. 

For data on chronic conditions and impairments, medical records, if available, were routineIyused to supplement the information provided by the respondent. 

The Census regional offices also performed certain 

checks during the course of the survey to insure that 

the interviewers were conducting the survey according 

to specified procedures. They reviewed alI question- , 

naires for completeness prior to transmittal to the 

Washington office and made inquiries as necessary to 

obtain the missing information. 

The completed questionnaires were edited and 

coded by the National Center for Health Statistics, and 

the data were processed on an electronic computer. 

This processing included assignment of weights, ratio 

adjustments, and other related procedures necessary 

to produce national estimates from the sample data. 

It also included matching with basic identifying information contained in the Master Facility Inventory, as 

weIl as carrying out internal edits and consistency 

checks to eliminate “impossible” response and errors 

in editing, coding, or processing. 

QUALIFICATIONS 

imputed to residents for whom data were not obtained 

the characteristics of residents of the same age and in 

the same type of home. For item nonresponse on age, 

the adjustment was restricted to characteristics of 

residents in the same type of home. Adjustment for 

nonresponse in resident data for responding homes 

ranged from 0.7 percent for age to 4.6 percent for 

24-hour nursing service. 

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

homes, to the nearest ten. For this reason detailed 

figures within the tables do not always add to totals. 

Percents were calculated using the original unrounded 

factor was the ratio of all in-scope sample homes in a 

stratum to the responding in-scope sample homes in 

the stratum. 

Data were also adjusted for nonresponse of sample 

residents within an establishment by a procedure which 

figures and will not necessarily agree with percents 

which might be calculated from rounded data. 

Estimation procedure.-Statistics reported in this 

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

ratio estimation is to take into account all relevant 

information in the estimation process, thereby reduc29 
ing the variability of the estimate. The first-stage 

ratio adjustment was included in the estimation of 

establishment and resident data for all primary servicesize strata from which a sample of homes was drawn. 

This factor was a ratio, calculated for each stratum. 

The numerator was the total beds according to the 

Master Facility Inventory for all homes in the stratum. 

The denominator was the estimate of the total beds 

obtained through a simple inflation of the Master Facility 

Inventory data for the sample homes in the stratum. 

The effect of the first-stage ratio adjustment was to 

bring the sample in closer agreement with the known 

universe of beds. The second-stage ratio adjustment 

was included in the estimation of resident data for all 

primary strata. For resident data, the second-stage 

ratio adjustment is the product of two fractions: the 

first is the ratio of the total number of residents in 

the establishment to the number of residents for whom 

questionnaires were completed within the home; the 

second is the sampling fraction for residents on which 

the selection is based. 

Reliability of estimates.-Since statistics pre,­

sented in this report are based on a sample, they will 

differ somewhat from figures that would have been 

obtained if a complete census had been taken using the 

same schedules, instructions, andprocedures. 

As in any survey, the results are also subject to 

reporting and processing errors and errors due to 

nonresponse. To the extent possible, these types of 

errors were kept to a minimum by methods built into 

survey procedures. 

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

number of observations in the sample, Thus, as the 

sample size increases, the standard error decreases. 

The standard error is primarily a measure of the 

Figure I. Approximate relative standard errors of estimated numbers of residents, conditions, employees, or establishments shown in this report. 

Sire of Estimate 

Example of use of figure I, An estimate of 100,000 total residents has a relative standard errgr of 3.3 percent) 

(read from scale at left side of figure). The estimate has a standard error of 3,300 (3.3 percent of 100,000). 

30 
Table II. Approximate standard errors of percent for residents 

Estirrlated percent Base of percent (number of 

residents) z 

Standard error expressed in 

percentage points 

1,000--------

2,500~------- ::2 6’2

13.6 15.8 

5,000-------- 4:2 :*: 10.0 

10,000----- 4:: 3.0 4:3 Ki 

2o,l33J-------- 1.5

30,000-------- 1.3 :*: 4-i 1.;

40,000-------- 1:5 2:1 2:5 

50,000-------- ::; 1.3 1.6 2.2 

80,0()0----- 1.5 

100,000-------- E isi 1.0 2: 

200,000-------- 0:5 017 

500,000-------- 0.3 0.4 E ;:: 

variability that occurs by chance because only a sample, 

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

part of the measurement error, but it does not measure 

any systematic biases in the data. The chances are 

about two out of three that an eslknatefrom the sample 

differs from the value which would be obtained from a 

complete census by less than the standard error. The 

chances are about 95 out of 100 that the difference is 

less than twice the standard error and about 99 out of 

100 that it is lesr. th;7n ?‘:ptimes as large. 

Relative standard errors of aggregates shown in 

this report can be determined from figure I. The rclative standard error of an estimate is obtained by dividing the standard error of the estimate by the estimacc 

itself and is expressed as a percent of rhe estimate. .\n 

example of how to convert the relxive error into a 

standard error is given with fii:ure I. Standard errors 

of estimated percentages are shown in table II. 

To determine the standard error of a mean value, 

of a median value, or of the difference between two 

statistics, the following rules may beused. 

Standard EYWOYof mean nwnher- of conditions pmpersdn.-From figure I, obtain the relative standard 

error of the estimated number of conditions and of the 

estimated number of persons. The square root of the 

sum of the squares of these two relative standard errors 

provides an approximation for the relative standard 

error of the desired mean. The standard error of the 

mean may be obtained by multiplyingthe relative standard error by the mean value. 

Example: For .i mean of three conditions per person 

based on a denominator of 50,000 residents, the standard 

error may be obtained as follows: 

1. The relative standard error of 150,000 conditions is about 2.7 percent, or .027 (curve A). 

2. The relative standard error of 50,000 residents 

is about 4.6 percent, or .046 (curve A). 

3. The relative standard error of the mean three 

conditions per person is ~\.@2;‘? + (.046r* 

= .169. 

4. The standard error is .169 x3 =..XK conditions 

per person. 

Standard e$T-ooyOJ a median.- Ihu medians shown 

in this report were calculated from grouped data. .ipprosimate confidence intervals for these estimated 

medians can be computed as follows: 

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

characteristic whose denominator is equal to 

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

based. For example, the median age of males 

is 77.7 years. The estimated number of males 

is 193,SO0 (cable 1). The standard error of a 

SO-percent characteristic whose base is 

193,SO0 is shown in table II, by inrerpolation, 

to be 1.13 percentage points. 

(b) Apply this standard error to the cumulative 

frequency distribution to obtain a confidence 

interval around rhe median. The steps are as 

follows: For the above example, using the 

95-percent level of confidence, determine the 

points on the cumulative frequency distribution 

corresponding to the -C.-q percent (50 percent 

minus two standard errors) and 52.26 percent 

(50 percent plus Iwo standard errors). The 

points are 92,500 (47.71 x 193,800) and 101,300 

(52.26 x 193,800). From cable 1, determine the 

ages rhat correspond to these points. They are 

77.1 and 78.3 years, respectively. Therefore, 

the confidence limit for the estimated median 

age of 77.7 years is 77-l-78.3 years at the 

95-percent level of confidence. 

It is possible to investigate whether the observed 

differences between two estimated medians can be attributed to sampling error alone by obtaining the upr?er 

68-percent confidence limit, 21:, of the smaller median, 

Mi. and the lower 6S-percent confidence limit, L:, of the 

larger median, Mi. These limits may be found byusing 

the method outlined above, but using one standard error 

instead of two. The square root of the sum of the squared 

differences between Mi and Vi and l$ and Lh is the 

31 
standard error of the difference between Mi and M; ; that Stundard e’y”Yoy qf a difjevence between two estiis, mates .-The standard error of a difference is approximately the square root of the sum of the squares of 

S 

CM; - M;) M; - U;,* + CM; - L;j2 each standard error considered separately. This formlula will represent the actual standard error quite 

For the purpose of this report, any difference between accurately for the difference between separate and 

M: and Ml greater than 2.5 uncorrelated characteristics, although it is only a e-cd a significant differencp; . - Mh) has bsen consid- L rough approximation in m:lst other cases.

OOL 

32 
APPENDIX II 

A. DEFINITIONS OF CERTAIN TERMS USED IN THIS REPORT 

Resident: 

A resident is d,efined as a person who has been 

formally admitted to an establishment but not 

discharged. All such persons were included in the 

survey even though they were not physically present. 

Chronic conditions and impairments: 

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

This list was expanded, based on the further query 

“Does he have any other chronic conditions listed 

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

additional questions about specified conditions. 

The expanded list is contained in Appendix II-D 

as a basic list of diagnostic categories used for 

coding purposes. 

Condition: 

This term is used synonomously with the term 

“chronic conditions and impairments” since no 

distinction has been m,.de between the two groups 

in this report. 

Limitation of mobility: 

Restriction in ms,bility is defined in this report ds 

being limited to bed or room. Al1 other residents, 

including those who were routinely taken olt of the 

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

Length of stay: 

Length of stay refers to the current period of stay 

in the institution. The period of stay starts with 

the date of last admission to the institution and 

ends with the date of the survey. 

Time interval since last saw doctor: 

This refers to the period of time from the date the 

resident last saw a doctor in the institution during 

his current stay to the date of the survey. 

Supervisory nurse: 

This is defined as the person in charge of the daily 

nursing activities provided in the home, such as 

the head nurse. 

Registered nuY.s0: 

This is defined as a registered professional nurse 

or graduate nurse. 

Licensed practical nuz.e: 

This is defined as a licensed practical nurse or 

licensed vocational nurse. 

_ uyse oy nwsers aide on duty 24 JZOUYS a day: 

Nursing service is routinely provided at all hours 

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

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

Levels of nursing OYpersonal caye: 

These levels are defined in terms of the implied 

intensivzncss 6 ca~-j or the condition of the resid’ant. The level of care is defined by the services 

performed, not bjr the type of person who performed 

the service. Based on these criteria, nursing and 

personal care services are grouped as follows, 

each s.lcceeding level being exclusive of the previ01s levels: 

Intensive nursing care 

Catheterization 

Bowel and bladder retraining 

Oxygen therapy 

Intravenous injection 

Nasal feeding 

Full bed bath 

Less Intensive nursing care 

Application of sterile dressings or bandages 

Irrigation 

Hypodermic injection 

Intramuscular injection 

Routine nursing care 

Temperature-pulse-respiration 

Enema 

Blood pressure 

Personal care 

Help with dressing, shaving, or care of hair 

Help with tub bath or shower 

Help with eating (feeding of resident) 

Rub and massage 

Xdninistration of medications or treatment 

Special diet 

33 
Nursing or personal care not provided 

In sections of this report the levels of intensive 

nursing care and full bed bath are combined and 

referred to as intensive nursing care. The levels 

of less intensive nursing care and routine nursing 

care are combined under “other nursing care.” 

T>!pe of caye Yeceived when admitted: 

The three types of care a resident received when 

admitted to the home were determined by questions 

17 and 18 of the resident questionnaire in Appendis III. 

Primarily nursing care. If a resident receivedmainly 

the nursing care items 7-19 in question 17, he was 

ciassified as receiving “primarily nursing care” in 

question 18. 

Primarily personal care. If a resident received 

mainly the personal care items 1-5 in question 17, 

he was classified as having “p:rimarily personal 

care” in question 18. 

Room and board only. This refers to a resident who 

received food and lodging only, with no provision of 

personal or nursing care. 

B. CLASSIFICATION OF HOMES BY TYPE OF SERVICE 

For purposes of stratification of theuniverseprior 

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

classified as either nursing care, personal care with 

nursing, personal care, or domiciliary care homes. 

The latter two classes were combined and designated 

as personal care homes. Details of the classification 

procedure in the MFI have been published. i 

DLW to the time interval between the MFI survey 

and the RPS-2 s’urvey it was felt that for producing 

statistics by type of service for the R.?S-2 survey, the 

homes should be reclassified oa the basis of the current 

darta collected in the survey. This classification procedure is essentially the same as the MFI schcmc. 

The three types of service classes delineated by RPS-2 

are defined as follows: 

1, A nursing care ko?ne is defined as one in which 

50 percent or rnol-e 0: the residents received 

C. RULES FOR CODING CHRONIC 

‘The list of dbgnostic categories which was used 

for coding chronic ct,hditions and irnpairm~?,lts is shown 

below. This list rc,pr’.*scnr s u cxpunsion of the two 

lists (Cards D and I,) furnished to the interviewers. 

The classification scheme wxs bAsed on the International 

Classification of Diseases with some modifications. 

Certain medical coding principles developed by the 

IIealth Interview Survey (HIS), from which statistics 

on the institutional population of the United States are 

derived,” ware used in coding the data for RPS-2. Thfe 

ml:dical coding consisted of assigning a code to each 

codable chronic condition and impairment reported for 

a resident. All codable conditions which were not specified as chronic but which could be acute or chronic (i.e., 

sinusitis, bronchitis, gastritis, or a hearing or visual 

disturbance) were assumed to be chronic. 

The medical coding principles developed by HIS 

were adapted to the coding of chronic diseases and 

impairments as follows: Im>airm;nts were coded in 

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

nursin; care in the home during the week 

prior to the survey, wi.th an R.N or LPN employed 15 hours or more per week. In this 

reptort, geriatric hospitals are included with 

nursing care hom~es. 

2. A pa~sonal cave home with nursing is defined 

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

the residents received nursing care during the 

week prior to the s$Jrvey, but there wereno RN’s 

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

50 percent, of the residents received nursing 

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

staff. 

3. A personal cave home is defined as one in 

which residents routinely received personal 

care, but no nursing care during the week prior 

t.) the survey. 

CONDITIONS AND IMPAIRMENTS 

Symptom.3, and conditions said to be due to other conditions, were coded for the most part as for HIS. Heart, 

hypertensive, and arteriosclerotic conditions were corn ­

bined as for HIS. 

Th’e coding rules allow for the assignment of one 

or more chronic conditions and impairments for each 

resident, with some loss of detail due to the restricted 

number of diagnostic categories. Some restriction exists 

for the assignment of impairments which are a result 

of the chronic condition, Some chronic conditions are 

not reported separately but are combined with other 

categories under coding rules. 

Special coding procedures were followed in coding 

categories related to senility and mental conditions. 

Injuries and traumatic origin of chronic conditions 

were not identified as such except in cases of fracture 

of the hip. Also, specific coding procedures for other 

individual chronic conditions and impairments were 

followed. 

/ 

34 
D. BASIC LIST OF DIAGNOSTIC CATEGORIES REPORTED FOR RESIDENTS 

IN NURSING AND PERSONAL CARE HOMES 

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

Malignant neoplasms, with menti.on of surgery--------

Benign and unspecified neopIasms-------------------

Asthma ________________________________________--

Diseases of thyroid gland -__-_ -___-_-_______________ 

Diabetes mellitus _________________________________ 

Avitaminoses and other nutritional weight problems---

Mental retardation without mention of senility * 

Mental retardation with mention of senile psychosis’ 

Mental retardation with senility not specified as psychotic 1 

Senile psychosis with or without other mental conditionSenility without mention of psychosis----------------

Specified mental disorders __________________-______ 

Vascular lesions affecting central nervous system----

Multiple sclerosis _______________-_-_______________ 

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

Epilepsy ________________________________________-

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

Cataract ________________________________________-

Glaucoma ________________________________________ 

Other diseases of the eye _______________ ___ _ ________ 

Diseases of the ear ______ _____ I ____ _____--___- _____ 

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

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

General arteriosclerosis ___________________________ 

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

Hemorrhoids ________________-__-_________________ 

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

Chronic sinusitis __________________________________ 

Bronchitis, witi emphysema _______-_________-______ 

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

Emphysema without mention of hronchitis------------

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

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

Hernia of abdominal cavity- ________________________ 

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

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

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

Diseases of urinary system--- _---- -------------__-_ 

Diseases of male genitalorgans---------------------

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

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

Ilrthritis-----------------------------------------

Rheumatism ______________ _ _ _ __-____ ___ __-_- ______ 

Intemationat CLass<ficatim qf Diseases 

Code Xmbers, 1955 Revision 

140-205 

140-205 

210-239 

241 

250-254 

260 

280-283,285,286’ 

304 

794 

300-303.305-324 

330-334 

345 

3iO 

353 

MO-343.354-357.361-369 

385 

38’ 

R-0-379, 380-384.386.388 

390-396 

410-4-C+. X2.1, 782.2, 782.4 

444-347 

4.50 

460,462 

461 

400403, -El--I%, 463-168, -82.0, 782.3, X2.5-7829 

313 

io2.0 

502.1 

527.1 

510.0, 512. 314-526, 527.0, 527.2, 783 

540-532 

560, 561 

584-586 

330-339, 5X3-545. 352. 553, 570, 572-574, 577, ,576, 

580-583, 587. 784 

785.7. 786.2 

391-594, 600-609, ‘86.0. 786.1, ‘86.3-786.5, 789 

610-617, 786.6 

620.621,623,623, 626, 630-637, 786.7 

700-716 

720-723 

726.0, 726.1, 726.3, 727 

35 
-- 

Other specified diseases of bones and organs of movement _-_-____________________________________---

Fracture, femur (old) ___________-__________________ 

All other chronic conditions, excluding impairmentsVisual impairment: inability to read newspaper with 

glasses ’ 

Other visual impairments ’ 

Hearing impairments’ 

Speech impairments due to stroke1 

Speech impairments due to other 

causes l 

Paralysis, palsy due to stroke * 

Paralysis, palsy due to other 

Absence, fingers and/or toes’ 

Absence, major extremities’ 

Impairment, limbs, back, trunk’ 

All other impairments 1 

or unspecified 

unspecified causes’ 

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

N820.9, N821.9 

Residual 

of a special supplementary code developed for the Household Interview SurCoding Manua2 and the Short Index, NHS-HIS-1000, 1965. 

ooolSelected conditions and all impairments are classified by means 

vey. The details of this classificntion are contained in the Medical 

36 
APPENDIX III 

RESIDENT QUESTIONNAIRE AND OTHER SURVEY FORMS 

U.S. DEPARTMENT OF COMMERCE 

BUREAU OFI-“E CENSUS 

WASHINGTON. D.C. a%?33 

J 

Dear Administrator: 

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

United States Public Health Service, is conducting a nationwide survey 

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

nurs:.ng, personal, and domiciliary care to the aged and infirm. The 

purpose of this survey is to collect much needed statistical information 

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

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

Congxss because of the urgent nee d for up-to-date statistics on the 

health of our people. 

The ourpose ,of this letter is to request your cooperation and to inform 

gou that a representatdve of the Bureau of the Cpnsus will visit your

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

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

convenient appointment time. 

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

strictly confidential by the Publi c Health Service and the Bureau of 

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

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

Sincerely yours, 

G%G 

Richard M. Scsmmon 

Director 

Bureau of the Census 

37 
Budger Elurean No. G&R620.R2: Approval Expires December 31. 1964 

CONFIDENTIAL - This iniormarian 1s callecred for the U.S. Public Health Service under aurhodcy of Public Law 652 of the 84th Congress

(70 Stat. 409; 42 U.S.C. 305). All information which would permr idenrificnrion of rhe individual will be held siricrly confidential, will be 

used only hy persons engaged tn and for rhe purposes or the survey, and will nor he disclosed or released IO others for any ocher purposes

(22 FR 1687). 

U.S. NATIONAL HEALTH SURVEY 

ESTABLISHMENT QUESTIONNAIRE 

- I 

I

I I 

Registered Licensed SOllEOW 4. Is the person who supervises NURSING CARE 1 0 professional z 0 practical 3 0 else a reaistcred nrofessionol o lizased I 

5. Does she work full-time or part-time?

By full-time we mean 40 or wara hours (I week. I 

10 Yes 20 No

I 6. Is there a nurse or nur<e’s aide ON DUTY 24 hours Q day? I 

38 

I 
I Budget Bureau No. 6&R62O.Rz, Approval Expires December 31. 1964 

Establishment number Resident’s (patient’s) line No. 

Month ; Year 

1. What is the month and year of this resident’s (patient’s) birth? I 

2 sex I c] Male (Aek pueetfico 3) 2 0 Female (Go to quSs+ion 4) 

3a. Has he served in 3~: R-?-O INTERVIEWER: 

.!7ourcs of “&e&m *tadtf&s the Armed Forces of t 0 Yes (Ask Q. 3b) z 0 No (Go to Q. 4) 3 0 Unknown information the United S+a+es? 

b. Did he serve in I 0 Record z 0 Sample person 

World War I? tOYe* ZIJNO 3 0 Unknown 3 0 Respondent 

4. Is this rasidant (patient) married, I 0 Married a 0 Divorced s 0 Never married widowed, divorced, separated, or z 0 Widowed 4 0 Separated never married? 

Month ’ Year 

I 5. In wh a t month and year was he (la‘+) acbnittad to this home? 

6. With whom did he live a? -I j-J In another nursing home or 

the’time of his admission? related facility 

(Check tbe FIRST 8 0 In mental hospital 

box that applies) 9 0 J.n a long-rerm specialty hospital

(except mental) 

s 0 Lived in aparrmenc or own homc- 10 0 In a general or short-stay hospital 

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

6 [7 IO boarding home 

7. How ohsn do friends or t 0 At least once a week J 0 Less than once a month nlotivss visit him? 

(Check the FIRST z 0 Less often than once a week but at 4 0 Never box that applies) least once a month 

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

b. Doss he stay in his own room all or most of the day? I 0 Yes z 0 No (Ask question SC) 

c. Does he go off the premises lust to walk, shop, or 

visit with friends or relatives and so forth? I I-J Yes ZI-JNO 

9. Which of these special aids (chock all that spply) does this resident (patient) 

I 0 Hearing aid a 0 Braces 7 0 Eye glasses 

2 0 Walker s 0 Wheel chair OR 

B I-J Ctutches 6 0 Artificial limb(s) a 0 None of these aids used 

10. During his stay hero when did he last see CI Month ’ Year I-J Never saw doctor 

use? (show car.3 C) 

doctor for treatment, medication, or for on I I I while here I examination bv the doctor? I

111~. During his stay hers, 

has he seen a dentist? t 0 Yes ,‘Ask question fib) z 0 No (Go to qoestion 12) 

M0ntb ;YW 

h. When was the lost time he saw a dentist? I 

120. Ho‘ he lost ALL of his teeth? I 0 Yes (Ask quselian l2b) 2 0 No (Go to question 13) 

b. Does he wear full upper and lower dentures? SI-JYC‘ I[=jNO 

13. Does this resident (patient have any of these conditions? 

(Show card D. Record in 4 able I each eonditiar which the patient has) 1 l--JYes 2l-JNo 

14. Does he hove any of these conditions? 

(show csrdE. Record in Table 1 each condition which the patient has) 10 Yes 2mNo 

1% Doer he have any other CHRONIC conditions listed in his record that you have not told me &out? 10 Yes 2l-JN.z. 

If “Yes,,” ask: 

b. What are they? 

(Recordin Table 1 each chronic condition mentioned) 

Page 6 

39 
Table 1 

Enter conditions from questions 13, 14 oc 15 For the following conditions ask these questions 

ILL EFFECTS OF STROKE. . . . . Who+ ore +he present ill effects? 

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

PARALYSIS, PERMANENT not 

Enrer chP words used by rhe cespondenr co STIFFNESS . . . . . . . . . . . . . . . Who+ port of the body is affected? write 

describe the condition. TUMOR, CYST, OR GROWTH. . . . Who+ port of the body is affeskd? in 

Is it malignant or benign? this 

DEAFNESS, HEARING TROUBLE, column 

OR ANY EYE CONDITION. . . . . . Is one or both ears (ayes) (Include glaucoma rmd cetoroa) affected? 

(a) (b) Cc) 

1. 

2. 

7. 

8. 

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

You tdld me about this resident’s (patient’s) eye condition. 

Can he see well enough to read ordinary newspaper print with glosses? 10 Yes 20NO 

17. During the 7 days which postof 1 0 Help with dressiag, shaving, 8 0 Temperacuce-pulse- 17 0 Intravenous injection 

these servicer or care of hair respcration 18 0 Incramusculac injection 

did this resident 2 0 Help with rub bath 9 0 Full-bed bath 19 0 Nasal feeding 

(patient) receive? or shower I o 0 Enema 

3 0 Help with eating 1 I 0 Catheterization OR (Show card F 

one and 4 0 (feeding check each Rub and the resident(patienc)) 12 0 Bowel and bladder 

mentioned) 5 massage retraining 20 0 None of the above 0 Adminisccacion of ~3 0 Blood pressure services received 

6 0 ’ medicationsdiet or treatment Special 14 0 Irrigation

7 0 Application of sterile 15 I-J Oxygen therapy 

dcessinas or bandaaes 16 0 Hypodermic injection 

18. At the time this resident (patient) was admitted +o 1 0 Primarily 2 0 Primarily 3 0 Room and this home, who+ kind of core did he receive-primarily nursing P.XSO”d board only nursing core, primarily personal core, or room and care care board onlv? (Check one box on/v) 

A”lou”c 

19. What was +he TOTAL charge for this resident’s (patient’s) core last month? s 

o. What is the PRIMARY sourse of poymsn+ for his core? ; 20b. Are there any odditionol sources of payment?

(Check ONE box only) I (Check ALL boxes that apply) 

1 0 Own income oc family support (Include private plma, 1 0 Own income oc family support (Include private plans, retirement funds, social security, etc.) retirement fuods, social secudty, etc.) 

2 0 Church support 2 0 Church support 

3 0 Veterans benefits 3 0 Veremns benefits 

4 0 Public assistance oc welfare 4 0 Public assistance or welfare 

5 0 Initial payment - life care 5 !J Initial payment - life care 

6 0 Other (Please describe) 6 0 Ocher (Please describe) 

I I

I 

I 

7 0 

OR 

No additional sources 

I 

I I 

Page 35 

40 
card D card E 

LIST OF CHRONIC CONDITIONS LIST OF SELECTED CONDITIONS 

Does this resident have any of these conditions? Does this resident have any of these conditions? 

1. Asthma 1. Deafness or SERIOUS trouble hearing with one or both ears 2. CHRONIC bronchitis 2. SERIOUS trouble seeing with one or 

3. REPEATED attacks of sinus trouble both eyes even when wearing glasses Any speech defect 4. Hardening of the arteries 2: Missing fingers, hand, or arm--toes,

5. High blood pressure foot, or leg Palsy 

6. Heart trouble 2: Paralysis of any kind 

Any CHRONIC trouble with back or spine

7. Ill effects of a stroke i: PERMANENTstiffness or any deformity 

8. TROUBLE with varicose veins of the foot, leg, fingers, arm, or back 

9. Hemorrhoids or piles 

10. Tumor, cyst or growth Card F 

11. CHRONIC gall bladder or liver trouble LIST OF SERVICES 

12. Stomach ulcer 1. Help with dressing, shaving, or care 

13. Any other CHRONIC stomach trouble of hair 

Help with tub bath or shower 14. Bowel or lower intestinal disorders Help with eating (feeding the patient) 

15. Kidney stones or CHRONIC kidney trouble 4. Rub and massaee 

5. Administratio; of medications or treatment 16. Mental illness Special diet 

17. CHRONIC nervous trouble ;: Application of sterile dressings or 

bandages 18. Mental retardation Temperature - pulse - respiration

19. Arthritis or rheumatism ? Full bed bath 

Enema 20. Diabetes :"1: Catheterization 

Bowel and bladder retraining 21. Thyroid trouble or goiter 2: Blood pressure Irrigation 22. Epilepsy \ 2: Oxygen therapy

23. Hernia or rupture Hypodermic injection 

24. Prostate trouble :;: Intravenous injection Intramuscular injection 25. ADVANCEDsenility :t : Nasal feeding 

41 

* “. s. GOVERNMENT PRINTING OFFICE? 1968-3342040/9 
Series 1. 

Series 2. 

Series 3. 

Series 4. 

Series 10. 

Series 11. 

Series 12. 

Series 13. 

Series 20. 

Series 21. 

Series 22. 

OUTLINE OF REPORT SERIES FOR VITAL AND HEALTH STATISTICS 

Public Health Service Publication No. 1000 

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

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

and other material necessary for understanding the data. 

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

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

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

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

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

health statistics, and documents such as recommendedmodelvital registration laws and revised birth 

and death certificates. 

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

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

in a continuing national household interview survey. 

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

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

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

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

universe of persons. 

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

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

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

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

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

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

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

and time series analyses. 

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

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

geographic and time series analyses, studies of fertility. 

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

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

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

life, characteristics of pregnancy, etc. 

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

National Center for Health Statistics 

U.S. Public Health Service 

Washington, D.C. 20201