Data from the Series 13 NATIONAL HEALTH SURVEY Number 43 The National Nursing Home Survey: 1977 Summary for the United States . Data collected in the 1977 National Nursing Home Survey (NNHS) are presented in 43 tables according to standard sets of descriptive variablk The tables are grouped into six categories: facility, staff, financial, resident, discharge, and charge characteristics. Data are presented that measure utilization, staffing patterns, cost of provid- ing care, health and functional status of residents and dkcharges, and payment for care. Information on completed episodes of care are available for the first time from this survey system based on data collected on persons discharged during 1976. The 1977 NNHS covered all types of nursing homes in the conterminous United States. DHEW Publication No. (PHS) 79-1794 U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service Office of Health Research, Statistics, and Technology National Center for Health Statistics Hyattsville, Md. July 1979 1 Library of CongrassCataloging in Publication Data United States. National Center for Health Statistics. The national nursing home survey. (Vital and health statistics : Series 13, Data from the National Health Survey ; no. 43) (DHEW publication; no. (PHS) 79-1794) Includes bibliographical references and index. 1. Nursing homes–United States–Statistics. I. Title. II. Series: United States, National Center for Health Statistics. Vital and health statistics : Series 13, Data from the National Health Survey, Data on health resources utilization ; no. 43. III. Series: United States. Dept, 1 of Health, Education, and Welfare. DHEW publication ; no. (PHS) 79.1794. [DNIJvl: 1, Nursing homes–United States–Statistics. W2 AN148vm no, 43] RA407.3A349 no. 43 [RA997] 362.1’1’0973s [362.1’6’0973] ISBN 0-8406 -0166-2 79-607104 For saleby the Snpmfntendentof Documents,U.S. GomrzmmntPrfnting OfEce Washington,D.C. 2010s NATIONAL CENTER FOR HEALTH STATISTICS DOROTHY P. RICE, Director ROBERT A. ISRAEL, Deputy Director JACOB J. FELDMAN, Ph.D., Associate Director for Analysis GAIL F. FISHER, Ph.D., Associafe Director for the Cooperative Healfh Sfafktics System ROBERT A. ISRAEL, Acting Associate Director for Data Systems JAMES T. BAIRD, JR., Ph.D., Associate Director forInternafional Statistics ROBERT C. HUBER, Associafe Director for Management MONROE G. SIRKEN, Ph.D., Associate Director foriklafhematical Stafisti.cs PETER L. HURLEY, Associafe Director for Operations JAMES M. ROBEY, ph~., As.ociafe Director forProgr.m Developmcrrt PAUL E. LEAVERTON, Ph.D., Associate Direcfor for Research ALICE HAYWOOD, Information Officer DIVISION OF HEALTH RESOURCES UTILIZATION STATISTICS SIEGFRIED A. HOERMANN , Director JOAN F. VAN NOSTRAND, Chief Long-Term Care Statistics Brarsck JAMES E. DELOZIER, ChieJ Ambulatory Care Statktics Bran:h SIEGFRIED A. HOERMANN, Acting Chiej Hospital Care Sfafisfics Branch MANOOCHEHR K. NOZARY, Chiej Technical Services Brarsch STEWART C. RICE, ChieJ Family Plann{ng Sfafkfics Branch Vital and Health Statistics-Series 13-No. 43 DHEW Publication No. (PHS) 79-1794 Library of Congress Catalog Card Number 79-607104 , CONTENTS Introduction ......................................................................................................................................... ... 1 Overview ....................................................................................................................a...................... 1 - Scope ................................................................................................................................................ Interpretation and Source of Data .................................................................................................... : Trend Comparisons .... ......................................................................................................... .............. 2 Qualifications .................................................................................................................................... Publication Plans ............................................................................................................................... :. References .............................................................................................................................................. 4 List of Dcta.ifed Tables ........................................................................................................................... 5 Appendixes I. Technical Notes on Methods ..................................................................................................... 115 II. Definition of Certain Terms Used in This Report ...................................................................... 130 111. Survey Instruments Used in the 1977 National Nursing Home Survey ...................................... 142 IV. Criteria for Classifying Nursing Homes According to Level of Nursing Care .............................. 209 Index ..................................................................................................................... ................................- 211 Ill SYMBOLS Data not available— —— ..- Category not applicable———— . Quantity zero ——.. — - Quantity more than O but less than 0.05— 0.0 Figure does not meet standards of reliahlity or precision (more than 30 percent relative standard error)———— * iv .- THE NATIONAL NURSING HOME SURVEY: 1977suivmmw FORTHE‘LiiITED-STATES Joan F. Van Nostrand, Aurora Zappolo, Esther Hing, Barbara Bloom, Bennett Hirsch, and Daniel J. Foley, Division of Health Resources Utilization Statistics INTRODUCTION of facility; resident days; admissions; live and dead discharges; occupancy rate; certi- Overview fied beds; and selected service, buildlngj and operating characteristics. This report summarizes the data collected in the 1977 National Nursing Home Survey Staff characteristics. –Tables include occupa- (NNHS). This nationwide sample survey of nurs- tional category, full-tim~equivalent employ- ing homes—their residents, their discharges, and ees, full-time equivalent employees per 100 r their staff–was conducted by the National Cen- beds, average hourly wage, years of experi- ter for Health Statistics from May through De- ence, selected employee characteristics, and cember 1977. All types of nursing homes in the number of vacant staff positions. conterminous United States were included in the Financial characterktics of the facility.– 1977 NNHS regardless of their intensity of serv- ice and their participation in the Medicare or Tables include cost and revenue per patient day, cost and revenue by components, net Medicaid programs. Although provisional statis- income, cash flow, and capital returns. tics on residents and dkchargesl and on facili- ties have been published, thk is the first time Resident characterktics. -Tables include that final estimates, based on the entire nation- demographic characteristics; outside living wide sample, have been released. To aid in arrangements; length of stay since admission; understanding and interpreting the data, this primary diagnosis at last examination; introduction provides a description of the scope chronic conditions and impairments; pri- of the report and a review of background infor- mary re~ on for c=e; me~lcations; func- mation about the survey, presented in detail in tional status; use of speciaI aids or devices; appendixes I-IV. level of care; physician, therapy, and other health services received; and social contacts Scope and activities. The scope of this report includes virtually all Discharge -characteristics.—Tables include the data items collected in the 1977 NNHS. discharge status (live or dead); demographic They are presented in 43 tables according to characteristics; outside ~lving arrangements; standard sets of descriptive variables. The tables duration of stay; primary diagnosis at admis- are grouped in six categories: sion; chronic conditions and impairments; functional status; use of special aids or de- Facility characters_stics.-Tables include own- vices; level of care; and physician, therapy, ership; certification; bed size; location; type and other heahh services received. 1 I Charge characteristics for residents and for a sample of discharges ocenrring in 1976 discharges. –Tables include average total were collected by interviewing the nurse most monthly charge, primary source of payment, familiar with the relevant medical records. When and average amount paid by the primary responding, the nurse relied solely on medical source of payment. records because too long a time had passed be. tween the discharge event and the interview to The reader can locate data in this report in permit reliable recall of information. (Survey two ways: by referring to the List” of Detailed instruments used in the 1977 NNHS are pre- Tables and to the Index. The List of Detailed sented in appendix III.) Tables, immediately following this Introduction, These differences in design, coverage, and describes the content of each table. Tables are reference periods produced both snapshot and grouped according to the six categories as just duration data summaries.. Estimates of the num- described. The Index, at the end of this report, ber and eharactenstics of facilities, residents, presents each key variabIe along with a Jist of and employees are snapshot data and reflect the the tabIes in which the variable appears. situation on any particular day during the May- December 1977 survey period. Estimates of the interpretation