Data on NATIONAL HEALTH RESOURCES Employeesin NursingHomes in the UnitedStates: 1973-74 National Nursing Home Survey Statistics on nursing home employees including hourly wages, work experience, education, age, sex, and race, according to certification, ownership, bed capacity, and regional location of the homes. Based on data collected in the 1973-74 National Nursing Home Survey. DHEW Publication No. (PHS) 79-1815 Series 14 Number 20 U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service Office of the Assistant Secretary for Health National Center for Health Statistics Hyattsville, Md. February 1979
Transcript
Data onNATIONAL HEALTH RESOURCES
Employeesin NursingHomes
in the UnitedStates:1973-74 National Nursing Home Survey
Statistics on nursing home employees including hourly wages, workexperience, education, age, sex, and race, according to certification,ownership, bed capacity, and regional location of the homes. Basedon data collected in the 1973-74 National Nursing Home Survey.
DHEW Publication No. (PHS) 79-1815
Series 14Number 20
U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE
Public Health ServiceOffice of the Assistant Secretary for Health
National Center for Health StatisticsHyattsville, Md. February 1979
Library of Congress Cataloging in Publication Data
Sirmcm ), Alvin.Emplc )Iem in nursing hmncs in the U.S.
(1’it:d :Ind he31th st.ltistics: Series 1-!, Data on naticmal health resources: no. 20) (DI IE\\’pllhlicatii~n; (PHS) 7!3-1S 15)
ltlcl I.ldcs hihliographical references.1. Nursing homes-Unitecl States -EmpIo~ees-Statistics. I. Title. II. Serius: Lkiitcl I
St :itrs. N;lti~_j]~~ilCenter for Health Statistics. \~itaJ and health statistics: Series 14, Dai~l ~Innuti(tn:ti Ile;llth resources, rntinpo~ver and facilities; no. 2(I. 111. Series: United States. 13cpt.f~l’J-fu:ilIII, F,(ll[r:ltinn, and \\~clfoK. DHEIV publication: (PHS) 79-1 815. [DNLhi: 1. Nursin+AJ.~ll]]tlx\t:i.-LTnitecl States. 2. Nursing staff —SuppIy ancl distribution-unitec[ States.IY: ;\ N I 4s\m 11[:).2ft 11?.19!37.s55 S31.7’61’362160973 78-56s1lsm (1-s406-0130-1
NATIONAL CENTER FOR HEALTH STATISTICS
DOROTHY P. RICE, Director
ROBERT A. ISRAEL, Deputy DirectorJACOB J. FELDMAN, Ph.D., Associtite Director for Analysis
GAIL F, FISHER, Ph.D., Associate Director for the Cooperative Health Statistics SystemELIJAH L. WHITE, Associate Director for Data Systems
JAMES T. BAIRD, JR., Ph.D., Associate Director for Internutiotud StatisticsROBERT C, HUBER, Associate Director for Management
MONROE G. SIRKEN, Ph.D., Associate Director for Mathematical StatisticsPETER L. HURLEY, Associate Director for Operations
JAMES M. ROBEY, Ph.D., Associate Director for Program DevelopmentPAUL E. LEAVERTON, Ph.D., Associate Director for Research
ALICE HAYWOOD, Information Officer
DIVISION OF HEALTH MANPOWER AND FACILITIES STATISTICS
GLORIA HOLLIS KAPANTAIS, DirectorSHELDON STARR, Deputy Director
EVELYN MATHIS, ChieJ Health Facilities Statistics BranchJOSEPH BARBANO, Chief Health Manpower Statistics Branch
CHARLES CRONER, Chiej Technical Services Branch
Vital and Health Statistics-Series 14-No. 20
DHEW Publication No. (PHS) 79-1815.Library of Congress Catalog Card Number 78-5681
AppendixesI. Technical NotesonMethods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .H. Definitions of Certain Terms Used in This Report . . . . . . . . . . . . . . . . . . . . . . . . . .HI. Criteria for Classifying Nursing Homes According to Level of Nursing Care . . . . . . . . . . . .IV. Selected Questionnaires Used in the 1973-74 National Nursing Home Survey . . . . . . . . . .
LISTOFTEXTTABLES
A. Number of full-time and part-time administrative and medical employees in nursing homes, bytypeofemployee: United States, 1973-74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
B. Averages of total years of nursing home and hospital experience as a registered nurse and years ofcurrent nursing home employment, byaverage hourly wage: United States, 1973-74 . . . . . .
C. Averages of total years of nursing home and hospital experience as a licensed practical nurse andyears of current nursing home employment, b y average hourly wage: United States, 1973-74..
D. Averages of total years of nursing home and hospital experience as a nurse’s aide and years ofcurrent nursinghome employment, by average hourly wage: United States, 1973-74 . . . . . .
E. Numbers of full-time and part-time therapeutic employees in nursing homes, b y type of emplo yee:United States, 1973-74 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
F, Number of nursing homes and full-time equivalent (FTE) therapeutic emplo yees and rate per 100homes, by selected nursing home characteristics: United States, 1973-74 . . . . . . . . . . . . .
G. Number of full-time and part-time therapeutic employees, by region of hospitzd and years of
Data not available ----------------------------------------- ---
Category not applicable -------------------------------- . . .
Quantity zero ----------------------------------------------- -
Quantity more.than Obut less than 0.05------ 0.0
Figure does not meet standards ofreliability or precision ------------------------------ *
iv
EMPLOYEES IN NURSING HOMES IN THE UNITED STATES:
1973-74 NATIONAL NURSING HOME SURVEY
AlSirrocco, Division of Health Manpower and Facilities Statistics
INTRODUCTION
Scope of Report
From August 1973 to April 1974, the Na-tional Center for Health Statistics, through theDivision of Health Resources Utilization Sta-tistics, conducted a nationwide sample survey ofnursing homes, their residents, and staff. Thisreport presents estimates from that survey onthe characteristics of employees working inthose homes.
Data relating to nursing home characteristicssuch as certification, ownership, bed capacity,and regional location were obtained by means ofthe survey. In addition, numerous questionselicited data pertaining to employee charac-teristics such as race, sex, and age as well ascovering such topics as salary and other benefits,length of current and past employment, extentof formal education, and kinds of trainingcourses. Because so many important variableshave been defined, a tremendous amount ofinformation is available from the survey. How-ever, in order to present as many tables as possi-ble, the discussion and analysis of this report arelimited to only the highlights of the major em-ployee categories.
Background
Since 1963 the National Center for HealthStatistics (NCHS) has employed two types ofsurveys to gather nursing home data—universesurveys and sample surveys.
During universe surveys a mailout question-naire is used to elicit basic information on char-acteristics of all known nursing homes in theUnited States. A series of these universe surveys,called Master Facility Inventory (MFI) Surveys,has been conducted (1963,1 1967,2 1969,31971,4 and 19735). A special ad hoc universesurvey was conducted in 19686 and more de-tailed information was obtained than in the MFISurveys.
‘However, the more detailed and time con-suming surveys are perhaps more efficiently con-ducted as sample surveys, which cover only asmall fraction of the total universe and can beconducted via personal interviews rather thanmailings. This technique has been used a numberof times by NCHS in collecting nursing homedata (1963,7 1964,8 and 19699). The universeused in drawing the samples for these surveyshas in each case been the most recent MFI listingwith newly opened nursing homes added to it.The 1973-74 National Nursing Home Sur-vey 10-13 is the latest completed sample survey.
Qualifications of the Data
Since the 1973-74 nursing home survey wasconducted pn”or to the 1973 MFI Survey, theuniverse used in drawing the sample was the1971 MFI together with all nursing homes thatwere found to have begun operation betweenthe time of the 1971 MFI Survey throughJanuary 1973.
To be included in the sample, a nursinghome had to qualify by NCHS criteria as either a
nursing care home or a personal care home withnursing service (appendix IV). This samplingprovision excluded homes where the care of-fered was entirely personal or domiciliary. Alsoexcluded from the sample were nursing homes inAlaska and Hawaii,‘ BeZause t~unwerse was based on the-1971
.. . .. ..
survey, all homes found in that survey to bepersonal care or domiciliary care were excludedfrom the sampling frame, since there was no wayof knowing if they had upgraded to a personalcare with nursing or nursing care home by thetime the 1973-74 survey began. As a result ofthese exclusions, the estimates from this surveydo not correspond precisely to the figures fromthe 1973 MFI Survey. (See appendix I,“Sampling Frame,” for details.)
To participate as a Medicare provider, ahome must be certified as an extended care facil-ity (ECF) according to the requirements of Med-icare legislation in effect at the time of thesurvey (Title XVIII of the Social Security Act).To participate as a Medicaid provider, a homecould be certified as a skilled nursing home(SNH) and/or as an intermediate care facility(ICF) according to the requirements of Medicaidlegislation (Title XIX of the Social SecurityAct) .’
Of the homes which were certified, somewere certified under bo i% the Medicare andMedicaid programs. Other homes certified onlyby the Medicaid program were certified to par-ticipate as both a skilled nursing home and anintermediate care facility. In order to providedetailed data by certification status, some smallcertification subgroups were combined withlarger ones when both provided similar levels ofcare. Thus, those homes classified throughout
, this report as having been certified by bothMedicare and Medicaid actually include 8 per-cent that were certified by Medicare only. Simi-larly, those homes classified as having been certi-fied by Medicaid as skilled nursing homes actu-ally include 35 percent that were also certifiedas intermediate care facilities.
‘The extended care facility and skilled nursing homedesignations are used in this report because most of thesurvey was conducted prior to legislation that createdthe skilled nursing facility designation.
Many - of the survey findings discussed inthese pages are expressed as percentages of theestimated employees. Tables of sampling errorsfor these estimated percentages as well as othersampling errors appear in appendix I.
When discussed in terms of rates and ratios,employees in nursing homes probably can bestbe examined by using full-time equivalent (FTE)employees. This measurement has been usedfrom time to time throughout this report andcan be derived by using the follo~ving formula:FTE = (full-time employees) + (part-time em-ployee hours/35 hours). However, since theprimary emphasis is on the characteristics of thestaff, the central focus will be on the actualfull-time and part-time employees. Definitionsof terms used in this report are given in appen-dix II.
HIGHLIGHTS
The following discussion desk with totalstaff, the three major health-related categories ofemployees (administrative and medical staff,nursing staff, and therapeutic staff), and em-ployees in charge of shifts. The final group hasbeen included in order to compare attributes ofemployees selected to be in charge of nursingcare with those not selected. The survey countedbut did not collect information for the group“All other staff.” The counts are presented intables 1 and 2.
Total Staff
An estimated 590,000 full-time (table 1) and270,000 part-time (table 2) employees workedin the 15,700 nursing homes covered by the sur-vey. Excludlng the clerical and office staff, foodservice personnel, and housekeeping and main-tenance personnel, for \vhom no data \vere col-lected, the total numbers of health-related enl-ployees were approximately 409,000 full-time(table 1) and 174,000 part-time (table 2). Con-
verting these to full-time equivalents ( FTI?’s),there were 46 FTE health-related employees per100 residents. In 1968 a comparable statisticshowed a rate of 42 FTE’s per 100 residents.6
2
Administrative and Medical Staff
The types of nursing home employees in-cluded in this group are listed in table A, alongwith the number of full-time and part-timeemployees estimated to be in each category (ex-tracted from tables 1 and 2).
Table A. Number of full-time and part-time administrative and
medical employees in nursing homes, bv tvDe of emcdo’vee:United States,”1 973-74 -
Type of employee
Total administrative andmedical employ ees, . ... .. .. ... . .. .. .. ..
Other medical record administratorsand technicians ... . ... .. .. ... .. ... .. .. ... .. .. .
Full-time
24,700
18,8001,000
100
6001,300
*loo
1,600
1,200
Part-t ime
22,600
2,2005,7001,300
2,9006,000
1,600
1,900
1,000
The total number of all these types ofemployees working full time in nursing ‘homes\vas approximately 25,000, of which 19,000were administrators or assistant administrators.Because they made up such a large proportion ofthe group, the remainder of this section will dealonly with administrators and assistant adminis-trators, The survey did not distinguish be-t~vecn administrate ors and assistant administrators;thcrcl’ore, they will be treated as one andreferred to as administrators. The number ofpart-time administrators was so small that onlythe full-time administrators will be discussedhere.
A look at administrators as a whole revealed
● About an equal number of women andmen.
. Some black administrators (3 percent)but mostly white (96 percent).
. An average age of 47 years.
. An average hourly wage of $5.44.
. A preponderance of high school grad-uates (95 percent).
. 2 out of 5 with college degrees.● An average current employment of 6.3
years.● An average total work experience of
10.6 years as nursing home or hospitaladministrators.
Although this overall view is useful, an evenc1e are r picture emerges when comparisonsbetween the sexes, races, and ages are made rela-tive to their salaries, education, and work expe-rience. Additional analyses can then be made interms of the certification status, bed capacity,ownership, and location of the nursing homesthemselves.
One observation concerning nursing homeadministrators was that men apparently receivedmore compensation (wages and fringe benefits)in their capacity as administrators than womenreceived. This was shown in a number of tables,most of which will be discussed here.
The average hourly wage of full-time admin-istrators was $6.22 for men and $4.56 forwomen (table 1).Although this difference wasnot statistically significant, it is strikingly con-sistent with similar findings that werestatistically significant. For instance, only 22percent of the male administrators earned lessthan $4.00 per hour, whereas 45 percent of thefemale administrators earned less than this(tables 3 and 4, respectively). At the other end,nearly 36 percent of the men earned $6.00 ormore an hour, yet only 20 percent of thewomen did so.
There were also differences between thesexes in the fringe benefits received by these ad-ministrators. Most notably, in the area of healthand/or life insurance coverage, nearly 66 percentof the men compared with 44 percent of thewomen received this benefit (tables 3 and 4,respectively). In the area of pensions, about 21percent of the men compared with 9 percent ofthe women received pensions.
Men had more years of formal educationthan women, with the median being 15 years formen and 13 for women. If salaries for men andwomen of equal education (13 years or more)
3
are compared, the salaries for the men were stillsignificantly higher. Of this group, only 17 per-cent of the men versus 39 percent of the womenearned less than $4.00 per hour. Furthermore,40 percent of the men versus 24 percent of thewomen earned $6.00 or more per hour.
A nonsignificant difference was evident forthose with 12 years or less of education, as 60percent of the men compared with 41 percent ofthe women earned $4.00 or more per hour.
The women were approximately the sameage as the men (48 years of age and 45 years ofage, respectively) (table 1). Although tables 3and 4 show that women earned less than men ineach of the four age groups, none of the differ-ences were statistically significant. The tablesalso indicate that age had no apparent effect onsalaries for either men or women. This is illus-trated by the fact that the younger, the middle-aged, and the older administrators of each sexhad approximately the same proportion of theirage group earning less than $4.00, $4.00 to$5.99, and $6.00 or more per hour.
Women had not only more years of currentemployment than men but also more years oftotal experience as administrators in nursinghomes and hospitals. The average number ofyears of current employment as nursing homeadministrator was 7.2 for women and 5.3 formen (tables 4 and 3, respectively). The averagenumber of years of total experience was 12.0 forwomen and 9.0 for men. Actually, as tables 3and 4 indicate, there appears to be little or norelationship between years of employment andsalaries for men or women.
The study showed that the administrators ofhomes of large bed size generally hadhigher salaries than those in the small homes.This seems reasonable since the large homeswould have more residents, more staff, and, ingeneral, more responsibilities. Tables 3 and 4show that the large nursing homes tended toemploy the men, while the small homes em-ployed the women. Specifically, in the homeswith 100 or more beds, of the 5,900 adminis-trators, 2 out of 3 were men. In the homes withless than 50 beds, of the 6,200 administrators, 2out of 3 were women.
On the surface, therefore, the salary differ-ences between male and female administrators
appear to depend on the size of the nursinghome; that is, the large homes (with highersalaries) employed more men, while the smallhomes (with lower salaries) employed morewomen. However, tables 3 and 4 indicate thatsalary differences between the sexes existedwithin both homes. For instance, in the largesthomes (100 beds or more) only 14 percent ofthe men compared with 38 percent of thewomen earned less than $4.00 an hour, whereas50 percent of the men compared with 26 per-cent of the women earned $6.00 or more anhour. Similarly, in the smallest homes (less than50 beds) women tended to earn lower wageswhile men tended to earn higher wages.
The survey found that 96.4 percent of thenursing home administrators were white and 3.1percent were black (table 5). Since there were sofew black administrators (about 600) and evenfewer were of all other races combined (less than100), detailed comparisons between races wouldnot prove significant because the sampling errorsare too large.
A synopsis of remaining highlights for ad-ministrative and medical staff follows.
From a regional standpoint, it was found(table 6) that the estimates were higher foraverage hourly wages paid to administratorsworking in the Northeast Region of the UnitedStates ($6.92), while the estimates were lowerfor wages paid to those in the South ($4.39).The differences between these estimates werenot statistically significant.
Type of ownership of the home had no dis-cernible effect on salaries. Proprietary nursinghomes paid approximately the same salaries toadministrators as nonprofit and governmenthomes paid (tables 6, 7, and 8).
During the year prior to the survey, approx-imately 77 percent of the administrators hadtaken nondegree health-related courses, and 62percent had taken courses specifically related tonursing home administration (table 9).
Finally, comparing this survey with a 1969surveyg showed an increase in the percent ofadministrators having more than 12 years ofeducation (50 percent in 1969 and 70 percent in1973-74) and more than double the number ofadministrators under the age of 35 (1,600 in1969 and 3,400 in 1973-74).
Nursing Staff
For purposes of this report the nursing staffwill be divided into three categories—registerednurses, licensed practical or vocational nurses,and nurse’s aides (and orderlies).
R eg”stered nurses.–h estimated 38,700full-time (table 1) and 28,500 part-time (table 2)registered nurses (RN’s) were employed in thenursing homes covered by the 1973-74 survey.As a, whole, these RN’s had the followingcharacteristics:
. More than 98 percent were women.
. Ninety-five percent were white and threepercent were black.
. Average age was 44.
. Average hourly wages were $4.83 forfull-time work and $4.61 for part-time.
. Virtually all (98 percent) had 13 years ormore of education.
. For full-time RN’s the average currentemployment was 3.5 years.
. For full-time RN’s the average totalwork experience as an RN was 14.2years.
With so few men and so few black RN’s,detailed comparisons could not be madebetween sexes and races. The large samplingerrors would render the differences not signific-ant. The following figures show the relative sizeof the estimate.
. Average hourly wage–women $4.83, men$4.93; white $4.82, black $5.56.
. Average age–women 44, men 39; white44, black 42.
. Total llN work experience–women 14.2“years, men 10.9 years; white 14.3 years,black 14.7 years.
In the absence of sex and race comparisons,other points of interest arose. Full-time RN’searned an average of $4.83 an hour, a rate thatwas quite uniform throughout the United States.
The range in the hourly wage paid to RN’sfrom one region to another was from $5.02 perhour in the South to $4.61 per hour in the West(table 6). A further indication of how uniform
their salaries were is shown in table 7, whichindicates that 73 percent of all full-time RN’searned between $3.00 and $4.99 an hour. Infact, 88 percent earned between $3.00 and$5.99 an hour (not shown).
Neither the age of the nurse nor the owner-ship or certification of the nursing home had anappreciable effect on the RN’s salaries (tables 6and 7). However, the bed size of the home didreflect a difference in their salaries. As table 7illustrates, RN’s in the large homes tended tomake higher salaries. Years of experience alsoseemed to make a difference in the hourly wageearnings of RN’s. Those with higher wages hadmore years of experience (table B). (As obviousas this may seem, no such statement could bemade regarding the administrators.)
In the area of fringe benefits, RN’s generaIlyreceived paid vacations (86 percent) and othertypes of leave (68 percent) but seldom receivedpensions (20 percent), cash bonuses (13 per-cent), or meals (38 percent). About half receivedhealth and/or life insurance benefits (table 10).
Finally, there were an estimated 53JiO0 full-time equivalent RN’s employed in_ nursinghomes–a substantial increase over the 34,500employed in 1968.6 The number of full-timeequivalent RN’s per 100 residents increasedfrom 4.2 in 1968 to 5.0 in 1973-74 (table 11).
Licensed practical or vocational nurses.–Anestimated 52,100 full-time and 20,500 part-time ‘licensed practical or vocational nurses (LPN’s)were employed in nursing homes during1973-74. As a whole, these LPN’s had thefollowing characteristics:
. Almost 98 percent were women.
. About 80 percent were white, 18 per-cent black, and 2 percent SpanishAmerican.
. Average age was 41.
. Average hourly wage was $3.21.
. More than 75 percent had 13 years ormore of education.
● For full-time LPN’s the average currentemployment was 3.3 years.
. For full-time LPN’s the average totalwork experience as an LPN was 9.2years.
Table B. Averages of total years of nursing home and hospital experience as a registered nurse and years of current nursing home employ.
ment, by average hourly wage: United States, 1973-74
Average hourly wageAll
Employment in hospitals and nursing homes registered Less thannurses $3.00 $3.00-$3.99 $4.00-.$4.99
As with RN’s, comparisons between maleand female LPN’s would not be statistically sig-nificant. The following figures show the relativesize of the estimates.
● Average hourly wage-men $3.81, wom-en $3.20.
● Average age–men 37, women 41.. Total LPN work experience–men 11.3
years, women 9.2 years.
There was a much higher percentage of blackLPN’s than black RN’s. The estimated 10,100black full-time LPN’s represented nearly one-fifth of all full-time LPN’s. There were an esti-mat ed 1,000 Spanish-American LPN’s. Largesampling errors rule out comparisons, but thefollowing figures show the relative size of theestimates.
. Average hourly wage–white $3.09, black$3.70.
. Average age–white 41, black 40.
. Total LPN work experience-white 8.8years, black 10.8 years.
Although e durational requirements forLPN’s varied among States, a look at the educa-
tional levels of LPN’s is still useful. Most full-time LPN’s (57 percent) had 13 years of educa-tion, whereas 25 percent had 12 years or less,and 18 percent had 14 years or more. Thenumber of years of education appeared to havean effect on LPN salaries, as seen in table 7. Oneindication of this is that only 36 percent ofLPN’s with 11 years or less of education earned$3.00 or more an hour; 63 percent of LPN’swith 14 years or more of education earned thisamount.
Table 6 shows that age had no noticeableeffect on salaries, and table 7 indicates the samefor ownership. The bed size of the home appearsto have a slight effect on salaries (largehomes paying more) but not to the extent thatwas shown for RN’s (table 7). LPN’s with themost years of experience usuaUy earned thehighest wages (table C).
In terms of certification, those homescertified for both Medicare and Medicaid(includes Medicare only) had a higher percentageof full-time LPN’s earning $3.00 or more perhour than did any of the other certificationgroups.
Table C. Averages of tota I years of nursing home and hospital experience as a licensed practical nurse and years of current nursing homeemployment, by average hourly wage: United States, 1973-74
All Average hourly wage
licensed
Employment in hospitals and nursing homes practical Less than$2.50-$2.99 $3.00-$3.99
The average hourly wage of LPN’s ($3.21per hour) varied the most between the NortheastRegion ($3.53 per hour) and the South ($2.90per hour) as seen in table 6. The differencebetween the two was not statistically significant,however.
MI me arett of trmge benefits, LPN’s generallyreceived paid vacations (83 percent) but seldomreceived cash bonuses (14 percent), pensions (15percent ), or meals (32 percent). Just under halfreceived health and/or life insurance benefits,and just over half received other types of leave(table 10). _
Finally, there were an estimated 63,700 full-time equivalent LPN’s employed in nursinghomes–a substantial increase over the 42,600 em-
ployed in 1968.6 The number of full-time equiv-alent LPN’s per 100 residents increased from 5.2in 1968 to 5.9 during 1973-74 (table 11).
Nurse’s aides.–An estimated 283,400 full-time and 91,000 part-time nurse’s aides (andorderlies) were employed in nursing homesduring 1973-74 (table 5). As a whole, thesenurse’s aides had the following characteristics:
. Ninety-five percent were women.
. Seventy-four percent were white, 21 per-cent were black, and 3 percent wereSpanish American.
. Average age was 36.
. Average hourly wage was $2.25 for full-time and $2.11 for part-time.
. Most had 12 years or less of education(82 percent).
. For full-time nurse’s aides the averagecurrent employment was 2.9 years (tableD).
Table D, Averages of total years of nursing home and hospitalexperience as a nurse’s aide and years of current nursing homeemployment, by average hourly wage: United States, 1973-74
. For full-time nurse’s aides the averagetotal work experience as a nurse’s aidewas 5.1 years (table D).
As before, differences are not statisticaHysignificant when comparing men and womenwho are full-time nurse’s aides. The followingfigures for full-time nurse’s aides show therelative size of the estimates.
● Average hourly wage–men $2.36, wom-en $2.24.
. Average age–men 33, women 36.
. Total nurse’s aide work experience–men5.3 years, women 5.1 years.
For an estimated 201,500 white, 67,300black, and 10,900 Spanish American full-timenurse’s aides, the following figures can beshown, although the differences are not statis-tically significant.
● Average hourly wage–white $2.15, black$2.57, Spanish American $2.09.
. Average age–white 36, black 37, SpanishAmerican 32.
. Total nurse’s aide work expenence–white 4.9 years, black 5.6 years, SpanishAmerican 4.0 years.
A brief look at the educational levels offull-time nurse’s aides showed an estimated 43percent had less than 12 years of education, withanother 40 percent having exactly 12 years ofeducation (table 8).
Once again bed size had the most noticeableeffect on salaries. Full-time nurse’s aides whoworked in nursing homes with less than 100 bedsearned an average of $2.03 an hour comparedwith those working in homes with 200 beds ormore, who averaged $2.90 an hour (table 6).
From one geographical region to anotherthere was little difference in the average hourlywage paid to nurse’s aides working in nursinghomes. The Northeast Region had the highestaverage hourly wage with $2.63, while the NorthCentral and South had the lowest with $2.08 and$2.06, respectively (table 6).
As for fringe benefits, nurse’s aides generallyreceived paid vacations (79 percent ) but seldomreceived cash bonuses (13 percent), pensions (15percent), or meals (25 percent). Less than half (41
7
percent) received health and/or life insurance ben-efits and approximately haIf received other typesof leave (table 10).
Finally, there were an estimated 335,500full-time equivalent nurse’s aides in nursinghomes–a substantial increase over the 216,700employed in 1968.6 The number of full-timeequivalent nurse’s aides per 100 residents in-creased from 26.6 in 1968 to 31.2 in 1973-74(table 11).
Therapeutic Staff
The types of nursing home employees in-cluded in this group are shown in table E, alongwith the number of full-time and part-time em-ployees estimated to be in each category (ex-tracted from table 1).
A look at the data for the therapeutic staffrevealed
. About 8 out of 10 were women.
. Nearly 96 percent where white.
. Average age was 40.
. Average hourly wage was .$3.87 for full-time work and $7.88 for part-time.
. Average current employment was 2.8years.
. Average total work experience for full-time work was 5.4 years and 9.8 yearsfor part-time.
Table F, which shows the number of full-timeequivalent therapeutic employees per 100 homes,indicates that the small and noncertified nursing
Table E. Numbers of full-time and part-time therapeutic em-ployees in nursing homes, by type of employee: UnitedStates, 1973-74
18 percent of these homes were certified for Medicare only.235 percent of these frorneswere certified asboth skikl nUrs-
ing horn-es and intermediate care facilities.
NOTE: Figures may not add to totak due to rounding.
homes were the least likelypersonnel on their staff.
to have therapeutic
The regional picture in table G shows theNortheast and North Central with more thantwice as many therapeutic staff persons as theSouth and West. This table also shows part-timetherapeutic staff members as having more yearsof education than those on the full-time staff.
Staff in Charge of Shifts
An important measure of care provided bynursing homes is the level of skill of the person incharge of nursing care for the entire facility. Thissection will focus on those persons in charge whowere on duty (awake, dressed, and serving theresidents) for one or more shifts.
Since other reportsl 1Y1~ have already dis-cussed the person in charge of the various shiftsin terms of the characteristics of the home, this
Table G. Number of full-time and part-time therapeutic em-Dloyees, bv region of hos~ital and years of education: United
report will deal only with the characteristics ofthe people themselves.
At the time of the survey, there were about44,300 shifts in the 15,700 nursing homes, with86 perctmt of the homes utilizing 3 shifts.Approximately 39,000 of these shifts were super-vised by full-time employees, while the remaining5,300 shifts were supervised by part-time em-ployms, Most of the shifts were run by RN’s( 17,2L}L) full-time and 3,400 part-time), followedc-I(js~Ily by LPN’s (13,800 full-time and 1,300
part-time), then nurse’s aides (6,7 00 full-time and600 part-time) and administrators (1,200 full-time).
It is interesting to note that, although therewere about an equal number of male and femaleadministrators (9,400), of the 1,200 admin-istrators in charge, 1,100 were women.
Table 12 shows the average age of each of thefull-time employee groups in charge of shifts.When compared with the ages of the employeegroups as a whole (table 1), there was very littleage difference found.
Table 12 gives the average hourly wages offull-time employees in charge of shifts and thiscan be compared with the wages of the entireemployee groups shown in table 1. Although thestaff in charge showed lower average hourly wagesin every instance, their numbers were too small tomake these differences statistically significant.
The distribution of the people in charge byregions of the country are also shown in table 12.Note the rather large differences in the use ofRN’s, LPN’s, and nurse’s aides. The North CentralRegion utilized nurse’s aides in nearly 1 out ofevery 3 shifts, whereas the Northeast and WestRegions rarely had nurse’s aides in charge. Onepossible explanation for this is that the NorthCentral Region had more small homes (less than50 beds) than the other regions,l 0 and nurse’saides were much more likely to be put in chargeof the small rather than the large homes (table 12).
—ooo —
REFERENCES
1National Center for Health Statistics: Developmentand maintenance of a national inventory of hospitals andinstitutions. Vital and Health Statistics. PHS Pub. No.1000-Series l-No. 3. Public Health Service. Washington.U.S. Government Printing Office, Feb. 1965.
2National Center for Health Statistics: Inpatienthealth facilities as reported from the 1967 MFI Survey,by A. Sirrocco. Vital and Health Statistics. Series 14-No.4. DHEW Pub. No. (HSM) 72-1065. Health Services andMental Health Administration. Washington. U.S. Gover-nmentPrinting Office, June 1972.
3National Center for Health Statistics: Inpatienthealth facilities as reported from the 1969 MFI Survey,by A. Sirrocco. Vital and Health Statistics. Series 14-No.6. DHEW Pub. No. (HSM) 73-1801. Health Services andMental Health Administration. Washington. U.S. Gover-nmentPrinting Office, Dec. 1972.
4 National Center for Health Statistics: Inpatienthealth facilities as reported from the 1971 MFI Survey,by A. Sirrocco. Vital and Health Statistics. Series 14-No.12. DHEW Pub. No. (HSM) 74-1807. Health Servicesand Mental Health Administration. Washington. U.S.Government Printing Office, Mar. 1974.
5National Center for Health Statistics: Inpatienthealth facilities as reported from the 1973 MFI Survey,by A. Sirrocco. Vital and Health Statistics. Series 14-No.16. DHEW Pub. No. (HRA) 76-1811. Health ResourcesAdministration. Washington. U.S. Government PrintingOffice, May 1976.
6National Center for Health Statistics: Employees innursing homes, United States, April-September 1968, byJ. F. Van Nostrand. Vital and Health Statistics. Series12-No. 15. DHEW Pub. No. (HSM) 73-1700. HealthServices and Mental Health Administration. Washington.U.S. Government Printing Office, Oct. 1972.
7National Center for Health Statistics: Institutionsfor the age d and chronically ill, United States,April-June 1963, by E. E. Bryant. Vital and Health Sta-t istics. PHS Pub. No. 1000-Series 12-No.1. PublicHealth Service. Washington. U.S. Government PrintingOffice, July 1965.
8National Center for Health Statistics: Employees innursing and personal care homes: Number, work experi-ence, special training, and wages, United States,
May-June 1964, by C. A. Taube and E. E. Bryant. J’italand Health Statistics. PHS Pub. No, 1000-Series 12-No.6. Public Health Service. Washington. U.S. GovernmentPrinting Office, Jan. 1967.
9National Center for Health Statistics: Adminis-trators of nursing and personal care homes: Educationand training, United States, June-August 1969, by B. G.Brown. Vital and Health Statistics. Series 12-No. 18.DHEW Pub. No. (HSM) 73-1703. Health Services andMental Health Administration. Washington. U.S. Gover-nmentPrinting Office, Feb. 1973.
1‘National Center for Health Statistics: Selectedoperating and financial characteristics of nursing homes,United States: 1973-74 National Nursing Home Survey,by M. R. Meiners. Vital and Health Statistics. Series13-No. 22. DHEW Pub. No. (HRA) 76-1773. Health Re-sources Administration. Washington. U.S. GovernmentPrinting Office, Dec. 1975:
11 National Center for Health - Statistics: Charac-teristics, social contacts, and activities of nursing homeresidents, United States, 1973-74 National NursingHome Survey, by A. Zappolo. Vital and Health Statis-tics. Series 13-No. 27. DHEW Pub. No. (HRA) 77-1778.Health Resources Administration. Washington. U.S.Government Printing Office, May 1977.
12 National Center for Health Statistics: Utilization ofnursing homes, United States, National Nursing HomeSurvey, August 1973-April 1974, by J. F. Sutton. J’italand Health Statistics. Series 13-No. 28. DHEW Pub. No.(HRA) 77-1779. Health Resources Administration.Washington. U.S. Government Printing Office, July1977.
13 National Center for Health Statistics: Nursinghomes in the United States, 1973-74 National NursingHome Survey, by A. Sirrocco and H. Koch. Vital andHealth Statistics. Series 14-No. 17. DHEW Pub. No.(HRA) 78-1812. Health Resources Administration.Washington. U.S. Government Printing Office, Oct.1977.
14Van Nostrand, J. F.: Development of survey meth-odology to measure cost and quality of care in nursinghomes. Paper presented at 10lst Annual Meeting ofAmerican Public Health Association, San Francisco,NOV. 8, 1973.
10
LIST OF DETAILED TABLES
1.
2.
3,
4.
5.
6.
i’,
8.
9.
Number, averageStates, 1973-74
Number, averageStates, 1973-74
hourly wage, and averege age of full-time nursing home employees, by sex and selected occupations: United
Administrator, assistantadministra tor----------------Physician2--------------------Dentist -----------------------Pharmacist --------------------Dietitian or nutritionist -----
Registered medical recordadministra tor----------------Other professionaloccupati0ns3 -----------------Othermedicalrecordadministrators andtechnicians ------------------
All other staff4--------
18,8001,000*loo600
1,300
*loo
1,600
1,200
180,000
5.4417.5324.127.504.47
5.63
4.39
3.66
---
4949*
2:
46
41
41
---
1Excludes “all other staff.1!2lncl”des medical doctors and doctors of osteopathy.31ncludes interns, residents , and therapeutic recreators.4Includes clerks, bookkeepers, cooks, kitchen help, housekeeping and maintenance personnel, etc.
12
Table 2. Number, average hourly wage, and average age of part-time nursing home em-ployees, by sex and selected occupations: United States, 1973-74
Number of Dart-time Average hourly wage Average ageemplo$ees
Administrator, assistantadministra tor----------------Phvsician2 --------------------Dentist-----------------------Pharmacist --------------------Dietitian or nutritionist -----Registered medical recordadminis trator----------------Other professionalOccupatiOns 3-----------------
Other medical recordadministrators andtechnicians------------------
All other staff J--------——. —- ——. .——-— —..-..—-..
8.5023.8613.7210.51
*
4.64
12.32
9.13
---
—.-. ..
5.5418.71
,“:6.227.64
10.70
6.34
4.63
---
-.
46
::41?.
46
42
52
---
.
4946.:
4542
45
35
43
---
. -—
2,2005,7001,3002,9006,000
1,600
1,900
1,000
95,000
_ .-.——.
1,4005,3001,3002,600
i-loo
900
>?20(3
22,000—..—— -...
800*400
*3(3(36,000
1,500
1,000
800
73,000
—.
7.3923.4916.339.937.68
10.48
8.88
5.27
---
1Excl Lldes “all other staff .“‘Includes medical doctors and doctors of osteopathy.{Includes interns, residents, and therapeutic recreators.+Includes clerks , bookkeepers , cooks , kitchen help, housekeeping and maintenance personnel, etc.
13
Table 3. Data for selected characteristics of full-time male administrators: UnitedStates, 1973-74
Characteristic
All homes -----------------------------
NURSING HOM8
Bed size
Less than 50 beds---------------------------50-99beds----------------------------------100 beds or more----------------------------
Proprietary ---------------------------------Government and nonprofit --------------------
ADMINISTRATOR
Age—
Under 35 years ------------------------------35-44 years---------------------------------45-54 years ---------------------------------55 years and over ---------------------------
Education
Less than 12 years--------------------------12 years ------------------------------------13 years------------------------------------14 years------------------------------------15 years or more ----------------------------
Benefits
Paid vacation -------------------------------Cash bonus ----------------------------------Pension-------------------------------------Health, life insurance ----------------------Other leave’--------------------------------Meals ---------------------------------------
Current employment -------------------------Total experience --------------------------
Average age of administrator ----------------
.- ; X1.1 :
‘Includes civic and personal leave (jury duty, military reserves, voting, and funerals) and release time faratt$nding training institutes.
-Includes only experience as administrator in nursing home or hospital.
14
Table 4, Data for selected characteristics of full-time female administrators: United
Characteristic
.
All homes -----------------------------
NURSING HOME
Bed size
LCSY than 50 beds ---------------------------50-99 beds ----------------------------------100 beds cm more -----------------------------
Region
Nertheast -----------------------------------North Central -------------------------------%nYch---------------------------------------West ----------------------------------------
Ownership
Pruprictary---------------------------------Government and nonprofit --------------------
ADNINISTMTOR
Age—
Onder 35 years ------------------------------35-/44years ---------------------------------
45-54 years ---------------------------------55 years and over ---------------------------
I?ducation
Lusa than 12 years --------------------------12 years ------------------------------------13 years ------------------------------------14 years ------------------------------------15 years or more ----------------------------
Current employment --------------------------Tut.11experience !---------------------------
Avuraxe age of administrator ----------------
States, 1973-74
Total
9,400
4,2003,2002,100
2,3003,0003,0001,100
7,6001,800
1,2001,8002,9003,500
7002,8001,8001,1003,000
6,6001,500900
4,2007,1005,200
Numberreportingwages
7,900
3,2002,8001,800
1,8002,5002,5001,000
6,3001,500
1,2001,6002,3002,800
~<4002,3001,5001,0002,600
6,1001,400900
3,7006,3004,300
Full- time female administrator
Averagehourlywage
1:::48
$4.56
4.074.924.87
5.274.743.874.53
4.474.91
4.314.164.644.82
,~4.224.163.954.135.47
4.764.764.314.994.674.47
Wages per hour
II I I I
All Lesshourly than $:.:;- $;.;;- $6.00
wages $4.00 “ “ or more
II I I I
percent distribution
100.0
100.0100.0100.0
100.0100.0100.0100.0
100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0100.0
100.0100.0100.0100.0100.0100.0
45.4
56.238.337.7
28.351.353.741.1
44.449.6
51.648.840.544.9
56.;52.748.826.4
41.939.4:;.;
42:649.8
Average in year
. . . . . .
. . . . . .
. . . . . .I
47 I
23.3
19.728.122.0
24.020.225.524.1
25.016.0
25.022.022.124.1
>?
18.129.827.023.3
25.024.223.826.424.421.2
1!:;48
11.7
9.612.813.9
18.1
1;::12.8
12.29.9
U17.110.9
>:13.63.713.315.8
12.914.513.814.612.312.6
1::$50
19.6
14.620.826.4
29.623.4
2::;
18.424.5
17.219.720.319.9
>:
11.713.711.034.5
20.221.814.528.220.816.5
1:::49
I I I
iIncludes civic and personal leave (jury duty, military reserves , voting, and funerals) and release tise forsttcndin}x training institutes.
JIncludes only experience as administrator in nursing home or hospital.
15
Table 5. Number and percent distribution of full-time and part-time nursing homeemployees, by race or ethnicity and age for selected occupational categories andoccupations: United States, 1973-74
Race or ethnicityAll employees
Spsnish American Other 1Age for selectedoccupational category
and occupation
Black 1Whitel
Full-time
30,000
41.626.820.011.7
800
>’$J<*,,,
*400
Part-time
!5,400
51.322.213.612.9
600
*>:>,<
%-
*~200
>’C,!r,,<*
!4,600
53.121.712.712.5
>;-
>’<>’:>t>?
f:400
>:-.~.>:>rc
2,700
35.029.722.5
*
.1,500
57.819.810.512.0
Full-time .
5,400
48.516.524.410.6
*300——
>’C>’:>,..,c.-
;Woo
>k;’C;!;:
5,000
47.816.025.211.0
>...———
.,,,:’./,,:;,..
700
Full-time
Part-time
174,300
80,30033,20029,80031,100
22,600——4,8006,7006,0005,200
11,800
Full -time
311,600
41.219.021.618.2
23,500
Part-time
155,000
45.418.617.618.4
21,700
Full-time
Part-t~me
Part-time
—.409,300 12,300
60.220.115.14.6
*loo
l,fiofl
5~.1
>,,.Y:
;,:30(3
All employees- -----
Under 35 years -----------35-44 years --------------45-54 years --------------55 years and over--------
1;;,:-7:
86:30067,300
24,700
Occupational category
Administrateive andmedical -----------
Under 35 years -----------35-44years --------------45-54years --------------55 years and over--------
Therapeutic --------
5,200;,:3:
7:300
10,400
20.320.129.629.9
9,800
21.029.326.423.2
11,400
34.924.724.216.1
L21,900
**;’e.,,<
*—.
>,;
>:>7<
?r
2,200
50.123.1,,..
,.>.
.....
,,.->’,.,’,..
,...
,.,..
2’.(
*.,,..
,.,.
1,300
Under 35 years -----------35-44years --------------45-54years --------------55 years and over --------
Nursing ------------
4,2002,1002,2001,800
374,200
4,1003,0002,8001,900
1.40,000
40.620.221.118.0
278,300
;,<>k
,,.
,:
78,800
41.926.819.811.5
600
>,e**f?
1,500
>:33.9
>**
LO,1OO
>’?
>k;,..
.A.
12,100
60.320.015.24.6
Under 35 years -----------35-44years --------------45-5byears --------------55 years and over --------
162,30076,80076,80058,200
18,800
71,40023,60021,00024,000
2,200
~:.]
20:917.3
18,100
50.716.115.417.7
2,100
55.1.....,...>,..
,:—
,$<,!:>’<>7..
,’:400
Occupation
Administrator ------
Under 35 years -----------35-44years --------------45-54years --------------55 years and over--------
3,4003,8006,0005,600
38,700
>’t
>’<
700700
28,500
18.520.231.729.6
36,300
;:.;’<
30.230.5
27,600
>’;
:’:;,<
>7<
>~zoo
>k>\->$,...
1,000
Registered nurse---—
Under 35 years -----------35-44 years --------------45-54years --------------55 years and over--------
Licensed practicalnurse-------------
9,5009,00010,5009,600
52,100
7,9008,1006,7005,800
20,500
23.922.827.925.4
40,600
27.028.4;$ ;.
17,400
>,,7:
>’<>,,
;’:200
;,c>:.,,*
1,800
50.7>,:?<>!
:,::’..
?<>,.$
,*500—.
.,!,.>...;f.-;,..
1,800
48.7.,,.,29.5
>’;
,.:;7..
:’:.,,..
;’:200
Under 35 years -----------35-44 years --------------45-54 years --------------55 years and over --------
18,50011,50011,40010,800
283,400
9,0004,0003,1004,400
91,000
35.020.721.822.5
201,500
44.917.614.123.4
76,900
35.826.023.414.8
;7,300
;:.;
19:310.9
52.6>,<;,,7:
10,900Nurse’s aide -------
Under 35 years -----------35-44 years --------------45-54 years--------------55 years and over --------
134,30056,40054,90037,800
54,50011,50011,10013,800——
48.017.819.514.7
60.611.312.715.5
61.919.015.1
;’.-
1Excludes Spanish American.‘Excludes “all other staff” (clerks,
etc.).bookkeepers, cooks, kitchen help, housekeeping and maintenance personnel ,
16
Table 6. Average hourly wage for selected full-time nursing home employees, by selectedcharacteristics: United States, 1973-74
*
Characteristic
All homes------------------
NURSING HOME
Bed size
Less than 50 beds----------------50-99 beds-----------------------100-199beds---------------------200 beds or more-----------------
Less than 12 years------------12 years----------------------13 years----------------------14 years----------------------15 years or mOre--------------
Number,eportingwages>
3:,;::
11;70020,900
24,3003,2008,50012,600
12,9001,4003,1008,300
18,900900
5,70012,400
10,6001,0003,4006,200
4,1001,2001,8001,100
3,5001,500800
1,200
13,80010,2006,4006,700
*ZOO*4003,7004,20028,600
Registered nurse
Average hourly wage group
~
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0100.0
Percent distribution
30.738.637.825.0
31.535.735.527.7
29.345.444.121.1
25.231.132.021.6
34.435.244.229.0
3B.532.240.541.7
40.550.545.525.1
26.132.240.428.7
25.5 45.852.3 13.1
32.2;:; 32.53.0 30.4
42.643.138.844.6
44.244.942.545.2
39.639.128.843.7
44.747.944.044.7
41.548.832.845.1
40.443.536.743.0
37.336.232.441.8
43.242.638.944.9
lB.629.935.940.744.1
22.710.319.027.4
19.9
1?::23.9
28.011.522.632.8
27.516.521.531.0
20.512.118.822.8
11.5
1;:;11.9
16.3
1::328.9
2B.121.213.522.7
10.0
2:::23.922.6
vLicensed practical nurse
Numberreportingwages]
50,2007,90016,70025,600
35,0006,100
12,30016,500
15,2001,8004,3009,100
21,0001,6006,800
12,600
15,6001,7005,4008,500
9,1002,9003,2003,000
;,;():
1;3001,500
12,50013,50016,4007>800
4,8007,700
2B,7006,2002,800
Average hcmrly wage group
~II I 1 1
Percent distribution
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0100.0
14.922.018.610.5
15.623.917.411.3
13.515.622.29.0
1;.$’
17:419.2~
14.719.917.811.6
22.031.521.513.4
IB.725.921.08.5
10.312.623.97.8
2B.315.913.611.611.6
1Excludes employees who donated their services.28 percent of these homes were certified for Medicare only.335 percent of these homes were certified as b~h skilled nursing homes and intermediatecare facilities
33.937.736.631.0
35.234.037.534.0
30.950.524.125.6
25.540.224.924.0
40.041.644.137.0
44.036.048.147.li
32.034.338.223.9
18.634.947.228.8
35.535.136.125.125.5
40.634.837.844.3
39.236.038.041,3
43.930.637.149.7
::.:
47:747.7
37.035.932.040.3
28.524.327.533.5
41.731.73h.559.5
49.445.625.449.9
28.640.041.247.741.0
NOTE: Figures may not add to totals due to rounding.
18
Table 8. Data for selected characteristics of full-time administrators and ftill-timenurse’s aides: United States, 1973-74
Characteristic
All nursing homes---------------------Less than 50 beds -------------------50-99 beds--------------------------100 beds cm more--------------------
NLIRSINGHOME
Ownership
Proprietary-----------------------Less than 50 beds---------------------50-99 beds ----------------------------100 beds ar more----------------------
Gavcrnment and nonprofit----------Less than 50 beds---------------------50-99 beds----------------------------100 beds or more----------------------
Certification
Both Mcdi.careand Medicaid2-------Less than 50 beds---------------------50-99 beds ----------------------------100 beds or more----------------------
Skilled nursing home3-------------Less than 50 beds---------------------50-99 beds----------------------------100 beds cm more----------------------
Intermediatecare facility--------Less than 50 beds---------------------50-99 beds----------------------------100 beds or more ----------------------
Not certified ---------------------Less than 50 beds---------------------50-99 beds ----------------------------100 beds or more----------------------
Less than 12 years--------------------12 wars------------------------------13 years------------------------------14 b.cara------------------------------15 years cm more----------------------
Numberreportingwages1
16,7005,2006,2005,300
12,8004,5004,8003,600
3,900700
1,5001,700
5,000*5002,0002,500
4,4001,0001>9001,600
f,;:g
1:600900
3,0001,900800
*400
4,1005,5004,9002,300
7004,0002,1002,5007,400
Administrator
Average hourly wage group
Percent distribution
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0100.0
33.048.030.621.7
32.146.628.818.7
36.456.436.128.2
15.833.415.912.2
26.728.631.819.5
41.443.339.141.7
59.366.546.450.2
20.536.841.329.4
I
75.846.142.829.1 !20.6
—d
22.921.827.418.8
24.124.526.320.7
19.1
3::?14.8
22.930.430.115.8
17.610.521.117.6
30.828.134.828.9
19.618.920.720.7
17.721.730.020.3
14.118.330.233.520.6
15.711.717.617.3
16.611.119.919.0
12.615.210.113.7
20.33.4
23.920.7
20.327.218.917.8
11.912.712.49.2
6.84.99.2
11.1
19.811.615.418.7
4.218.18.415.517.7
———
28.218.524.442.1
27.217.825.041.5
31.823.122.7&3.4
41.032.730.051.3
35.433.528.245.0
15.915.813.720.1
14.49.8
23.717.9
42.029.713.331.6
5.917.518.621.941.0
-—
.Nurse’s aide
Numberreportingwages!
274,10038,10094,200
141,900
191,50028,20071,10092,200
82,6009,800
23,10049,700
113,4005,700
36,20071,600
79,0006,200
26,60046,300
53,00016,00021,10015,900
28,70010,30010>300
8,200
57,20090,70076,30049,900
118,200109,900
22,60013,600
9>900
Average hourly wage group
E4E!-_L“’;’-‘cPercent distribution
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0
100.0100.0100.0100.0100.0
1Iticludcs employees who dons ted their services.28 puccnt of these homes were certified for Nedicare only.335 p~,rcent of these homes were certified as -lled nursing homes and intermediate care facilities
54.967.764.645.0
61.770.968.653.6
38.958.552.129.0
45.044.’256.139.3
53.766.362.646.8
75.178.778.766.6
59.964.070.241.8
19.957.575.957.9
57.154.454.747.143.8
29.524.429.730. E
27.322.326.529.4
34.830.639.433.5
34.438.337.032.8
29.832.131.228.7
19.515.317.726.3
28. o26.324.434.4
39.931.716.933.2
28.131.628. o35.519.0
.—
15.77.8
2.2:;
11.0
::;17.0
26.211.0
3%:
20.616.8
2;:;
16.51.6
2::;
2:83.57.1
12.29.7
2;:;
40.310.7
7.39.0
14.813.917.317.437.1—
NoTI: : Figures may not add tO totals due to rounding.
19
Table 9. Percent of selected full-time nursing home employees taking nondegree health-related courses, by type of course: IJni.tedStates, 1973-7’4
Type of course
One or more courses ---------
Nursing care of the aged ----------Medical care of the aged ----------Social problems of the aged -------Physical therapy------------------Occupational therapy --------------Nutrition -------------------------Nursing home administration -------Inservice education ---------------Medical records -------------------Activity programs -----------------Social services -------------------Pharmacology and care of drugs----
Allfull-timeemployees
35.5
18.0$;
;:!?
2:$19.64.25.83.36.0
Full-time employee
Administrator
77.1
37.0
3::;13.3
2;::62.024.117.223.017.015.1
Registerednurse
56.9
33.6
2:::17.15.5
H34.010.7
2:;18.7
Licensedpracticalnurse
41.0
19.4
12:$9.13.2
H26.14.45.8
12:;
Nurse’s aide
27.4
14.83.85.65.3
H
1;:!2.33.0
i:;
20
Table 10. Number and percent of selected full-time nursing home employees receivingfringe benefits, by type of benefit: United States, 1973-74
Type of benefit
All full-timeemployees----
Paid vacation--------------------Cash bonus-----------------------Pension--------------------------Health, life insurance-y---------Other leavel---------------------Meals----------------------------
lIncludescivic and personal leave (jury duty,military reserves,Voting, funerals)and releasetime for attending institutes.
21
Table 11. Number and rate per 100 residents of full-time equivalent registered nurses,licensed practical nurses, and nurse’s aides in nursing homes, by selected nursinghome characteristics: United States, 1973-74
Nursing homecharacteristic
All homes-----------------------
Certification
Both Medicare and Medicaid~-----------Skillednursing homez-----------------Intermediatecare facility -----------Not certified-------------------------
Bed size
Less than 50 beds---------------------50-99 beds----------------------------100 beds or more----------------------
18 ercent of these homes were certified for Medicare Only.z35ppercentof these homes were certifiedas both skilled nursing homes and intermediate
facilities.care
NOTE: Figures may not add to totals due to rounding.
22
Table 12. Data for selected characteristics of full-time employees incharge of shifts,by type of employee: United States, 1973-74
Characteristic
All homes-------------------Less than 50 beds-----------------50-99 beds ------------------------100 beds or more ------------------
NURSING HOME
Ownership
Proprietary -------------------Less than 50 beds -----------------50-99 beds ------------------------100 beds or more ------------------
Government and nonprofit ------Less than 50 beds -----------------50-99 beds ------------------------100 beds or more ------------------
Certification
Both Medicare and Medicaid --------Skilled nursing home--------------Intermediate care facility--------Not certified ---------------------
ReEion
Northeast -------------------------North Central ---------------------south-----------------------------West ------------------------------
EMPLOYEE
Education
Less than 12 years----------------12 years --------------------------13 years --------------------------14 years --------------------------15 years or more ------------------
Employment
Current employment ----------------Total experiencel -----------------
lV. Selected Questionnaires Used in the 1973-74 National Nursing Home Survey . . . . . . . . . . . . .
LISTOFAPPENDIX TABLES
I. Dktributionof facilities in the 1973-74 National Nursing Home Survey universe anddkpositionof sample facilities according to primary sampling stratz Conterminous United States . . . .
From August 1973 to April 1974, theDivision of Health Resources Utilization Statis-tics (DHRUS) conducted the National NursingHome Survey (NNHS)–a sample survey ofnursing homes, their residents and staff in thel-onterminous United States. The survey wasclesi~ncd and developed by DHRUS in conjunc-ti(m ~vith a group of experts in various fieldsencompassing the broad area of long-termcare.14 It was specifically designed as the first ofa series of surveys to satisfy the diverse dataneeds of those who establish standards for, plan,pnn’ide, and assess long-term care services.
Sampling Frame
“Jle 1973-74 NNHS focused on nursingh[nmes Ivhich provided some level of nursingrm’. Only facilities providing nursing care wereincluded because detailed questions on facilityservices and resident health status were relevant(only to these facilities. They included bothnursing care homes and personal care homeswith nursing, while personal care homes withoutnursing and domiciliary care homes were ex-cluded. Facilities were either freestandingestablishments or nursing care units of hospitals,retirement centers, and similar institutions. Adefinition of nursing care and detailed criteriafor classifying facilities providing such care arepresented in appendix III.
The survey universe consisted of two groupsof facilities: ,those providing some level of
*NOTE: A list of references follows the text.
nursing care as classified in the 1971 MasterFacility Inventory (MFI) and those opening forbusiness in 1972. The major group (93 percent)was composed of all nursing homes providingsome level of nursing care as classified by the1971 MFI. MFI is a census of all inpatient healthfacilities conducted every 2 years by mail by theNational Center for Health Statistics. A detaileddescription of how MFI was developed, its con-tent, and procedures for updating and assessingits coverage has been published.
In order for data collection to begin inAugust, the sampling frame was “frozen” in thespring of 1973 so that the sample could beselected in ample time to permit the schedulingof nationwide data collection. To obtain as cur-rent a sample frame as possible, all nursinghomes which opened for business during 1972were also included in the universe. (Facilitiesopening in early 1973 could not be includedsince data about them were not yet available.)The facilities which opened in 1972 comprisedthe second, and smaller (7 percent), group offacilities in the universe. Although the universeinclude d only facilities providing nursing care,all facilities opened in 1972 were includedbecause the level of nursing care they pro-vided was unknown prior to the survey. OnceNNHS was conducted, facilities not meeting thecriteria were classified as out of scope (see tabIeI for details).
Although NNHS was conducted in 1973-74,it should be noted that estimates will not corre-spond precisely to figures from the 1973 MFIcensus for several reasons. In comparison to theMFI, the NNHS universe excluded the follow-ing: 1) personal care homes and domiciliary care
25
Table 1. Distribution of facilities in the 1973-74 National Nursing Home Survey universe and disposition of sample facilities according to
primary sampling strata: Conterminous United States
Number of facilities in sampleUniverse
(samplingframe) 1
17,685
4,099
2149538
1,7131,385
22468
20
7,473
Certification status and size of facility Out of scopeor out
lThe universe c~n~isted of nursing homes providing some level of nursing care as classified in the 1971 MFI and those Wened ‘orbusiness in 1972.
tion of establishments and the seccmd stage was
a selection of residents and employees of the
sample establishments. In preparation for thefirst-stage sample selection, establishments listedin MFI were sorted into three types of stratabased on Medicare and Medicaid certification:1) both Medicare and Medicaid and MedicareonIy; 2) Medicaid only; and 3) not certified,Facilities in each of these three strata weresorted into bed size groups, producing 26 pri-mary strata as shown in table I. The nursinghomes in the universe were ordered by type of
homes; 2) facilities which opened in 1973; and3) facilities which, between 1971 and 1973,upgraded the level of care they provided, there-by meeting the “nursing care” criteria whensurveyed in the 1973 MFI. Data from NNHS arealso subject to sampling variability, while datafrom MFI are not, since MFI is a census.
Sampling Design
The sampling was a stratified two-stageprobability design: The fii-st stage was a selec-
26
ownership, geographic region, State, and county.The sample was then selected systematicallyafter, a random start within each primary stra-tum. Table I sho~vs the distribution of establish-ments in the sampling frame and the finaldisposition of the sample with regard to re-sponse imd in-scope status. The number of facil-ities estimated by the survey (15,749) is lessthan the universe figure (17,685) because somefacilities went out ‘of business or out of scopebct~reen the time the universe was “frozen” andthe survey was conducted. Differences rangingiknn 2,100-2,900 between survey estimates anduniverse figures occurred in the 1963,11964,S and 1969s nursing home surveys for
the same reason.The second-stage selection of residents and
employees was carried out by the interviewers atIhc time of their visits to the establishments inaccorckmce with specific instructions given formch sample establishment. The sample framefor residents was the total number of residents(m the rwqister of the establishment on the eve-ning prior to the day of the survey. Residents1v11oIvere physically absent from the facility dueto cwernight leave or a hospital visit but had abccl maintained for them at the establishmentwere included in the sample frame. An averageof 10 residents were in the sample per facility.
The sampling frame for employees was theStuff Control Record on which the interviewerIistcd the names of all staff (including thosemnployed by contract) and sampled professional,semiprofessional, and nursing staff. Those gener-ally not involved in direct patient care, such asofllcc staff, food service, housekeeping, andmaintenance personnel, were excluded from thesample. The interviewer used predesignatedsampling instructions that appeared at the headuf each column of this form. An average of 14staff were in the sample per facility.
Data Collection Proceduresfor 1973-74National Nursing Home Survey
The 1973-74 NNHS utilized eight question-mtirm. (See appendix IV for copies of question-n:(ircs relevant to this report. ”For all other datam]llcction instruments, see reference 1O.)
NOTE: A list of references follows the text.
Administrator Letter andFacility QuestionnaireExpense QuestionnaireResident Control RecordResident Questionnaire
Worksheet
Staff Questionnaire-Parts I and IIStaff Control Record
Data were collected according to the follow-ing procedure:
1.
2.
3.
A letter was sent to the administrators ofsample facilities informing them of thesurvey and the fact that an interviewerwould contact them for an appointment.On the back of the letter was a work-sheet which the administrator wasrequested to fill out prior to the inter-viewer’s visit. This worksheet asked forthose data that required access to rec-ords and some time in compiling (suchas total admissions and discharges, in-patient days of care, etc.). Included withthis introductory letter were letters ofendorsement from the American NursingHome Association and the AmericanAssociation of Homes for the Aging
urging the administrators to participatein the survey.
Several days to 1 week after the mailingof the letters, the interviewer telephonedthe sample facility and made an appoint-ment with the administrator.
At the time of the appointment, the fol-lowing procedures were followed: TheFacility Questionnaire was completed bythe interviewer who interviewed theadministrator or owner of the facility.After completing this form, the inter-viewer secured the administrator’spermission to send the Expense Ques-tionnaire to the facility’s accountant. (Iffinancial records were not kept by anoutside firm, the Expense Questionnairewas filled out by the administrator, withthe interviewer present.) The interviewercompleted the Staff Control Record (alist of all currently employed staff bothfull and part time), selected the sample
27
of staff from it, and prepared Staff Ques-tionnaires, Parts I and II, which were leftfor each sample staff person to com-plete, seal in addressed and frankedenvelopes (one for each part of the ques-t ionnaire), and return either to the inter-viewer or by mail. The interviewer thencompleted the Resident Control Record(a list of all residents currently in thefacility), selected the sample of residentsfrom it, and filled a Resident Question-naire for each sample person by inter-viewing the member of the nursing stafffamiliar with care provided to the resi-dent. The nurse referred to the resident’smedical records. No resident was inter-viewed directly.
If the Expense Questionnaire was not returnedwithin 2 weeks, the interviewer telephoned theaccountant requesting its prompt return. If theStaff Questionnaires were not returned in 1\veek, the intervie~ver contacted the staff mem-ber and requested the return of the form.
Figure I presents a summary of the data col-Iectio; proce-dures.
GENERAL QUALIFICATIONS
Nonresponse and Imputationof Missing Data
Response rates differed for each typequestionnaire as indicated below:
Generally, response rates were higher forquestionnaires administered in a personal inter-view situation (facility and resident) as com-pared to those which were self-enumerated
(expense and staff). Statistics presented in thisreport were adjusted for failure of a facility torespond. Data were also adjusted for non-
Figure 1. Summary of data collection procedures
1 I
Questionnaire I Respondent I interviewsituation
Facility . .. . .. .. ... . . Administrator
Expense .. . ... ... .. . Facility’s accountant
Rasident . ... .. ... ... Member of nursing stafffamiliar with care pro-vided to the residentor resident’s medicalrecords (1 O sampledresidents per facility)
response which resulted from failure to com-plete one of the questionnaires (expense, resi-dent, staff) or from failure to complete an itemon a questionnaire. Those items left unansweredon a partiaHy completed questionnaire (facility,expense, resident, staff) were generally imputedby assigning a value from a responding unit withmajor characteristics identical to those of thenonresponding unit.
Rounding of Numbers
Estimates of employees have been roundedto the nearest hundred. For this reason detailedfigures within tables do not always add to totals.Percents were calculated on the basis of oli,qinal,unrounded @ures and will not necessarily agreeprecisely with percents which might be cal-culated from rounded data.
Data Processing
A series of checks was performed during thecourse of the survey. This included field follow-ups for missing and inconsistent data, somemanual editing of the questionnaires, extensiveediting conducted by computer to assure that allresponses were accurate, consistent, logical, andcomplete. Once the data base was edited, thecomputer was used to calculate and assign
weights, ratio adjustments, recodes, and otherrelated procedures necessary to produce nationalestimates from the sample data.
28
Estimation Procedures
Statistics reported in this publication arederived by a ratio estimating procedure. Thepurpose of ratio estimation is to take into ac-count all relevant information in the estimationprocess, thereby reducing the variability of theestimate. The estimation of number of establish-ments and establishment data not related to sizeare inilated by the reciprocal of the probabilityof selecting the sample establishment and ad-justed for the nonresponding establishmentswithin primary certification-size strata. Two ratioadjustments, one at each stage of selection, wereako used in the estimation process. The first-stage ratio adjustment (along with the aboveinflation factors) was included in the estimationof establishment data related to size, residentdata, and staff data for alI primary certification-size strata from which a sample of facilities wasdruwn. The numerator was the total beds ac-cording to the Master Facility Inventory data forall facilities in the stratum. The denominatorwas the estimate of the total beds obtainedthrough a simple inflation of the Master FacilityInventory data for the sample homes in the stra-tum. The effect of the first-stage ratio adjust-ment was to bring the sample in closer agree-ment with the known universe of beds. Thesecond-stage ratio adjustment was included inthe estimation of resident and staff data withinestablishments. The second-stage ratio adjust-ment is the product of two fractions: The first isthe inverse of the sampling fraction for residents(or staff) upon which the selection is based; thesecond is the ratio of the number of sample resi-dents (or staff) in the establishment to the num-ber of residents (or staff) for whom question-naires were completed within the facility.
RELIABILITY OF ESTIMATES
As in any survey, the results are subject toreporting and processing errors and errors due tononresponse. To the extent possible, these typesof errors were kept to a minimum by methodsbuilt into survey procedures.
Since statistics presented in this report arebased on a sample, they will differ somewhat
from figures that would have been obtained if acomplete census had been taken using the sameschedules, instructions, and procedures.
The standard error is primarily a measure ofthe variability that occurs by chance becauseonly a sample, rather than the entire universe, issurveyed. The standard error also reflects part ofthe measurement error, but it does not measureany systematic biases in the data. It is inverselyproportional to the square root of the numberof observations in the sample. Thus, as the sam-pIe size increases, the standard error generallydecreases.
The relative standard error of an estimate isobtained by dividing the standard error of theestimate by the estimate itself and is expressedas a percentage of the estimate. According toNCHS standards, reliable estimates are thosewhich have a relative standard error of 25 per-cent or less. For a relative standard error of 25percent or less, the minimum number of em-ployees is 600. Thus employee estimates mustbe 600 or larger in order to meet the standardsof reliability. In this report asterisks are shownfor any cell with a number of less than 600 or apercent which represents a number of less than600, that is, with more than a 25-percent rela-tive standard error. Tables II and III presentstandard errors for categories of employees, andtables IV and V present standard errors foraverage hourly wages for categories of em-ployees. Tables VI, VII, and VIII present stand-ard errors for average age, years of education,and years of employment for employees, respec-tively.
Because of the relationship between therelative standard error and the estimate, thestandard error of an estimate can be found bymultiplying the estimate by its relative standarderror.
For example, table 4 shows that in nursinghomes with less than 50 beds, 56.2 percent ofthe 4,200 female administrators earned less than$4.00 per hour, while table 3 shows that 34.6percent of the 2,000 male administrators earnedthis amount. Using the standard errors of per-centages in table II and interpolating, it wasfound that the standard error was 4.32 for thewomen and 5.21 for the men. The chances areabout 95 out of 100 that an estimate from the
29
Table II. Standard errors of percents for professional employees
Baseof estimated percent(number of professional employees)
sample differs from the value that would have differences between selected characteristics arebeen obtained from a complete census by lessthan twice the standard error. To continue theabove example, the chances are 95 out of 100that the true values are contained in the intervals56.2 * 2(-!.32) for women (47.7 to 64.7), and34.6 + 2(5.21) for men (24.4 to 44.8).
Statistical tests to determine whether the
statistically significant can be performed bycomparing the confidence intervals for the esti-mates in question. If there is no overlapping ofthe confidence intervals, the estimates are con-sidered statistically different. In the exampleabove there is no overlapping and, therefore, thedifferences are statistically different.
Table V. Standard errors of average hourly wages for total and nonprofessional employees
Resident. –A resident is a person who hasbeen formally admitted but not discharged froman establishment. All such persons were includedin the survey whether or not they were phys-ically present at the time of the survey.
Certification status. —Certification statusrefers to the facility certification by the Medi-care and/or Medicaid programs.
Medicare refers to the medical assistanceprovided in Title XVIII of the Social Secu-rity Act. Medicare is a health insurance pro-gram administered by the Social SecurityAdministration for persons aged 65 yearsand over who are eligible for benefits.
Extended care facility refers to certifica-tion as an extended care facility underMedicare.
Medicaid refers to the medical assistanceprovided in Title XIX of the Social SecurityAct. Medicaid is a State-administered pro-gram for the medically indigent.
Skilled nursing home refers to certifica-tion as a skilled nursing home underMedicaid.
Intermediate care facility refers to certi-fication as an intermediate care facilityunder Medicaid.
Not certified refers to facilities which arenot certified as providers of care eitherby Medicare or Medicaid.
Type of ownership. –Type of ownershiprefers to the type of organization that controlsand operates the nursing home.
Proprietary facility is a facility operatedunder private commercial ownership.‘Nonprofit facility is a facility operatedunder voluntary or nonprofit auspices, in-cluding both church-related facilities andthose not church related.Government facility is a facility operatedunder Federal, State, or local governmentauspices.
Employee. –This term refers to any personwho was on the staff of the facility or was em-ployed under contract. It includes any paidworker, proprietor, or member of a religiousorder who contributes his services.
Full-time employees are those who worked35 hours or more in the week prior to thesurvey.Part-time employees are those who workedless than 35 hours in the week prior to thesurvey.Full-time equivalents are equal to 35 hoursof “part-time” employees’ work per weekfor the purposes of this report.
Race or ethnicity. –Race or ethnicity refersto the resident’s primary racial or ethnic heritageas perceived by the staff informant. In thisreport, persons reported as “Caucasian” wereclassified as “white ,“ those reported as “Negro”
34
Figure 11.States included in the four geographic regions
Region States Included
Northeast, ........ Maine, New Hampshire, Vermont, Massachusetts,Rhode Islend, Connecticut, New York, NewJersey, Pennsylvania
North Central., Michigan, Ohio, Indiana, Illinois, Wisconsin,Minnesota, Iowa, Missouri, North Dakota,South Dakota, Kansas, Nebraska
Scwth . .. .. ... ... . .. Delaware, Maryland, District of Columbia,Virginia, West Virginia, North Carolina, SouthCarolina, Georgia, Florida, Kentucky, Texas,
West . ... .. ... .. .. ..m Montana, Idaho, Wyoming, Colorado, New
Mexico, Arizona, Utah, Nevada, Washington,Alaska, Oregon, California, Hawaii
as “black,” and those reported as “AmericanIndian,” “Oriental,” or “other” as “other.”Those reported as “Spanish American” wereclassified as such.
Geographic region. –Classification of facili-ties by geographic area is provided by groupingthe States (excluding Alaska and Hawaii) intoregions. These regions correspond to those usedby the U.S. Bureau of the Census and are shownin figure II.
—ooo —
35
APPENDIX Ill
CRITERIA FOR CLASSIFYING NURSING HOMESACCORDING TO LEVEL OF NURSING CARE
Types of Facilities IncludedIn the Survey
Institutions included in the 1973-74 NursingHome Survey were those classified as eithernursing care homes or personal care homes withnursing according to data collected in the 1971Master Facility Inventory Survey4 conducted bythe National Center for Health Statistics.
Definitions for these two classes of nursinghomes were as follows:
Nursing Care Home
. Fifty percent or more of the residentsreceived nursing care during the weekprior to the survey. (Nursing care isdefined as the provision of one or moreof the following services: takingtemperature-pulse-respiration or bloodpressure; full bed bath;. application ofdressings or bandages; catheterization;intravenous, intramuscular, or hypo-dermic injection; nasal feeding; irriga-tion; bowel and bladder retraining; oxy-gen therapy; and enema.)
NOTE: A list of references follows the text.
. At least one full-time (35 hours or moreper week) registered nurse (RN) or li-censed practical nurse (LPN) was em-ployed.
Personal Care Home With Nursing
Some but less than 50 percent of theresidents received nursing care during theweek prior to the survey.
At least one full-time RN or LPN wasemployed.
or
Some of the residents received nursingcare during the week prior to the survey.
No full-time RN or LPN was employed.
The institution either:
Provided administration of medicines orsupervision over self-administered medi-cines.
or
Provided assistance with three or moreactivities for daily living (such as helpwith tub bath or shower; help with dress-ing, correspondence, or shopping; help
with walking or getting about; and helpwith eating).
—ooo —
36
APPENDIX IV
SELECTED QUESTIONNAIRES USEDIN THE 1973-74 NATIONAL NURSING HOME SURVEY
7-J~,~ L !,, ,
(0..
(’.:i~,,”;, DEF’ARTMENT OF HEALTH, EDUCATION, AND WELFARE. .!.,<,...= ,+. PUBLIC HEALTH SERVICE
~HEALTH RESOURCES ADMINISTRATION
ROCKVILLE, MARYLAND 20S52
NATIONAL CENTER FORHEALTH sTATI ST[CS
Dear Administrator:
The National Center for Health Statistics (NCHS) of the U. S. PublicHealth Service is conducting a sample survey of resident facilitiesproviding nursing and personal care to obtain basic data on theirpolicies, services, and staff. This survey is being conducted as apart of the Department of Health, Education, and Welfare’s nursinghome improvement program. The information from this survey will beused to compile statistics on the number and kinds of such facilitiesin the United States. Enclosed are two summary reports from previoussurveys, which are illustrative of the kinds of data to be obtainedfrom this survey. These statistics will be used to meet the needs ofCongress, State legislatures, Federal, regional, and local healthplanners, national health associations, and many others who plan andprovide health services to the aged.
As you can see from these reports, it is not possible to identify anyparticular facility. We wish to as sure you that any information whichpermits the identification of the services provided by your facility,or the residents and staff will be held strictly confidential. Thisinformation will be used only by persons engaged i.~ and for the purposesof the survey, and will not be disclosed or released to others for anypurpose. Because the NCHS is committed to provide a factual basis forplanning national programs designed to advance the health of the Americanpeople, limited basic information about your facility (such as name,address, size, type, and ownership) will be made available upon requestto the NCHS.
Within about one week an interviewer will contact you for an appointment;this person will be with Applied Management Sciences, the firm underFederal contract to co~duct this survey. In preparation for this call,please review the worksheet printed on the back of this letter. Thesequestions request necessary information which may take time to assemblefrom your records. I have enclosed them so that you may do this atyour convenience prior to the interviewer’s visit.
This survey includes a small, carefully selected nationwide sample ofnursing homes and similar facilities. Because this ntirsing home repre-sents several facilities of similar type, your participation is vital inobtaining accurate and complete data. We would appreciate your cooperationin this effort.
Sincerely yours,
G?_.”d G fl~.Edward B. Perrin, Ph. D. Acting Director
37
STAFF CLASSIFICATION CARD
1973 Nursing Home SurveyNational Center for Health StatisticsHealth Resources AdministrationRockville, Maryland
WHICH OF THE FOLLOWING JOB CATEGORIES BEST FITS THE JOB WHICH THIS EMPLOYEE DOES IN THIS FACILITY?
JOB OTHER THANTHOSE LISTED ABOVE (PLEASE SPECIFYJOB ~TITLE ON THEINDIVIDUALLINE OF STAFF CONTROL RECORD) . . . .
GROUP BEnter in Column j
of Staff Control Record
GROUP CEnter in Column k
of Staff Control Record
GROUP DEnter in Column I
of Staff Control Record
GROUP E
Enter in Column mof Staff Control Record
38
.SIAEE.QUES.TKMMd.liE-MTJ1673 Nursing Homo SurveyNational Contor for Health StatisticsHMlth Ramurms Admlnistmtlon
IWR%=’-7
Rockvlllo, Maryland
F
ASSURANCE OF CONFIDENTIALITY-All Informationwhich would parmit Identification of the i“dividud will be heldIn strict confidence, will be usedonly by partons engagedin andfor the purpa%Gsof tho suwev, and will not be discloted or released
6CC1-4
A. ESTABLISHMENT NO.
~ 3;” “NENO”uIlCC2 ccl 1
The National Center for Health Statistics of the Health Your answerswill be givenconfidemial treatmem. The i“forrnati.an will beResourcesAdministration isco”ducti”g a nationwide usedfor statistical purposesonly, and will be presentedin such a manner thatsurvey in nursing homes. One of the pwpmes of the swvey no individual permnOr e=bllshmO.t ~nbaide"tifi&. After completing theisto obtain certain information about the staff emdwed i“ these form pleasereturn it in the envetorm!mwided.facilities. Wewmddappreciateym.irtaki”gthebriefamoumoftime necessaryto complete this questionnaire.
You may ask questionsof the intewiewer or by calling 80&636-W56.
1. HOW LONG HAVE YOU WORKED AS A
a. IN THIS FACILITY?no
Years MonthsCC20
b.CC22
‘%;;%;:F;%;;M:: n n ‘RSIMILAR FACILITIESYears MonthsCC24 CC26
c. IN HOSPITALS?OnoR
Years MonthsCczs CC30
Mark (X) this box[f you have neverworked in any othernursinghome.
Mark (Xl this boxif you havenwer workedin a hospital.
•1
❑
2. WHAT IS YOUR DATE OF BIRTH? //Month Day YearCC32,33 CC34,35 CC36,37
3. HOW MANY HOURS PER WEEK 00 YOU USUALLY WORK IN THIS FACILITY7
Uho”rsCC38
4. HOW MANY HOURS DID YOU WORK LAST WEEK IN THIS FACILITY?
n hours ‘R ❑ noneCC40
6, BESIDES THE HOURS WORKED IN THtS FACILITY, HOW MANY ADDITIONAL HOURS OID YOU WORK IN YOURPROFESSION LAST WEEK?
o hours ‘R ❑ .0..CC42
6. WHAT IS YOUR SALARY BEFORE DEDUCTIONS FOR THE WORK YOU PERFORM IN THIS FACILITY ONLY?
( Mark (X) Only One BOX)
$ . perCC44
\ 152-1 ❑ week
-2 •l hOurOR -3 ❑ two weeks
❑ I C1.a”atem,,ew,cm-1 ❑ one month
CC51.1 -5 •1 other time rmricd, specify 53
Form 73NHS4 Page 1
39
—— ——-- .. ---- .7. IN ADDITION TO THIS SALARY, 00 YOU RECEIVE:
If “Oneofth,se,mark (x) box ~ andskipmouestlo. 111
CC37,3S CC39,40
Form 73NHs-4 Pase2
11, HAVE YOU TAKEN ANY NON-DEGREE TRAININGCOURSES lNTHE PAST YEAR? TRAINING COURSES INCLUDECLASSSESSIONSAND SEMINARS. DO~lNCLUDE COURSES FOR DEGREE CREDIT.
42.1 Yes -2
L.
No
(skip to aumtlon 12)
b. FOR EACH OF THE SUBJECTAREAS c. NUMBER OFLISTEO BELOW, INDICATE HOW MANY COURSES”NON-DEGREE TRAINING COURSES* YOU TAKEN IN PASTHAVE TAKEN WITHIN THE PAST YEAR. 12 MONTHS
a. Nursing care of the agedor chronically Ill
b. Medical or dental care of the
aged or chronically ill I ICC43,44
CC45,46
c. Mental or social problems ofthe aged or chronically ill I I (%47,4s
d, Physical theropy orrehabilitation
I I0. Occupational therapy
f. Nutrition or food services
9. Nursing home administration
h. Inmwica Education
1. Medical records
CC49,50
CC51,52
CC53,54
CC55,56
CC57,58
CC69,60
1. Activity programs for theaged or chronically ill I I CC61,62
k. Social Se!vices for the agedor chronically ill I I CC63,64
1. Pharmacology and care ofdrugs I I
I
m, Other course related to your worki
SpecifyG7. I I
‘Tralnlng coursns include claswxionsa”d seminars. Cm not includecourses for degree credit.
/“ ‘2In the mclossd postagt paid envelopeeither to the intewiewer or to:
/
Applied Mamwment SciencesS62 Wayne Avenue, Suite 701Silver SPri”g, Maryland 2CM1O)
b. DO YOU ATTENO YOUR OWN PRIVATE PATIENTS IN THIS HOME?
CARD3 15-1 ❑ Yes*b.1 HOW MANY OF YOUR OWN PRIVATE PATIENTS DO YOU ATTEND IN THIS FAClLlTY7_m
pmimts
“2~N”
CC16
c, ARE YOU NOW ATTENOING PATIENTS TEMPORARILY IN THISFACILITY TO COVER FOR THE PATlENT’S OWN PHYSICIAN? 19-10 Yes .2D NCI
d. DO YOU TAKE EMERGENCY CALLS FOR,4VYPATIENT IN THIS HOME?— Z&l ❑ Yes -20 ‘0
e. 00 YOU, PROVIOE OTHER OIRECTPATIENTSERVICE IN BEHALF OFTHE HOME’S RESPONSIBILITY FOR SECURING SUCH COVERAGES(e.g., AOMISSION EXAMS, PRONOUNCING DEATHS, SECURINGMEDICATION ANO OIETOROERS, ETC.]? 21-10 Y., .20 No
f. 00 YOU PROVIOE INSERVICE TRAINING TO THE HOME% PERSONNEL? 22.10 Yes -20 No
% FOR HOW MANY RESIDENTS IN THIS HOME 00 YOU PROVIOE MEOICAL CARE?
ra$ident$CC23
Thank wwforyourco opermion. PluaSreturn thequtilonnaire intheencloA postwpaidonvalopeeither to the interviewer .x to:
42
Applied Manas.smentSciences,Inc.S62 Wayne Avenue, Suite 7013ilv0r Spring, Maryla”d zO91O
Page4 Form 73NHs.4
STAFF CONTROL RECORDSheet _of _
1973 N.mlng H.mu surveyN,tlonal Cent,, for Health StatT,tlcs
m
Health ResourcesAdmlnlstmtlon%ckvllle. Maryland
ASSURANCE OFCONFIOENTIALIW .Alllnformatlon wM&wo.ld@fmit Idendflc?wmcc, 3 cd
of thn individual wIN be held 1. strict mnf,dm=, wIN be .ssd ..1” by ww.s .nsdwd ESTABLISHMENT NO
[n and for the wpws of the s.rw, and will not be dhcl.sal or releasd to 00xrs10,..” pu,ooses,
LINENR.
2’7AFF sEX ETIIN,c .ACKGRO. NC. SMPL.3YE. HOURS WORKED OCCUPATION LINENR,
Programs and Collection Procedures. –Reports which describe the general programs of the NationalCenter for Health Statistics and its offices and divisions and data collection methods used and includedefinitions and other material necessary for understanding the data.
Data Evaluation and Methods Research. –Studies of new statistical methodology including experi-mental tests of new survey methods, studies of vital statistics collection methods, new analyticaltechniques, objective evaluations of reliability of collected data, and contributions to statistical theory.
Analytical Studies. –Reports presenting analytical or interpretive studies based on vital and bed thstatistics, carrying the analysis further than the expository types of reports in the other series.
Documents and committee Re~orts. –Final reports of maior committees concerned with vital andhealth statistics and documents” such as recommended model vital registration laws and revised birthand death certificates.
Series 10. Data From the Health Interview Survey. –Statistics on illness, accidental injuries, disability, use ofhospital, medical, dental, and other services, and other health-related topics, all based on data collectedin a continuing national household interview survey. +
S(,ri,,.\ 11. Data h’rorn the Health Examination Survey and the Health and Nutrition Examination Survey. –Datafrom direct examination, testing, and measurement of national samples of the civilian noninstitu-tionalized population provide the basis for two types of reports: (1) estimates of the medically definedprevalence of specific diseases in the United States and the distributions of the population with respectto physical, physiological, and psychological characteristics and (2) analysis of relationships among thevarious measurements without reference to an explicit finite universe of persons.
Series 12. Data From the Institutionalized Population Survey s.–Discontinued effective 1975. Future reports from
these surveys will be in Series 13.
Series 13. Data on Health Resources Utilization. –Statistics on the utilization of health manpower and facilitiesproviding long-term care, ambulatory care, hospital care, and family planning services.
Series 14. Data on Health Resources: Manpower and Facilities. –Statistics on the numbers, geographic distri-bution, and characteristics of health resources including physicians, dentists, nurses, other healthoccupations, hospitals, nursing homes, and outpatient facilities.
Series 20. Data orL Mortality, –Various statistics on mortality other than as included in regular annual or monthlyreports. Special analyses by cause of death, age, and other demographic variables; geographic and timeseries analyses; and statistics on characteristics of deaths not available from the vital records based onsample surveys of those records.
Series 21. Data on Natality, Marriage, and Divorce. –Various statistics on natality, marriage, and divorce otherthan as included in regular annual or monthly reports. Special analyses by demographic variables;geographic and time series analyses; studies of fertility; and statistics on characteristics of births notavailable from the vital records based on sample surveys of those records.
Series 22. Data From the National Mortality and Natality Surveys. --Discontinued effective 1975. Future reportsfrom these sample surveys based on vital records will be included in Series 20 and 21, respectively.
Series 23. Data From the National Survey of Family Growth. –Statistics on fertility, family formation and dis-solution, family planning, and related maternal and infant health topics derived from a biennial surveyof a nationwide probability sample of ever-married women 15-44 years of age.
For a list of titles of reports published in these series, write to: Scientific and Technical Information BranchNational Center for Health StatisticsPublic Iiealth ServiceHyattsville, \ld. 20782
