29.

Rochester and Monroe County (New York) Council of Social
Agencies, Nursing Homes Study Subcommittee. Care of Persons
with Long-Term Illness in Nursing Homes: Preliminary Infor·
mation. Rochester, New York, September 1958. 47 pp.
w/appendices. Processed.

To collect data both about patients and the services provided,
questionnaires were mailed to the 33 approved proprietary
nursing homes in Monroe County, and, on a specific day, a
census was taken of the patients in the 30 homes that responded.
Also, a random sample of 29 patients was used as a clinical
review study group.

The questionnaires obtained information pertaining to admission policies, staff education, and charges to patients. The census provided data regarding the characteristics of the patients.

The 29 patients selected as a clinical review study group were
used in analyzing the rehabilitation potential of the patients in
nursing homes. The results indicated that 14 percent of the
patients were potentially able to manage complete self-care
and an additional 65 percent were judged able to develop
partial self-care.

30. Niagara Falls Council of Social Agencies. The Changing Pattern of Illness: Niagara County Study of Chronic and Long-Term Illness. Niagara Falls, New York, Council of Social Agencies, 1960. 165 pp.

This publication reflects the findings of a survey of chronic and long-term illness in Niagara County, New York. Various areas of the broad range of chronic illness were studied, including the area of nursing homes.

Information is presented on 13 of the 14 proprietary homes in
operation in March 1958 and one 30-bed voluntary nonprofit
home. These 14 homes had a total of 324 beds, with an occupancy
rate of 85 percent. The buildings were, with two exceptions,
converted frame residences, generally estimated to be between
25 and 30 years old.

All of the homes met the minimum State requirement of super-
vison at all times by at least a licensed practical nurse. How-
ever, four homes, comprising 25 percent of the total bed capacity,
had no supervision from a registered professional nurse at any time.

Data concerning the personal characteristics of patients as to age, sex, length of stay, ambulatory status, major diagnoses, and prognoses are given. The findings show that 25 percent of the patients were bedfast and 17 percent were confined to a wheelchair.

Often medical records were incomplete and out-of-date; in general, there was no stated plan for care based upon a medical and social evaluation for each patient; and few of the homes had adequate social and recreation rooms where patients could receive visitors or take part in other activities.

NORTH CAROLINA

31. Cameron, Charles M., Jr. and Holley, Lydia S. A Study of Patients in Licensed Nursing Homes of North Carolina. Chapel Hill, North Carolina, University of North Carolina, Department of Public Health Administration, School of Public Health, 1962. 91 pp. Processed.

A one-day census in January 1962 revealed that 1, 093 persons were then receiving care in the 37 licensed nursing homes of North Carolina. To determine the physical therapy needs and services of these nursing home patients, a representative sample of 100 was selected as the basis of the detailed study.

Information was obtained as to the personal characteristics and background of the patients being studied. Data were then collected so the patients could be categorized according to their present physical condition. Further analysis was made to define the level at which they were functioning in the essential activities of daily living.

The characteristics of the homes were evaluated to determine the appropriateness of the physical facilities within the homes for the needs of the study group. An appraisal of the physical therapy skills needed by nursing home patients to achieve the highest feasible level of independence was also made.

Based on the findings, conclusions are presented, which in turn become the basis for a series of recommendations for the improvement of care of long-term patients.

32.

Cassel, John. The Guilford County Chronic Disease Survey.
Greensboro, North Carolina, Greensboro County Council,
June 1958. 68 pp. w/appendices. Processed.

The objectives of this countywide survey were to determine: (1) the
number of known chronic illness cases, (2) the services received by
such individuals and the additional services needed for adequate
care, and (3) the adequacy of existing community services and facili-
ties to meet the needs of the chronically ill.

Of the 3, 796 cases of chronic illness reported, 3, 427 were not in
any institution, 318 were in boarding homes, and 51 were in a
hospital or nursing home in the county. Approximately 1,800
noninstitutionalized chronically ill persons were estimated to be
in the county.

The survey recommends the establishment of a convalescentrehabilitation center. This center would assist over one-fifth of the present boarding home residents to obtain the care they need to reintegrate them into the community. This, in turn, would assist the chronically ill persons who need boarding home care and are unable to receive it because facilities are lacking.

33.

OHIO

Wheeler, Charles and Livingston, H. Farrand. Nursing and Rest
Homes in Ohio. (Staff Research Report No. 31.) Columbus, Ohio,
Ohio Legislative Service Commission, January 1959. 42 pp.

Data on nursing and rest homes in Ohio were compiled mainly from State licensing records. The reported information includes the number of facilities, the type of construction, and the number, age, and primary diagnoses of the patients.

Of the total of 21, 384 beds in licensed nursing and rest homes in Ohio
as of June 1958, 68.3 percent qualified as skilled nursing home beds,
according to the Public Health Service definition. Only 15.6 percent
of these skilled nursing home beds were classified as "suitable;"
the others were considered "unsuitable" or "replaceable," primarily
because of fire hazard.

The average age of the patients was 82 years, and practically all had some type of chronic disease.

Data on operating costs and charges were obtained through a questionnaire submitted to each nursing home in the State. A total of 119

proprietary and 49 philanthropic homes responded; not all replies
were complete. Operating costs of nursing homes varied widely,
and the size of the home did not appear to affect costs.
The average
charge for skilled nursing care was $180 a month.

34. United Community Council of Summit County. Chronic Illness Study. Akron, Ohio, May 1959. Various pagings.

Processed.

In order to obtain data for the section of the study which is concerned with nursing homes, an inventory was conducted of the privately operated nursing homes of the county and information on a home for the aged was provided by its administrative staff. Members of the committee visited the nursing homes and reports were made on their general impressions of these homes, the personnel, medical records, attitude of patients, services and care given patients, food, and recreational facilities.

Of the total 890 beds in the county for the chronically ill and aging, 537 were in 26 privately operated nursing and rest homes. Most of these homes failed to meet adequate standards the majority were not in good repair, many presented fire hazards, nearly all lacked recreational facilities, few provided a central dining room.

Characteristics of the patients, including age, marital status,
physical condition, activities, and medical care received, were
determined through questionnaires completed on 25 percent of the
patients. The results show that 50 percent of these patients would
not need to be in a nursing home if they had someone in their own
homes who could look after them, 33 percent needed only good board-
ing home care, and only 17 percent needed skilled nursing care.

OKLAHOMA

35. Sub-Committee, Fact Finding Committee. Oklahoma Conference on Aging: Report of Fact Finding Committee on Nursing Homes. April 15, 1960. Various pagings. Processed. (Limited supply.)

This survey includes tabulations of the number of licensed nursing homes, rest homes, and convalescent hospitals in the State, and the size, occupancy rate, and type of staff of each classification of facility. The committee discusses the present and projected need for nursing home beds. It believes the available bed capacity is adequate at this time (although many of the beds should be replaced), and that future needs can be met by a gradual increase.

The committee offers a series of recommendations to increase the quality of care in facilities for the aged. Among these recommendations are that rest homes and nursing homes meet the same standards for licensure.

Included in this publication is a study made in 1954 by the Oklahoma State Department of Health and the National Commission on Chronic Illness. This study contains 27 tables covering the characteristics of all establishments within the State for the care of the aged, chronically ill, and convalescent, and of the patients within these establishments.

PENNSYLVANIA

36. Pennsylvania Department of Public Welfare, Office for the Aging and Office of Program Research and Statistics. Costs of Providing Care in Pennsylvania Nursing Homes and Related Facilities. Harrisburg, Pennsylvania, The Department, November 1961. 100 pp. Processed.

The primary objectives of this survey were to (1) determine the
1958-59 costs per resident day in a representative sample of
Pennsylvania nursing homes providing differing types of care,
for use in establishing equitable public assistance payments and
(2) provide the basis for developing guide materials for adminis-
trators of similar institutions in estimating operating costs.
Technical assistance was provided by the U. S. Public Health
Service.

Of the approximately 900 homes for the aged and infirm in Pennsylvania, 106 facilities were randomly selected for study. During July- November 1959, one or more staff interviewers visited each of these facilities. Information was obtained in three areas: the costs of providing care per resident day, the characteristics of the facilities and their staffing, and the kinds of patients or residents and their physical and mental conditions. The basic sources of data were the expense statements and payroll and patient records.

For the purposes of the study and to facilitate comparisons with other State and community surveys, the facilities were classified, according to the primary type of care provided, ranging from sheltered care homes (16 percent) to multicare facilities (8 percent).