The estimated "real" cost of providing care in the 106 nursing
homes and related facilities varied greatly ranging from $2.00
to $24.00 per resident day. However, the average (mean) cost of
care in all of the facilities was found to be $5.91. In terms of types
of care category, the average cost of care per resident day ranged
from $4.26 in the sheltered care homes to $7. 16 in the multicare
facilities. Salaries and wages were the largest single expenditure,
accounting for 40 to 50 percent of the total resident day costs.
It was found that slightly more than 40 percent of the facilities studied had a registered professional nurse on their staff; another 25 percent had a licensed practical nurse. About 30 percent of the homes had no staff person who was either a registered professional nurse or a licensed practical nurse.
The median age of the residents was 80 years, and more than threefourths were 65 years of age or over. The physical and mental conditions of the residents varied considerably among the various types of facilities. Data were also obtained on the residents' sources of
37. Tucker, Elizabeth Lamberty and Snyder, in Nursing Homes of Washington State. 85-95, January 1958.
Personnel Time Public Health Reports 73:
This is a report of a study which had the following objectives:
(1) to learn the number and kinds of personnel in all types of
nursing homes, (2) to develop staffing guides from the data, and
(3) to provide data that can be used to compare nursing home
practice in Washington State with that in other States.
Nursing homes were classified into four groups depending upon qualifications and number of nursing personnel. Personnel time was analyzed as to type of service and number of hours, then related to size of homes and number of patients.
The study shows that specific requirements for skilled nursing staff
influence the staffing patterns, particularly in small homes. In
Group I homes, skilled nursing time averaged 44 minutes, in
Group II homes, 43 minutes, in Group III, 27 minutes, and in
Group IV, 24 minutes per patient per day. Groups I and II are
quite similar in both total nursing time and in skilled nursing time,
while there is considerable difference between these two groups and Groups III and IV. On this basis, it was recommended that there be only two types of homes: (1) intensive care homes providing skilled nursing 24 hours a day, and (2) limited care homes, in which a registered professional nurse or licensed practical nurse is in charge of nursing service but not necessarily on duty all the time.
Washington State Department of Public Assistance. Nursing Home
Cost Study. Olympia, Washington, February 1961. 89 pp.
This study was made to provide a basis for the establishment of equitable rates of payment for the care of public assistance recipients in licensed private nursing homes. The cost data, based on calendar year 1959, were obtained in such a form that future adjustments may be made for changes in prices, wage rates, and staffing requirements.
The characteristics of a random sample of public assistance
recipients in nursing homes were analyzed so that the results
of the cost study could be properly evaluated. The following
data were obtained on this sample (five percent) of patients:
age, sex, impairments, mental condition, bed status, mobility,
continence, and services received. Information was also obtained
as to the length of time each patient had been in the nursing home,
and the estimated period for which care was required.
In addition, social characteristics of the patients are presented in tabular form. These include marital status, customary living arrangement prior to entering nursing home, and the sources of income.
Median costs, which were determined for four classes of
care, and adjusted for changes since the reporting period, are:
Class I, $6.07; Class II, $5.27; Class III, $4.66; Class IV, $4. 14.
Detailed breakdowns of cost by department are given for each
class.
39. Beattie, Walter M., Jr. Dane County Survey of Health Needs, Services and Facilities for the Aging and Long-Term Patient. Madison, Wisconsin, Community Welfare Council, July 1956. 106 pp. Processed.
This survey was undertaken to obtain data on which to build a
program of coordinating and planning health services for the
aging population of Dane County. The groups surveyed were
nursing homes, visiting nurse service, physicians, and hospitals.
There were 30 nursing homes in Dane County, of which 25 were
proprietary. In addition to information concerning the size,
ownership, and location of these facilities, the admission policies,
staff, discharges, and problems of care are discussed. The
characteristics of all patients in nursing homes in the county
during the month of March 1954 were analyzed, including the
age, sex, marital status, diagnoses, and disabilities. Informa-
tion was also obtained regarding the social and recreational
activities of the patients, the sources of funds for payment for
care, and visits to patients by a physician.
The survey reveals that: nine nursing homes had house physi-
cians; all other homes reported that each patient had his own
attending physician; no organized recreational or social activ-
ities were reported by the homes for their patients; and charges
for nursing home care ranged from less than $60 to more than
$300 a month.
State of Wisconsin Department of Public Welfare, Division of
Public Assistance. Expenditure for Health Care Services for
Public Assistance Recipients in Wisconsin. October 1956.
Madison, Wisconsin, April 1, 1957. 16 pp. w/appendix.
Processed.
This report covers a survey made in October 1956. It is the fourth in the series of studies conducted concerning current costs of medical care and related health services provided to public assistance recipients.
Costs for medical care had continued to rise steadily. The survey showed a 28. 6 percent increase over the October 1954 figure, and that much of the actual dollar increase was registered in payments to nursing homes, public medical institutions, and hospitals.
Not all of the rise in cost for nursing home care and care in
public medical institutions, however, was due to increases in
the rates charged for care in these institutions. A very signifi-
cant part resulted from an increase in the number of persons
receiving care in facilities of this type. This number advanced
by over one-fifth between October 1954 and October 1956 and
this trend was continuing. Counties have opened new and larger
institutions or improved existing institutions, and the number
of available nursing homes has risen and the bed capacity has
increased.
Inasmuch as the residents of these facilities who receive public assistance would still need public funds if they were able to take care of themselves outside of an institutional setting, part of the increased cost was due to a transfer of expense from a nonmedical to a medical category of public assistance expense.
41. Wisconsin Department of Public Welfare, Division of Public Assistance. Characteristics of Residents of County and City Homes in Wisconsin - December 31, 1956. Madison, Wisconsin, April 25, 1957. 6 pp. w/statistical tables. Processed.
The results of the study are indicative of a trend toward a
continuing increase in the population of city and county homes.
This trend reflects a continued rise in numbers of the aged
population and the need by more and more people for the type
of custodial and nursing care provided by these institutions.
On December 31, 1950, there were 2, 899 residents in these
public facilities; by December 31, 1956, this number had grown
to 3, 543 persons. Two sizable public institutions which some
years ago had been leased to private nursing home operators had
recently been returned to county control.
The number of persons aged 85 and over in city and county homes
increased from 9.4 percent of the total resident population in
1950 to 16.7 percent in 1956. Statistics are included on the
(1) amount of care required by residents, (2) number of years in
the institutions, (3) sex and race of residents, (4) commitment
status of residents, (5) payment for care, and (6) special
problems of residents.
The tables which follow summarize the type of infor
mation included in each of the surveys listed in the
The information is grouped according
to whether it relates to patients or to facilities. The
table shows the extent of comparability among the
|