SURVEYS OF

NURSING HOMES AND RELATED FACILITIES

NATIONAL

1. American Nursing Home Association and Council on Medical Service, American Medical Association. Summary of a Survey of Nursing Homes, 1958-1959. Chicago, Illinois, American Medical Association, Council on Medical Service. 5 pp.

During 1958-59 questionnaires were sent to the 4, 500 members
of the American Nursing Home Association. In addition to the
1, 350 nursing homes that responded, staff members of the
American Medical Association Council on Medical Service visited
66 of the "better skilled nursing homes" in 22 States to obtain
supplementary data. Since the questionnaire was sent only to
members of the American Nursing Home Association and the
additional homes in the study were chosen because they were
regarded as being among the best homes in the selected States,
these survey homes do not constitute a representative sample of
nursing homes throughout the country.

About 95 percent of the homes participating in the questionnaire
survey were proprietary, 2 percent were church-affiliated, and
3 percent were controlled by other nonprofit or government
agencies. Thirty-c
-one percent of the homes had been operating for
a period of 10 years or more.

Ninety-three percent of the patients in the homes required nursing care, 6 percent required personal care, and 1 percent needed residential services only. About 19 percent of the nursing home patients were completely bedfast, 30 percent were in bed most of the time, and 51 percent were ambulatory with minimum help. About four-fifths of the homes had arrangements with a nearby hospital for transfer of any patient who needed hospital care and about 61 percent had a staff or consulting physician.

Nursing and rehabilitation services, social and recreational
activities offered, and financial aspects of nursing home care
are also discussed.

2. Solon, Jerry; Roberts, Dean W.; Krueger, Dean E.; Baney, Anna Mae. Nursing Homes: Their Patients and Their Care (Public Health Monograph No. 46.) Washington, D. C., U. S. Department of Health, Education, and Welfare, Public Health Service, 1957. 58 pp. (Available from U. S. Government Printing Office, Washington, D. C. Price: 40 cents.)

This monograph describes nursing homes, domiciliary care institutions, and chronic disease hospitals from the perspective of the types of patients and care found in these facilities. The findings are based on a 13-State survey conducted jointly by the Commission on Chronic Illness and the Public Health Service during 1953-1954.

Data relating to the characteristics of the patients include: age, sex, marital status, race, physical and mental conditions, and medical diagnoses. Other information presented describes the types of services received, staffing, frequency of attendance by physician, sources of patient funds, and charges for care.

Because of the number of proprietary nursing homes in existence the report is focused primarily on this group of facilities. The survey revealed that patients in these homes were aged, severely disabled, chronically ill, and destined for a prolonged stay. Their average age was 80; one-half were severely limited in ability to walk, one-fifth confined to bed, two-thirds had some heart or circulatory condition; and the average length of stay, at time of survey, was one year. Fully one-half of the patients were recipients of public assistance.

ALABAMA

3. Alabama State Department of Health and State Department of Pensions and Security. Survey of Licensed Nursing, Rest or Convalescent Homes for Adults in Alabama. Montgomery, Alabama, Winter 1961-1962. 15 pp. w/statistical tables. Processed.

This study was conducted to obtain information regarding facilities in Alabama licensed to provide nursing, rest or convalescent care for adults and to measure the progress made by the homes since the first such study was made in the spring of 1954. Data were obtained through interviews and supplemented by State licensure records.

Findings relating to the facilities include: sponsorship or ownership, year of establishment, the physical condition of buildings and grounds, staffing, recreational facilities, and the educational background of the administrators. With respect to the residents, the following social

and medical characteristics are summarized: age, race, sex, place of residence, physical condition, illnesses, personal services needed, and proportions receiving public assistance.

As suggested in the 1954 survey, consideration had been given to the
establishment of nursing homes by general hospitals, both publicly
and privately owned. Also, many of the privately owned and
administered nursing homes have become affiliated with hospitals,
in order to provide more adequate care for the chronically ill.

Statistical tables summarizing the findings of this survey and all of the data from the 1954 study are presented.

Since 1954 the nursing homes in Alabama are reported to have made significant improvements. A series of recommendations are offered to further improve standards of care for the residents of these homes.

ARIZONA

4. Arizona State Health Department, Division of Hospital Survey, Planning and Construction. A Study of Patient Characteristics and Staffing in Nursing, Personal Care and Sheltered Homes in Arizona. Phoenix, Arizona, March 1, 1956. 11 pp. Processed.

Data on the characteristics of patients, gathered by a questionnaire mailed to all licensed homes, are reviewed. Bed capacity and personnel data were abstracted from license applications and inspection reports.

The following information is summarized for each of the three
categories of facilities studied--nursing, personal care, and sheltered
homes: number of homes, beds, and patients; average occupancy;
age ana sex of patients; number and type of personnel employed; ratio
of beds per employee; primary diagnoses of patients; number of
patients receiving treatment and/or medication; activity status of
patients; and place of residence.

A total of 76 homes with 1,286 beds and 944 patients was included in the study. The findings show that: one person in 10 over 85 years old is in a home; over one-half of the patients in the nursing homes are over age 75; three-fifths are female; 15 percent of all nursing home employees are graduate nurses; the larger nursing homes have more beds per nursing employee than do smaller homes; and most patients are residents of the county where the home is located.

5.

FLORIDA

Britt, Ferne Hobson and Jacks, Margaret H. Cost of Care of Aged and Infirm Residents in Florida Nursing and Boarding Homes. Public Health Reports 71:735-741, August 1956.

Although this report deals primarily with the costs of care in nursing homes, some information is also included on the number of homes and nursing services offered.

At the time the study was made there were 274 licensed nursing homes and boarding homes in the State. Although less than half of these licensed homes participated in the study, the ratio of nursing homes to boarding homes was almost identical to that existing in the State.

The time spent on services, as reported by the homes on the
schedules furnished for gathering information, was compared
with current State nursing home standards. The personnel
required by the Florida State Board of Health standards for
nursing homes would provide 2. 8 hours per day of nursing
care for each patient. However, the survey showed that hours
of daily nursing service per patient ranged from 3. 2 hours in
the better-equipped homes to a minimum of 1.2 hours in the less
well-equipped homes. The average of 2. 3 hours is considered
substandard; it is believed that a minimum of 2. 6 hours per day
must be provided for acceptable care.

6.

Florida Citizens Medical Committee on Health. Report of
Citizens Medical Committee on Health. Tallahassee, Florida,
Governor's Office, January 15, 1959. 66 pp.

As part of an overall study of health needs, a comprehensive survey of all licensed nursing homes in Florida was undertaken. Information was obtained on 330 of the 344 licensed nursing homes in the State, and 6, 298 of the 6, 567 patients reported in residence. Each home was visited by a representative of the County Health Department to obtain overall data relating to the home, and forms were filled out for each of the patients by the staff of the home.

Of the 330 homes, 83 percent were privately owned, 11 percent
were nonprofit, and six percent were city or county institutions.
The survey showed that 17 percent of the homes had less than
10 beds. The median charge for care was $123 per month.

The study reveals that the average resident had been in the
same nursing home for almost two years and that less than
50 percent of the residents were able to walk alone. Other data
presented regarding the characteristics of the patients include
age, marital status, religious preference, the major current
medical condition, and mental status.

In the opinion of those who provided the data, approximately onethird of all patients in nursing homes did not need the special care provided in such homes, and, of the remaining two-thirds who were considered to require the special care provided, only about one-half regularly required skilled nursing attention.

GEORGIA

7. Georgia Department of Public Health. A Study of Nursing Homes in Georgia for the 1958 General Assembly. Atlanta, Georgia, December 1957. 56 pp. w/ appendices. Processed.

This survey covered all nursing homes in the State providing care for the aged. A questionnaire was prepared and the information desired was obtained through an interview with each

administrator.

Among the phases of nursing home care which are covered in
this comprehensive survey are: the location, ownership, and
supervision of the home, the physical plant, medical and reha-
bilitation practices in the home, the characteristics of patients,
and financial data (charges, costs, and sources of patient income).

Many of the homes are in converted frame buildings, of obsolete construction and considerable age. The majority of homes are not constructed of fire-resistant materials. The homes tend to be small; a large percentage of them have from 1 to 14 beds. Three-fourths of them do not provide for organized recreation. A large majority do not provide skilled nursing care.

An appendix to the study surveys dental conditions in the nursing
homes in one county in Georgia. The findings of the dental needs
of the patients in this county, the investigators believe, would
be representative of the needs of the patients in the State as a
whole.

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