8.

ILLINOIS

Nicholson, Edna. Nursing Homes and Related Facilities for Care of the Infirm and Chronically Ill. The Proceedings of The Institute of Medicine of Chicago 23:123-138, September 15, 1960.

This report summarizes the needs and resources for the care of Chicago and Cook County patients in nursing homes and similar institutional facilities. With the increase in population and life expectancy, there had been a resultant increase in the number of people (an estimated 80, 000) in the survey area who need longterm care. This number was exclusive of the tuberculous and mentally ill. It was believed that about two-thirds could be cared for in their own or relatives' homes. The remaining one-third, approximately 27, 000 persons, needed care in nursing homes, homes for the aged, and similar facilities.

Statistical information is presented as to the ages of the persons needing nursing home-type care, the primary cause of disability, and the amount of care required. Approximately 60 percent needed regular nursing services; the remainder required chiefly personal attention and routine care, or minimum care only.

Although it was estimated that a total of 27, 000 persons needed
nursing home care, there were, at the time of the survey, only
16, 446 beds in 323 facilities of this type. Almost 80 percent
were privately owned. The average occupancy was 93 percent.
Data are included as to the date of the establishment of the homes
and their bed capacities.

The author notes progress with respect to the quality of the physical facilities and the services available. However, it is stated that standards have not reached an adequate level. The majority of the proprietary homes are old residences not designed for nursing home use. Less than one-third of the homes employed registered professional nurses. It is recommended that continued efforts be made to develop more and better facilities for the care of the chronically ill and infirm.

INDIANA

9. Indiana County Homes Survey. Background Studies Prepared by State Committees for the White House Conference on Aging. (A Report by the Subcommittee on Problems of the Aged and Aging to the Committee on Labor and Public Welfare, United States Senate. Part III.) Washington, D. C., U.S. Government Printing Office, 1960. pp. 15991657. ($2.75)

visited by a professional More than 50 percent of

Each of the 73 county homes in Indiana was
team to obtain information for this survey.
the homes were constructed prior to 1900. A determination was made
of the compliance with minimum housing, sanitation, and safety
requirements.

The total resident capacity of the homes was 4, 371, with a range of 8 to 421. At the time of the survey the homes were utilized at a rate of 64 percent of their capacity.

The average age of the 2, 814 residents was 68. 6. Information was obtained as to their marital status, length of stay, financial resources, ambulation status, and the type of care needed. The report indicates that 46 percent of the residents required residential care, 34 percent required limited nursing care, and 20 percent required comprehensive nursing care.

Data are presented also concerning the employees, their educational levels, length of employment, and hours worked per day.

Arrangements for medical care in the homes were reviewed. Sixtythree counties employed a physician to care for county home residents. All of the homes provided for prompt medical care.

KANSAS

10. Poland, Eleanor; Lembcke, Paul A., M. D.; and Shain, Max. Regional Health and Hospital Study: Kansas Nursing Homes. Kansas City, Missouri, Community Studies, Inc., November 1959. 105 pp. Processed.

The information reported in this study was obtained through a field survey of nursing homes, boarding homes, and homes for the aged in Kansas. Each facility was classified by the administrator as to the type of service provided. Of the 440 homes, the administrators

considered 74 percent to be nursing or convalescent homes for adults, 17 percent to be homes for the aged (either with or without nursing care), and 9 percent to be boarding homes.

Among the data obtained regarding the residents are: age, sex, mari-
tal status, race, previous residence, length of stay in home, and
physical and mental status. Information is included as to the size
of the home, the number of years in operation, ownership, occupancy
rates, type of staff, and charges for care.

The authors conclude, on the basis of the survey, that many of the
present homes are not satisfactory. Among the deficiencies listed
are: that many of the buildings are not structurally suitable; that
80 percent of the homes are not provided with skilled nursing care
or supervision; that there are few recreational facilities; and that
there is no organized system for determining the rehabilitation needs
and potentials of patients.

11. Kansas State Board of Health. Characteristics of Residents in a Sample of Care Homes for the Aging in Kansas. Background Studies Prepared by State Committees for the White House Conference on Aging. (A Report by the Subcommittee on Problems of the Aged and Aging to the Committee on Labor and Public Welfare, United States Senate. Part IV.) Washington, D. C., U. S. Government Printing Office, 1960. pp. 2017-2046. ($2.75)

Information for this survey was obtained through a random sampling of 100 licensed nursing homes, adult boarding homes, and homes for the aged located in 47 of the 105 counties in Kansas. Public health nurses interviewed the administrators at the time the homes were evaluated or relicensed.

The homes surveyed ranged in size from a minimum of three residents to a maximum of 79. Thirty-three percent of the homes had fewer than 10 residents; 90 percent fewer than 25.

Only six registered nurses and one licensed practical nurse were employed in the 100 homes. The majority of homes did not provide a staff physician.

Data concerning residents of the homes are given as to age, sex, marital status, and source of payment for care. Public assistance was the source of payment for care for 69.4 percent of the residents. The medical condition and extent of disability of the residents were analyzed; 83 percent were ambulatory in varying degrees.

KENTUCKY

12. Eller, C. Howe, M. D. Patients in Private Nursing Homes in Jefferson County, Kentucky. Louisville, Kentucky, Kentucky State Department of Health, January 15, 1959. 25 pp. w/appendix. Processed.

This study of patients in 31 of the 33 licensed private nursing homes
in Jefferson County, Kentucky was made as a "pilot" study for the
State. Forty percent of the total patients in these 31 homes were
selected as a sample and a detailed history was prepared for each
of these 252 patients. Information was obtained principally from the
patients themselves, the nursing home administrators and personnel,
physicians, hospitals, and social agencies.

Data are presented concerning the characteristics of the patients, including age, sex, marital status, and religion, and also on their their mental and physical status, and the sources of payment for their care. Among the findings are: about one-half of the patients were 80 years of age or older; almost all of the patients had fairly serious medical problems, but only about one-half were physically or mentally so disabled that true nursing care was required; and 32 percent of the patients were receiving either complete or partial support through welfare funds.

An evaluation of the facilities was made, and the homes are compared according to their ratings and average charges. The author states that the overall correlation between charges and the adequacy of facilities and care is good.

Simultaneously with the nursing home study, dental examinations were performed on 156 of the 252 patients. These examinations revealed extensive dental needs.

MAINE

13. Maine Department of Health and Welfare, Division of Research and Statistics. Nursing Homes in Maine. Augusta, Maine, December 1956. 24 pp. Processed. (Out of print. )

This summarizes the findings of a 1956 survey conducted jointly by the Department of Health and Welfare, the Nursing Home Association of Maine, and the Maine Committee on Aging. It covers information on the characteristics of nursing homes, including convalescent

and rest homes (all of which must be licensed), the characteristics of patients, the care, cost, and sources of patient income, and the nursing staff.

At the time of the study, Maine had approximately 3.2 nursing home
beds per 1,000 population. The 194 nursing homes surveyed repre-
sented about 88 percent of all licensed nursing homes in the State.
These facilities, accounting for about 91 percent of all nursing home
beds, were providing care to 2, 158 patients. Although 72 percent
of all the homes had fewer than 15 beds, their size ranged from 1 to
225 beds.

Nursing home proprietors evaluated the kind of care needed by the patients surveyed. Fifty-eight percent definitely needed nursing home care. One-third of the patients could have been cared for at home, if the patient had such a home and if a relative were available to help him. Nine percent of the patients required principally boarding care.

MARYLAND

14. Maryland State Department of Health, Bureau of Medical Services and Hospitals. A Study of Nursing Home Care in Maryland. Baltimore, Maryland, The Department, October 1960. 29 pp. Processed.

This survey, initiated in January 1960, covers 154 of the 158 licensed nursing homes in Maryland and 65 percent of the 1, 340 welfare patients in these homes. It includes a study of the nursing home facilities, nursing home costs, and the characteristics of the welfare patients.

With respect to the facilities, the data relate to the structures, compliance with fire regulations, the provision of dining room and recreational facilities, and food service. Information is also given as to the hours of nursing service provided.

To obtain data on nursing home costs, a random sample of administrators of homes ranging in size from 5 to 103 beds was selected for participation. Among these facilities, the costs ranged from $3.21 to $10.28 per day, with an average of $6.31.

Of the patients studied, 80 percent were 65 years of age or older. Sixty-four percent were women. Information was also obtained as to their physical and mental conditions and the medical diagnoses.