21.

Masterman, Louis E. and Shain, Max. Rehabilitation Potential and Medical Needs of Missouri Nursing Home Patients.

Kansas City, Missouri, Community Studies, Inc., December 1957. 55 pp. Processed.

This is a study of the rehabilitation potential and medical needs of residents of nursing homes in Missouri. The purpose of this study was to estimate the number of nursing home residents who could be helped toward a greater degree of self-care, the kinds of services that would be needed to accomplish this result, and the cost of such services."

A professional team examined and interviewed the selected
sample of 88 residents in 24 nursing homes. The results of
these examinations were projected to the total nursing home
population of the State. On this basis, estimates were made of
the numbers of residents who could (1) be cared for in private
homes (10 percent), (2) be transferred to nursing homes pro-
viding less skilled care if the recommended services were
provided (23 percent), and (3) benefit from recommended
treatment to improve their ability to care for themselves in
the homes in which they were then residents (47 percent).
Thus, these three groups comprise 80 percent of all nursing
home residents in Missouri.

22. Poland, Eleanor; Lembcke, Paul A., M. D.; and Shain, Max. Regional Health and Hospital Study: Missouri Nursing Homes. Kansas City, Missouri, Community Studies, Inc., August 1959. 87 pp. w/schedules. Processed.

Data were obtained through visits to all nursing homes, homes for the aged, and boarding homes in Missouri, excluding those in St. Louis City and County. These 560 facilities provided all types of services skilled nursing care, personal services,

or boarding care.

-

The findings reveal that the homes, in general, were small
(29 percent had less than 10 beds); that more than one-half
of the 444 homes reporting the age of the facility had been in
operation for less than five years; that 19 percent of the homes
had an occupancy rate of 100 percent; and that 67 percent of the
homes employed neither a registered professional nurse nor a
licensed practical nurse.

23,

NEBRASKA

Nebraska State Department of Health. Report of Survey of Patient
Care in Nursing Homes and Homes for Aged and Infirm of
Nebraska. Lincoln, Nebraska, 1959. 26 pp.

For this study, every home in Nebraska licensed and operating as of April 1, 1958 was surveyed, and over 10 percent of the resident population was interviewed.

Among the data included in the survey which relate to medical and nursing care are: post-admission medical care by physicians, nursing services needed and given, personal services required, and the mental status of the residents.

Information was obtained on the characteristics of personnel employed in the homes, the characteristics of the homes, and the charges for care. Very few homes were able to state their actual operating cost.

Data on the characteristics of residents include age, race,
admitting diagnoses, and measures of disability.

A sampling survey of dental needs of patients in the homes was conducted separately, and the findings and recommendations are included in this report.

24.

NEW MEXICO

Schumacher, Elizabeth T. Nursing Homes in New Mexico.
Santa Fe, New Mexico, New Mexico Department of Public
Health, 1961. 192 pp.

This study included 33 of the 34 nursing homes in the State,
two of which are for the care of mentally defective children.
The information presented was obtained through questionnaires,
personal interviews, and licensing and Hill-Burton files.

The homes were classified by level of care provided to the patients. Most of the homes are small; 24 of them had 20 beds or less. The majority are operated under proprietary auspices. Data are given concerning the physical plant, occupancy rates, and the number of years in operation.

The characteristics of the 1,071 patients residing in the nursing homes during 1960 were analyzed as to age, sex, and marital status. Information is given as to the reasons for their admissions and discharges, their condition on discharge, and the length of stay of discharged patients. The primary diagnoses, the walking status, bed status, and mental condition of the patients are also included. The various types of services they received were listed.

Inquiry was made as to the medical care received by the patients. Data are presented as to the frequency of doctors' visits to patients. It was found that the records kept by most of the homes are incomplete.

Other areas covered in this study are nursing home adminis-
tration policies and procedures and the personnel available in the
nursing homes. The administrators were questioned as to their
major problems. In addition, data are offered on the volume of
nursing services provided. The hours of care given per patient per
day ranged from 0.4 to 2.8, as compared with the estimated
amount of care needed, which ranged from 1.0 to 3.0. Ten
percent of the patient care was given by professional nursing
personnel.

The costs of operating the homes ranged from $2.53 to $9.74
per patient day. Costs are further analyzed by classification
and size of home.

25.

NEW YORK

Brightman, I. Jay, M. D.; Lyons, Elizabeth C.; and Gramm, E. Ray.
Proprietary Nursing and Convalescent Homes: Their Role in
Providing Care for the Chronically Ill. New York State Journal
of Medicine 55:1713-1719, June 15, 1955.

To determine the characteristics of the patients in the proprietary nursing and convalescent homes of upstate New York and the services provided, a sample group of nursing and convalescent homes was surveyed.

Information obtained includes the age, sex, and primary diagnoses
of the patients, and the length of time they had been residents in
the homes. Approximately one-fourth of the patients in each type
of home had been in the home for three years or more.
About three-fourths of the patients in nursing homes had been
seen by a physician within a month prior to the date of the study.

The median age of the nursing homes at the time of the survey
was 7.5 years; the convalescent homes, 8. 25 years. Social
and recreational activities in the homes were found to be very
meager, especially in view of the high degree of mobility and
mental clarity of the patients and the often long duration of stay.
The authors recommend that more social and recreational
programs be planned.

26.

Notkin, Herbert, M. D. A Survey of Specified Chronically Ill
Disabled Residents of Onondaga County. Syracuse, New York,
Onondaga County Department of Public Welfare, May 1956.
14 pp. Processed.

Data for this survey were obtained by completing questionnaires
on 1, 371 chronically ill residents of Onondaga County who were
institutionalized or who were receiving care at home through
a nursing agency. Institutions surveyed included all the licensed
and approved convalescent and nursing homes (all of which were
proprietary), homes for the aged, all general hospitals, certain
special hospitals, a long-term care hospital, and home nursing
agencies.

The data presented for each type of institution include the sex, age, primary diagnoses, and degree of disability of the patients, monthly charges for care, and the patients' sources of financial support.

Many individuals in the study did not seem significantly disabled; the most disabled group was in the nursing homes, and the least disabled were in their own homes or homes for the aged.

27.

Greater Utica Community Chest and Planning Council, Health
and Welfare Committee on the Committee on Aging. Report of
the Survey Committee on Community Resources for the Care
and Housing of the Chronically Ill in the Utica, New York Area.
Utica, New York, June 11, 1957. 5 pp. Processed.

Data for this survey were obtained through visits to the nursing homes and hospitals. Twenty-three nursing homes are covered in this survey, but complete information was not obtained from all of these.

All of the 23 homes are converted residences. Twelve of the
17 homes giving information concerning the date of construction
gave an accurate or estimated date as 1900 or earlier. The
median year of construction of those reporting is 1900.

The median size of the homes was 23 beds; 94 percent of the residents were 65 years of age or older; and 36 percent of the residents had been in their present homes for three years or

more.

Information is included concerning charges for care, both for welfare and private patients. Eleven of the 23 homes reported data regarding operating cost. The median cost per patient day was $5.36.

28.

Rochester and Monroe County (New York) Council of Social Agencies,
Homes for the Aged Subcommittee. Care of Persons with Long-
Term Illness in Homes for the Aged: Preliminary Information.
Rochester, New York, June 1958. 35 pp. w/appendices.
Processed.

Executives of homes for the aged were interviewed with respect
to services to chronic patients. These interviews provided
information about admission and discharge policies, services
to long-term patients, education, costs, and future plans. In
addition, a census of long-term patients was taken on a given
day and a random sample of 27 patients was used as a clinical
review study group.

Information concerning the residents is given for age, marital status, length of stay, disabling conditions, and sources of payment for care.

The residents comprising the clinical review study group were
analyzed as to their rehabilitation potential. Seventy-four
percent appeared capable of partial self-care and 18 percent
of complete self-care. About half of the patients studied could
have benefited from occupational therapy, more than a third
from purposeful recreational activity, and 7 percent from
physical therapy. Half of the group was thought to need skilled
nursing care; the remainder needed only unskilled nursing care
or primarily personal services.