Source Book on Long-Term Care Data

Publication Date

Jul 28, 1983

Joel Cohen, Judith Feder, Carol Hamcke, Martha Krieger, Susan O’Loughlin, William Scanlon, Margaret Sulvetta, William Weissert, Sidney Katz, Denise Mahalak, Marilyn Moon, Joseph Papsidero, Beth Soldo and Allan Unger

The Urban Institute, Health Policy Center

July 29, 1983

PDF Version: http://aspe.hhs.gov/daltcp/reports/source.pdf (201 PDF pages)

This report was prepared under contract #HHS-100-80-0158 between the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Social Services Policy (now the Office of Disability, Aging and Long-Term Care Policy) and the Urban Institute. For additional information about this subject, you can visit the DALTCP home page at http://aspe.hhs.gov/_/office_specific/daltcp.cfm or contact the office at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201. The e-mail address is: webmaster.DALTCP@hhs.gov. The Project Officer was Phyllis Thorburn.

The opinions and views expressed in this report are those of the authors. They do not necessarily reflect the views of the Department of Health and Human Services, the contractor or any other funding organization. Dr. William Scanlon of The Urban Institute is the principal investigator for the contract and responsible for overall management.

CONSULTANT AFFILIATIONS

INTRODUCTION

DESCRIPTION OF DATA BASES

NOTES

I. LIST OF TABLES

II. SIZE, GROWTH AND DEMOGRAPHIC CHARACTERISTICS OF THE ELDERLY POPULATION

III. PREVALENCE OF DEPENDENCY

IV. ECONOMIC STATUS OF THE ELDERLY AND IMPAIRED

V. LONG-TERM CARE INSTITUTIONS AND USE OF LONG-TERM CARE INSITUTIONS

VI. DETERMINANTS OF NURSING HOME USE

VII. CHARACTERISTICS OF NURSING HOME USERS

VIII. PROVIDERS

IX. INFORMAL CARE

X. SPENDING FOR LONG-TERM CARE SERVICES

XI. COST

APPENDICES

APPENDIX A: Selected Adapted Task Items

APPENDIX B: Use, Source, Charges and Expenditures for Non-Long-Term Care Services by Age

LIST OF TABLES

TABLE 1: Proportion of Population 65 Years and Over, 1990-1980

TABLE 2: Persons 65 Years Old and Over--Characteristics, by Sex: 1960 to 1980

TABLE 3: Number and Percent Distribution of U.S. Population Aged Over 65 Residing in Urban and Non Urban Areas, by Sex and Race, 1974 and 1970

TABLE 4: Expectation of Life at Birth: 1920 to 1979

TABLE 5: Marital Status of the Population, by Sex and Age: 1980

TABLE 6: Characteristics of Widows, by Age Group: 1970 and 1980

TABLE 7: Living Arrangements of Elderly Widowed Persons: 1970 to 1980

TABLE 8: Persons Living Alone, by Age and Sex: 1060 to 1980

TABLE 9: Households, by Number of Persons, 1950-1981

TABLE 10: Age of Householder: Percent Distribution Selected Years 1968-81

TABLE 11: Number and Percent of Elderly Living Alone, by Sex, 1960, 1970 and 1980

TABLE 12: Persons 65-74 and 75 and Over as a Percent of Total Population, by State and Division, 1980

TABLE 13: Hierarchical Ordering of HIS and NNHS Respondents Aged 65 Years and Over by Type of Dependency

TABLE 14: Numbers of Noninstitutionalized Dependent Persons and Rates of Dependency by Age Group

TABLE 15: Percent Standard Errors for Table 14

TABLE 16: Comparison of 1977 and 1979 Health Interview Survey Dependency Rates Among the Noninstitutionalized Aged

TABLE 17: Comparison of HIS and Framingham Disability Study Estimates of Dependency Among the Noninstitutionalized Aged for Comparable Items

TABLE 18: Number and Percent of Noninstitutionalized Aged Who Are Unmarried, Live Alone or Are Poor by Dependency Level

TABLE 19: Numbers of Persons and Rates of Dependency by Race and Sex for Two Age Groups of the Noninstitutionalized Aged

TABLE 20: Comparison of Metropolitan Residence in 1977 for Non-institutionalized Persons Needing Mobility or Personal Care Assistance and U.S. Civilian Population

TABLE 21: Number and Percent of Americans in 1977 Suffering Dependency in Personal Care or Mobility by Community Versus Nursing Home Residency

TABLE 22: Synthetic Estimates of Prevalence Rates for Personal Care and Mobility Dependency

TABLE 23: Comparison Between Age and Mortality Based Synthetic Estimates of Prevalence Rates for Personal Care Dependency Aged Only

TABLE 24: Comparison Between Age and Mortality Based Synthetic Estimates of Prevalence Rates for Mobility Dependency Aged Only

TABLE 25: Distribution of Income by Family Characteristics for Families with Head Aged 65 and Over

TABLE 26: Distribution of Income for Elderly Couples and Individuals by Age of Head

TABLE 27: Percentage of Homeowners by Income and Family Characteristics

TABLE 28: Average Interest and Dividend Income by Income and Family Characteristics

TABLE 29: Mean Resources of Elderly by Age and Family Size Using Alternative Definitions of Resources

TABLE 30: Distribution of Resources Among Nonworking Individuals Living Alone by Age Using Alternative Definitions of Resources

TABLE 31: Percentage of Income Available for Discretionary Purposes by Age and Household Characteristics

TABLE 32: Average Income of Families with Impaired Persons by Definition of Impairment and Relationship of Impaired Persons to Family Head

TABLE 33: Distribution of Resources and Average Resources by Alternative Definitions for All Families With Impaired Members

TABLE 34: Average Family Resource Levels and Family Size by Age and Relationship to Head of Impaired Persons

TABLE 35: Distribution of Resources by Alternative Definitions of Resources When Impaired Person is Head or Spouse Under Age 65

TABLE 36: Distribution of Resources by Alternative Definitions of Resources When Impaired Person is Head or Spouse Aged 65 or Over

TABLE 37: Distribution of Resources by Alternative Definitions of Resources When Impaired Person is Child or “Other” Relative of Household Head

TABLE 38: Distribution of Resources by Alternative Definitions of Resources When Impaired Person Lives Alone

TABLE 39: Distribution of Resources Among Nonworking Elderly Couples by Age Using Alternative Definitions of Resources

TABLE 40: Distribution of Income for Elderly Couples and Individuals Without Earnings by Age of Head

TABLE 41: Mean Resources of Elderly by Age and Family Size for Two Combined Definitions of Resources

TABLE 42: Mean Resources of Nonworking Elderly by Family by Family Size and Selected Characteristics Using Alternative Definitions of Resources

TABLE 43: Mean Resources of Nonworking Elderly by Age and Family Size Using Alternative Definitions of Resources

TABLE 44: Persons With and Without Health Insurance: Percent Distribution by Age

TABLE 45: Uninsured Persons, Family Setting, and Insurance Coverage of Other Family Members: Percent Distribution by Type of Coverage

TABLE 46: Number of Persons and Percent of U.S. Population Residing in Long-Term Care Institutions as Reported by Census of Population

TABLE 47: Percent of the Elderly in Institutions by Age Cohort, 1950-1970

TABLE 48: Components of Institutional Population Growth Persons 65 and Over, 1950-1970

TABLE 49: Proportion of Aged Recipients in Nonmedical Facilities to Total SSI Recipients, by State December 1979

TABLE 50: Utilization of Facilities for the Mentally Impaired by Age

TABLE 51: Number and Percent Change in Inpatient Days of Care in Mental Health Facilities, United States 1971, 1973, 1975

TABLE 52: All Ages: Number and Percent of White and Non-White Persons Aged 65 and Over or Under 65 Who Live in Nursing Homes

TABLE 53: Rates of Nursing Home Residency by Type of Dependency Among the Aged

TABLE 54: Elderly Only: Institutionalization Rates by Demographic Characteristics, Dependency, Diagnostic Group and Climate

TABLE 55: Elderly Only: Institutionalization Rates of Persons with High Risk Characteristics

TABLE 56: Age, Sex, Race and Marital Status of Nursing Home Residents, 1977

TABLE 57: Age, Sex, Race and Marital Status of Nursing Home Residents, 1977

TABLE 58: Number and Percent of Residents of Nursing Homes in 1977 and Discharges in 1976, by Primary Source of Payment, According to Selected Characteristics: United States

TABLE 59: Number and Percent of Nursing Home Residents, by Selected Health Diagnoses and Conditions Statuses: United States, 1977

TABLE 60: Number of Percent Distribution of Nursing Home Residents by Dependency in Activities of Daily Living and Index of Dependency in Activities of Daily Living, According to Selected Other Resident Characteristics: United States, 1977

TABLE 61: Percentage of Nursing Home Residents by Age Within Diagnostic Category

TABLE 62: Percentage of Nursing Home Residents by Marital Status Within Diagnostic Category

TABLE 63: Percentage of Nursing Home Residents by Race Within Diagnostic Category

TABLE 64: Percentage of Nursing Home Residents By Sex Within Diagnostic Category

TABLE 65: Percentage of Nursing Home Residents by Need for Help of Another Person in Activities of Daily Living, Within Diagnostic Category

TABLE 66: Percentages of Nursing Home Residents by Need for Assistance in Activities of Daily Living Within Diagnostic Category

TABLE 67: Percentage of Nursing Home Residents by Ability to Communicate Within Diagnostic Category

TABLE 68: Percentage of Nursing Home Residents by Predicted Date of Discharge Within Diagnostic Category

TABLE 69: Percentage of Nursing Home Residents by Prior Residence Within Diagnostic Category

TABLE 70: Percentage of Nursing Home Residents by Discharge Destination Within Diagnostic Category

TABLE 71: Distribution of Other Diagnosis in Nursing Home Patients Within Mental Disorder as Primary Diagnosis

TABLE 72: Number of Persons With a Mental Diagnosis in Nursing Homes Selected Years

TABLE 73: Source of Payment for Nursing Home Patients With Mental Diagnosis

TABLE 74: Percentage of Nursing Home Residents by Type of Behavioral Problem Within Diagnostic Category

TABLE 75: Percentage of Nursing Home Residents Receiving Medication for Mental Impairments Within Diagnostic Category

TABLE 76: Percentage of Nursing Home Residents Receiving Tranquilizers Within Diagnostic Category

TABLE 77: Percentages of New Patients Having Selected Conditions by Home’s Ownership Type and Patient Payment Source

TABLE 78: Percentages of New Patients Having Selected Conditions by Home’s Per Diem Health Labor Cost and Patient Payment Source

TABLE 79: Percentages of New Patients Having Selected Conditions by Home’s Size and Patient Payment Source

TABLE 80: Percentages of New Patients Having Selected Conditions by Home’s Occupancy Rate and Patient Payment Source

TABLE 81: Percentages of New Patients Having Selected Conditions by Home’s Percentage of Days for Medicaid and Patient Payment Source

TABLE 82: Percentage of New Nursing Home Patients Having Selected Conditions by Patient Payment Source

TABLE 83: Prevalence of Diagnosis in Source of Payment Groups

TABLE 84: Nursing Home Discharge Status for Elderly, Aged 65 and Over by Number and Percent, 1977

TABLE 85: Number and Community Discharge Rates of Nursing Home Patients Aged 65 and Over Discharged in 1976

TABLE 86: Community Discharge Rates from Nursing Homes by Age Group, 1977

TABLE 87: Community Discharge Rates from Nursing Homes by Marital Status and Other Characteristics

TABLE 88: Community Discharge Rates by Dependency Status

TABLE 89: Community Discharge Rates by Source of Payment

TABLE 90: Length of Nursing Home Stay by Marital Status, Age, and Source of Payment

TABLE 91: Nursing Home Length of Stay by Primary Diagnosis, 1977

TABLE 92: Proportion of Nursing Home Admissions Having a Length of Stay of Less Than 3 Months, 3 or More Months, and 6 or More Months, by Additional Length of Stay

TABLE 93: Growth in Nursing Home Beds Per Thousand Elderly 1967-1973

TABLE 94: Ownership Distribution of Nursing and Personal Care Homes

TABLE 95: Counts of Medicare and/or Medicaid Certified Nursing Home Facilities and Beds 1980

TABLE 96: Total Medicare or Medicaid Certified Nursing Home Beds per Elderly Persons, By State

TABLE 97: Number of Long-Term Care Facilities and Beds by Certification Level, MMACS 1980

TABLE 98: Distribution of Facilities by Total Bed Size and Certification, MMACS

TABLE 99: Distribution of Beds by Total Bedsize and Certification, MMACS

TABLE 100: Facilities by MFI Level of Care and Certification, 1976

TABLE 101: Uncertified Nursing Home and Beds by State, 1978 MFI

TABLE 102: Uncertified Nursing Homes and Beds by Bed Size 1978 MFI

TABLE 103: Uncertified Nursing Homes and Beds by Type of Ownership 1978 MFI

TABLE 104: Uncertified Nursing Homes by Type of Ownership and Bed Size 1978 MFI

TABLE 105: Beds in Uncertified Nursing Homes by Size of Facility 1978 MFI

TABLE 106: Number of Medicare Certified Home Health Agencies by Type of Agency and Division, 1974-1980

TABLE 107: Home Health Agencies, Persons Served, Visits Charges, and Reimbursements Under the Medicare Program by Geographic Area, 1974-1980

TABLE 108: Persons Served, Visits, Visit Charges, Average Visits per Person Served, Average Visit Charges per Person Served, Average Charge per Visit, Under the Medicare Program by Home Health Agency Type, 1974-1980

TABLE 109: Persons Served, Percent of Persons Receiving Visiting, Visits, Percent of Visits and Visit Charges for Home Health Agency Services Under the Medicare Program by Type of Visit, 1975

TABLE 110: Persons Served, Percent of Persons Receiving Visiting, Visits, Percent of Visits and Visit Charges for Medicare Home Health Agency Services, by Type of Visit, 1980

TABLE 111: Distribution of Home Health Agencies by Geographic Division Within Agency Type 1974 and 1980

TABLE 112: Distribution of Home Health Agencies by Agency Type Within Geographic Division 1974 and 1980

TABLE 113: Relative Shares of Persons Served, Visits, and Visit Charges Under the Medicare Program by Type of Home Health Agency 1974-1980

TABLE 114: Factors Explaining the Growth Rate in Medicare Home Health Services 1974-80

TABLE 115: State and County Psychiatric Hospitals, by State, 1978 NIMH

TABLE 116: Number of Psychiatric Hospitals and Beds by Type of Ownership 1978 MFI

TABLE 117: Psychiatric Hospitals, Beds, Admissions, by Type of Ownership, 1978

TABLE 118: Long-Term Psychiatric Hospitals, Beds, Admissions, Inpatient Days and Occupancy Rates by Type of Ownership, 1978

TABLE 119: Number of Psychiatric Hospitals by Bed Size 1978

TABLE 120: Total Psychiatric Hospitals by Type of Ownership and Size, 1978

TABLE 121: Facilities for the Mentally Impaired as Reported by the Master Facility Inventory 1971-1976

TABLE 122: V.A. Medical Centers--Nursing Home Care Units: Selected Data by State Fiscal Year 1979

TABLE 123: Veterans Administration Community Nursing Home Program: Selected Data by State Fiscal Year 1979

TABLE 124: VA Medical Centers--Domiciliary Care Units: Selected Data by State Fiscal Year 1979

TABLE 125: V.A. Medical Centers--Hospital-Based Home Care: Selected Data by State Fiscal Year 1979

TABLE 126: State Veterans’ Homes--Nursing Homes: Selected Data by State Fiscal Year 1979

TABLE 127: State Veterans’ Homes--Domiciliaries: Selected Data by State Fiscal Year 1979

TABLE 128: Percent of Elderly Housing Projects Offering Special Facilities, Services and Amenities

TABLE 129: Various Indicators of the Availability of Informal Care Providers by Long-Term Care Status and Select Sociodemographic Characteristics

TABLE 130: Percent of All Elderly With at Least One Daughter Who Do Not Have Frequent Contact with at Least One or Who Do Not Live Nearby at Least One, by Number of Daughters and Marital Status, and Place of Residence

TABLE 131: Percent of All Elderly With at Least One Daughter Who Do Not Have Either Frequent Contact with at Least One or Live Nearby at Least One, by Marital Status and Living Arrangements

TABLE 132: Percent of All Elderly with Surviving Children Who Do Not have Frequent Contact with at Least One and Percent Who Do Not Live Nearby at Least One, by Family Composition

TABLE 133: Percentage Distribution of ADL Service Use Pattern by Sex Composition of Surviving Children Among the Elderly with Moderate to Severe Incapacities for Self-Care, by Marital Status

TABLE 134: Percentage Distribution of ADL Service Use Pattern by Type of Living Arrangement Among Elderly with Severe to Moderate Incapacities for Self-Care

TABLE 135: Percentage Distribution of ADL Service Use Pattern by Sex Composition of Surviving Children Among the Elderly with Moderate to Severe Incapacities for Self-Care, by Marital Status

TABLE 136: Percentage Distribution of IADL Service Use Pattern by ADL Service Use Pattern Among Elderly with Moderate to Severe Incapacities for Self-Care

TABLE 137: Percentage Distribution of IADL Service Use Pattern by Number of Surviving Children Among Elderly with Moderate to Severe Incapacities for Self-Care

TABLE 138: Percentage Distribution of Supportive Service Use Pattern by Number of Surviving Children Among the Bedfast Elderly

TABLE 139: Public Expenditures on Long-Term Care Services by Program, Fiscal Year 1980

TABLE 140: Public Expenditures on Long-Term Care Related Services by Program and State, Fiscal Year 1980

TABLE 141: Public Expenditures on Long-Term Care Related Services by Service Category and State, Fiscal Year 1980

TABLE 142: Percent of Total Reported Medicaid Expenditures Used to Finance Long-Term Care Services, Fiscal Year 1980

TABLE 143: Nursing Home Spending Growth by Source and Year, 1948-1981

TABLE 144: Distribution of Medicaid Nursing Home Days Between Skilled and Intermediate Care by State, Fiscal Year 1979

TABLE 145: Medicaid Nursing Home Days of Care and Certified Beds Per Thousand Elderly, Fiscal Year 1979

TABLE 146: Medicaid Nursing Home Services: Recipients, Days of Care, and Cost, by Fiscal Year

TABLE 147: Medicaid Nursing Home Recipients* and Expenditures, Fiscal Year 1980

TABLE 148: Percentage Change in Medicare Covered Days Per Person Age 65 and Over, 1977-1979, by State

TABLE 149: Medicare Covered SNF Days Per 1,000 Persons Age 65 and Over: 1979

TABLE 150: Medicare Covered Days, Total Reimbursements, and Reimbursement Per Day for Skilled Nursing Facility Services for the Aged, by State, Calendar Year 1979

TABLE 151: Total Reimbursements for Home Health Care, Number of Home Visits, and Reimbursement Per Visit, 1972-1980

TABLE 152: Home Health Visits, Total Reimbursements, and Reimbursement Per Visit by State, 1980

TABLE 153: Total Medicare Reimbursement, Reimbursement for Home Health Services and Number of Home Health Visits: Calendar Years 1967-1980

TABLE 154: Medicare Reimbursements for Home Health Services by Program and Type of Enrollee, Selected Years

TABLE 155: Medicaid Home Health Services, Recipients and Expenditures, 1975-1980

TABLE 156: Medicaid Non-institutional Long-Term Care Recipients and Expenditures, Fiscal Year 1980

TABLE 157: Expenditures Under Title III of the Older Americans Act, by Service Category, Fiscal Year 1980

TABLE 158: Payment Levels and Maximum State Payments in States with Optional SSI Supplements for Non-Medical Long-Term Care, as of October 1, 1980

TABLE 159: Federal and State Expenditures on Optional State Supplements to Recipients in Non-Medical Long-Term Care Living Arrangements for States with Federally Administered Supplement Programs, 1982

TABLE 160: State Expenditures on Optional State Supplement to Recipients in Non-medical Long-Term Care Living Arrangements For States with State Administered Supplement Programs, Fiscal Year 1980

TABLE 161: Percent Utilization of Federal Social Services Allocations by State, Fiscal Years 1972-1979

TABLE 162: Percent of State Median Income at White Title XX Income Eligibility Levels Set, by State, Fiscal Year 1980

TABLE 163: States Use of Fees for Title XX Services, FY 80 Final CASP Plans

TABLE 164: Expenditures Under Title XX On Potential Long-Term Care Related Services¹ for SSI Recipients, Fiscal Year 1980

TABLE 165: Percentage of Total Expenditures Allocated to SSI Recipients by Service and State, Fiscal Year 1980

TABLE 166: Selected Social Service Expenditures Under Title XX, by Service and Recipient Category, Fiscal Year 1980

TABLE 167: Title XX SSI Recipient Long-Term Care Service Related Expenditures, by Service and State, Fiscal Year 1980

TABLE 168: Older Americans Act Title III Appropriations, Fiscal Year 1980

TABLE 169: Older Americans Act Title IV Appropriations, Fiscal Year 1980

TABLE 170: Veterans Administration Community Nursing Home Program: Expenditures by State

TABLE 171: V.A. Medical Centers--Nursing Home Care Units: Expenditures by State

TABLE 172: Summary of Publicly Financed Housing Assistance for the Elderly and Handicapped

TABLE 173: Property Tax Relief Across States

TABLE 174: Benefit Amounts and Property Tax Relief Under State Circuit-Breaker Programs: Number of Claimaints

TABLE 175: V.A. Medical Centers--Hospital-Based Home Care: Expenditures by State

TABLE 176: VA Medical Centers--Domiciliary Care Units: Expenditures by State

TABLE 177: State Veterans Home -- Domiciliaries: Expenditures by State

TABLE 178: State Veterans’ Home -- Nursing Homes: Costs and Expenditures by State

TABLE 179: States With SSI Supplements to Nonmedical Facilities, With Levels of Income Support and Amount of State Payment

TABLE 180: Amount Per Resident Day and Percent Distribution of Nursing Home Revenues and Costs, According to Ownership and Certification: United States, 1976

TABLE 181: Average Total Monthly Charge and Average Paid by Primary Source for Residents of Nursing Homes in 1977 and Discharges in 1976, by Primary Source of Payment and Selected Nursing Home Characteristics: United States

TABLE A-1: Selected Adaptive Task Items and Their Use in 16 Major Assessment Instruments

TABLE B-1: Use of Inpatient Hospital Services: Percent of Persons Without and With Hospital Admission, Mean Length of Stay, and Mean Number of Hosital Admissions per 1,000 Population and Per Person With at Least One Hospital Admission, by Age

TABLE B-2: Use of Prescribed Medicines: Percent of Persons With and Without Prescribed Medicines, Mean Number of Prescribed Medicines Per Person and Per Person Without at Least One Prescribed Medicine, by Age

TABLE B-3: Usual Sources of Care: Percent Distribution of Persons by Age

TABLE B-4: Use of Ambulatory Physician Services: Percent Distribution of Persons With and Without Physician Contracts, by Age

TABLE B-5: Annual Expenditures and Sources of Payment for Inpatient Hospital Services: Mean Expense per Person with Hospital Expense and Percent Paid by Source of Payment, by Age

TABLE B-6: Out of Pocket Expense for Inpatient Hospital Services: Percent Distribution of Persons With and Without Admissions, by Intervals of Out-of-Pocket Expense and Age

TABLE B-7: Charges and Sources of Payment for Inpatient Hospital Services: Mean Charge Per Admission and Proportion Paid by Different Sources of Payment, by Age

TABLE B-8: Annual Expenditures and Sources of Payment for Ambulatory Physician Services: Mean Expense per Person with Expense and Percent Paid by Source of Payment, by Age

TABLE B-9: Out-of-Pocket Expense for Ambulatory Physician Services: Percent Distribution of Persons With and Without Contacts, by Intervals of Out-of-Pocket Expense, by Age

TABLE B-10: Annual Expenditures and Sources of Payment for Ambulatory Non-Physician Services: Mean Expense per Person with Expense and Percent Paid by Source of Payment, By Age

TABLE B-11: Annual Out-of-Pocket Expenses for Personal Health Services: Percent of Persons With and Without Out-of-Pocket Expenses, and Means per Person and per Person with Out-of-Pocket Expenses, By Age

TABLE B-12: Level of Individual Out-of-Pocket Expenses for Personal Health Services: Percent Distribution of Persons With and Without Expense, by Intervals of Annual Out-of-Pocket Expense and Age

TABLE B-13: Annual Expenditures and Sources of Payment for Prescribed Medicines: Mean Expense per Person with Expense and Percent Paid by Source of Payment and Age

TABLE B-14: Out-of-Pocket Expenses for Prescribed Medicines: Percent Distribution of Persons With and Without Prescribed Medicine by Out-of-Pocket Expense and Age

TABLE B-15: Charges and Sources of Payment for Prescribed Medicine: Mean Charge per Prescribed Medicine and Proportion Paid by Different Sources of Payment, by Age

TABLE B-16: Annual Expenditure and Source of Payment for Medical Equipment and Supplies: Mean Expense per Person with Expense and Percent Paid by Source, by Age

TABLE B-17: Out-of-Pocket Expenses for Medical Equipment and Supplies: Percent Distribution of Persons With and Without Purchase or Rental of Medical Equipment and Supplies, by Intervals of Out-of-Pocket Expense and Age

CONSULTANT AFFILATIONS

Dr. Sidney Katz	Director, Southeastern New England Long Term Care Gerontology Center Brown University Box G Providence, Rhode Island 02912
Dr. Sidney Katz	Formerly Professor and Chairman Department of Community Health Science Colleges of Human and Osteopathic Medicine Michigan State University East Lansing, Michigan 48824
Ms. Denise Mahalak	Department of Community Health Science Colleges of Human and Osteopathic Medicine Michigan State University East Lansing, Michigan 48824
Dr. Marilyn Moon	Congressional Budget Office House Annex No. 2 2nd and D Streets, S.W. Room 419 Washington, D.C. 20515
Dr. Joseph Papsidero	Professor, Department of Community Health Science Colleges of Human and Osteopathic Medicine Michigan State University East Lansing, Michigan 48824
Dr. Beth J. Soldo	Senior Research Scholar The Joseph and Rose Kennedy Institute of Ethics Center for Population Research 3520 Prospect Street, Room 305 Georgetown University Washington, D.C. 20057
Dr. Alan Unger	Statistician Group Operations, Inc. 1110 Vermont Avenue, N.W., Suite 500 Washington, D.C. 20005

INTRODUCTION

Tables in this volume were prepared in response to a contractual charge from the Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, to analyze existing data sources for answers to as many long-term care questions as data and resources would permit. More than two dozen research papers containing roughly 500 tables were produced as a result of that effort. This volume contains a substantial portion of those tables.

Although data presented here are useful, it is important to note that many crucial limitations affected the reports' contents, including the nature of the volume and the quality and completeness of the data sources available.

Specifically, it is important to consider that this is not a comprehensive set of tables describing all aspects of long-term care. Rather it is the by product of many individual analytical efforts addressing a set of issues constrained principally by the availability of data in which to pursue answers. And, while the project included aggressive efforts to obtain access to all potentially useful data sets, not all efforts at obtaining data sets were successful. Some data which might have proved useful may have been missed or were omitted due to resource and time constraints. For example, the volume contains virtually nothing on manpower available for long-term care although some survey and analytical work has been done in this field, most notably the confidential staffing data on nursing homes collected as part of the 1977 National Nursing Home Survey.

By its nature, the volume also excludes many tables on long-term care which are available from published sources. For example, a large number of tables presenting organizational characteristics of nursing homes and characteristics of nursing home residents are included in NCHS publications but only a small number were inserted into this volume. Likewise, 1980 U.S. Census data were beginning to become available as the project was ending. Some of the more obviously long-term care related tables were sought and included. In addition, some data were obtained on a prepublication basis for use in one or more analyses. But as more 1980 Census publications are released they may contain information which relates to long-term care issues.

Finally, the 'tables-without-text" nature of the volume dictated omission of some of the tables produced by the analytical studies. One criterion for such omissions was that the table could not be effectively interpreted without text to explain variable construction, amputations, extrapolations, etc. Examples are several regression analyses on a variety of topics including nursing home residency and discharge determinants. Another criterion for table omission was that sample sizes were too small to report estimates even though in a working paper tables may have been presented to show patterns in the data. Finally, tables were omitted if a later analysis produced similar data from a more recent data set. The reader is referred to the final report of the project which contains all working papers produced by the project.

Even more severe limitations were imposed by the quality and completeness of data available for analysis. Sample sizes were a constant barrier to adequate pursuit of prevalence rates of dependency and other characteristics and utilization of community and institutional care, especially in the National Health Interview Survey, the National Nursing Home Survey, and a group of community surveys using the OARs instrument (described in the section on data sets). As tables in this volume show, the low prevalence rates of dependent persons in the general population results in very small cell sizes when national probability sample data are presented by age, sex and other traits. Standard errors frequently greatly exceed 100 percent. Utilization patterns of some services are impossible to profile even in samples limited to the aged because those using long-term care services are such a small subsample of the aged population. Virtually no analysis at the state level could be carried out because sample sizes were too small to produce reliable estimates below the national or major regional level. Likewise, analysis of racial differences was generally impossible even at the national level.

Nor were data sets as comprehensive as would have been ideal. For example, the national nursing home survey doesn't cover all types of homes. Board and care homes and related facilities appear to be systematically counted no where. Data are virtually nonexistent with regard to many aspects of home health care, including:

the extent of private financing;
agency costs and their determinants (e.g., patient characteristics, ownership type, length of visit);
numbers of agencies--at present, only Medicare certified agencies can be identified; and,
patient or user characteristics.

Panel data, essential for outcome analysis, are available for no type of long-term care service, setting or population subgroup.

Financing data on long-term care services at the state and local level are especially lacking. Indeed, no inventory of state or locally funded long-term care programs exists. Even state reporting of Medicaid long-term care recipients and spending leaves out some categories--personal care and adult day care.

It would also be useful to know the extent to which persons who are dependent and need long-term care services also hold substantial equity in their homes which could be converted into cash for various types of services or insurance. But surveys which collect dependency data rigorously defined in terms of personal care, mobility, household activities, etc., have not included home equity data, and vice versa.

Crudeness of measures was a major concern, especially in studying effects of social, policy and organizational characteristics on patients and other individuals. For example, household structure is a grossly inadequate measure of social support, per capita income derived by dividing household income by household size is a grossly inadequate measure of resources available to an elderly individual, and discharge status is not even a rough proxy for health status effects of nursing home staffing or care practices. Income and care received from outside the household are simply ignored in most surveys. And federal spending data under Title XX and the Older Americans Act are classified by service categories so broad that long-term care services cannot reliably be distinguished from non long-term care services.

Self-reported diagnoses must raise major concerns about how validly health status is being measured, especially the prevalence of mental disorders.

For all of these reasons, this initial effort at compiling a data base for long-term care policy falls considerably far short of perfection, and for some purposes, even adequacy. Indeed, perhaps one of its most important contributions may be to point the direction for filling major gaps in the data available for long-term care policy and planning. Having experienced the often frustrating task of trying to find data where it did not exist or was of unacceptable quality, the group of researchers who contributed to this volume may be in the best position to make some suggestions about priorities for data gap filling. Users of the report will want to add to the list, but as a strating point, the following major problems should be addressed in future data collection efforts:

Larger sample sizes are needed, describing the propulation most likely to suffer dependency and to use long-term care services;¹
Panel studies are needed which permit assessment of changes in patients and populations' health and dependency status and utilization through time, both within institutions and in the general population;
Systematic profiling and costs of the informal and formal community care delivery system and its responsiveness to increased care options should be undertaken;
More sensitive measures of inputs and outcomes in nursing homes are needed;
Systematic census and profiling of board and care homes, their residents, staff, client sources, occupancy ratest services, costs, discharge patterns and licensure standards are needed;
Data are needed on state and local policy variations on long-term care expenditures, rates, recipients, reimbursement policies, eligibility policies, and quality assurance mechanisms, community care coverage and licensure and other regulations of long-term care providers;
More extensive data on the mentally retarded and the menatlly ill including their use of long-term care services, both formal and informal and the causes of institutionalization among this population are needed;
Hospital administrative day data are also needed.

Structure and Content of the Report

It is worth noting again that this volume is a compendium of tables available, not an inventory of answers. While an effort was made to group tables into a structure which reflects common policy themes such as size and characteristics of the population, supply of services, utilization, etc., the tables included are those which were available from the research papers produced for this project. As such, no section is exhaustive or even complete on a topic, and the level of detail provided on topics and subtopics varies as a function of what was avilable. Thus, a quick review of the table of contents will demonstrate that data are considerably more available on institutional than noninstitutional care, formal as compared to informal care, and utilization as compared to demand, costs, and outcomes.

DESCRIPTION OF DATA BASES

1. The 1977 Health Interview Survey (HIS)

This is a nationally representative health-related survey of the civilian noninstitutionalized population. It was administered by the Bureau of the Census (for the National Center for Health Statistics) to 41,277 households containing 111,279 persons, of whom 11,698 were aged 65 years or over. In addition to demographic variables, the 1977 survey contained questions on health status and impairments, illnesses, accidents and injuries. it included questions on ability to perform certain activities of daily living, presence of self-reported medical conditions, hospitalization, and nursing homes stays. Income variables were limited to total income in ten income classes.

2. The 1979 Health Interview Survey (HIS)

Like the 1977 Health Interview Survey, the 1979 HIS was designed to obtain information on the incidence and prevalence of illness and the use of health services among the noninstitutionalized U.S. population. In 1979, 110,530 individuals were included in the sample. Of those 11,730 were aged.

Respondents were questioned on whether or not they needed help or were limited in certain types of activities, what they identified as the condition causing their need for help or their limitation, and other items related to need for and receipt of assistance. Most of these long-term care questions were in a special supplement included in the 1979 version of the survey.

3. The 1977 National Nursing Home Survey

This is a nationally representative survey of all nursing homes in the continental United States. The survey was a two-stage probability sample commencing with the selection of facilities and subsequent selection of residents and discharges. Within the sampled nursing homes, a current resident sample was selected from the list of all patients in the home the night preceding the survey administration. A sample of discharged residents was selected from the population of all residents discharged during the previous year. The sample included 1,451 nursing homes, 7,033 current residents and 5,142 discharged residents. A facility questionnaire was also administered. It contained information on certification status, facility size, type of ownership and total number of inpatient days of care provided by certification. It also included information on admissions policies and provision of services. Detailed expenses and revenues were also reported. The current and discharged resident questionnaires included information on impairments, physicial functioning, certain aspects of behavior, primary and secondary diagnoses, and use of services. Total charges billed for care, primary source of payment and amount paid by primary source were also collected for current and discharged residents.

4. Medicare/Medicaid Automated Certification System (MMACS)

The Medicare/Medicaid Certification System (MMACS) was implemented by the Health Standards and Quality Bureau (HSQB) of the Health Care Financing Administration as an adjunct to the surveying process of health care facilities and services in the United States. Specifically, the centralized MKACS data base contains information on all health care facilities that participate in the Title XVIII Medicare/Title XIX Medicaid programs. Data on uncertified facilities are not available from this data base.

For all long-term care facilities, the MMACS data base contains identifying information such as provider number and location, facility information such as type of facility control, and type of services that could be provided by the staff. Also, the number of full-time equivalent employees for eleven classifications is included in the data base. Similar information is also maintained for Home Health Agencies.

5. National Medical Care Expenditure Survey (NMCES)

This survey of a nationally representative sample was conducted by personal and telephone interviews in 13,500 households with 37,000 people, 5,400 of whom were aged. The sample families were interviewed five times from January 1977 to June 1978. Additional information on diagnosis and cost was obtained from physicians and institutions who provided care to the sampled families. The data were further augmented through interviews with employers and health insurers to obtain information on health insurance benefits and sources of payment for insurance premiums. The survey contained information on disability days, medical conditions, doctor, dental and other medical visits, use of aids, and medications. Detailed questions concerning access to care were included as well as queries on health insurance coverage, covered services and payments. Expenditures for medical care and source of payment were also gathered in detail using a diary methodology. The survey also collects detailed demographic and income information on all respondents.

6. The 1976 Survey of Income and Education (SIE)

In 1974, Congress directed that an expanded Current Population Survey (CPS) or a new survey be conducted to furnish current state-representative data on the total number of school age children living in families with incomes below poverty level. To fulfill this Congressional mandate, the Bureau of the Census, along with agencies of HEW, designed the SIE and administered it between April and July 1976.

The survey included questions on current employment, past work experience, income, school enrollment, disability, health insurance, food stamp recipiency, housing and assets.

Approximately 158,500 households from 50 states and the District of Columbia were eligible for the SIE interview. The data set contains 151,170 household records, 160,975 family records and 440,815 person records.

7. The Master Facility Inventory (MFI)

The 1978 National Master Facility Inventory (MFI), produced by the National Center for Health Statistics, contains only information on nursing homes. (In previous years other inpatient health facilities were part of the MFI.) This file contains the 1976 MFI information for the state of California, New York, North Carolina and the District of Columbia due to the low response rates of those states in 1978. There are 18,722 nursing homes represented in the 1978 MFI including the 1976 information for the four states mentioned above. For all other states, only those homes that responded to the survey are present on the 1978. The 1978 MFI data base contains the nursing home identification number, facility name, facility type, street address, city, zip, state code, county code, telephone number, ownership type, number of licensed beds, Medicare beds, Medicaid skilled beds, Medicaid intermediate beds, beds set up, number of residents and staffing. Only the data on staffing was confidential.

8. Framingham Functional Disability Survey

This study involved administration of a functional disability assessment questionnaire to 2,600 men and women aged 60 to 90 years old between 1976 and 1978. These persons had participated in a longitudinal study to determine the risk factors for and development of coronary heart disease. The data are useful in providing information on the functional limitations of the noninstitutionalized population.

9. National Survey of the Aged Questionnaire (NSA) 1975

The National Survey of the Aged Questionnaire was administered to a sample of 2,143 noninstitutionalized elderly persons. Its purpose was to describe the population aged 65 and over and to indicate the extent to which the old are sick or well, isolated or surrounded by family, poor or able to manage financially. In addition, it was anticipated that the instrument would measure change in the status of the elderly in the United States. This questionnaire was based on the instrument used by a study in 1962 done by Dr. Ethel Shanas and her colleagues of older persons in three industrial societies: the United States, Great Britian and Denmark. The original instrument was designed to provide information about the life situation of the elderly in three countries. The 1962 survey questionnaire concentrated on the physical well-being, family relationships, and financial status of the elderly. Additional information was included on the 1975 survey in order to assess the effects of several governmental policies such as Medicare, Medicaid, Supplemental Security Income, and special programs in housing, transportation, and community services designed to improve the life of older people.

10. NIMH Survey of State and County Mental Hospitals

The NIMH survey includes only state and county mental hospitals. Published reports include information on the number of additions and resident patients at the end of the year by age and diagnosis. An "addition during the year" includes persons admitted or readmitted as well as returns from extended leave and transfers from other facilities. Resident patients at the end of the year include those persons present in the inpatient service at the end of the year and those away on short leave who are expected to return to the inpatient service. (U.S. DHHS, NIMH, 1981)

11. The 1973 Consumer Expenditure Surveys

This two-wave survey collected detailed information on family expenditures and income from a sample of 10,000 families each in 1972 and 1973. It included dollar expenditures for nursing home care, medical or health services, physician care, homemaker services (including care for elderly persons or invalids in the consumer unit), medical applicances and other health related items. It also contained extensive information on health insurance. Detailed income and demographic questions were also included.

12. Census of Institutions

The census of institutions provides age, sex and race status on the populations of institutions for the years 1950, 1960 and 1970 Data are drawn from U.S. Census Bureau decennial survey of the U.S. population.

13. Older American Resources and Services Instrument (OARS)

These data come from four surveys administered in local areas using the OARS instrument. Three of the surveys were conducted by the U.S. General Accounting office in Cleveland, Kentucky, and Oregon; the other survey was done by the Virginia Center on Aging of Virginia elderly. The three GAO surveys used identical instruments while the Virginia instrument was basically the same. Most differences could be easily reconciled to produce comparable responses. Each of the samples were designed to be self-weighting representative samples of the elderly population in the survey area. Nearly 4,000 respondents were included in the sample.

The OARS instrument involves two components--a functional assessment, and a survey of service utilization. The functional assessment includes the domains of mental health, physical health, activities of daily living (ADL) and instrumental activities of daily living (IADL) dependencies, social resources, and economic resources. The services utilization inventory covers 28 service types ranging from job placement assistance to personal care. Services likely related to long-term health needs include: periodic checking, continuous supervision, case management, homemaker, meal preparation, nursing care, personal care, physical therapy, and multidimensional assessment. Other services such as transportation, escort, or social/recreational, may be used by dependent persons, but may as frequently be used by unimpaired aged.

NOTES

One important step in this direction was taken by the National Center for Health Statistics in its decision to collect data for a special home care supplement during both the 1979 and 1980 surveys. Merging these two year's data when the 1980 data become available will substantially reduce standard errors in long-term care prevalence estimates, although some subgroup sample sizes will still be too small for reliable analysis.

I. LIST OF TABLES

Table Number	Title	Cross Reference Final Report*
Size, Growth and Demographic Characteristics of the Elderly Population
1.	Proportion of Population 65 Years and Over, 1990-1980
2.	Persons 65 Years Old and Over--Characteristics, by Sex: 1960 to 1981
3.	Number and Percent Distribution of U.S. Population Aged Over 65 Residing in Urban and Non-Urban Areas, by Sex and Race, 1974 and 1970
4.	Expectation of Life at Birth, 1920-1979
5.	Marital Status of the Population, by Sex and Age: 1980
6.	Characteristics of Widows, by Age Group: 1970 and 1980
7.	Living Arrangements of Elderly Widowed Persons: 1970 to 1980
8.	Persons Living Alone, by Age and Sex, 1960-1980
9.	Households, by Number of Persons, 1950-1981
10.	Age of Householder: Percent Distribution Selected Years 1968-81
11.	Number and Percent of Elderly Living Alone, 1960, 1970 and 1979
12.	Persons Aged 65-74 and 75 and Over as a Percent of Total Population, by State and Division, 1980
Prevalence of Dependency
13.	Hierarchical Ordering of HIS and NNHS Respondents Age 65 Years and Over by Type of Dependency	III.1
14.	Number of Noninstitutionalized Dependent Persons and Rates of Dependency by Age Group, 1979	II.5
15.	Percent Standard Errors for 14
16.	Comparison of 1977 and 1979 Health Interview Survey Dependency Rates Among the Noninstitutionalized Aged	II.3
17.	Comparison of HIS and Framingham Disability Study Estimates of Dependency Among the Noninstitutionalized Aged for Comparable Items	II.3
18.	Number and Percent of Noninstitutionalized Aged Who are Unmarried, Live Alone or are Poor, by Dependency Level.	II.3
19.	Numbers of Persons and Rates of Dependency by Race and Sex for Two Age Groups of the Noninstitutionalzed Aged	II.3
20.	Comparison of Metropolitan Residence in 1977 for Noninstitutionalized Persons Needing Mobility or Personal Care Assistance and U.S. Civilian Population
21.	Number and Percent of Americans in 1977 Suffering Dependency in Personal Care or Mobility by Community Versus Nursing Home Residency
22.	Synthetic Estimates of the Number of Persons Needing Help With Personal Care and Mobility in 1980: All Ages	II.5
23.	Comparison Between Age and Mortality Based Synthetic Estimates of Prevalence Rates for Personal Care Dependency: Aged Only	II.5
24.	Comparison Between Age and Mortality Based Synthetic Estimates of Prevalence Rates for Mobility Dependency: Aged Only	II.5
Economic Status of the Elderly and Impaired
25.	Distribution of Income By Family Characteristics for Families with Head Aged 65 and Over	IV.3
26.	Distribution of Income for Elderly Couples and Individuals by Age of Head	IV.3
27.	Percentage of Homeowners of Income and Family Characteristics	IV.3
28.	Average Interest and Dividend Income by Income and Family Characteristics	IV.3
29.	Mean Resources of Elderly by Age and Family Size Using Alternative Definitions of Resources	IV.3
30.	Distribution of Resources Among Nonworking Individuals Living Alone by Age Using Alternative Definitions of Resources	IV.3
31.	Percentage of Income Available for Discretionary Purposes by Age and Household Characteristics	IV.3
32.	Average Income of Families with Impaired Persons by Definition of Impairment and Relationship of Impaired Persons to Family Head	IV.3
33.	Distribution of Resources and Average Resources by Alternative Definitions for All Families with Impaired Members	IV.3
34.	Average Family Resource Levels and Family Size by Age and Relationship to Head of Impaired Persons	IV.3
35.	Distribution of Resources by Alternative Definitions of Resources When Impaired Person Is Head or Spouse Is Under Age 65	IV.3
36.	Distribution of Resources by Alternative Definitions of Resources When Impaired Person Is Head or Spouse Aged 65 or Over	IV.3
37.	Distribution of Resources by Alternative Definitions of Resources When Impaired Person Is Child or “Other” Relative of Household Head	IV.3
38.	Distribution of Resources by Alternative Definitions of Resources When Impaired Person Lives Alone	IV.3
39.	Distribution of Resources Among Nonworking Elderly Couples by Age Using Alternative Definition of Resources	IV.3
40.	Distribution of Income for Elderly Couples and Individuals Without Earnings by Age of Head	IV.3
41.	Mean Resources of Elderly by Age and Family Size for Two Combined Definitions of Resources	IV.3
42.	Mean Resources of Nonworking Elderly by Family by Family Size and Selected Characteristics Using Alternative Definitions of Resources	IV.3
43.	Mean Resources of Nonworking Elderly by Age and Family Size Using Alternative Definitions of Resources	IV.3
44.	Percent With and Without Health Insurance, Percent Distribution by Age
45.	Uninsured Persons, Family Setting, and Insurance Coverage of Other Family Members: Percent Distribution by Type of Coverage
Long-Term Care Institutions and Use of LTC Institutions
46.	Number of Persons and Percent of U.S. Population Residing in Long Term Care Institutions as Reported by Census of Population	V.1
47.	Percent of the Elderly in Institutions by Age Cohort 1950-1970	V.1
48.	Components of Institutional Population Growth Persons 65 and Over 1950-1970	V.1
49.	Proportion of Aged Recipients in Non-Medicaid Facilities to Total SSI Recipients, by State	V.2
50.	Utilization of Facilities for the Mentally Impaired by Age	IV.1
51.	Number and Percent Change in Inpatient Days of Care in Mental Health Facilities, United States 1971, 1973, 1975	IV.2
Determinants of Nursing Home Use
52.	All Ages: Number and Percent of White and Non-White Persons Aged 65 and Over or Under 65 Who Live in Nursing Homes	III.1
53.	Rates of Nursing Home Residency by Type of Dependency Among the Aged	III.1
54.	Elderly Only: Institutionalization Rates by Demographic Characteristics, Dependency, Diagnostic Group and Climate, 1977	III.1
55.	Elderly Only: Institutionalization Rates of Persons With High Risk Characteristics	III.1
56.	Elderly Only: Institutionalization Rates of Persons With High Risk Characteristics by Relative Bed Supply	III.1
Characteristics of Nursing Home Users
57.	Age, Sex, Race and Marital Status of Nursing Home Residents, 1977
58.	Number and Percent Distribution of Nursing Homes in 1977 and Discharges in 1976, by Primary Source of Payment, According to Selected Characteristics, United States.
59.	Number and Percent of Nursing Home Residents by Selected Diagnoses and Conditions
60.	Number and Percent Distribution of Nursing Home Residents by Dependency in Activities of Daily Living and Index of Dependency in Activities of Daily Living, According to Selected Other Resident Characteristics: United States 1977
61.	Percentage of Nursing Home Residents by Age Within Diagnostic Category	II.4
62.	Percentage of Nursing Home Residents by Marital Status Within Diagnostic Category	II.4
63.	Percentage of Nursing Home Residents by Rate Within Diagnostic Category	II.4
64.	Percentage of Nursing Home Residents by Sex Within Diagnostic Category	II.4
65.	Percentage of Nursing Home Residents by Need for Help of Another Person in Activities of Daily Living Within Diagnostic Category	II.4
66.	Percentage of Nursing Home Residents by Need for Assistance in Activities of Daily Living Within Diagnostic Category	II.4
67.	Percentage of Nursing Home Residents by Ability to Communicate Within Diagnostic Category	II.4
68.	Percentage of Nursing Home Residents by Predicted Date of Discharge Within Diagnostic Category	II.4
69.	Percentage of Nursing Home Residents by Prior Residence Within Diagnostic Category	II.4
70.	Percentage of Nursing Home Residents by Discharge Destination Within Diagnostic Category	II.4
71.	Distribution of Other Diagnosis in Nursing Home Patients With Mental Disorder as Primary Diagnosis	V.1
72.	Number of Persons With A Mental Diagnosis in Nursing Homes, Selected Years	V.1
73.	Source of Payment for Nursing Home Patients with Mental Diagnosis	V.1
74.	Percentage of Nursing Home Residents by Type of Behavioral Problem Within Diagnostic Category	II.4
75.	Percentage of Nursing Home Residents Receiving Medication for Mental Impairments Within Diagnostic Category	II.4
76.	Percentage of Nursing Home Residents Receiving Tranquilizers for Mental Impairments Within Diagnostic Category	II.4
77.	Percentages of New Patients Having Selected Conditions by Home’s Ownership Type and Patient Payment Sources
78.	Percentages of New Patients Having Selected Conditions by Home’s Per Diem Health Labor Cost and Patient Payment Sources
79.	Percentages of New Patients Having Selected Conditions by Home’s Size and Patient Payment Sources
80.	Percentages of New Patients Having Selected Conditions by Homes Occupancy Rate and Patient Payment Sources
81.	Percentage of New Patients Having Selected Conditions by Home’s Percentage of Days for Medicaid and Patient Payment Sources
82.	Percentage of New Patients Having Selected Conditions by Patient Payment Source
83.	Prevalence of Diagnosis in Source of Payment Groups	III.2
84.	Nursing Home Discharge Status for Elderly, Aged 65 and Over by Number and Percent	III.2
85.	Number and Community Discharge Rates of Nursing Home Patients Aged 65 and Over Discharged in 1976	III.2
86.	Community Discharge Rates From Nursing Homes by Age Group	III.2
87.	Community Discharge Rates From Nursing Homes by Marital Status and Other Characteristics	III.2
88.	Community Discharge Rates by Dependency Status	III.2
89.	Community Discharge Rates by Source of Payment	III.2
90.	Length of Nursing Homes Stay by Marital Status, Age, and Source of Payment
91.	Nursing Home Length of Stay by Primary Diagnosis, 1977
92.	Proportion of Nursing Home Admissions with a Length of Stay of Less Than 3 Months,3 or More Months, and 6 or More Months, by Additional Length of Stay
Providers of Long-Term Care
93.	Growth in Nursing Home Beds Per Thousand Elderly 1967-1973	V.1
94.	Ownership Distribution of Nursing and Personal Care Home	V.1
95.	Counts of Medicare and/or Medicaid Certified Nursing Home Facilities and Beds, 1980	V.1
96.	Total Medicare or Medicaid Certified Nursing Home Beds for Elderly Persons, By State	V.1
97.	Number of Long-Term Care Facilities and Beds by Certification Level, MMACs, 1980	V.1
98.	Distribution of Facilities by Total Bed Size and Certification, MMACs	V.1
99.	Distribution of Beds by Total Bed Size and Certification, MMACs	V.1
100.	Facilities by Level of Care and Certification, 1976 MFI	V.1
101.	Uncertified Nursing Homes by State, 1978 MFI	V.1
102.	Uncertified Nursing Homes and Beds by Bed Size, 1978 MFI	V.1
103.	Uncertified Nursing Homes and Beds by Type of Ownership, 1978 MFI	V.1
104.	Uncertified Nursing Homes by Type of Ownership and Bed Size, 1978 MFI	V.1
105.	Beds in Uncertified Nursing Homes by Size of Facility, 1978 MFI	V.1
106.	Number of Medicare Certified Home Health Agencies by Type of Agency and Division, 1974-1980	V.2
107.	Home Health Agencies, Persons Served, Visits, Charges and Reimbursements, Under the Medicare Program by Geographic Area and Year, 1974-1980	V.2
108.	Persons Served, Visits, Visit Charges, Average Vists Per Person Served, Average Visit Charges Per Person, Average Charge Per Visit, Under the Medicare Program by Home Health Agency Type and Year, 1974-1980	V.2
109.	Persons Served, Percent of Persons Receiving Visit, Visits, Percent of Visits and Visit Charges for Home Health Agencies Services, Under the Medicare Program, by Type of Visit, 1975	V.2
110.	Persons Served, Percent of Persons Receiving Visit, Visits, Percent of Visits and Visit Charges for Medicare Home Health Agency Services, by Type of Visit, 1980	V.2
111.	Distribution of Home Health Agencies by Geographic Division Within Agency Type, 1974 and 1980	V.2
112.	Distribution of Home Health Agencies by Agency Type Within Geographic Region, 1974 and 1980	V.2
113.	Relative Shares of Persons Served, Visits and Visit Charges Under the Medicare Program by Type of Home Health Agency, 1974-1980	V.2
114.	Factors Explaining the Growth Rate in Medicare Home Health Services 1974-80	V.2
115.	State and County Psychiatric Hospitals, by State, 1978, NIMH	V.1
116.	Number of Psychiatric Hospitals and Beds by Type of Ownership, 1978 MFI	V.1
117.	Psychiatric Hospitals Beds, Admissions, by Type of Ownership, 1978	V.1
118.	Long-Term Psychiatric Hospital Beds, Admissions Inpatient Days and Occupancy Rates by Type of Ownership, 1978	V.1
119.	Number of Psychiatric Hospitals by Bed Size, 1978	V.1
120.	Total Psychiatric Hospitals by Type of Ownership and Size, 1978	V.1
121.	Facilities for the Mentally Impaired as Reported by the Master Facility Inventory, 1971-1976	V.1
122.	V.A. Medical Centers--Nursing Home Care Units: Selected Data by State, Fiscal Year 1979	IV.1
123.	Veterans’ Administration Community Nursing Home Program: Selected Data by State, Fiscal Year 1979	IV.1
124.	VA Medical Centers--Domiciliary Care Units: Selected Data by State, Fiscal Year 1979	IV.1
125.	V.A. Medical Centers--Hospital Based Home Care: Selected Data by State, Fiscal Year 1979	IV.1
126.	State Veterans’ Homes--Nursing Homes: Selected Data by State Fiscal Year 1979	IV.1
127.	State Veterans’ Homes--Domiciliaries: Selected Data by State, Fiscal Year 1979	IV.1
128.	Percent of Elderly Housing Projects Offering Special Facilities, Services and Amenities	IV.1
Informal Care
129.	Various Indicators of the Availability of Informal Care Providers by Long-Term Care Status and Select Sociodemographic Characteristics	III.3
130.	Percent of All Elderly With at Least One Daughter Who Do Not Have Frequent Contact with at Least One or Who Do Not Live Nearby at Least One, by Number of Daughters and Marital Status, and Place of Residence	III.3
131.	Percent of All Elderly With at Least One Daughter Who Do Not Have Either Frequent Contact With at Least One or Live Nearby at Least One, by Marital Status and Living Arrangements	III.3
132.	Percent of All Elderly With Surviving Children Who Do Not Have Frequent Contact With at Least One and Percent Who do Not Live Nearby at Least One by Family Composition	III.3
133.	Percentage Distribution of ADL Service Use Pattern by Number of Surviving Children Among the Elderly with Moderate to Severe Incapacities for Self Care, by Marital Status	III.3
134.	Percentage Distribution of ADL Service Use Pattern by Type of Living Arrangement Among Elderly with Severe to Moderate Incapacities for Self-Care	III.3
135.	Percentage Distribution of ADL Service Use Pattern by Sex Composition of Surviving Children Among the Elderly with Moderate to Severe Incapacities for Self-Care, by Marital Status	III.3
136.	Percentage Distribution of IADL Service Use Pattern by ADL Service Use Pattern Among Elderly with Moderate to Severe Incapacities for Self-Care	III.1
137.	Percentage Distribution of IADL Service Use Pattern by Number of Surviving Children Among the Elderly with Moderate to Severe Incapacities for Self-Care	III.1
138.	Percentage Distribution of Supportive Service Use Pattern by Number of Surviving Children Among The Bedfast Elderly	III.1
Spending for Long-Term Care Services
139.	Public Expenditures On Long-Term Care Services By Program, Fiscal Year 1980	IV.1
140.	Public Expenditures On Long-Term Care Related Services by Program and State, Fiscal Year 1980	IV.1
141.	Public Expenditures On Long-Term Care Related Services by Service Category and State, Fiscal Year 1980	IV.1
142.	Percent of Total Reported Medicaid Expenditures Used to Finance Long-Term Care Services, Fiscal Year 1980	IV.1
143.	Nursing Home Spending Growth by Source and Year, 1948-1981
144.	Distribution of Medicaid Nursing Home Days Between Skilled and Intermediate Care by State, Fiscal Year 1979	IV.1
145.	Medicaid Nursing Home Days of Care and Certified Beds Per Thousand Elderly, Fiscal Year 1979	IV.1
146.	Medicaid Nursing Home Services: Recipients, Days of Care, and Cost, by Fiscal Year (Skilled and Intermediate Care Facilities)	IV.1
147.	Medicaid Nursing Home Recipients and Expenditures, Fiscal Year 1980	IV.1
148.	Percentage Change in Medicare Covered Days Per Person Age 65 and Over, 1977-1979, by State	IV.1
149.	Medicare Covered SNF Days Per 1,000 Persons Age 65 and Over, 1979	IV.1
150.	Medicare Covered Days, Total Reimbursements, and Reimbursement Per Day for Skilled Nursing Facility Services for the Aged, By State, Calendar Year 1979	IV.1
151.	Total Reimbursements for Home Health Care, Number of Home Visits, and Reimbursement Per Visit, 1972-1980	IV.1
152.	Home Health Visits, Total Medicare Reimbursements, and Reimbursement Per Visit By State, 1980	IV.1
153.	Total Medicare Reimbursement, Reimbursement for Home Health Services and Number of Home Health Visits, Calendar Years 1967-1980	V.2
154.	Medicare Reimbursement for Home Health Services by Program and Type of Enrollee, Selected Years	V.2
155.	Medicaid Home Health Services, Recipients and Expenditures, 1975-1980	IV.1
156.	Medicaid Non-Institutional Long-Term Care Recipients and Expenditures, Fiscal Year 1980	IV.1
157.	Expenditures Under Title III of the Older Americans Act, by Service Category, Fiscal Year 1980	IV.1
158.	Payment Levels and Maximum State Payments in States with Optional SSI Supplements for Non-Medical Long-Term Care, as of October 1, 1980	IV.1
159.	Federal and State Expenditures on Optional State Supplements to Recipients in Non-Medical Long-Term Living Arrangements for States with Federally Administered Supplement Programs, 1982	IV.1
160.	State Expenditures on Optional State Supplements to Recipients in Non-Medical Long-Term Care Living Arrangements for States with State Administered Supplement Programs, Fiscal Year 1980	IV.1
161.	Title XX Utilization of Federal Social Services Allocations by State, Fiscal Years 1972-1979	IV.1
162.	Percent of State Median Income at Which Title XX Income Eligibility Levels Set, by State Fiscal Year 1980
163.	States Use of Fees for Title XX Services, FY 80 Final CASP Plans	IV.1
164.	Expenditures Under Title XX On Potential Long-Term Care Related Services for SSI Recipients, Fiscal Year 1980	IV.1
165.	Percentage of Total Expenditures Allocated to SSI Recipients by Service and State, Fiscal Year 1980	IV.1
166.	Selected Social Service Expenditures Under Title XX, by Service and Recipient Category, Fiscal Year 1980	IV.1
167.	Title XX SSI Recipient Long-Term Care Service Related Expenditures, by Service and State, Fiscal Year 1980	IV.1
168.	Older Americans Act Title III Appropriations, Fiscal Year 1980	IV.1
169.	Older Americans Act Title IV Appropriations, Fiscal Year 1980	IV.1
170.	Veterans’ Administration Community Nursing Home Program: Expenditures by State, Fiscal Year 1979
171.	V.A. Medical Centers--Nursing Home Care Units: Expenditures by State, Fiscal Year 1979
172.	Summary of Publicly Financed Housing Assistance for the Elderly and Handicapped	IV.1
173.	Property Tax Relief Across States	IV.1
174.	Benefit Amounts and Property Tax Relief Under State Circuit-Breaker Programs, Number of Claimants	IV.1
175.	V.A. Medical Centers--Hospital-Based Home Care: Expenditures by State, Fiscal Year 1979	IV.1
176.	V.A. Medical Centers--Domiciliary Care Units: Expenditures by State, Fiscal Year 1979	IV.1
177.	State Veterans’ Homes--Domiciliaries: Expenditures by State, Fiscal Year 1979	IV.1
178.	State Veterans’ Homes--Nursing Homes: Costs and Expenditures by State, Fiscal Year 1979	IV.1
179.	States With SSI Supplements to Nonmedical Facilities, With Levels of Income Support and Amount of State Payment	IV.2
Cost
180.	Nursing Home Cost Allocations
181.	Nursing Home Revenues by Source
Appendix A: Selected Adapted Task Items
A-1	Selected Adapted Task Items and Their Use in 16 Major Assessment Instruments
Appendix B: Use, Sources, Charges and Expenditures for Non-Long-Term Care Services by Age
B-1	Use of Hospital Services: Percent of Persons Without and With Hospital Admission, Mean Length of Stay, and Mean Number of Hospital Admissions Per 1,000 Population and Per Person With at Least One Hospital Admission, by Age
B-2	Use of Prescribed Medicines: Percent of Persons With and Without Prescribed Medicines, Mean Number of Prescribed Medicines Per Person Without At Least One Prescribed Medicine by Age
B-3	Usual Sources of Care: Percent Distribution of Persons of Age
B-4	Use of Ambulatory Physician Services: Percent Distribution by Persons With and Without Physician Contacts, by Age
B-5	Annual Expenditures and Sources of Payment for Inpatient Hospital Services: Mean Expense Per Person With Hospital Expense and Percent Paid by Source of Payment, by Age
B-6	Out of Pocket Expense for Inpatient Hospital Services: Percent Distribution of Persons With and Without Admissions, by Intervals of Out-of Pocket Expense and Age
B-7	Charges and Sources of Payment for Inpatient Hospital Services, Mean Charge Per Admission and Proportion Paid by Different Sources of Payment, by Age
B-8	Annual Expenditures and Sources of Payment for Ambulatory Physician Services: Mean Expense Per Person With Expense and Percent by Source Paid by Source of Payment, by Age
B-9	Out-of-Pocket Expense for Ambulatory Physician Services: Percent Distribution of Persons With and Without Contacts, by Intervals of Out-of-Pocket Expense, by Age
B-10	Annual Expenditures and Sources of Payment for Ambulatory Non-Physician Services: Mean Expense for Source of Payment, by Age
B-11	Annual Out-of-Pocket Expenses for Personal Health Services: Percent of Persons With and Without Out-of-Pocket Expenses, and Means for Person and Per Person With Out-of-Pocket Expense, by Age
B-12	Level of Individual Out-of-Pocket Expenses for Personal Health Services: Percent Distribution of Persons With and Without Expense, by Intervals of Annual Out-of-Pocket Expense and Age
B-13	Annual Expenditures and Sources of Payment for Prescribed Medicines: Mean Expense Per Person With Expense and Percent Paid by Source of Payment and Age
B-14	Out-of-Pocket Expenses for Prescribed Medicines: Percent Distribution of Persons With and Without Prescribed Medicine by Out-of-Pocket Expense and Age
B-15	Charges and Sources of Payment for Prescribed Medicine: Mean Charge Per Prescribed Medicine and Proportion Paid by Different Sources of Payment, by Age
B-16	Annual Expenditures and Source of Payment for Medical Equipment and Supplies: Mean Expense per Person With Expense and Percent Paid by Source, by Age
B-17	Out-of-Pocket Expenses for Medical Equipment and Supplies: Percent Distribution of Persons With and Without Purchase or Rental of Medical Equipment and Supplies, by Intervals by Out-of-Pocket Expense and Age
* Tables with no cross reference indicated were not used in any other report. References are by volume and chapter as it appears in the Final Report for this project.

II. SIZE, GROWTH AND DEMOGRAPHIC CHARACTERISTICS OF THE ELDERLY POPULATION

TABLE 1. Proportion of Population Aged 65 Years and Over, 1990-1980
Year	Total Population	Population Aged 65 Years and Over	Proportion of Population Aged 65 Year and Over
1980	226,546,000	25,550,000	11.28
1970	203,211,920	20,065,502	9.87
1960	179,323,175	16,559,580	9.23
1950	150,697,361	12,269,537	8.14
1940	131,669,275	9,019,314	6.85
1930	122,775,046	6,633,805	5.40
1920	105,710,620	4,933,215	4.67
1910	91,972,266	3,949,524	4.30
1900	75,994,575	3,080,948	4.05
SOURCE: 1900-1970, U.S. Bureau of the Census, Historical Statistics of the United States, Colonial Times to 1970, Bicentennial Edition, Part 1. Washington, D.C., 1975, 1980, U.S. Bureau of the Census, *Statistical Abstract of the United States, 1982* (103d edition) Washington, D.C., 1982.

TABLE 2. Persons 65 Years Old and Over--Characteristics, by Sex: 1960 to 1980 (Institutional Population Excluded)
Characteristics	1960		1970		1980		1981
Characteristics	Male	Female	Male	Female	Male	Female	Male	Female
Total¹ (million)	7.5	9.0	8.3	11.5	9.8	14.0	10.1	13.6
Percent of total population	8.6	9.9	8.5	11.1	9.3	12.4	9.3	12.6
White¹ (million)	6.9	8.4	7.6	10.6	8.8	12.6	9.1	13.2
Black¹ (million)	.5	.6	.7	.9	.8	1.2	.8	1.2
Age:²
65-69 years (percent)	3.3	3.7	3.2	3.7	3.6	4.2	3.5	4.2
70-74 years (percent)	2.5	2.8	2.3	3.0	2.7	3.4	2.6	3.5
75-79 years (percent)	1.6	1.9	1.6	2.2	1.6	2.2	1.7	2.6
80 years and over (percent)	1.2	1.6	1.4	2.3	1.5	2.6	1.6	3.1
Median income:^1,3
Family householders (dollars)	2,831		4,779	4,986	11,320	11,227	12,965	12,285
Unrelated individuals (dollars)	1,008		2,101	1,777	5,186	4,538	5,746	4,957
Percent below poverty level:^1,4
Family householders	29.7	31.5	16.6	23.5	8.3	13.5	8.2	14.0
Unrelated individuals	58.5	69.1	40.0	49.9	25.3	30.4	24.4	32.3
PERCENT DISTRIBUTION
Marital status:¹
Single	7.3	8.5	7.5	7.7	5.1	5.9	4.5	5.7
Married	71.7	36.8	73.1	35.6	77.6	39.7	79.3	39.4
Spouse present	69.0	35.0	69.9	33.9	75.5	38.0	77.0	37.8
Spouse absent	2.7	1.8	3.2	1.7	2.0	1.7	2.3	1.6
Widowed	19.4	53.1	17.1	54.4	13.6	51.0	12.8	51.3
Divorced	1.7	1.5	2.3	2.3	3.7	3.4	3.4	3.6
Family status:¹
In families	82.3	67.7	79.2	58.5	83.0	57.0	83.4	56.6
Nonfamily householders	12.8	26.8	14.9	35.2	15.5	41.8	15.2	42.4
Secondary individuals	2.4	3.0	2.4	1.9	1.5	1.1	1.3	.9
Residents of institutions¹	2.5	2.4	3.6	4.4	(NA)	(NA)	(NA)	(NA)
Years of school completed
8 years or less	72.5	66.4	61.5	56.1	45.4	41.6	43.0	41.1
1-3 years of high school	10.4	12.8	12.6	13.9	15.5	16.7	16.2	16.5
4 years of high school	7.8	11.6	12.5	18.1	21.4	25.8	21.7	26.4
1-3 years of college	4.9	6.1	5.6	6.7	7.5	8.6	8.1	9.3
4 years or more of college	4.3	3.2	7.9	5.2	10.2	7.3	11.0	6.8
Labor force participation:⁵
Employed	30.9	9.9	26.2	10.0	18.6	7.9	17.8	7.7
Unemployed	1.7	.4	1.0	.3	.5	.3	.5	.3
Not in labor force	67.3	89.7	72.8	89.7	80.9	91.8	81.6	92.0
Living arrangements:¹
Living in household	97.4	97.0	95.5	95.0	99.9	99.7	100.0	99.9
Living alone	(NA)	(NA)	14.1	33.8	14.7	40.9	14.3	41.4
Spouse present⁶	73.2	36.9	69.9	33.9	75.5	38.0	77.0	37.8
Living with someone else	(NA)	(NA)	11.5	27.4	9.7	20.8	8.7	20.7
Not in household⁷	2.6	3.0	4.5	5.0	.1	.3	--	.1
SOURCE: Except as noted, U.S. Bureau of the Census, *Current Population Reports, series P-20, No. 372, and earlier reports; series P-23, Nos. 57, 59, and 85; series P-25, No. 917; and series P-60, No. 132 and earlier reports. Resident population as of March. Beginning 1975, excludes institutional population. Estimated total resident population as of July. Income for preceding year. Poverty status based on income in preceding year. Source: U.S. Bureau of Labor Statistics, Employment and Earnings*, monthly. For 1960 and 1965, includes a small number of “spouse present” in group quarters. In institutions and other group quarters. NA Not available.

TABLE 3. Number and Percent Distribution of U.S. Population Aged Over 65 Residing in Urban and Non Urban Areas, by Sex and Race, 1974 and 1970 (In Thousands)
Population Over 65 Sex and Race	Metropolitan		Non-Metropolitan		All Areas
Population Over 65 Sex and Race	1974	1970	1974	1970	1974	1970
All Races
Both Sexes	13,106 (9.2)	12,344 (9.0)	7,496 (11.4)	6,891 (11.0)	20,602 (9.9)	19,235 (9.6)
Male	5,281 (7.7)	5,128 (7.8)	3,247 (10.0)	3,079 (10.1)	8,528 (8.5)	8,207 (8.5)
Female	7,825 (10.6)	7,216 (10.1)	4,249 (12.7)	3,812 (11.8)	12,074 (11.3)	11,028 (10.7)
White
Both Sexes	11,856 (9.7)	6,324 (9.4)	6,898 (11.6)	11,207 (11.2)	18,754 (10.3)	17,532 (10.0)
Male	4,728 (8.0)	2,822 (8.1)	2,999 (10.2)	4,625 (10.3)	7,727 (8.8)	7,447 (8.8)
Female	7,128 (11.4)	3,502 (10.7)	3,899 (12.9)	6,583 (12.1)	11,027 (11.9)	10,085 (11.2)
Black
Both Sexes	1,101 (6.2)	1,027 (6.3)	571 (9.1)	522 (9.1)	1,672 (7.1)	1,549 (7.0)
Male	480 (5.8)	448 (5.9)	235 (8.4)	234 (8.6)	716 (6.5)	681 (6.6)
Female	621 (6.6)	579 (6.7)	336 (11.1)	288 (9.6)	957 (7.7)	867 (7.4)
SOURCE: U.S. Bureau of the Census, *Social and Economic 1Characteristics of the Metropolitan land Non-Metropolitan Population 1974 and 1970*, Current Population Reports Special Studies, Series p-23, No. 55, September 1975. Adapted from Table 1. Data for 1980 not yet available.

TABLE 4. Expectation of Life at Birth: 1920 to 1979 (In years prior to 1960, excludes Alaska and Hawaii. Data prior to 1940 for death-registration states only. Beginning 1970, excludes deaths of non-residents of the United States. See also Historical Statistics, Colonial Times to 1970.)
Year	Total			White			Black and Other
Year	Total	Male	Female	Total	Male	Female	Total	Male	Female
1920	54.1	53.6	54.6	54.9	54.4	55.6	45.3	45.5	45.2
1930	59.7	58.1	61.6	61.4	59.7	63.5	48.1	47.3	49.2
1940	62.9	60.8	65.2	64.2	62.1	66.6	53.1	51.5	54.9
1950	68.2	65.6	71.1	69.1	66.5	72.2	60.8	59.1	62.9

1955	69.6	66.7	72.8	70.5	67.4	73.7	63.7	61.4	66.1
1960	69.7	66.6	73.1	70.6	67.4	74.1	63.6	61.1	66.3
1965	70.2	66.8	73.7	71.0	68.0	75.6	65.3	61.3	69.4
1970	70.9	67.1	74.8	71.7	68.0	75.6	65.3	61.3	69.4

1971	71.1	67.4	75.0	72.0	68.3	75.8	65.6	61.6	69.7
1972	71.1	67.4	75.1	72.0	68.3	75.9	65.6	61.5	69.9
1973	71.3	67.6	75.3	72.2	68.4	76.1	65.9	61.9	70.1
1974	71.9	68.1	75.8	72.7	68.9	76.6	67.0	62.9	71.3

1975	72.5	68.7	76.5	73.2	69.4	77.2	67.9	63.6	72.3
1976	72.8	69.0	76.7	73.5	69.7	77.3	68.3	64.1	72.6
1977	73.2	69.3	77.1	73.8	70.0	77.7	68.8	64.6	73.1
1978	73.3	69.5	77.2	74.0	70.2	77.8	69.2	65.0	73.6
1979	73.7	69.9	77.6	74.4	70.6	78.2	69.9	65.5	74.2
SOURCE: U.S. National Center for Health Statistics, Vital Statistics of the United States, annual; and unpublished data.

TABLE 5. Marital Status of the Population, by Sex and Age: 1980 (In thousands of persons 18 years old and over, except percent. As of March. Based on Current Population Survey, which includes members of Armed Forces living off post or with their families on post, but excludes all other members of the Armed Forces.)
Sex and Age	Total	Single	Married	Widowed	Divorced	Percent Distribution
Sex and Age	Total	Single	Married	Widowed	Divorced	Total	Single	Married	Widowed	Divorced
MALE	74,101	17,434	50,825	1,972	3,871	100.0	23.5	68.6	2.7	5.2
18-19 years	4,042	3,808	232	--	2	100.0	94.2	5.7	--	--
20-24 years	9,807	6,721	2,924	2	154	100.0	68.6	29.8	--	1.6
25-29 years	9,076	2,904	5,650	8	479	100.0	32.4	62.3	.1	5.3
30-34 years	8,270	1,298	6,310	11	651	100.0	15.7	76.3	.1	7.9
35-44 years	12,297	904	10,358	45	989	100.0	7.4	84.2	.4	8.0
45-54 years	10,962	699	9,347	176	740	100.0	6.4	85.3	1.6	6.8
55-64 years	9,870	565	8,414	397	495	100.0	5.7	85.2	4.0	5.0
65-74 years	6,549	357	5,346	557	290	100.0	5.5	81.6	8.5	4.4
75 years and over	3,234	142	2,244	776	71	100.0	4.4	69.4	24.0	2.2

FEMALE	82,054	13,977	51,767	10,479	5,831	100.0	17.0	63.1	12.8	7.1
18-19 years	4,184	3,465	689	3	26	100.0	82.8	16.5	.1	.6
20-24 years	10,246	5,148	4,705	23	370	100.0	50.2	45.9	.2	3.6
25-29 years	9,357	1,947	6,584	33	792	100.0	9.5	78.2	1.2	11.1
30-34 years	8,561	810	6,695	102	954	100.0	9.5	78.2	1.2	11.1
35-44 years	13,042	728	10,612	292	1,411	100.0	5.6	81.4	2.2	10.8
45-54 years	11,670	552	9,222	821	1,074	100.0	4.6	69.9	18.9	6.7
55-64 years	11,304	504	7,413	2,082	735	100.0	4.6	69.9	18.9	6.7
65-74 years	8,549	480	4,282	3,444	342	100.0	5.6	50.1	40.3	4.0
75 years and over	5,411	344	1,264	3,677	126	100.0	6.4	23.4	68.0	2.3
SOURCE: U.S. Bureau of the Census, Current Population Reports, series P-20, No. 365. -- Represents zero or rounds to zero.

TABLE 6. Characteristics of Widows, by Age Group: 1970 and 1980 (In thousands of persons, except percent. Except as indicated, covers persons 14 years old and over in 1970 and 15 years old and over in 1980.)
Characteristic	1970					1980
Characteristic	Total	Under 45 yr.	45-64 yr.	65-74 yr.	75 yr. and over	Total	Under 45 yr.	45-64 yr.	65-74 yr.	75 yr. and over
Total	9,734	392	3,063	3,065	3,214	10,479	453	2,903	3,444	3,677
Percent, by age	100.0	4.0	31.5	31.5	33.0	100.0	4.3	27.7	32.9	35.1
Per 100 widows	475	478	564	501	395	531	686	507	618	474
In labor force²	2,542	223	1,732	587		2,924	338	1,879	707
Employed	2,463	(NA)	(NA)	(NA)		2,808	309	1,806	693
		PERCENT					PERCENT
White	8,559	3.2	30.5	31.6	34.6	9,060	3.5	26.2	33.3	36.9
Black	1,120	10.4	38.1	30.4	21.2	1,280	9.4	38.0	29.8	22.8
Living Arrangement
Householder	7,308	12.1	47.0	22.0	18.9	2,518	14.0	29.0	34.2	32.3
Family householder	2,392	12.1	47.0	22.0	18.9	2,518	14.0	45.2	21.8	19.0
Nonfamily householder	4,915	1.1	29.0	38.0	31.9	6,394	.8	22.6	39.0	37.6
Not householder³	2,426	2.0	21.1	27.6	49.3	1,567	3.2	20.5	25.5	50.7
In families	1,862	2.3	22.1	29.4	46.2	1,410	2.2	18.7	25.8	53.3
Inmates of institutions	362	--	8.0	18.2	73.8	(NA)	(NA)	(NA)	(NA)	(NA)
SOURCE: U.S. Bureau of the Census, Current Population Reports, series P-20, forthcoming report, and unpublished data. -- Represents zero. NA Not available. Data revised using population controls from the 1970 census. Covers widows 16 years old and over. Source: U.S. Bureau of Labor Statistics. Includes secondary individuals not shown separately.

TABLE 7. Living Arrangements of Elderly Widowed Persons: 1970 to 1980 (Persons 65 years and over. As of March. Noninstitutional population. Based on Current Population Survey)
Widowed Persons	Householder				Not a Householder
	Total (1,000)	Percent Family Householder	Percent Nonfamily Householder Living:		Total (1,000)	In Families	Percent Living with No Relatives
	Total (1,000)	Percent Family Householder	Alone	With Non-Relatives	Total (1,000)	In Families	Percent Living with No Relatives
1970: Total	5,296	22.3	74.6	3.1	1,984	89.4	10.5
Widow	4,344	22.2	75.0	2.9	1,519	92.2	7.7
Widower	952	22.9	73.0	4.1	465	80.0	19.8
1975: Total	6,117	18.6	78.9	2.5	1,588	92.3	7.7
Widow	5,110	18.8	78.7	2.4	1,407	93.5	6.5
Widower	1,007	17.3	79.4	3.2	181	82.9	17.1
1979: Total	6,886	16.5	81.1	2.4	1,575	90.7	9.3
Widow	5,833	16.7	81.0	2.4	1,277	93.3	6.7
Widower	1,053	15.5	81.8	2.6	298	79.2	20.8
1980: Total	7,011	17.4	80.6	1.9	1,443	91.5	8.5
Widow	5,926	17.3	80.9	1.8	1,194	93.5	6.5
Widower	1,085	18.1	79.0	2.9	249	82.3	17.7
SOURCE: U.S. Bureau of the Census, *Current Population Reports*, series P-20, No. 365 and earlier issues.

TABLE 8. Persons Living Alone, by Age and Sex: 1060 to 1980
Sex and Age	Number of Persons (1000)			Percent Distribution
Sex and Age	1960	1970	1980	1960	1970	1980
BOTH SEXES	7,064	10,851	17,816	100.0	100.0	100.0
14-24 years	234	556	1,670¹	3.3	5.1	9.4¹
25-44 years	1,212	1,604	4,607	17.2	14.8	25.9
45-64 years	2,720	3,622	4,400	38.5	33.4	24.7
65 years and over	2,898	5,071	7,139	41.0	46.7	40.1
MALE	2,628	3,532	6,793	37.2	32.5	38.1
14-24 years	124	274	919¹	1.8	2.5	5.2¹
25-44 years	686	933	2,848	9.7	8.6	16.0
45-64 years	965	1,152	1,589	13.7	10.6	8.9
65 years and over	853	1,174	1,437	12.1	10.8	8.1
FEMALE	4,436	7,319	11,022	62.8	67.5	61.9
14-24 years	110	282	751¹	1.6	2.6	4.2¹
25-44 years	526	671	1,759	7.4	6.2	9.9
45-64 years	1,755	2,470	2,809	24.8	22.8	15.8
65 years and over	2,045	3,897	5,703	28.9	35.9	32.0
SOURCE: U.S. Bureau of the Census. *U.S. Census of Population: 1960, Subject Report, PC(2)-4B, and Current Population Reports*, series P-20, No. 365 and earlier issues.

TABLE 9. Households, by Number of Persons, 1950-1981 (In millions, except for percent)
Size of Household	1950	1960	1965	1970	1975	1980	1981
TOTAL	43.5	52.6	57.3	62.9	71.1	80.8	82.4
1 person	4.7	6.9	8.6	10.7	13.9	18.3	18.9
Male	1.8	2.3	2.9	3.5	4.9	7.0	7.3
Female	3.0	4.6	5.7	7.2	9.0	11.3	11.7
2 persons	12.5	14.6	16.1	18.1	21.8	25.3	25.8
3 persons	9.8	9.9	10.2	10.9	12.4	14.1	14.6
4 persons	7.7	9.3	9.2	9.9	11.1	12.7	12.8
5 persons	4.4	6.1	6.3	6.5	6.4	6.1	6.1
6 persons	2.2	3.0	3.3	3.5	3.1	2.5	2.5
7 or more	2.1	2.9	3.5	3.2	2.5	1.8	1.6
Percent of total:
1 person	10.9	13.1	15.0	17.0	19.6	22.7	23.0
2 persons	28.8	27.8	28.1	28.8	30.6	31.4	31.3
3 persons	22.6	18.9	17.9	17.3	17.4	17.5	17.7
4 persons	17.8	17.6	16.1	15.8	15.6	15.7	15.5
5 persons	10.0	11.5	11.0	10.4	9.0	7.5	7.4
6 persons	5.1	5.7	5.8	5.6	4.3	3.1	3.1
7 or more	4.9	5.4	6.1	5.1	3.5	2.2	2.0
SOURCE: U.S. Bureau of the Census, *Current Population Reports, series P-20, No. 371 and earlier reports. See also Historical Statistics, Colonial Times to 1970* Series A 335-349.

TABLE 10. Age of Householder: Percent Distribution Selected Years 1968-81
Age of Householder (Years)	Percent Distribution
Age of Householder (Years)	1968	1970	1975	1980	1981
14-24	6.3	6.8	8.2	8.1	7.8
25-34	17.5	18.5	21.0	22.9	23.3
35-44	19.7	18.6	16.7	17.3	17.6
45-54	19.8	19.5	18.2	15.7	15.4
55-64	17.1	17.1	15.9	15.5	15.4
65 and over	19.5	19.5	20.1	20.5	20.5
Total Households (in millions)	60.8	63.4	71.1	80.8	82.4
SOURCE: U.S. Bureau of the Census, *Current Population Reports*, Series P-20, No. 371 and earlier reports.

TABLE 11. Number and Percent of Elderly Living Alone, by Sex, 1960, 1970 and 1980 (number in thousands)
	1960	1970	1980
Both Sexes	2898 (17.50%)	5071 (25.27%)	7139 (27.77%)
Female	2045 (22.58%)	3897 (33.45%)	5703 (37.17%)
Male	853 (11.37%)	1174 (13.95%)	1437 (13.87%)
SOURCE: U.S. Bureau of the Census. *U.S. Census of Population: 1960*, Subject Report PC(2)-4B, and current Population Reports, series P-20, No. 365 and earlier.

TABLE 12. Persons 65-74 and 75 and Over as a Percent of Total Population, by State and Division, 1980
Division and State	Total Population (in thousands)	Elderly as % of Population
Division and State	Total Population (in thousands)	65-74	75+
U.S.	226,546	6.98	4.40
New England	12,340	7.26	5.06
Maine	1,125	7.29	5.24
New Hampshire	921	6.73	4.45
Vermont	511	6.65	4.70
Massachusetts	5,737	7.37	5.30
Rhode Island	947	8.02	5.39
Connecticut	3,108	7.08	4.67
Middle Atlantic	36,787	7.52	4.85
New York	17,558	7.36	4.9
New Jersey	7,365	7.21	4.47
Pennsylvania	11,864	7.96	4.95
East North Central	41,682	6.49	4.29
Ohio	10,798	6.55	4.29
Indiana	5,490	6.38	4.10
Illinois	11,427	6.67	4.38
Michigan	9,262	6.01	3.84
Wisconsin	4,706	7.01	4.97
West North Central	17,183	7.28	5.51
Minnesota	4,076	6.62	5.43
Iowa	2,914	7.38	5.94
Missouri	4,917	7.75	5.43
N. Dakota	653	7.20	5.05
S. Dakota	691	7.38	5.93
Nebraska	1,570	7.26	5.86
Kansas	2,364	7.32	5.63
South Atlantic	36,959	7.48	4.34
Delaware	594	6.23	3.87
Maryland	4,217	5.86	3.51
D.C.	638	7.21	4.39
Virginia	5,347	5.95	3.50
W. Virginia	1,950	7.54	4.67
N. Carolina	5,882	6.60	3.67
S. Carolina	3,122	6.09	3.14
Georgia	5,463	6.06	3.40
Florida	9,746	10.87	6.43
East South Central	14,666	7.02	4.27
Kentucky	3,661	6.80	4.40
Tennessee	4,591	7.04	4.25
Alabama	3,894	7.14	4.16
Mississippi	2,521	7.14	4.32
West South Central	23,747	6.70	3.98
Arkansas	2,286	8.40	5.25
Louisiana	4,206	6.06	3.54
Oklahoma	3,025	7.44	4.99
Texas	14,229	5.95	3.68
Mountain	11,373	5.91	3.42
Montana	787	6.61	4.19
Idaho	944	6.14	3.71
Wyoming	470	4.89	2.98
Colorado	2,890	5.16	3.42
New Mexico	1,303	5.76	3.15
Arizona	2,718	7.43	3.86
Utah	1,461	4.65	2.81
Nevada	800	5.75	2.50
Pacific	31,800	6.21	3.96
Washington	4,132	6.36	4.07
Oregon	2,633	7.03	4.52
California	23,668	6.22	3.98
Alaska	402	1.97	0.75
Hawaii	965	5.07	2.80

III. PREVALENCE OF DEPENDENCY

TABLE 13. Hierarchical Ordering of HIS and NNHS Respondents Aged 65 Years and Over by Type of Dependency
	HIS	NNHS
Proportion of those dependent in eating who are also dependent in:
Toileting	83.8%	73.8%
Dressing	91.5	95.8
Bathing	95.0	99.3
Mobility	90.9	95.3
Proportion of those dependent in toileting who are also dependent in:
Dressing	91.4	94.5
Bathing	94.2	98.6
Mobility	93.1	93.9
Proportion of those dependent in dressing who are also dependent in:
Bathing	85.8	98.8
Mobility	82.9	88.2
Proportion of those dependent in bathing who are also dependent in:
Mobility	83.9	82.3
SOURCE: 1977 HIS and 1977 NNHS.

TABLE 14. Numbers of Noninstitutionalized Dependent Persons and Rates of Dependency by Age Group (1979)
Age	Personal Care¹		Mobility²		Household Activities³		Health Services⁴		Total Dependent
Age	Number	Percent	Number	Percent	Number	Percent	Number	Percent	Number	Percent
0-64	898,000	0.5	268,300	0.1	966,300	0.5	659,000	0.3	2,791,600	1.5
65-74	370,000	2.5	206,700	1.4	431,500	2.9	90,000	0.6	1,098,200	7.4
75+	710,800	8.5	336,300	4.0	708,200	8.4	107,500	1.3	1,862,800	22.1
Total	1,978,800	0.9	811,300	0.4	2,106,000	1.0	856,500	0.4	5,752,600	2.7
65+	1,080,800	4.6	543,100	2.3	1,139,700	4.9	197,500	0.8	2,961,000	12.7
SOURCE: 1979 HIS. Self-reported or caretaker reported need for human assistance in bathing, dressing, toileting, eating or a combination of these and other activities. (Caretakers were the respondents for 45.2 percent of the individuals aged 65 years and over surveyed who reported dependency in personal care.) Self-reported or caretaker reported need for human assistance in walking or going outside or a combination of these and other activities other than personal care as defined above. (Caretakers were the respondents for 30.8 percent of the individuals surveyed aged 65 years and over who reported dependency in mobility.) Self-reported or caretaker reported need for human assistance in meal preparation, shopping, chores other than yard work, handling money or a combination of these and other activities excluding personal care and mobility as defined above. (Caretakers were the respondents for 21.6 percent of the combined group suffering dependency in household activities or health services administration, defined below.) Self-reported or caretaker reported need for human assistance in administration of a variety of home administered health services (most predominantly injections). Individuals may suffer additional dependencies, excluding personal care, mobility or household activities as defined above. (Caretakers were the respondents for 21.6 percent of the combined group suffering dependency in household activities or health services administration. For persons aged 65 years and over suffering none of the dependencies shown in this table, caretakers were the respondents in 21.7 percent of cases.

TABLE 15. Percent Standard Errors for Table 14
Population Size	Prevalence Rate
Population Size	1%	5%	10%	15%	20%
100,000	100	100	100	100	100
250,000	100	100	90	80	75
500,000	100	85	60	18	40
1,000,000	100	60	42	13	27
1,500,000	90	50	35	11	23
2,000,000	75	45	30	10	20
3,000,000	65	35	24	8.5	16
5,000,000	53	27	19	6.5	12
EXAMPLE: If a rate of dependency is 5% and it corresponds to a population of 2 million the Standard Error would be 45% or 900,000. SOURCE: Calculated from Vital and Health Statistics, Series 10, No. 136, Current Estimates from the National Health Interview Survey: United States, 1979, DHHS, Pub. No. (PHS) 81-1564, National Center for Health Statistics, Hyattsville, Maryland, April 1981, Figure IX, p. 56.

TABLE 16. Comparison of 1977 and 1979 Health Interview Survey Dependency Rates Among the Noninstitutionalized Aged
Dependency	1977 HIS Percent	1979 HIS Percent
No personal care help needed	95.1	95.6
Bathing	1.6	1.3
Dressing	1.5	1.2
Toileting	0.8	1.1
Eating	1.0	0.8
TOTAL	100.0	100.0
SOURCE: 1977 HIS and 1979 HIS.

TABLE 17. Comparison of HIS and Framingham Disability Study¹ Estimates of Dependency² Among the Noninstitutionalized Aged for Comparable Items
Age	Eating		Transferring		Bathing		Dressing		Walking
Age	Framingham	HIS	Framingham	HIS	Framingham	HIS	Framingham	HIS	Framingham	HIS
65-74	0%	0.4%³	0%	0.9%	1%	2.0%	1%	1.4%	1%	3.9%
75-84	0%	0.8%³	2%	2.6%	4%	5.1%	2%	3.3%	7%	8.4%
SOURCE: 1979 HIS and Framingham Disability Study. The Framingham data come from the third wave of the Massachusetts Health Care Panel study, a longitudinal investigation of the health and social needs of the noninstitutionalized elderly. The analyses are based on personal interviews conducted in the fall of 1980 with 825 survivors of the original panel (1,625 respondents, an 85% completion rate of the then-eligible members of the cohort). Members were all over the age of 70. NOTES: Jette and Branch, 1981. Needs help from another person and/or special equipment. Due to small sample sizes, the reliability of these estimates may be affected. Sample sizes are 58,200 for ages 65-74, and 57,800 for ages 75-84, which represent 29.2 and 29.0 unweighted cases, respectively.

TABLE 18. Number¹ and Percent of Noninstitutionalized Aged Who Are Unmarried, Live Alone or Are Poor by Dependency Level
	Personal Care Dependent²			Other Dependencies³			Independent
	Number	Percent	% of All Elderly	Number	Percent	% of All Elderly	Number	Percent	% of All Elderly
Unmarried	542,600	50.9	2.3	1,280,800	67.7	5.5	8,593,200	42.3	36.9
Lives Alone	175,200	16.4	0.8	717,500	37.9	3.1	5,928,600	29.2	25.4
Poor	252,700	23.7	1.1	713,900	37.7	3.1	4,405,200	21.7	18.9
SOURCE: 1979 HIS. NOTES: Percent standard error of many of these estimates is quite large. See Table 21A. Includes those who need assistance in eating, continence, transferring, toileting, bathing and dressing. Includes those who need assistance in walking, going outside, meal preparation, money management, household chores, shopping or administration of home delivered health services. (Help needed with infections was the most frequently reported health services dependency.)

TABLE 19. Numbers¹ of Persons and Rates of Dependency² by Race and Sex for Two Age Groups of the Noninstitutionalized Aged
Race/Sex	All Dependencies				Total
	65-74		75+		Total
	Number	Percent	Number	Percent	Number	Percent
Non-White Female	111,100	13.4	137,100	30.1	248,100	19.3
Non-White Male	72,100	11.1	58,000	19.1	130,700	13.6
White Female	594,500	7.8	1,164,400	24.0	1,758,900	14.1
White Male	318,600	5.5	500,700	17.8	819,300	9.5
TOTAL	1,096,300	7.3	1,860,800	22.1	2,957,100	12.7
SOURCE: 1979 HIS. NOTES: Percent standard error of many of these estimates is quite large See Table 21A. Includes dependency in personal care (ADL), mobility, household activities and health services.

TABLE 20. Comparison of Metropolitan Residence in 1977 for Non-institutionalized Persons Needing Mobility or Personal Care Assistance and U.S. Civilian Population (Numbers in Millions, Percent of Total in Parentheses)
	Mobility		Personal Care		U.S. Civilian Population (6/1/77 estimate)
	Needs Help Outside House	Needs Help Inside House	Needs Help Bathing or Dressing	Needs Help Toileting or Eating	U.S. Civilian Population (6/1/77 estimate)
Living in Metropolitan Area	1.194 (68.5)	0.141 (66.8)	0.721 (66.5)	0.398 (60.6)	158.6 (73.3)
Living in Non-Metropolitan Area	0.550 (31.5)	0.070 (33.2)	0.364 (33.5)	0.259 (39.4)	57.8 (26.7)
All Persons	1.745 (100.0)	0.211 (100.0)	1.085 (100.0)	0.657 (100.0)	216.4 (100.0)
SOURCES: Persons need mobility or personal care assistance--date from 1977 Health Interview Survey; U.S. Civilian Population--*Current Population Reports* Series P-20 No. 336 “Population Characteristics,” U.S. Bureau of the Census, April 1979. Totals may not add to 100 percent due to rounding. See Table for description of hierarchial ordering of respondent by type of dependency.

TABLE 21. Number and Percent of Americans in 1977 Suffering Dependency in Personal Care or Mobility by Community Versus Nursing Home Residency
	Mobility		Personal Care		Total
	Needs Help Outside House	Needs Help Inside House	Needs Help Bathing or Dressing	Needs Help Toileting or Eating	Total
Lives in Community	1,744,500 (98.1)	211,000 (97.9)	1,084,700 (69.9)	656,900 (49.5)	3,697,100 (75.9)
Lives in Nursing Homes	33,800 (1.9)	4,500 (2.1)	467,400 (30.0)	671,300 (50.5)	1,177,000* (24.1)
TOTAL	1,778,300 (100)	215,500 (100)	1,552,100 (100)	1,328,100 (100)	4,874,100 (100)
SOURCE: Merger of the 1977 Health Interview Survey and the 1977 National Nursing Home Survey. Entries may not equal totals due to rounding. NOTE: Persons are classified by their most severe dependency, i.e., those who suffer dependency in toileting or eating may also be dependent in any other activity; those dependent in bathing or dressing may also be depending in any other activity except toileting or feeding; those dependent inside the house may also be dependent outside the house but are not dependent in personal care; and those dependent in mobility outside the house are dependent in no other activity included in this table. * Excludes 125,700 institutionalized persons who suffer no personal care or mobility dependency. (See Table 6 and text).

TABLE 22. Synthetic Estimates of Prevalence Rates for Personal Care and Mobility Dependency
State	Total 1980 Population	Personal Care Assistance		Mobility Assistance		Total
State	Total 1980 Population	Number	Percent	Number	Percent	Number	Percent
Alabama	3,890,061	51,844	1.3	35,869	.9	87,713	2.2
Alaska	400,481	2,079	.5	1,646	.4	3,725	.9
Arizona	2,717,866	34,616	1.3	24,353	.9	58,969	2.2
Arkansas	2,285,513	36,165	1.6	24,406	1.1	60,571	2.7
California	23,668,562	306,802	1.3	211,388	.9	518,190	2.2
Colorado	2,888,834	33,322	1.2	22,932	.8	56,254	2.0
Connecticut	3,107,576	46,303	1.5	31,532	1.0	77,835	2.5
Delaware	595,225	7,590	1.3	5,270	.9	12,860	2.2
D.C.	637,651	8,991	1.4	6,195	1.0	15,186	2.4
Florida	9,739,992	180,372	1.9	122,686	1.3	303,058	3.2
Georgia	5,464,265	63,248	1.2	44,425	.8	107,673	2.0
Hawaii	965,000	9,814	1.0	7,069	.7	16,883	1.7
Idaho	943,935	11,747	1.2	8,012	.9	19,759	2.1
Illinois	11,418,461	158,235	1.4	108,032	1.0	266,267	2.4
Indiana	5,490,179	74,445	1.4	50,688	.9	125,133	2.3
Iowa	2,913,387	50,466	1.7	32,759	1.1	83,225	2.8
Kansas	2,363,208	39,270	1.7	25,768	1.1	65,038	2.8
Kentucky	3,661,433	50,147	1.4	34,209	.9	84,356	2.3
Louisiana	4,203,972	49,236	1.2	34,315	.8	83,551	2.0
Maine	1,124,660	17,679	1.6	11,771	1.1	29,450	2.0
Maryland	4,216,446	50,515	1.2	35,586	.8	86,101	2.0
Massachusetts	5,737,037	91,923	1.6	61,367	1.1	153,290	2.7
Michigan	9,258,344	116,806	1.3	80,601	.9	197,407	2.2
Minnesota	4,077,148	62,737	1.5	41,287	1.0	104,024	2.5
Mississippi	2,520,638	34,225	1.4	23,310	.9	57,535	2.3
Missouri	4,917,444	79,234	1.6	52,928	1.1	132,162	2.7
Montana	786,690	10,834	1.4	7,301	.9	18,135	2.3
Nebraska	1,570,006	26,744	1.7	17,352	1.1	44,096	2.8
Nevada	799,184	7,886	1.0	5,898	.7	13,784	1.7
New Hampshire	920,610	12,932	1.4	8,770	1.0	21,702	2.4
New Jersey	7,364,158	105,297	1.4	72,890	1.0	178,187	2.4
New Mexico	1,299,968	14,288	1.1	10,054	.8	24,342	1.9
New York	17,557,288	266,060	1.5	181,104	1.0	447,164	2.5
North Carolina	5,874,429	72,358	1.2	50,898	.9	123,256	2.1
North Dakota	652,695	10,038	1.5	6,631	1.0	16,669	2.5
Ohio	10,797,419	148,488	1.4	101,558	.9	250,046	2.3
Oklahoma	3,025,266	45,678	1.5	30,751	1.0	76,429	2.5
Oregon	2,632,663	37,562	1.4	25,444	1.0	63,006	2.4
Pennsylvania	11,866,728	183,453	1.6	125,715	1.1	309,168	2.7
Rhode Island	947,154	15,555	1.6	10,459	1.1	26,014	2.7
South Carolina	3,119,208	34,592	1.1	24,636	.8	59,228	1.9
South Dakota	690,178	11,820	1.7	7,656	1.1	19,476	2.8
Tennessee	4,590,750	62,024	1.4	42,845	.9	104,869	2.3
Texas	14,228,383	170,780	1.2	118,236	.8	289,016	2.0
Utah	1,461,037	14,357	1.0	9,910	.7	24,267	1.7
Vermont	511,456	7,461	1.5	4,974	1.0	12,435	2.5
Virginia	5,346,279	63,596	1.2	44,706	.8	108,302	2.0
Washington	4,130,163	54,993	1.3	37,543	.9	92,536	2.2
West Virginia	1,949,644	28,325	1.5	19,407	1.0	47,732	2.5
Wisconsin	4,705,335	70,963	1.5	47,369	1.0	118,332	2.5
Wyoming	470,816	4,999	1.1	3,456	.7	8,455	1.8
TOTAL		3,148,894	1.4	2,153,967	1.0	5,302,861	2.3
NOTE: There is no way to validate synthetic estimates. They are developed by assigning the prevalence rates of the dependent variable (dependency) found in demographic subgroups of a national survey to subgroup data available at the state level. Although efforts were made in the methodology employed for these estimates to adjust for sampling error variations among subgroups, there is no way to validate the implicit assumption that the correlations found in the national data between the classification variables and the dependent variable hold equally for all states. This is especially true for retirement states such as Florida, where the aged population is probably more healthy than in other states. That is, much of the Florida elderly population migrated from other states, possibly reflecting health and economic status characteristics which make them different from those who did not migrate. As alternative data bases are used to develop the national relationships, estimates are likely to vary somewhat. This is reflected in the following two tables which compare estimates produced by reliance first upon a merger of the 1977 National Health Interview Survey and the 1977 National Nursing Home Survey, and secondly, upon states mortality tables. For a more complete discussion of these issues see: Alan Unger and William Weissert, “Data for Long-Term Care Planning: Application of a Synthetic Estimation Technique,” Urban Institute Working Paper No. 1466-24, revised May 1983.

TABLE 23. Comparison Between Age and Mortality Based Synthetic Estimates of Prevalence Rates for Personal Care Dependency¹ Aged Only (65 and over)
State	Total 1980 Population	Age-Based Model		Mortality-Based Model
State	Total 1980 Population	Number	Percent	Number	Percent
Alabama	439,938	38,234	8.69	35,647	8.10
Alaska	11,530	834	7.23	811	7.03
Arizona	306,971	25,102	8.18	18,563	6.05
Arkansas	312,331	28,138	9.00	24,564	7.86
California	2,414,725	223,184	9.24	188,815	7.82
Colorado	247,151	23,591	9.55	20,060	8.11
Connecticut	364,864	34,690	9.51	30,243	8.29
Delaware	59,284	5,429	9.16	5,186	8.75
D.C.	77,202	6,698	8.68	6,458	8.70
Florida	1,684,972	144,394	8.57	105,595	6.27
Georgia	516,814	44,480	8.61	40,856	7.91
Hawaii	76,230	6,428	8.43	4,263	5.59
Idaho	93,680	8,565	9.14	6,724	7.18
Illinois	1,161,160	117,494	10.12	115,125	9.13
Indiana	585,425	55,119	9.42	53,671	9.17
Iowa	387,498	40,312	10.40	34,809	8.98
Kansas	306,179	31,010	10.10	26,202	8.56
Kentucky	409,853	37,463	9.14	36,097	8.81
Louisiana	403,939	35,008	8.67	33,935	8.40
Maine	140,918	13,725	9.74	12,397	8.80
Maryland	395,594	35,281	8.92	32,977	8.34
Massachusetts	726,531	71,207	9.80	63,183	8.70
Michigan	912,321	84,051	9.21	80,250	8.80
Minnesota	479,746	48,815	10.18	38,958	8.12
Mississippi	289,352	25,726	8.89	24,154	8.34
Missouri	648,289	61,861	9.54	57,539	8.88
Montana	84,559	8,100	9.58	7,576	8.96
Nebraska	205,576	21,379	10.40	18,348	8.93
Nevada	65,767	4,946	7.52	4,498	6.84
New Hampshire	102,967	9,715	9.44	8,712	8.46
New Jersey	794,666	77,645	9.77	74,554	8.67
New Mexico	115,690	9,883	8.54	7,762	6.71
New York	2,160,558	201,672	9.33	189,865	8.79
North Carolina	602,273	51,499	8.55	44,417	7.37
North Dakota	80,447	7,835	9.74	6,644	8.26
Ohio	1,169,437	109,514	9.36	107,324	9.18
Oklahoma	376,042	35,158	9.08	32,235	8.57
Oregon	303,294	28,340	9.34	23,915	7.89
Pennsylvania	1,531,107	138,675	9.06	136,863	8.94
Rhode Island	126,922	12,047	9.49	10,896	8.59
South Carolina	287,287	23,735	8.26	21,268	7.40
South Dakota	91,014	9,447	10.38	7,828	8.60
Tennessee	517,524	45,825	8.85	40,295	7.79
Texas	1,371,040	122,596	8.94	106,749	7.79
Utah	109,220	9,750	8.92	8,186	7.49
Vermont	58,166	5,718	9.83	5,039	8.67
Virginia	505,204	44,646	8.84	41,034	8.12
Washington	431,417	40,552	9.40	34,023	7.89
West Virginia	237,868	21,299	8.95	21,210	8.92
Wisconsin	564,228	54,625	9.68	47,428	8.41
Wyoming	37,218	3,452	9.28	3,116	8.37
SOURCE: 1980 Unpublished U.S. Census Data. See notes from previous table.

TABLE 24. Comparison Between Age and Mortality Based Synthetic Estimates of Prevalence Rates for Mobility Dependency¹ Aged Only (65 and over)
State	Total 1980 Population	Age-Based Model		Mortality-Based Model
State	Total 1980 Population	Number	Percent	Number	Percent
Alabama	439,938	23,312	5.30	22,412	5.09
Alaska	11,530	535	4.64	537	4.66
Arizona	306,971	15,591	5.08	12,803	4.17
Arkansas	312,331	16,985	5.44	15,496	4.96
California	2,414,725	133,539	5.53	1,118,015	4.89
Colorado	247,151	13,981	5.66	12,245	4.95
Connecticut	364,864	20,570	5.64	18,602	5.10
Delaware	59,284	3,254	5.49	3,184	5.37
D.C.	77,202	4,033	5.22	4,038	5.44
Florida	1,684,972	88,644	5.26	72,070	4.28
Georgia	516,814	27,173	5.26	26,195	5.07
Hawaii	76,230	3,947	5.18	2,933	3.85
Idaho	93,680	5,136	5.48	4,326	4.62
Illinois	1,161,160	70,174	6.04	69,087	5.48
Indiana	585,425	32,828	5.61	32,218	5.50
Iowa	387,498	23,368	6.03	20,673	5.33
Kansas	306,179	18,112	5.92	15,711	5.13
Kentucky	709,853	22,523	5.50	22,059	5.38
Louisiana	403,939	21,373	5.29	21,352	5.28
Maine	140,918	8,103	5.75	7,492	5.32
Maryland	395,594	21,327	5.39	20,728	5.24
Massachusetts	726,531	36,442	5.02	38,334	5.28
Michigan	912,321	50,333	5.52	48,738	5.34
Minnesota	479,746	28,468	5.93	23,918	4.99
Mississippi	289,352	15,587	5.39	15,150	5.24
Missouri	648,289	36,757	5.67	34,819	5.37
Montana	84,559	7,789	5.66	4,460	5.27
Nebraska	205,576	12,396	6.03	10,901	5.30
Nevada	65,767	3,141	4.78	2,957	4.50
New Hampshire	102,967	5,783	5.62	5,323	5.17
New Jersey	794,666	46,785	5.89	45,340	5.27
New Mexico	115,690	6,048	5.23	5,085	4.40
New York	2,160,558	120,515	5.58	115,275	5.33
North Carolina	602,273	31,519	5.23	29,108	4.83
North Dakota	80,447	4,622	5.75	4,019	5.00
Ohio	1,169,437	65,289	5.58	64,555	5.52
Oklahoma	376,042	21,011	5.59	19,694	5.23
Oregon	303,294	16,894	5.57	14,908	4.92
Pennsylvania	1,531,107	83,496	5.45	83,076	5.42
Rhode Island	126,922	7,160	5.64	6,688	5.27
South Carolina	287,287	14,667	5.11	14,107	4.91
South Dakota	91,014	5,481	6.0	4,723	5.19
Tennessee	517,524	27,792	5.37	25,786	4.98
Texas	1,371,040	74,153	5.41	67,716	4.94
Utah	109,220	5,899	5.40	5,136	4.70
Vermont	58,166	3,367	5.79	3,064	5.27
Virginia	505,204	27,054	5.35	25,965	5.14
Washington	431,417	24,085	5.58	21,091	4.89
West Virginia	237,868	12,875	5.41	12,875	5.41
Wisconsin	564,228	32,290	5.72	28,951	5.13
Wyoming	37,218	2,060	5.53	1,901	5.11
SOURCE: 1980 Unpublished U.S. Census Data. See notes from previous table.

IV. ECONOMIC STATUS OF THE ELDERLY AND IMPAIRED

TABLE 25. Distribution of Income by Family Characteristics for Families with Head Aged 65 and Over (1976 data)
Family Characteristics	Income Class (1976 dollars)
Family Characteristics	Up to $5,000	$5,000-10,000	$10,000-15,000	$15,000 or above
HEAD AGED 65-74
Single Person Household
Percent of families	64.5	25.8	5.8	3.9
Mean Income	$2,959	$6,901	$12,079	$23,338
Mean Wages	$155	$1189	$2758	$6,234
Wage as % of Income	5.3	17.2	22.8	26.7
Two Person Household
Percent of families	18.8	40.8	19.2	21.2
Mean Income	$3,675	$7,296	$12,334	$26,404
Mean Wages	$207	$949	$3,339	$9,395
Wage as % of income	5.6	13.0	27.1	35.6
HEAD AGED 75 OR ABOVE
Single Person Household
Percent of families	76.5	17.3	3.2	3.0
Mean Income	$2,830	$6,820	$12,025	$25,962
Mean Wages	$34	$263	$888	$3,333
Wage as % of income	1.2	3.9	7.4	12.8
Two Person Household
Percent of families	29.1	44.3	13.5	13.1
Mean Income	$3,652	$7,000	$12,027	$27,560
Mean Wages	$63	$381	$1,047	$3,915
Wage as % of income	1.7	5.4	8.7	14.2
SOURCE: Survey of Income and Education.

TABLE 26. Distribution of Income for Elderly Couples and Individuals by Age of Head (1976 Data)
Income Level	Age of Head
Income Level	65-69	70-74	75-79	80-84	85 and Above
$2500 and less	11.7%	12.3%	16.7%	22.1%	29.1%
$2501 - 5000	24.4	32.5	37.1	39.5	41.0
$5001 - 10,000	33.3	34.5	29.6	27.1	20.3
$10,000 - 15,000	15.0	10.5	8.6	5.3	4.8
$15,001 and above	15.5	10.3	8.0	5.9	4.7
TOTAL	100.0%	100.0%	100.0%	100.0%	100.0%
SOURCE: Survey of Income and Education.

TABLE 27. Percentage of Homeowners by Income and Family Characteristics (1976 data)
Family Characteristics	Income Class
Family Characteristics	Up to $5,000	$5,000-10,000	$10,000-15,000	$15,000 or above
Head Aged 65-74
Single Person Household	54.8	64.0	70.1	63.1
Two Person Household	76.5	83.7	85.2	85.2
Head Aged 75 and Above
Single Person Household	56.7	63.8	60.7	73.1
Two Person Household	76.6	80.7	83.9	80.0
SOURCE: Survey of Income and Education.

TABLE 28. Average Interest and Dividend Income by Income and Family Characteristics (1976 data)
Family Characteristics	Income Class
Family Characteristics	Up to $5,000	$5,000-10,000	$10,000-15,000	$15,000 or above
Head Aged 65-74
Single Person Household	$278	$1515	$3636	$9,317
Two Person Household	235	866	1,907	6,783
Head Aged 75 and Above
Single Person Household	317	2,227	4,635	12,791
Two Person Household	255	1,043	3,286	10,094
SOURCE: Survey of Income and Education.

TABLE 29. Mean Resources of Elderly by Age and Family Size Using Alternative Definitions of Resources (1976 data)
Resource Definition	Age of Head
Resource Definition	65-69	70-74	75-79	80-84	85%	All Elderly
Elderly Persons Living Alone
Income Minus Earnings	4052	4509	4277	3895	3950	4191
Income Minus Earnings Plus Food Stamps	4072	4523	4292	3909	3969	4207
Income Minus Earnings Plus Food Stamps and Partial 10 year annuity*	4959	5620	5309	4791	5159	5204
Income Minus Earnings Plus Food Stamps and full 10 year annuity*	6324	6993	6594	6001	6272	6508
Elderly Couple
Income Minus Earnings	7075	8051	7831	8028	6671	7438
Income Minus Earnings Plus Food Stamps	7090	8065	7846	8042	6681	7452
Income Minus Earnings Plus Food Stamps and partial 10 year annuity*	8855	10117	9743	10377	8245	9323
Income Minus Earnings Plus Food Stamps and Full 10 year annuity*	11676	12847	12230	12742	10438	11986
SOURCE: Survey of Income and Education. * Partial annuity is based on all assets other than the home. Full annuity includes net worth of home in calculations.

TABLE 30. Distribution of Resources Among Nonworking Individuals Living Alone by Age Using Alternative Definitions of Resources (1976 Data)
Resource Level	Income	Income Minus Earnings Plus Food Stamps and Partial 10 Year Annuity*	Income Minus Earnings Plus Food Stamps and Full 5 Year Annuity*
Individuals Aged 65 through 74
$2,500 or less	27.6%	24.2%	16.8%
$2,501 to $5,000	44.4	41.9	28.9
$5,001 to $10,000	21.4	22.0	24.5
$10,001 to $15,000	4.4	7.0	12.9
$15,000 and above	2.2	4.9	16.9
TOTAL	100.0	100.0	100.0
Individuals Aged 75 and Above
$2,500 or less	32.8%	28.9%	19.4%
$2,501 to $5,000	47.2	44.4	30.6
$5,001 to $10,000	15.7	17.8	25.6
$10,001 to $15,000	2.5	5.4	11.2
$15,000 and above	1.8	3.6	13.2
TOTAL	100.0	100.0	100.0
SOURCE: Survey of Income and Education. * Partial annuity is based on all assets except the home. Full annuity includes net worth of home in calculations.

TABLE 31. Percentage of Income Available for Discretionary Purposes by Age and Household Characteristics
Family Characteristics	Income Class (1976 Dollars)*
Family Characteristics	Up to $2,500	$2,500-5,000	$5,000-10,000	$10,000-15,000	$15,000 or above
Head Aged 65-74
Single Person Household	1%	33%	52%	69%	77%
Two Person Household	0	23	52	64	75
Head Aged 75 and Above
Single Person Household	9	30	57	68	83
Two Person Household	0	32	55	68	77
SOURCE: Survey of Consumer Expenditures. * Information is based on 1973 data but expressed in 1976 dollars. The inflator used is median income of persons 65 and over.

TABLE 32. Average Income of Families with Impaired Persons by Definition of Impairment and Relationship of Impaired Persons to Family Head (1976 Data)
Relationship of Impaired Person to Family Head	Definition of Impairment
Relationship of Impaired Person to Family Head	Needs Help With Personal Care	Has Problems With Mobility	Has Either Personal Care or Mobility Problems
Head	$9,420	$9,449	$9,537
Wife	10,789	11,294	11,310
Child	13,273	13,363	13,181
Other Relative	13,574	13,921	13,566
Primary Individual	3,972	3,834	3,885
ALL PERSONS	10,531	9,983	10,073
SOURCE: Survey of Income and Education

TABLE 33. Distribution of Resources and Average Resources by Alternative Definitions for All Families With Impaired Members (1976 Data)
Family Resource Level	Income	Income Minus Earnings of Impaired Person	Income Minus Earnings Plus Food Stamps and Partial Annuity*	Income Minus Earnings Plus Food Stamps and Full Annuity*
$2,500 and less	13.1%	15.3%	12.8%	9.8%
$2,501 to $5,000	23.3	23.9	23.4	19.3
$5,001 to $7,500	16.1	16.1	16.1	14.7
$7,501 to $10,000	11.4	11.1	11.5	11.9
$10,001 to $15,000	14.8	14.4	15.1	16.8
$15,001 and above	21.3	19.2	21.2	27.5
TOTAL	100.0	100.0	100.0	100.0
AVERAGE	$10,073	$9,447	$10,340	$12,112
SOURCE: Survey of Income and Education. * Partial annuity is based on all assets except the home. Full annuity includes net worth of home in calculations. Annuities are assured to have a 10-year term.

TABLE 34. Average Family Resource Levels and Family Size by Age and Relationship to Head of Impaired Persons (1976 Data)
Relationship to Head and Age of Impaired Person	Income	Income Minus Impaired Person Earnings	Income Minus Earnings Plus Food Stamps and Partial Annuity*	Income Minus Earnings Plus Food Stamps and Full Annuity*	Average Family Size
Head or Spouse	$10,223	$9,247	$10,211	$12,105	2.8
Age 44 and under	10,582	8,234	8,722	9,931	4.2
45 to 64	11,965	10,370	11,132	13,172	3.0
65 to 74	9,072	8,718	9,784	11,724	2.4
75 and above	8,726	8,606	9,954	11,891	2.3
Child	13,181	12,783	13,566	15,429	4.4
Other Relative	13,565	13,316	14,312	16,479	3.2
64 and under	10,274	9,574	10,184	11,733	3.1
65 and above	14,655	14,558	15,682	18,055	3.3
Primary Individual	3,885	3,557	4,246	5,247	1.0
64 and under	3,929	2,957	3,244	4,046	1.0
65 and above	3,872	3,757	4,578	5,645	1.0
All Persons	10,072	9,448	10,339	12,110	2.8
SOURCE: Survey of Income and Education. * Partial annuity is based on all assets except the home. Full annuity includes new worth of home in calculations. Annuities are assured to have a 10-year term.

TABLE 35. Distribution of Resources by Alternative Definitions of Resources When Impaired Person is Head or Spouse Under Age 65 (1976 Data)
Family Resource Level	Income	Income Minus Earnings of Impaired Person	Income Minus Earnings Plus Food Stamps and Partial Annuity*	Income Minus Earnings Plus Food Stamps and Full Annuity*
$2,500 and less	5.0%	10.4%	8.1%	5.6%
$2,501 - $5,000	19.0	21.4	20.5	17.2
$5,001 - $7,500	13.5	14.5	15.9	14.3
$7,501 - $10,000	15.1	14.6	14.0	13.1
$10,000 - $15,000	19.5	18.3	19.4	20.4
$15,001 and above	27.8	20.6	22.0	29.4
TOTAL	100.0	100.0	100.0	100.0
SOURCE: Survey of Income and Education. * Partial annuity is based on all assets except the home. Full annuity includes net worth of home in calculations. Annuities are assured to have a 10-year term.

TABLE 36. Distribution of Resources by Alternative Definitions of Resources When Impaired Person is Head or Spouse Aged 65 or Over (1976 Data)
Family Resource Level	Income	Income Minus Earnings of Impaired Person	Income Minus Earnings Plus Food Stamps and Partial Annuity*	Income Minus Earnings Plus Food Stamps and Full Annuity*
$2,500 and less	3.3%	3.7%	3.0%	2.2%
$2,501 - $5,000	28.0	18.8	25.8	17.4
$5,001 - $7,500	27.1	27.4	25.4	19.6
$7,501 - $10,000	14.8	14.7	15.5	17.1
$10,000 - $15,000	13.9	13.6	14.9	19.6
$15,001 and above	12.9	12.4	15.5	24.1
TOTAL	100.0	100.0	100.0	100.0
SOURCE: Survey of Income and Education. * Partial annuity is based on all assets except the home. Full annuity includes net worth of home in calculations. Annuities are assured to have a 10-year term.

TABLE 37. Distribution of Resources by Alternative Definitions of Resources When Impaired Person is Child or “Other” Relative¹ of Household Head (1976 Data)
Family Resource Level	Income	Income Minus Earnings of Impaired Person	Income Minus Earnings Plus Food Stamps and Partial Annuity²	Income Minus Earnings Plus Food Stamps and Full Annuity²
$2,500 and less	9.2%	10.1%	8.0%	5.8%
$2,501 - $5,000	12.4	12.3	12.2	10.9
$5,001 - $7,500	14.3	14.3	14.5	12.3
$7,501 - $10,000	10.8	11.0	11.4	10.3
$10,000 - $15,000	19.2	19.1	18.7	18.9
$15,001 and above	34.2	33.3	35.3	41.9
TOTAL	100.0	100.0	100.0	100.0
SOURCE: Survey of Income and Education. “Other” relative means a relative other than wife or child. In most cases this will be a parent of the head or spouse. Partial annuity is based on all assets except the home. Full annuity includes net worth of home in calculations. Annuities are assured to have a 10-year term.

TABLE 38. Distribution of Resources by Alternative Definitions of Resources When Impaired Person Lives Alone (1976 Data)
Family Resource Level	Income	Income Minus Earnings of Impaired Person	Income Minus Earnings Plus Food Stamps and Partial Annuity*	Income Minus Earnings Plus Food Stamps and Full Annuity*
$2,500 and less	41.0%	44.4%	38.7%	31.0%
$2,501 - $5,000	41.6	41.3	43.6	38.8
$5,001 - $7,500	8.4	7.1	7.5	13.7
$7,501 - $10,000	3.8	2.9	3.7	6.9
$10,000 - $15,000	3.1	2.6	3.7	5.3
$15,001 and above	2.0	1.7	2.7	4.3
TOTAL	100.0	100.0	100.0	100.0
SOURCE: Survey of Income and Education. * Partial annuity is based on all assets except the home. Full annuity includes net worth of home in calculations. Annuities are assured to have a 10-year term.

TABLE 39. Distribution of Resources Among Nonworking Elderly Couples by Age Using Alternative Definitions of Resources (1976 Data)
Resource Level	Income	Income Minus Earnings Plus Food Stamps and Partial 10 Year Annuity*	Income Minus Earnings Plus Food Stamps and Full 5 Year Annuity*
Couples with Head Aged 65 through 74
$2,500 or less	2.6%	1.9%	1.9%
$2,501 to $5,000	24.7	22.3	11.4
$5,001 to $10,000	48.4	44.2	24.0
$10,000 to $15,000	14.4	15.9	22.2
$15,000 and above	9.9	15.8	41.2
TOTAL	100.0	100.0	100.0
Couples with Head Aged 75 and Above
$2,500 or less	3.4	3.1	1.7
$2,501 to $5,000	29.8	26.3	13.4
$5,001 to $10,000	46.4	43.8	27.6
$10,000 to $15,000	12.0	12.6	22.1
$15,000 and above	8.3	14.2	35.1
TOTAL	100.0	100.0	100.0
SOURCE: Survey of Income and Education. * Partial annuity is based on all assets except the home. Full annuity includes net worth of home in calculations.

TABLE 40. Distribution of Income for Elderly Couples and Individuals Without Earnings by Age of Head (1976 Data)
Income Level	Age of Head
Income Level	65-69	70-74	75-79	80-84	85 and Above
$2500 and less	18.5%	15.5%	19.5%	24.5%	31.1%
$2501 - 5000	33.2	38.3	41.2	41.3	41.9
$5001 - 10,000	33.4	32.7	27.9	25.9	20.0
$10,000 - 15,000	9.3	8.2	7.1	4.4	3.8
$15,001 and above	5.7	5.4	4.4	3.9	3.1
TOTAL	100.0%	100.0%	100.0%	100.0%	100.0%
SOURCE: Survey of Income and Education.

TABLE 41. Mean Resources of Elderly by Age and Family Size for Two Combined Definitions of Resources* (1976 Data)
Family Characteristics	Alternative 1 Using Only Nonearners	Alternative 2 Using Income Minus Earnings
Head Aged 65-74
Single Person Household	$6,882	$6,649
Two Person Household	5,748	3,875
Head Aged 75 and Above
Single Person Household	6,439	6,176
Two Person Household	4,627	4,690
SOURCE: Survey of Income and Education and Survey of Consumer Expenditures. * These definitions use 10 year annuities. For the single person households the full annuity is used and no adjustments are made for necessary expenditures. For couples, the partial 10 year annuity is used and necessities are subtracted from the measure. See the test for additional details.

TABLE 42. Mean Resources of Nonworking Elderly by Family by Family Size and Selected Characteristics Using Alternative Definitions of Resources (1976 data)
Resource Definition	Homeownership Status		Race		Sex
Resource Definition	Own	Rent	White	Other	Male	Female
Elderly Persons Living Alone
Income	$4,543	$3,976	$4,403	$2,740	$4,863	$4,134
Income Plus Food Stamps and Partial 10-Year Annuity*	5,774	4,630	5,542	3,015	5,761	5,128
Income Plus Food Stamps and Full 10-Year Annuity*	7,975	4,630	6,782	3,461	6,984	6,405
Income Plus Food Stamps and Full 5-Year Annuity*	11,268	5,548	9,198	4,096	9,116	8,705
Elderly Couples
Income	8,459	7,633	8,430	5,127	8,261	--**
Income Plus Food Stamps and Partial 10-Year Annuity*	10,631	9,295	10,407	5,387	10,150	--
Income Plus Food Stamps and Full 10-Year Annuity*	13,546	9,295	13,007	6,377	12,667
Income Plus Food Stamps and Full 5-Year Annuity*	18,537	13,142	17,658	7,350	17,130	--
SOURCE: Survey of Income and Education * Partial annuity is based on all assets except the home. Full annuity includes net worth of home in calculations. ** The SIE automatically considers a male to be family head, if present.

TABLE 43. Mean Resources of Nonworking Elderly by Age and Family Size Using Alternative Definitions of Resources (1976 Data)
Income Level	Age of Head
Income Level	65-69	70-74	75-79	80-84	85 and Above
Elderly Persons Living Alone
Income	4,468	4,583	4,226	3,839	3,803
Income Plus Food Stamps and Partial 10 Year Annuity*	5,409	5,666	5,181	4,672	4,888
Income Plus Food Stamps and Full 10 Year Annuity*	6,716	7,025	6,443	5,842	5,995
Income Plus Food Stamps and Full 5 Year Annuity*	8,951	9,516	8,681	7,842	8,314
Income Plus Food Stamps and Full Value of Assets	44,199	45,003	41,504	39,724	42,689
Elderly Couples
Income	8,612	8,657	7,938	7,905	6,416
Income Plus Food Stamps and Partial 10 Year Annuity*	10,317	10,756	9,742	10,093	7,723
Income Plus Food Stamps and Full 10 Year Annuity*	12,930	13,442	12,114	12,388	9,939
Income Plus Food Stamps and Full 5 Year Annuity*	17,183	18,328	16,352	17,141	13,351
Income Plus Food Stamps and Full Value of Assets	56,694	67,749	58,098	58,808	48,085
SOURCE: Survey of Income and Education. * Partial annuity is based on all assets except the home. Full annuity includes net worth of home in calculations.

TABLE 44. Persons With and Without Health Insurance: Percent Distribution by Age (NMCES: Household Data, 1977)
Age	Population in Thousands	Total	Percent Distribution
Age	Population in Thousands	Total	Without Insurance Coverage	With Insurance Coverage
All ages	211,513	100.00	12.6	87.4
1 - 64	189,443	100.00	13.5	86.6
65 and Over	22,070	100.00	4.3	95.7
SOURCE: National Center for Health Services Research.

TABLE 45. Uninsured Persons, Family Setting, and Insurance Coverage of Other Family Members: Percent Distribution by Type of Coverage (NMCES: Household Data, 1977)
Age	Type of Coverage in Families of Uninsured Persons							Unrelated Individual Without Insurance
Age	Population in Thousands	Medicare Only or With Private or Other Insurance	Medicaid Only or With Private or Other Insurance	Both Medicare and Medicaid or Both With Private or Other Insurance	Private Insurance Only or Private With Other Insurance Excluding Medicare and Medicaid	Other Public Insurance Only	No Insurance	Unrelated Individual Without Insurance
All Persons	26,560	7.2	5.9	2.3	28.1	1.0*	43.2	12.2
1 - 64	25,605	6.9	5.9	2.4	28.2	1.0*	44.0	11.6
65 and Over	955	16.3	4.8	0.7*	26.6	0.5*	22.8	28.2
SOURCE: National Center for Health Services Research. * Relative Standard error equal to or greater than 30 percent

V. LONG-TERM CARE INSTITUTIONS AND USE OF LONG-TERM CARE INSTITUTIONS

TABLE 46. Number of Persons and Percent of U.S. Population Residing in Long-Term Care Institutions as Reported by Census of Population
	1950		1960		1970
	Persons	Percent of Population	Persons	Percent of Population	Persons	Percent of Population
All Ages
All LTC Institutions	1,161,974	0.76	1,406,266	0.78	1,670,167	0.82
Nursing Homes	296,783	0.20	469,717	0.26	927,514	0.46
With Nursing Care	N/A	N/A	200,609	0.11	298,881	0.15
Not Known to have Nursing Care	N/A	N/A	269,108	0.15	628,633	0.31
Mental Institutions¹	747,817	0.50	804,773	0.44	635,882	0.31
TB & Chronic Diseases	96,375	0.06	107,485	0.06	84,032	0.04
Physically Handicapped	20,999	0.01	5,486	0.003	6,879	0.003
Blind & Deaf	N/A	N/A	18,805	0.01	15,860	0.008
Under 65
All LTC Institutions	783,459	0.56	798,349	0.49	710,330	0.38
Nursing Homes	79,247	0.06	81,764	0.05	131,707	0.07
With Nursing Care	N/A	N/A	27,830	0.02	41,573	0.02
Not Known to have Nursing Care	N/A	N/A	53,934	0.03	90,134	0.05
Mental Institutions	602,287	0.44	622,171	0.37	512,112	0.28
TB & Chronic Disease	80,926	0.06	70,123	0.04	43,772	0.02
Physically Handicapped	N/A	N/A	N/A	N/A	N/A	N/A
Blind & Deaf	N/A	N/A	N/A	N/A	N/A	N/A
65 & Over
All LTC Institutions	378,515	3.05	607,917	3.64	959,837	4.78
Nursing Homes	217,536	1.77	387,953	2.32	795,807	3.96
With Nursing Care	N/A	N/A	172,779	1.03	257,308	1.28
Not Know to have Nursing Care	N/A	N/A	215,174	1.29	538,499	2.68
Mental Institutions	145,530	1.19	182,602	1.09	123,770	0.62
TB & Chronic Disease	15,449	0.13	37,362	0.22	40,260	0.20
Physically Handicapped	N/A	N/A	N/A	N/A	N/A	N/A
Blind & Deaf	N/A	N/A	N/A	N/A	N/A	N/A
SOURCE: U.S. Bureau of the Census, U.S. Census of Population: 1950. Vol. IV, *Special Reports, Part 2, Chapter C, Institutional Population. U.S. Government Printing Office, Washington, D.C., 1953. U.S. Bureau of the Census, U.S. Census of Population: 1960. Subject Reports: Final Report PC(2)-8A: Inmates of Institutions, U.S. Government Printing Office, Washington, D.C., 1963. U.S. Bureau of the Census, U.S. Census of Population: 1970. Subject Reports*: Final Report PC(2)-4E: Persons in Institutions and Other Group Quarters, U.S. Government Printing Office, Washington, D.C., 1973. Includes mental hospitals, facilities for mentally impaired and residential treatment centers.

TABLE 47. Percent of the Elderly in Institutions by Age Cohort, 1950-1970
Age Group	1950	1960	1970
65-69	1.8%	1.8%	1.7%
70-74	2.6%	2.6%	2.7%
75-79	4.3%	4.3%	5.1%
80-84	6.6%	7.8%	10.2%
85+	11.7%	12.6%	17.9%
SOURCE: U.S. Bureau of the Census, U.S. Census of Population: 1950. Vol. IV, *Special Reports, Part 2, Chapter C, Institutional Population. U.S. Government Printing Office, Washington, D.C., 1953. U.S. Bureau of the Census, U.S. Census of Population: 1960. Subject Reports: Final Report PC(2)-8A: Inmates of Institutions, U.S. Government Printing Office, Washington, D.C., 1963. U.S. Bureau of the Census, U.S. Census of Population: 1970. Subject Reports*” Final Report PC(2)-4E: Persons in Institutions and Other Group Quarters. U.S. Government Printing Office, Washington, D.C., 1973.

TABLE 48. Components of Institutional Population Growth Persons 65 and Over, 1950-1970
Factor	1950-1960		1960-1970
Factor	Average Annual Growth Rate	Percent of Institutional Growth Attributable to this Factor	Average Annual Growth Rate	Percent of Institutional Growth Attributable to this Factor
Growth of Population 65 and over	3.00%	64.2%	1.86%	41.1%
Increase in Rate of Institutionalization	1.67	35.8	2.67	58.9
Change in Age Composition of Population 65 and Over	0.39	8.4	.91	20.1
Change in Age Adjusted Rate of Institutionalization	1.28	27.4	1.76	38.8
Total Institutional Population
Persons 65 and Over	4.67%	100.0%	4.53%	100.0%
SOURCE: Calculated from data in the 1950, 1960, and 1970 Censuses of Institutions. U.S. Bureau of the Census, U.S. Census of Population: 1950. Vol. IV *Special Reports, Part 2 Chapter C, “Institutional Population.” U.S. Government Printing Office. Washington, D.C., 1953. U.S. Bureau of the Census, U.S. Census of Population: 1960. Subject Reports: Final Report PC(2)-8A, “Inmates of Institutions,” U.S. Government Printing Office. Washington, D.C., 1963. U.S. Bureau of the Census, U.S. Census of Population: 1970. Subject Reports*: Final Report PC(2)-4E, “Persons in Institutions and Other Group Quarters.” U.S. Government Printing Office, Washington, D.C., 1973. The increase in the rate of institutionalization due to the change in the age composition of the population 65 and over is computed as: composition = where and u_i is the utilization rate for persons in the ith age interval (e.g., 65-69) in the base year (1950 or 1960). is the proportion of the 65+ population that is in the ith age interval in year t_k. The increase in the rate of institutionalization due to the change in the age adjusted rate of institutionalization is computed as the difference in average annual growth in the rate of institutionalization for persons 65 and over and the average annual growth in the rate of institutionalization due to the change in the age composition of the population 65 and over.

TABLE 49. Proportion of Aged Recipients in Nonmedical Facilities to Total SSI Recipients, by State December 1979
	SSI DCF	SSI Recipients in Nonmedical Facilities per Elderly	Rank
California	58,483	24.22	2
Delaware	395	6.69	9
District of Columbia	716	9.68	7
Hawaii	1,469	19.33	3
Iowa	86	.22	15
Maine	2,573	18.25	5
Massachusetts	4,674	6.43	10
Michigan	16,915	18.55	4
Montana	662	7.79	8
Nevada	233	3.53	12
New Jersey	4,740	5.51	11
New York	28,306	13.10	6
Pennsylvania	908	0.59	14
Vermont	1,534	26.45	1
Wisconsin	1,503	2.66	13
TOTAL	123,197	4.82
SOURCE: Data provided by Division of Supplemental Security Studies, Office of Research, Demonstration and Statistics, Social Security Administration.

TABLE 50. Utilization of Facilities for the Mentally Impaired by Age
	1950		1960		1970
	Number	Percent of Population	Number	Percent of Population	Number	Percent of Population
All Ages
Total Mental Hospitals	613,628	0.41%	624,724	0.34%	424,091	0.21%
Federal	59,847	0.04%	63,226	0.03%	42,953	0.02%
State, County, City	537,413	0.36%	541,625	0.30%	349,514	0.17%
Private	16,368	0.01%	19,873	0.01%	31,624	0.02%
Residential Treatment Centers	N/A	N/A	5,322	0.003%	9,799	0.005%
Facilities for Mentally Handicapped	134,189	0.9%	174,727	0.10%	201,992	0.10%
Total	747,817		804,733		635,882
Persons Under 65
Total Mental Hospitals	472,282	0.34%	447,437	0.27%	311,246	0.17%
Federal	57,173	0.04%	50,707	0.03%	33,145	0.02%
State, County, City	405,591	0.29%	385,564	0.23%	254,592	0.14%
Private	9,518	0.01%	11,166	0.01%	23,509	0.01%
Residential Treatment Centers	N/A	N/A	4,769	0.003%	9,601	0.005%
Facilities for Mentally Handicapped	130,005	0.09%	169,965	0.10%	191,265	0.10%
Total			622,171		512,112
Persons 65 and Over
Total Mental Hospitals	141,346	1.15%	177,287	1.06%	112,845	0.56%
Federal	2,674	0.02%	12,519	0.07%	9,808	0.05%
State, County, City	131,822	1.07%	156,061	0.93%	94,922	0.47%
Private	6,850	0.06%	8,707	0.05%	8,115	0.04%
Residential Treatment Centers	N/A	N/A	553	0.003%	198	0.001%
Facilities for Mentally Handicapped	4,184	0.03%	4,762	0.03%	10,727	0.05%
Total			182,602		123,770
SOURCE: U.S. Bureau of the Census, U.S. Census of Population: 1950. Vol. IV, *Special Reports, Part 2, Chapter C, Institutional Population. U.S. Government Printing Office, Washington, D.C., 1953. U.S. Bureau of the Census, U.S. Census of Population: 1960. Subject Reports: Final Report PC(2)-8A: Inmates of Institutions, U.S. Government Printing Office, Washington, D.C., 1963. U.S. Bureau of the Census, U.S. Census of Population: 1970. Subject Reports*: Final Report PC(2)-4E: Persons in Institutions and Other Group Quarters, U.S. Government Printing Office, Washington, D.C., 1973.

TABLE 51. Number and Percent Change in Inpatient Days of Care in Mental Health Facilities, United States 1971, 1973, 1975
Type of Hospital	Patient Days (in 000’s)			% Change 1971-1975
Type of Hospital	1971	1973	1975	% Change 1971-1975
Total	153,105	125,906	104,908	-31.5
Psychiatric Hospital Total	132,784	104,648	82,009	-38.2
State & County Hospital	119,200	92,210	70,584	-40.8
Private Hospitals	4,220	4,108	4,401	+4.3
VA Hospitals	9,364	8,331	7,024	-25.0
General Hospital Psychiatric Units
VA Hospitals	4,913	4,654	4,701	-4.3
Other	6,826	6,990	8,349	+22.3
Residential Treatment Center	6,356	6,338	5,900	-7.2
Community Mental Health Centers	2,225	3,276	3,948	+77.4
SOURCE: Howard H. Goldman, Carl A. Taube, and Daniel A. Regier, “The Present and the Future Role of the State Mental Hospital: Summary”. Paper presented at Annual Meeting of American Psychiatric Association, San Francisco, California, May 1980.

VI. DETERMINANTS OF NURSING HOME USE

TABLE 52. All Ages: Number and Percent of White and Non-White Persons Aged 65 and Over or Under 65 Who Live in Nursing Homes
	Lives in Nursing Home
	Number	Percent of Nursing Home Population	Percent of All Americans
AGE
Under 65	177,100	13.6	0.1
65 and Over	1,125,200	86.4	4.8
RACE
White	1,200,000	92.2	0.5
Non-White	102,200	7.8	0.4
TOTAL	1,302,100	100.0	0.5
SOURCE: Merger of 1977 HIS and 1977 NNHS.

TABLE 53. Rates of Nursing Home Residency by Type of Dependency Among the Aged
Age	Personal Care		Mobility	Other or No Dependency
Age	Toileting/Feeding	Bathing/Dressing	Mobility	Other or No Dependency
65-79	49.0	29.1	2.9	0.2
80+	71.3	45.9	2.3	1.3
SOURCE: Merger of 1977 HIS and 1977 NNHS.

TABLE 54. Elderly Only: Institutionalization Rates by Demographic Characteristics, Dependency, Diagnostic Group and Climate (1977)
Lives in Nursing Home	Percent
AGE
65 - 74	1.5
75+	10.2
MARITAL STATUS
Married	1.1
Unmarried	8.9
POVERTY STATUS
Above Poverty Level	2.4
Below Poverty Level	14.6
DEPENDENCY
No human ADL or mobility help needed	0.4
Human help needed in mobility	2.6
Human help needed bathing/dressing	37.8
Human help needed toileting/eating	62.0
DIAGNOSTIC GROUPS
Mental	65.6
Cancer, digestive, metabolic, blood, genitouninary	22.4
Injury	21.0
Circulatory	18.4
Skeletal	13.5
Nervous	6.5
Respiratory	5.3
Other	0.2
CLIMATE
Warm	4.2
Mild	4.3
Cool	5.0
Cold	8.2
ALL ELDERLY	4.8
SOURCE: Merger of 1977 HIS and 1977 NNHS.

TABLE 55. Elderly Only: Institutionalization Rates of Persons with High Risk Characteristics
	65-74	75+	Total
All Elderly
Married	0.4%	2.9%	1.1%
Unmarried	3.2%	14.5%	8.9%
Total	1.5%	10.2%	4.8%
One or More High Risk Diagnoses¹
Married	1.3%	7.3%	3.2%
Unmarried	9.5%	32.1%	22.8%
Total	4.4%	23.6%	13.0%
Poverty²
Married	2.3%	7.7%	4.3%
Unmarried	8.5%	28.3%	19.5%
Total	6.0%	23.3%	14.6%
Bathing/Dressing Dependent
Married	6.3%	16.4%	11.9%
Unmarried	46.2%	48.7%	48.2%
Total	27.3%	41.7%	37.8%
Toileting/Feeding Dependent
Married	23.4%	39.2%	32.6%
Unmarried	53.9%	77.0%	73.8%
Total	40.0%	69.2%	62.0%
Unmarried, High Risk Diagnoses and In Poverty
Married	73.4%	72.7%	72.9%
Unmarried	88.4%	91.4%	91.0%
Total	77.4%	83.5%	83.0%
SOURCE: Merger of 1977 HIS and NNHS. Includes mental, disgestive, metabolic, blood, genitourinary, circulatory and skeletal disorders, cancer and injuries. Nursing home residents were classified as poor if their charges for care were paid by Medicaid, general welfare or a charitable organization. For persons in the community, the definition of poverty is based on that developed by the U.S. Bureau of the Census. Families and individuals are classified as being above or below the poverty level. This index provides a range of income cutoffs adjusted to take into account such factors as family size, sex and age of the family head, the number of children, and farm-nonfarm residence. The cutoff levels are updated annually to reflect changes in the CPI. For a detailed explanation see *Current Population Reports*, Series, P-23, No. 28, “Revision in Poverty Statistics,” 1959 to 1968.

VII. CHARACTERISTICS OF NURSING HOME USERS

TABLE 57. Age, Sex, Race and Marital Status of Nursing Home Residents, 1977
Resident Characteristics	Number	Percent
Age
Under 45 years	32,900	2.52
45-54	43,500	3.33
55-64	100,800	7.74
65-69	81,700	6.27
70-74	129,700	9.95
75-79	197,200	15.29
80-84	265,500	20.37
85-89	263,700	20.24
90-94	141,300	10.84
95 years and over	44,900	3.45
Median Age in Years	81
Total Number of Residents	1,303,100	100.0
Sex
Male	375,300	28.80
Female	927,800	71.20
Race or Ethnicity
White (not Hispanic)	1,200,900	92.16
Black (not Hispanic)	81,400	6.25
Hispanic	14,400	1.11
Marital Status
Married	155,400	11.93
Widowed	810,700	62.21
Divorced or Separated	87,500	6.71
Never Married	249,500	19.15
SOURCE: National Nursing Home Survey, 1977.

TABLE 58. Number and Percent of Residents of Nursing Homes in 1977 and Discharges in 1976, by Primary Source of Payment, According to Selected Characteristics: United States
Resident Characteristic	Primary Source of Payment for Residents in 1977
	Number							Percent
	All Sources	Own Income or Family Support	Medicare	Medicaid		Other Government Assistance or Welfare	All Other Sources	All Sources	Own Income or Family Support	Medicare	Medicaid		Other Government Assistance or Welfare	All Other Sources
	All Sources	Own Income or Family Support	Medicare	Skilled	Intermediate	Other Government Assistance or Welfare	All Other Sources	All Sources	Own Income or Family Support	Medicare	Skilled	Intermediate	Other Government Assistance or Welfare	All Other Sources
All residents	1,303,100	500,900	26,200	260,700	362,600	83,400	69,200	100.0	38.4	2.0	20.0	27.8	6.4	5.3
DEMOGRAPHIC CHARACTERISTICS
Age
Under 45 years	32,900	5,600	--	8,900	9,400	5,400	--	100.0	17.1	--	27.1	28.8	16.3	--
45-54 years	43,500	10,200	--	6,600	14,700	7,300	--	100.0	23.5	--	15.3	33.7	16.8	--
55-64 years	100,800	30,600	--	17,200	35,600	9,800	7,200	100.0	30.4	--	17.1	35.4	9.7	7.2
65-69 years	81,700	22,500	--	16,800	29,100	--	6,300	100.0	27.6	--	20.5	35.6	--	7.7
70-74 years	129,700	48,300	--	23,200	36,800	10,100	5,200	100.0	37.3	--	17.9	29.9	7.8	4.0
75-79 years	199,200	80,400	5,900	41,200	53,200	10,700	7,900	100.0	40.4	2.9	20.7	26.7	5.4	4.0
80-84 years	265,500	121,500	6,000	47,100	62,600	12,300	16,000	100.0	45.7	2.3	17.7	23.6	4.6	6.0
85-89 years	263,700	115,100	--	53,900	68,000	11,700	10,000	100.0	43.7	--	20.4	25.8	4.4	3.8
90-94 years	141,300	50,000	--	32,300	39,600	9,800	8,100	100.0	35.3	--	22.8	28.0	6.9	5.7
95 years and over	44,900	16,600	--	13,500	11,400	--	--	100.0	37.0	--	30.0	25.5	--	--
Sex
Male	375,300	145,800	7,900	63,400	96,100	30,000	30,100	100.0	38.8	2.1	16.9	26.1	8.0	8.0
Female	927,800	355,200	18,300	197,300	264,500	53,500	39,100	100.0	38.3	2.0	21.3	28.5	5.8	4.2
Race or ethnicity
White (not Hispanic)	1,200,900	486,600	24,200	233,500	320,000	73,200	63,300	100.0	40.5	2.0	19.4	26.7	6.1	5.3
Black (not Hispanic)	81,400	10,700	--	21,000	38,200	5,800	--	100.0	13.1	--	25.8	46.9	7.1	--
Hispanic	14,400	--	--	--	--	--	--	100.0	--	--	--	--	--	--
American Indian or Alaska native	--	--	--	--	--	--	--	--	--	--	--	--	--	--
Asian or Pacific Islander	--	--	--	--	--	--	--	--	--	--	--	--	--	--
Marital status
Married	155,400	77,200	--	23,100	30,100	10,000	10,500	100.0	49.7	--	14.9	19.4	6.5	6.8
Widowed*	810,700	325,500	18,600	171,300	219,000	42,900	33,400	100.0	40.1	2.3	21.1	27.0	5.3	4.1
Divorced or separated	87,500	24,200	--	19,200	27,500	8,700	7,100	100.0	27.6	--	22.0	31.4	10.0	8.1
Never married	249,500	74,100	--	47,000	86,000	21,700	18,200	100.0	29.7	--	18.8	34.5	8.7	7.3
LENGTH OF STAY SINCE ADMISSION
Less than 3 months	189,300	76.200	22,400	24,000	31,200	13,100	22,400	100.0	40.2	11.8	12.7	16.5	6.9	11.8
3 months to less than 6	122,100	52,600	--	25,000	26,700	7,500	7,400	100.0	43.1	--	20.5	23.5	6.1	6.0
6 months to less than 12	163,100	71,600	--	33,900	42,300	9,300	5,900	100.0	43.9	--	20.8	25.9	5.7	3.6
1 year to less than 3	427,800	176,200	--	90,400	124,200	26,100	10,000	100.0	41.2	--	21.1	29.0	6.1	2.3
3 years to less than 5	192,900	67,100	--	45,500	59,700	11,600	8,200	100.0	34.8	--	23.6	31.0	6.0	4.3
5 years or more	207,900	57,200	--	41,900	76,500	15,900	15,400	100.0	27.5	--	20.1	36.8	7.6	7.4
SOURCE: “The National Nursing Home Survey: 1977 Summary for the United States,” *Vital and Health Statistics*, data from the National Nursing Home Survey, Series 13, No. 43, Table 40.

TABLE 59. Number and Percent of Nursing Home Residents, by Selected Health Diagnoses and Conditions Statuses: United States, 1977
Health Status¹	Residents
Health Status¹	Number	Percent
Total	1,303,100	100.0
PRIMARY DIAGNOSIS AT LAST EXAMINATION
Diseases of the circulatory system
Total	516,800	39.7
Congestive heart failure	52,800	4.1
Arteriosclerosis	264,400	20.3
Hypertension	47,700	3.7
Stroke	103,500	7.9
Heart attack, ischemic heart disease	22,500	1.7
Other	25,800	2.0
Mental disorders and senility without psychosis
Total	266,100	20.4
Senile psychosis	21,200	1.6
Other psychosis	57,400	4.4
Chronic brain syndrome	96,400	7.4
Senility without psychosis	26,600	2.0
Mental retardation	42,400	3.3
Alcoholism	6,800	.5
Other mental disorders	15,300	1.2
Other diagnoses²
Total	429,700	33.0
Diseases of the musculoskeletal system and connective tiisues:
Arthritis and rheumatism	56,200	4.3
Diseases of the nervous system and sense organs:
Blindness	5,100	.4
Multiple sclerosis	7,300	.6
Epilepsy	6,800	.5
Parkinson’s disease	23,300	1.8
Accidents, poisonings, and violence:
Hip fracture	29,300	2.2
Other bone fracture	10,600	.8
Endocrine, nutritional, and metabolic diseases:
Diabetes	71,700	5.5
Neoplasma:
Cancer	28,900	2.2
Diseases of the respiratory system:
Emphysema	8,000	.6
Pneumonia	--	--
Other respiratory diseases	18,500	1.4
Diseases of the digestive system:
Ulcers	8,600	.7
Diseases of the blood and blood-forming organs:
Anemia	7,300	.6
Diagnosis unknown³
Total	90,500	6.9
CHRONIC CONDITIONS OR IMPAIRMENTS⁴
Diseases of the circulatory system
Arteriosclerosis	620,200	47.6
Hypertension	272,900	20.9
Stroke	214,000	16.4
Paralysis or palsy, other than arthritis, related to stroke	80,800	6.2
Heart trouble	449,000	34.5
Mental disorders and senility without psychosis
Mental illness	148,300	11.4
Chronic brain syndrome	324,700	24.9
Senility	416,400	32.0
Mental retardation	79,800	6.1
Alcoholism	36,900	2.8
Drug addiction	--	--
Insomnia	125,500	9.6
Other chronic conditions or impairments
Diseases of the musculoskeletal system and connective tissues:
Arthritis and rheumatism	320,500	24.8
Chronic back/spine problems, excluding stiffness and deformity	60,500	4.6
Permanent stiffness or deformity of back, arms, legs, or extremities, including feet, toes, hands, or fingers	181,500	13.9
Missing arms, legs, or extremities, including feet, toes, hands, or fingers	32,400	2.5
Diseases of the nervous system and sense organs:
Blindness	72,200	5.5
Glaucoma	34,000	2.6
Cataracts	80,000	6.1
Deafness	90,400	6.9
Parkinson’s disease	58,000	4.5
Paralysis or palsy, other than arthritis, unrelated to stroke	46,500	3.6
Accidents, poisonings, and violence:
Hip fracture	108,800	8.3
Other bone fracture	46,300	3.6
Endocrine, nutritional, and metabolic diseases:
Diabetes	189,600	14.5
Neoplasms:
Cancer	63,600	4.9
Diseases of the respiratory system:
Chronic respiratory disease	86,500	6.6
Diseases of the digestive system:
Constipation	313,200	24.0
Diseases of the blood and blood-forming organs:
Anemia	70,600	5.4
Diseases of the skin and subcutaneous tissue:
Bedsores	35,100	2.7
Conditions other than above:
Edema	233,500	17.9
Kidney trouble	131,700	10.1
None of these conditions
Total	13,000	1.0
SOURCE: “The National Nursing Home Survey: 1977 Summary for the United States,” *Vital and Health Statistics, data from the National Nursing Home Survey, Series 13, No. 14, Table 20. Disease group categories based on Eighth Revision International Classification of Diseases, Adapted for Use in the United States* (ICDA). Only diagnoses of sufficient magnitude are noted. Includes residents who received no physician visits while in facility. Figures may not add to total because resident may have had more than 1 reported condition or impairment.

TABLE 60. Number of Percent Distribution of Nursing Home Residents by Dependency in Activities of Daily Living and Index of Dependency in Activities of Daily Living, According to Selected Other Resident Characteristics: United States, 1977
Resident Characteristic	All Residents	Dependency in Activities of Daily Living						Index of Dependency in Activities of Daily Living¹
Resident Characteristic	All Residents	Requires Assistance in Bathing	Requires Assistance in Dressing	Requires Assistance in Using Toilet Room	Mobility--Walks Only with Assistance or is Chairfast or Bedfast	Continence --Difficulty with Bowel and/or Bladder Control	Requires Assistance in Eating	Not Dependent in Bathing, Dressing, Using Toilet Room, Mobility, Continence, or Eating	Dependent in Only 1 Activity	Dependent in Bathing and 1 Additional Activity	Dependent in Bathing, Dressing, and 1 Additional Activity	Dependent in Bathing, Dressing, Using Toilet Room, and 1 Additional Activity	Dependent in Bathing, Dressing, Using Toilet Room, Mobility, and 1 Additional Activity	Dependent in all 6 Activities	Other²
NUMBER
Total	1,303,100	1,124,600	904,900	684,700	861,700	589,800	424,900	124,500	161,000	158,000	110,400	125,000	203,600	303,300	116,400
DEMOGRAPHIC CHARACTERISTIC
Age
Under 65 years	177,100	127,300	97,700	67,700	82,200	56,600	46,400	41,500	27,600	22,800	12,800	11,800	22,600	27,700	10,400
65-74 years	211,400	171,600	129,500	99,200	120,100	79,400	57,200	29,500	34,900	28,300	14,300	20,900	32,100	37,300	14,100
75-84 years	464,700	413,200	336,700	252,200	310,600	219,000	157,200	33,600	57,300	54,500	44,800	48,700	70,900	112,800	42,000
85 years and over	449,900	412,600	341,000	265,600	348,800	234,800	164,100	19,800	41,200	53,400	38,600	43,600	78,000	125,400	49,900
Sex
Male	375,300	303,200	233,500	166,600	222,500	155,700	104,500	50,800	56,600	51,600	27,500	27,700	52,400	71,800	36,900
Female	927,800	821,400	671,400	518,100	639,100	434,000	320,400	73,700	104,400	107,300	83,000	97,400	151,200	231,400	79,400
Race or ethnicity
White (not Hispanic)³	1,200,900	1,038,900	831,700	628,700	793,000	542,400	389,700	114,100	151,300	145,400	102,000	115,800	184,500	280,300	107,400
Black (not Hispanic)	81,400	69,800	60,200	45,400	54,600	39,500	27,600	7,600	7,300	10,400	7,100	8,000	15,500	18,600	6,900
Hispanic, American Indian, Alaska native, Asian or Pacific Islander	20,800	16,000	13,100	10,600	14,100	7,900	7,600	--	--	--	--	--	--	--	--
Marital status
Married	155,400	138,500	121,300	101,200	113,000	87,800	86,100	12,000	13,400	11,400	10,400	14,700	30,200	47,800	15,400
Widowed³	810,700	725,400	501,100	451,900	579,100	385,000	275,800	52,200	91,300	97,100	75,500	82,700	135,200	200,800	75,900
Divorced or separated	87,500	64,200	47,000	32,900	46,100	28,000	21,200	18,400	14,100	12,400	6,300	6,300	11,400	13,200	5,400
Never married	249,500	196,400	145,600	96,700	123,500	89,000	61,800	41,800	42,200	36,000	18,200	21,400	26,800	41,500	19,700
PERCENT DISTRIBUTION
Total	100.0	86.3	69.4	52.5	66.1	45.3	32.6	9.6	12.4	12.2	8.5	9.6	15.6	23.3	8.9
DEMOGRAPHIC CHARACTERISTICS
Age
Under 65 years	100.0	71.9	55.2	38.2	46.4	32.0	26.2	23.4	15.6	12.9	7.2	6.7	12.8	15.7	5.8
65-74 years	100.0	81.2	61.2	46.9	56.8	37.6	27.1	14.0	16.5	13.4	6.7	9.9	15.2	17.6	6.7
75-84 years	100.0	88.9	72.5	54.3	66.8	47.1	33.8	7.2	12.3	11.7	9.6	10.5	15.3	24.3	9.0
85 years and over	100.0	91.7	75.8	59.0	77.5	52.2	36.5	4.4	9.2	11.9	8.6	9.7	17.3	27.9	11.1
Sex
Male	100.0	80.8	62.2	44.4	59.3	41.5	27.8	13.5	15.1	13.8	7.3	7.4	14.0	19.1	9.8
Female	100.0	88.5	72.4	55.8	68.9	46.8	34.5	7.9	11.3	11.6	8.9	10.5	16.3	24.9	8.6
Race or ethnicity
White (not Hispanic)³	100.0	86.5	69.3	52.3	66.0	45.2	32.4	9.5	12.6	12.1	8.5	9.6	15.4	23.3	8.9
Black (not Hispanic)	100.0	85.7	73.9	55.7	67.0	48.5	34.0	9.3	9.0	12.8	8.7	9.8	19.1	22.9	8.5
Hispanic, American Indian, Alaska native, Asian or Pacific Islander	100.0	76.7	62.9	51.1	67.7	38.0	36.5	--	--	--	--	--	--	--	--
Marital status
Married	100.0	89.2	78.1	65.1	72.7	56.5	42.5	7.8	8.6	7.4	6.7	9.5	19.4	30.8	9.9
Widowed³	100.0	89.5	72.9	55.7	71.4	47.5	34.0	6.4	11.3	12.0	9.3	10.2	16.7	24.8	9.4
Divorced or separated	100.0	73.4	53.7	37.6	52.6	32.0	24.2	21.0	16.2	14.2	7.2	7.2	13.0	15.1	6.1
Never married	100.0	78.7	58.3	39.5	49.5	35.7	24.8	16.8	16.9	15.2	7.3	8.6	10.7	16.6	7.9
SOURCE: “The National Nursing Home Survey: 1977 Summary for the United States,” *Vital and Health Statistics*, data from the National Nursing Home Survey, Series 13, No. 43, Table 23. Unknowns were considered not dependent for the purpose of this index. Includes residents who were dependent in at least two functions but were not classified into any of these categories. Includes a small number of unknowns.

TABLE 61. Percentage of Nursing Home Residents by Age Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
45 or younger	7.9%	1.6%	1.8%	0.0%	0.0%
45 - 64	25.5	8.1	12.4	2.0	1.0
65+^b	66.6	90.3	85.5	98.1	99.0
65 - 74	20.4	16.7	17.3	8.0	9.8
75 - 84	27.3	37.7	35.9	42.2	38.3
85+	18.9	35.9	32.6	47.9	50.9
TOTAL	100.0%	100.0%	100.0%	100.0%	100.0%
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded. Subtotal, not included in calculation of total.

TABLE 62. Percentage of Nursing Home Residents by Marital Status Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
Married	9.7	12.5	11.3	17.6	12.3
Ever Married	52.4	74.0	67.1	71.2	77.2
Never Married	37.9	13.6	21.6	11.2	10.5
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded.

TABLE 63. Percentage of Nursing Home Residents by Race Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
White	90.5	93.5	90.0	93.1	93.1
Black	7.9	5.0	7.8	6.9	5.9
Other	1.5	1.5	2.2	0.0	1.0
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded.

TABLE 64. Percentage of Nursing Home Residents By Sex Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
Male	31.3	29.7	29.3	23.7	21.6
Female	68.7	70.3	70.7	76.3	78.4
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded.

TABLE 65. Percentage of Nursing Home Residents by Need for Help of Another Person in Activities of Daily Living, Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
No Help	13.1	10.8	6.1	4.8	3.2
Mobility	4.6	3.0	2.3	1.5	2.0
Bath/Dress	37.1	40.8	30.2	39.9	30.2
Toilet/Eat	45.1	45.4	61.4	53.9	64.6
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded. Persons are assigned to the assistance category representing the most severe dependence. Dependencies are ordered for severity, as indicated in the above table, from no help to toileting/eating.

TABLE 66. Percentages of Nursing Home Residents by Need for Assistance in Activities of Daily Living Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
No Help	2.9	1.8	1.4	.5	1.2
Mobility	14.8	11.4	6.9	4.5	4.0
Bath/Dress	36.4	39.7	28.9	41.2	28.8
Toilet/Eat	46.0	47.1	62.8	53.9	66.0
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive.

TABLE 67. Percentage of Nursing Home Residents by Ability to Communicate Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
Verbal	77.6	92.7	80.2	84.0	85.7
Nonverbal	14.8	5.5	13.2	8.5	9.4
No Communication	7.6	1.8	6.6	7.5	4.8
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded.

TABLE 68. Percentage of Nursing Home Residents by Predicted Date of Discharge Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
Within 3 months	1.3	4.0	1.2	1.3	1.1
4 - 6 months	0.4	0.9	0.2	0.0	0.5
More than 6 months	98.3	95.1	98.7	98.7	98.3
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded.

TABLE 69. Percentage of Nursing Home Residents by Prior Residence Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
Private Home	28.6	41.5	35.2	50.9	44.3
Retirement Home	2.1	1.6	2.2	1.1	1.8
Health Facility	64.8	51.9	56.2	43.1	48.7
Other	4.5	5.0	6.3	5.0	5.1
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded.

TABLE 70. Percentage of Nursing Home Residents by Discharge Destination Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
Private Home	14.4	33.1	17.0	14.5	9.7
Retirement Home	0.7	1.8	1.0	0.0	1.2
Health Facility	55.2	38.8	48.8	55.6	50.1
Death	25.8	23.0	29.7	26.7	37.1
Other	3.9	3.4	3.5	3.2	1.9
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded.

TABLE 71. Distribution of Other Diagnosis in Nursing Home Patients Within Mental Disorder as Primary Diagnosis
Other Diagnosis	Percent of Persons with Mental Disorder as Primary Diagnosis
Circulatory	45.4%
Paralysis or Stroke	8.6
Musculoskeletal	24.5
Blind or Deaf	13.0
Cancer	2.0
Other	21.3
None	30.8
SOURCE: National Center for Health Statistics, U.S. Department of Health, Education & Welfare, *The National Nursing Home Survey: 1977 Summary for the United States*, Hyattsville, Maryland, July, 1979.

TABLE 72. Number of Persons With a Mental Diagnosis in Nursing Homes Selected Years
	1963	1969	1977
Persons with a Mental Diagnosis	221,721	426,712	775,800
Total Nursing Home Residents	505,242	815,130	1,302,100
Percent of Total Residents who have a Mental Diagnosis	43.9%	52.3%	59.6%
Average Annual Growth Rate - Persons with a Mental Diagnosis		10.9%	6.6%
Average Annual Growth Rate - Total Nursing Home Residents		8.0%	5.2%
SOURCE: U.S. Department of Health, Education and Welfare, National Center for Health Statistics, *Vital and Health Statistics, Series 12 Number 2, “Characteristics of Residents in Institutions for the Aged and Chronically Ill, April-June 1963,” U.S. Government Printing Office, Washington, D.C., 1965. U.S. Department of Health, Education and Welfare, National Center for Health Statistics, Vital and Health Statistics, Series 12 Number 19, “Characteristics of Residents in Nursing and Personal Care Homes, June-August 1969,” U.S. Government Printing Office, Washington, D.C., 1973. U.S. Department of Health, Education and Welfare, National Center for Health Statistics, Vital and Health Statistics*, Series 13 Number 51, “Characteristics of Nursing Home Residents, Health Status, and Care Received: National Nursing Home Survey, United States, May-December 1977,” U.S. Government Printing Office, Washington, D.C., 1981.

TABLE 73. Source of Payment for Nursing Home Patients With Mental Diagnosis
	Certified Facilities		Non-Certified		All Facilities
	Mental Only	Mental Plus Other Diagnosis	Mental Only	Mental Plus Other Diagnosis	Mental Only	Mental Plus Other Diagnosis
Medicaid	60.4	60.5	--	--	47.9	55.0
Public Assistance or Other Gov’t	11.7	7.5	44.6	27.7	18.3	8.8
VA	2.8	1.4	2.3	6.4	2.7	1.5
Private	23.3	28.5	47.3	55.0	28.1	31.5
Other	1.8	2.2	5.8	10.9	3.0	3.2
	100.0	100.0	100.0	100.0	100.0	100.0
SOURCE: National Center for Health Statistics, U.S. Department of Health, Education and Welfare, *The National Nursing Home Survey: 1977 Summary for the United States*, Hyattsville, Maryland, July 1979.

TABLE 74. Percentage of Nursing Home Residents by Type of Behavioral Problem^a Within Diagnostic Category^b
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
Depressed	43.2	30.5	40.0	27.5	36.6
Agitated	47.9	22.0	43.1	38.4	37.9
Abusive	26.6	9.2	25.2	20.6	16.9
Wandering	20.6	2.8	15.5	27.1	16.0
Other	12.3	6.3	12.1	4.9	8.0
No Behavior Problem	18.5	48.6	22.3	27.7	27.2
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Residents may be included in more than one behavioral category. Persons without diagnoses (numbering 57,000) have been excluded. Diagnostic categories are mutually exclusive.

TABLE 75. Percentage of Nursing Home Residents Receiving Medication for Mental Impairments Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
No Treatment	40.8	100.0	48.9	66.7	65.1
Treatment	59.2	0.0	51.1	33.3	34.9
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded.

TABLE 76. Percentage of Nursing Home Residents Receiving Tranquilizers Within Diagnostic Category^a
	Chronic Mental	Chronic Physical	Physical and Mental	Senile	Physical and Senile
No Tranquilizers	53.8	70.2	60.0	65.9	64.7
Tranquilizers	46.2	29.8	40.0	34.1	35.3
TOTAL	100.0	100.0	100.0	100.0	100.0
Number of Residents	232,000	514,000	263,000	27,000	210,000
SOURCE: National Nursing Home Survey 1977, Current Resident File. NOTE: Nursing home residents are classified into mutually exclusive diagnostic categories as follows: Chronic mental - persons with a mental condition (other than senility) as the primary diagnosis. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility. Senile - persons with senility as the primary diagnosis. Physical and senile - persons with a physical condition as the primary diagnosis and a secondary diagnosis of senility. Chronic brain syndrome is treated as senility. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded.

TABLE 77. Percentages of New Patients¹ Having Selected Conditions by Home’s Ownership Type and Patient Payment Source (1977 National Nursing Home Survey Current and Discharged Resident Data)
	All Patients				Private Patients
	Profit Chain	Profit Independence	Non- Profit	Government	Profit Chain	Profit Independence	Non- Profit	Government
Incontinence
Bowel	30.3	37.1	27.5	36.0	28.6	37.9	29.6	41.1
Bladder	38.9	42.7	33.2	42.7	35.0	46.0	32.8	59.8
Bowel and Bladder	43.9	47.7	36.7	47.7	41.6	50.7	38.6	59.8
Bedfast	14.7	12.1	10.1	18.7	10.4	12.7	9.5	5.9
Chairfast	30.0	32.9	25.2	26.2	30.2	32.8	21.7	48.7
Oxygen Therapy	4.7	6.3	4.8	5.2	2.7	6.0	5.3	2.9
Special Diet	40.7	45.4	44.8	50.0	38.1	43.2	42.4	42.9
Number of Patients	72,009	74,247	42,703	15,018	27,879	32,875	19,101	3,782
	Medicare Patients				Medicaid Patients²
	Profit Chain	Profit Independence	Non- Profit	Government	Profit Chain	Profit Independence	Non- Profit	Government
Incontinence
Bowel	27.5	29.9	18.4	48.1	30.7	36.2	30.7	28.1
Bladder	35.7	36.7	20.9	52.8	41.6	40.0	36.4	28.1
Bowel and Bladder	42.9	43.4	21.9	61.1	44.4	45.3	38.9	35.2
Bedfast	22.8	15.2	13.1	29.7	16.9	11.0	8.3	21.1
Chairfast	34.7	24.7	17.4	24.0	24.9	31.3	33.5	14.5
Oxygen Therapy	7.3	10.6	7.4	2.4	5.3	6.5	3.1	5.8
Special Diet	37.7	39.7	55.8	75.4	47.8	51.9	43.9	40.4
Number of Patients	9,021	5,301	8,339	3,187	27,750	29,560	11,747	6,844
	Medicaid/Private Patients³				Medicaid Only Patients³
	Profit Chain	Profit Independence	Non- Profit	Government	Profit Chain	Profit Independence	Non- Profit	Government
Incontinence
Bowel	34.9	41.6	28.6	10.7	25.0	27.4	31.2	34.3
Bladder	47.0	45.6	30.5	21.0	35.8	28.3	36.5	29.5
Bowel and Bladder	50.1	52.9	31.8	22.1	37.9	31.1	41.2	40.6
Bedfast	20.8	10.5	7.2	12.7	12.7	11.5	7.2	21.7
Chairfast	22.0	37.2	31.3	4.6	27.1	20.3	31.3	21.8
Oxygen Therapy	5.9	7.2	1.7	9.9	4.7	5.8	4.8	5.0
Special Diet	53.4	53.1	51.6	36.9	40.3	46.4	30.5	38.1
Number of Patients	15,366	17,160	6,113	1,919	11,430	11,418	4,462	4,146
SOURCE: 1977 National Nursing Home Survey, tabulated data. New Patients are defined as those with stays less than 60 days. Includes patients with any support from Medicaid or other government or welfare. Excludes patients with Medicare support.

TABLE 78. Percentages of New Patients Having Selected Conditions by Home’s Per Diem Health Labor Cost and Patient Payment Source (1977 National Nursing Home Survey Current and Discharged Resident Data)
	All Patients				Private Patients				Medicare Patients
	Less than $5.76²	$5.76 -7.15	$7.15 -9.20	More than $9.20	Less than $5.76²	$5.76 -7.15	$7.15 -9.20	More than $9.20	Less than $5.76²	$5.76 -7.15	$7.15 -9.20	More than $9.20
Incontinence
Bowel	27.7	32.3	43.5	26.7	25.6	34.9	37.8	30.8	63.5	27.4	46.1	16.5
Bladder	37.7	41.0	44.3	34.2	34.3	44.6	42.5	36.7	63.5	35.9	41.8	27.3
Bowel and Bladder	39.9	44.1	50.6	40.1	37.1	47.8	47.3	45.7	63.5	39.0	52.2	30.3
Bedfast	13.7	13.3	14.1	11.0	11.9	9.6	13.1	7.8	11.6	32.9	13.7	16.3
Chairfast	26.7	31.1	36.0	26.2	22.3	29.5	33.8	31.0	53.3	29.8	37.8	21.2
Oxygen Therapy	4.1	6.0	7.2	4.3	2.9	6.2	5.4	3.8	15.8	6.8	10.0	6.6
Special Diet	37.3	42.0	44.8	47.8	39.10	36.6	39.7	48.7	63.6	46.5	29.5	51.4
Number of Patients	30,044	40,106	45,366	64,177	13,025	17,309	21,298	24,236	1,071	2,719	4,297	15,335
	Medicaid Patients³				Medicaid/Private Patients⁴				Medicaid Only Patients⁴
	Less than $5.76²	$5.76 -7.15	$7.15 -9.20	More than $9.20	Less than $5.76²	$5.76 -7.15	$7.15 -9.20	More than $9.20	Less than $5.76²	$5.76 -7.15	$7.15 -9.20	More than $9.20
Incontinence
Bowel	30.1	31.9	48.3	24.9	34.4	35.3	54.8	21.3	19.0	26.7	36.3	28.0
Bladder	40.1	37.9	45.2	32.5	49.6	45.2	45.8	27.6	19.2	26.0	41.3	34.5
Bowel and Bladder	42.4	41.5	53.0	36.9	52.1	48.0	57.0	30.9	21.3	31.2	44.9	40.8
Bedfast	15.6	14.8	16.5	10.3	16.9	16.7	14.1	10.0	9.7	11.7	19.8	9.6
Chairfast	21.8	31.5	33.9	23.1	23.7	32.1	40.1	21.0	19.0	28.5	22.1	22.0
Oxygen Therapy	3.4	6.6	8.4	3.3	3.8	6.1	11.4	1.0	2.2	7.8	5.8	5.3
Special Diet	35.3	47.9	58.6	48.2	40.8	52.8	58.7	53.9	26.2	41.2	54.0	40.5
Number of Patients	12,927	16,913	15,804	18,727	8,416	10,469	8,306	7,784	4,315	6,145	6,498	8,942
SOURCE: 1977 National Nursing Home Survey, tabulated data. New Patients are defined as those with stays less than 60 days. Intervals are defined by quartile (25th percentile, 50th percentile, etc.) values for all certified facilities. Includes patients with any support from Medicaid or other government assistance or welfare. Excludes patients with Medicare support.

TABLE 79. Percentages of New Patients Having Selected Conditions by Home’s Size and Patient Payment Source (1977 National Nursing Home Survey Current and Discharged Resident Data)
	All Patients				Private Patients				Medicare Patients
	Less than 70 Beds Beds²	70-108 Beds	108-164 Beds	More than 164 Beds	Less than 70 Beds Beds²	70-108 Beds	108-164 Beds	More than 164 Beds	Less than 70 Beds Beds²	70-108 Beds	108-164 Beds	More than 164 Beds
Incontinence
Bowel	31.2	30.7	34.3	34.2	32.0	29.6	35.5	35.1	26.9	18.4	25.9	42.9
Bladder	37.6	35.6	43.6	40.4	31.7	37.8	41.4	48.6	39.5	24.6	34.0	37.7
Bowel and Bladder	41.7	40.1	46.8	47.7	38.1	41.0	46.3	52.5	40.3	26.2	39.7	52.1
Bedfast	14.1	10.9	13.0	14.8	12.9	6.5	11.8	13.3	18.4	18.5	17.2	22.2
Chairfast	28.7	27.1	34.2	28.5	27.3	29.7	32.7	29.6	28.3	15.8	28.0	34.2
Oxygen Therapy	6.5	4.4	6.1	4.2	6.0	2.9	6.4	2.9	5.6	6.0	10.5	7.7
Special Diet	42.4	40.6	47.6	45.0	40.2	36.7	43.9	44.5	47.3	50.8	49.5	45.8
Number of Patients	46,464	54,885	56,579	46,056	17,029	23,022	25,838	17,749	5,874	7,810	6,491	5,673
	Medicaid Patients³				Medicaid/Private Patients⁴				Medicaid Only Patients⁴
	Less than 70 Beds Beds²	70-108 Beds	108-164 Beds	More than 164 Beds	Less than 70 Beds Beds²	70-108 Beds	108-164 Beds	More than 164 Beds	Less than 70 Beds Beds²	70-108 Beds	108-164 Beds	More than 164 Beds
Incontinence
Bowel	33.9	33.6	32.1	30.7	36.1	41.5	28.7	36.0	28.8	24.1	33.5	25.7
Bladder	42.2	35.1	44.7	33.5	44.4	42.1	41.6	42.8	34.9	24.0	47.1	24.5
Bowel and Bladder	45.3	41.3	45.5	39.9	49.1	49.5	42.6	47.4	36.5	28.3	47.5	33.1
Bedfast	14.0	12.8	12.9	14.9	13.7	14.7	12.4	15.4	13.5	11.3	11.0	14.8
Chairfast	30.5	23.1	34.4	23.0	29.9	26.6	29.4	30.3	25.7	18.4	39.3	15.8
Oxygen Therapy	6.2	6.5	4.3	5.0	8.2	7.9	4.3	3.3	4.6	4.7	4.3	6.8
Special Diet	47.5	45.4	53.7	45.7	46.5	50.0	63.1	49.0	43.3	38.7	40.2	41.5
Number of Patients	18,953	19,390	19,301	18,258	10,364	10,777	10,301	9,118	6,942	7,945	7,912	8,657
SOURCE: 1977 National Nursing Home Survey, tabulated data. New Patients are defined as those with stays less than 60 days. Intervals are defined by quartile (25th percentile, 50th percentile, etc.) values for all certified facilities. Includes patients with any support from Medicaid or other government assistance or welfare. Excludes patients with Medicare support.

TABLE 80. Percentages of New Patients Having Selected Conditions by Home’s Occupancy Rate and Patient Payment Source (1977 National Nursing Home Survey Current and Discharged Resident Data)
	All Patients				Private Patients				Medicare Patients
	Less than 90 Percent²	90 -95.2 Percent	95.2 -98.3 Percent	More than 98.3 Percent	Less than 90 Percent²	90 -95.2 Percent	95.2 -98.3 Percent	More than 98.3 Percent	Less than 90 Percent²	90 -95.2 Percent	95.2 -98.3 Percent	More than 98.3 Percent
Incontinence
Bowel	29.1	30.8	37.2	38.0	29.2	32.9	38.3	34.5	30.0	20.7	34.4	40.5
Bladder	39.9	34.6	42.9	42.9	41.3	33.8	43.1	42.8	38.7	24.9	34.3	46.5
Bowel and Bladder	43.3	40.3	48.3	47.6	44.7	43.3	48.0	46.3	44.6	28.4	38.2	57.7
Bedfast	13.9	11.5	14.2	12.9	9.7	8.9	15.6	10.0	18.2	15.3	20.0	35.9
Chairfast	28.8	28.7	32.8	29.8	31.0	33.3	26.1	28.8	28.9	21.0	32.4	27.2
Oxygen Therapy	3.8	4.9	9.0	4.4	2.7	4.7	6.3	6.4	6.6	7.8	16.1	0.0
Special Diet	44.4	40.6	47.7	44.4	44.7	39.2	42.4	35.7	51.0	44.1	48.0	58.8
Number of Patients	68,902	62,777	43,150	29,154	29,268	22,033	18,949	13,388	9,645	10,870	2,685	2,648
	Medicaid Patients³				Medicaid/Private Patients⁴				Medicaid Only Patients⁴
	Less than 90 Percent²	90 -95.2 Percent	95.2 -98.3 Percent	More than 98.3 Percent	Less than 90 Percent²	90 -95.2 Percent	95.2 -98.3 Percent	More than 98.3 Percent	Less than 90 Percent²	90 -95.2 Percent	95.2 -98.3 Percent	More than 98.3 Percent
Incontinence
Bowel	27.1	34.4	34.6	37.4	25.2	39.0	37.4	44.3	28.7	26.6	32.4	22.5
Bladder	35.6	39.4	44.0	35.6	34.4	47.2	46.1	41.2	37.4	28.3	35.8	22.4
Bowel and Bladder	38.7	43.6	49.0	40.0	40.7	50.1	51.1	44.7	37.9	33.8	42.2	28.9
Bedfast	17.2	13.2	12.6	8.1	14.8	15.3	14.7	8.0	18.3	10.3	8.5	8.5
Chairfast	24.4	23.7	36.5	28.6	18.8	26.3	37.4	36.0	30.1	18.3	33.0	11.6
Oxygen Therapy	4.2	4.2	10.9	3.9	4.9	2.7	12.0	2.6	3.9	2.9	11.0	6.4
Special Diet	44.3	44.3	54.1	51.2	44.6	56.4	53.2	55.2	43.2	31.8	51.6	43.0
Number of Patients	23,315	23,555	19,409	9,623	10,612	12,292	12,077	5,578	11,545	10,602	5,742	3,568
SOURCE: 1977 National Nursing Home Survey, tabulated data. New Patients are defined as those with stays less than 60 days. Intervals are defined by quartile (25th percentile, 50th percentile, etc.) values for all certified facilities. Includes patients with any support from Medicaid or other government assistance or welfare. Excludes patients with Medicare support.

TABLE 81. Percentages of New Patients Having Selected Conditions by Home’s Percentage of Days for Medicaid and Patient Payment Source (1977 National Nursing Home Survey Current and Discharged Resident Data)
	All Patients				Private Patients				Medicare Patients
	Less than 55 Percent²	55-73 Percent	73-87 Percent	More than 87 Percent	Less than 55 Percent²	55-73 Percent	73-87 Percent	More than 87 Percent	Less than 55 Percent²	55-73 Percent	73-87 Percent	More than 87 Percent
Incontinence
Bowel	30.6	36.2	31.3	32.9	32.5	36.8	31.5	27.7	25.8	24.4	31.2	52.3
Bladder	38.7	38.4	40.2	42.5	38.8	41.2	39.8	42.9	40.1	16.9	36.2	62.1
Bowel and Bladder	43.1	45.1	43.2	45.8	43.9	47.8	43.6	49.6	42.0	27.8	41.4	63.0
Bedfast	11.9	14.5	13.4	13.0	11.5	10.6	10.4	9.4	19.8	19.4	19.9	10.3
Chairfast	29.8	28.0	31.6	30.8	28.2	29.4	33.5	35.9	30.3	14.2	24.3	51.2
Oxygen Therapy	5.5	5.5	5.1	4.7	5.0	4.7	2.9	6.4	9.0	5.3	12.4	2.1
Special Diet	40.3	48.0	43.6	46.9	39.2	43.8	44.6	37.1	45.9	48.0	52.3	66.4
Number of Patients	80,387	58,523	41,243	23,827	38,679	22,073	16,346	6,539	13,126	9,200	1,577	1,946
	Medicaid Patients³				Medicaid/Private Patients⁴				Medicaid Only Patients⁴
	Less than 55 Percent²	55-73 Percent	73-87 Percent	More than 87 Percent	Less than 55 Percent²	55-73 Percent	73-87 Percent	More than 87 Percent	Less than 55 Percent²	55-73 Percent	73-87 Percent	More than 87 Percent
Incontinence
Bowel	31.0	36.8	31.2	30.3	33.4	38.7	35.2	34.2	28.8	29.1	28.2	23.7
Bladder	34.8	42.6	39.9	38.3	38.5	46.2	43.7	41.1	28.9	33.1	34.7	34.2
Bowel and Bladder	40.7	47.0	42.6	41.0	44.6	52.5	46.8	42.5	34.8	35.3	37.2	39.3
Bedfast	8.3	15.0	17.3	14.7	9.5	12.4	19.7	15.2	5.1	17.8	15.7	15.0
Chairfast	29.5	28.4	26.7	25.8	31.1	28.4	27.3	29.5	27.3	23.2	25.5	19.2
Oxygen Therapy	3.7	6.6	7.1	4.1	2.6	9.9	5.4	5.0	4.4	2.5	9.8	2.7
Special Diet	42.3	56.1	43.0	52.1	40.2	62.9	49.3	54.4	43.3	43.8	32.3	46.3
Number of Patients	21,653	21,847	19,546	12,855	10,153	12,619	10,111	7,676	10,260	7,763	8,651	4,782
SOURCE: 1977 National Nursing Home Survey, tabulated data. New Patients are defined as those with stays less than 60 days. Intervals are defined by quartile (25th percentile, 50th percentile, etc.) values for all certified facilities. Includes patients with any support from Medicaid or other government assistance or welfare. Excludes patients with Medicare support.

TABLE 82. Percentage of New Nursing Home Patients¹ Having Selected Conditions by Patient Payment Source (1977 National Nursing Home Survey of Current and Discharged Resident Data)
	All Patients	Private Pay Only	Medicare Only	Medicaid²	Medicaid/³ Private	Medicaid Only
Incontinence
Bowel	32.6	33.1	27.6	32.6	35.7	28.0
Bladder	39.4	40.0	33.2	38.9	42.7	32.3
Bowel or Bladder	44.0	45.3	38.5	43.0	47.2	36.3
Bedfast	13.1	10.9	19.0	13.6	14.0	12.7
Chairfast	29.8	30.1	25.8	27.8	29.0	24.6
Oxygen Therapy	5.3	4.6	7.4	5.5	6.0	5.2
Special Diet	44.0	41.3	48.6	48.1	52.2	40.9
Number of Patients	203,935	83,630	25,848	75,898	40,559	31,456
SOURCE: 1977 National Nursing Home Survey, tabulated data. New Patients are defined as those with stays less than 60 days. Includes patients with support from Medicaid or other government assistance or welfare. Excludes patients with Medicare support.

TABLE 83. Prevalence of Diagnosis in Source of Payment Groups¹
Diagnosis	Charges Paid By:
	Private Patients		Medicaid
	No Medicare	Some Medicare	Medicaid
Circulatory	38.0	23.5	37.2
Stroke	12.3	16.0	13.2
Fracture	9.6	17.7	8.3
Mental	7.8	3.8	10.7
Cancer	7.1	13.1	6.3
Diabetes	4.7	1.7#	5.2
Respiratory	3.2	4.5	4.1
Other	17.3	19.8	15.0
All Diagnoses	100.0	100.0	100.0
Number of Persons	296,763	184,309	382,751
SOURCE: Discharged Resident File, 1977 National Nursing Home Survey (missing cases excluded item by item). NOTES: * All between-column differences are statistically significant at p = .05 or less. # Due to small cell sizes, this estimate may be unreliable. Cell size = 3,173, which represents 14.6 unweighted cases. The “Other” category is excluded from this table due to small cell size.

TABLE 84. Nursing Home Discharge Status for Elderly, Aged 65 and Over by Number and Percent, 1977
	Number	Percent
Discharged to Community
Private Residence	229,403	25.5
Rented Room or Retirement Home	16,357	1.8
Domiciliary Care Facility	5,944*	0.7
Other Community Arrangements	2,410*	0.3
Subtotal	254,114	28.3
Discharge to Non-Community Settings
Deceased¹	332,975	37.0
Short-term Hospital	223,205	24.8
Skilled Nursing Facility	36,530	4.1
Intermediate Care Facility	32,243	3.6
Mental or Long-Term Hospital	9,745	1.1
Other or Unknown Facility	10,051	1.1
Subtotal	644,749	71.7
TOTAL²	898,863	100.0
SOURCE: Discharged Resident File (consists of all discharges, both living and dead, from nursing homes in 1976) 1977 National Nursing Home Survey (missing cases excluded item by item). NOTES: * Due to small cell sizes, these estimates may be unreliable. For “Domiciliary Care Facilities” the population estimate = 5,944, which represents approximately 27 unweighted sample cases. For “Other Community Arrangements” cell size = 2,410, which represents 11.1 unweighted cases. Includes those who were dead at discharge or were discharged to other facilities but died shortly thereafter. Excludes 19,689 patients aged 65 and over who resided in certified facilities, but for whom discharge status was unknown.

TABLE 85. Number and Community Discharge Rates of Nursing Home Patients Aged 65 and Over Discharged in 1976
	Number¹ of Discharges	Percent Discharged to Community
Age²
65-79 years	371,902	36.4
80+ years	526,946	22.5
Marital Status
Married	201,389	41.2
Not Married³	673,377	24.8
Primary Diagnosis
Circulatory	303,907	25.2
Stroke	119,481	23.0
Fracture	93,475	50.3
Mental	72,681	8.6
Cancer	71,685	16.5
Diabetes	37,976	29.3
Respiratory	36,080	36.4
Other	151,928	37.7
ADL Dependency
Not Severe	224,363	53.8
Severe⁴	674,485	19.8
Charges Paid By⁵
Private Patients No Medicare Some Medicare	296,752 184,304	29.2 49.7
Medicaid	382,740	16.2
Other	35,070	39.6
All Discharges		28.3
SOURCE: Discharged Resident File, 1977 National Nursing Home Survey (missing cases excluded item by item). NOTES: Due to large sample size, all values are statistically significantly different from the mean (28.3) at the .05 level or less. Total cases may vary due to missing cases and rounding. 136,088 persons under age 65 who were discharged in 1976 are excluded from this table. 3,118 uncertified facilities with 79,624 persons are also excluded. Includes widowed, divorced, separated and never married. Includes patients who are bedfast, chairfast, incontinent of bowel, bladder or both; received a mechanical feeding, used a posey belt, cuffs or a similar device; or within seven days prior to discharge received a full bed-bath. Source of payment for care during entire nursing home stay. “Medicaid” includes Medicaid-skilled, Medicaid-intermediate, other government assistance or welfare, or religious organizations. “Medicare” includes Medicare patients who did not receive any support from sources grouped under “Medicaid.” “No Medicare” includes patients who used their own income or initial payment/life care funds, but at no time received support from “Medicaid” or “Medicare” sources. “Other” includes patients not grouped under “Medicaid,”

TABLE 86. Community Discharge Rates from Nursing Homes by Age Group, 1977
Characteristics	Age 65-79		Age 80+
Characteristics	Number of Discharges	Percent Discharged to Community	Number of Discharges	Percent Discharged to Community
Marital Status
Married	112,742	44.0	88,655	37.6
Not Married	250,589	33.5	422,806	19.6
Primary Diagnosis
Circulatory	101,852	37.5	202,065	19.0
Stroke	57,768	23.5	61,716	22.6
Fracture	37,195	59.3	56,281	44.3
Mental	29,819	13.9	42,863	4.9
Cancer	34,454	22.5	37,231	10.9
Diabetes	18,961	29.2*	19,015	29.4*
Respiratory	18,594	46.4	17,486	25.8
Other	70,399	48.9	81,532	28.1
ADL Dependency
Not Severe	105,985	60.7	118,390	47.7
Severe	265,929	26.8	408,572	15.2
Charges Paid By:
Private Patients
No Medicare	108,173	34.6	188,590	26.1
Some Medicare	88,377	59.2	95,932	40.9
Medicaid	155,612	22.9	227,139	11.6
Other	19,761	51.1	15,309	24.9
All Discharges		36.4		22.5
SOURCE: Discharged Resident File, 1977 National Nursing Home Survey (missing cases excluded item by item). NOTES: * Not significant at p=.05; all other differences significant at p=.05 or less.

TABLE 87. Community Discharge Rates from Nursing Homes by Marital Status and Other Characteristics
Characteristics	Married		Not Married
Characteristics	Number of Discharges	Percent Discharged to Community¹	Number of Discharges	Percent Discharged to Community
Age
65-79 years	112,742	44.0	250,589	33.5
80+ years	88,655	37.6	422,806	19.6
Primary Diagnosis
Circulatory	57,208	40.8	237,426	22.1
Stroke	41,825	37.8	76,166	15.3
Fracture	16,148	71.5	75,235	45.8
Mental	16,378	13.7	53,908	6.7
Cancer	22,365	29.8	47,381	10.8
Diabetes	7,512	57.6	29,953	22.3
Respiratory	6,161#	36.6	28,615	35.0
Other	31,463	50.7	116,050	34.6
ADL Dependency
Not Severe	46,218	70.5	170,619	50.2
Severe	155,174	32.4	502,775	16.1
Charges Paid By:
Private Patients
No Medicare	72,310	37.6	220,307	26.6
Some Medicare	58,308	59.1	119,552	46.2
Medicaid	56,900	22.5	313,960	15.3
Other	13,880	61.3	19,588	25.1
All Discharges		41.2		24.8
SOURCE: Discharged Resident File, 1977 National Nursing Home Survey (missing cases excluded item by item). NOTES: All between column differences significant at p = .05 or less. # Due to small cell sizes, these estimates may be unreliable. Cell size = 6,161, which represents 28.3 unweighted cases. Includes private residences, rented rooms or retirement homes, domiciliary care facilities and and other community arrangements. See earlier tables for distribution of community discharges among these settings. Most are to private residences.

TABLE 88. Community Discharge Rates by Dependency Status
Characteristics	ADL Dependency-Not Severe		ADL Dependency-Severe
Characteristics	Number of Discharges	Percent Discharged to Community	Number of Discharges	Percent Discharged to Community
Age
65-79 years	105,985	60.7	265,929	26.8
80+ years	118,390	47.7	408,572	15.2
Marital Status
Married	46,218	70.5	155,174	32.4
Not Married	170,619	50.2	502,775	16.1
Primary Diagnosis
Circulatory	77,575	50.5	226,338	16.5
Stroke	24,005	46.6	95,478	17.1
Fracture	25,363	80.3	68,112	39.1
Mental	20,226	21.4	52,456	3.6
Cancer	7,392	49.7	64,292	12.6
Diabetes	9,767	48.6	28,209	22.6
Respiratory	11,673	59.2	24,407	25.5
Other	43,397	65.6	108,533	26.6
Charges Paid By:
Private Patients
Self	76,207	53.0	220,553	21.0
Medicare	52,938	80.5	131,370	37.2
Medicaid	85,544	36.4	297,205	10.4
Other	9,687	68.6	25,383	28.6
All Discharges		53.8		19.8
SOURCE: Discharged Resident File, 1977 National Nursing Home Survey (missing cases excluded item by item). NOTES: See notes on previous table.

TABLE 89. Community Discharge Rates by Source of Payment¹
	Private Pay Patients				Medicaid
	No Medicare		Some Medicare		Medicaid
	Number of Discharges	Percent Discharged to Community	Number of Discharges	Percent Discharged to Community	Number of Discharges	Percent Discharged to Community
Age
65-79 years	108,173	34.6	88,377	59.2	155,612	22.9
80+ years	188,590	26.1	95,932	40.9	227,139	11.6
Marital Status
Married	72,310	37.6	58,308	59.1	56,900	22.5
Not married	220,307	26.6	119,552	46.2	313,960	15.3
Primary Diagnosis
Circulatory	110,735	26.3	43,316	56.7	140,290	14.9
Stroke	35,860	25.1	29,322	40.9	50,689	11.0
Fracture	27,659	43.7	32,657	69.5	30,059	34.6
Mental	22,867	12.4	6,982	15.7	40,276	4.7
Cancer	20,903	16.8	24,292	24.3	24,210	9.9
Diabetes	13,704	50.0	2,976#	58.2	20,190	11.3
Respiratory	9,470	32.2	8,296	42.3	15,626	26.0
Other	49,511	36.0	35,157	56.4	57,438	23.8
ADL Dependency
Not Severe	76,207	53.0	52,938	80.5	85,544	36.4
Severe	220,553	21.0	131,370	37.2	297,205	10.4
All Discharges		29.2		49.7		16.2
SOURCE: Discharged Resident File, 1977 National Nursing Home Survey (missing cases excluded item by item). NOTES: # Due to small cell sizes, these estimates may be unrealiable. Cell size = 2,976, which represents 13.7 unweighted cases. The “Paid by Other” category is excluded from this table due to unreliable cell sizes.

TABLE 90. Length of Nursing Home Stay by Marital Status, Age, and Source of Payment
Length of Stay	Characteristics				Primary Source of Payment
	Currently		Age		Primary Source of Payment
	Married (%)	Unmarried (%)	Under 79 (%)	79+ (%)	Own (%)	Other (%)
1 Day	1.4	1.4	1.2	1.6	1.5	1.4
2 - 7 Days	12.6	5.8	9.7	5.9	7.8	7.2
8 - 30 Days	29.6	22.5	26.3	22.5	22.6	24.7
31 - 90 Days	23.4	18.4	22.4	17.3	20.5	18.7
Over 90 Days	33.0	51.9	40.5	52.7	47.6	47.9
	100.0	100.0	100.0	100.0	100.0	100.0
SOURCE: 1977 National Nursing Home Survey, Discharged Resident File. NOTE: Includes residents discharged to community and not discharged to the community. Includes those discharged due to death.

TABLE 91. Nursing Home Length of Stay by Primary Diagnosis, 1977
Length of Stay	Circulatory Problem	Artherio- schlerosis	Arthritis	Stroke	Diabetes	Mental Problem	Fracture	Respiratory Problem	Cancer	Nervous	Other
1 day	2.2	0.5	0.7	3.5	0.3	0.3	1.6	0.7	2.0	4.3	0.6
2-7 days	6.6	5.7	4.2	7.5	5.6	5.1	6.2	15.6	11.1	8.2	10.2
8-30 days	27.7	12.7	38.6	24.3	20.7	10.6	23.6	24.6	39.8	14.9	26.8
31-90 days	17.0	15.2	11.9	21.1	12.4	15.0	30.3	21.7	20.3	16.9	24.7
91+ days	46.6	59.8	44.5	43.7	61.1	69.0	38.2	37.3	26.8	55.7	37.7
	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
SOURCE: Discharged Resident File, National Nursing Home Survey 1977.

TABLE 92. Proportion of Nursing Home Admissions Having a Length of Stay of Less Than 3 Months, 3 or More Months, and 6 or More Months, by Additional Length of Stay
Length of Stay	Additional Length of Stay (in months)
Length of Stay	0	1	2	3	4	5	6	7	8	9	10	11	12+
Less than 3 Months	56.0	22.8	11.6	9.3	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	0.0	100.0%
3 or More Months	0.0	0.0	0.0	0.0	9.1	6.8	6.0	4.6	3.6	4.2	3.3	2.8	59.5	100.0%
6 or More Months	0.0	0.0	0.0	0.0	0.0	0.0	0.0	5.8	4.7	5.4	4.2	3.6	76.3	100.0%
SOURCE: Discharged Resident File, National Nursing Home Survey 1977.

VIII. PROVIDERS

TABLE 93. Growth in Nursing Home Beds Per Thousand Elderly 1967-1973
State	1967 Beds per Elderly	Annual Growth Rate	1973 Beds per Elderly
Alabama	29.9	5.58%	41.8
Alaska	24.3	19.38%	77.8
Arizona	31.2	0.61%	32.4
Arkansas	47.8	6.31%	69.9
California	52.0	6.68%	77.6
Colorado	62.7	4.64%	82.7
Connecticut	59.5	4.03%	75.8
Delaware	35.6	4.51%	46.7
District of Columbia	29.9	6.60%	44.4
Florida	27.4	1.10%	29.3
Georgia	34.2	10.57%	64.4
Hawaii	36.5	6.16%	52.8
Idaho	48.7	2.47%	56.5
Illinois	47.1	6.88%	71.2
Indiana	46.6	5.94%	66.6
Iowa	81.8	3.09%	98.5
Kansas	68.1	3.28%	82.8
Kentucky	37.0	5.47%	51.4
Louisiana	36.5	5.79%	51.7
Maine	52.7	6.22%	76.5
Maryland	37.8	6.22%	54.9
Massachusetts	63.1	4.43%	82.3
Michigan	40.4	7.05%	61.7
Minnesota	73.8	5.87%	105.0
Mississippi	18.5	9.61%	32.9
Missouri	42.6	5.09%	57.8
Montana	48.9	5.01%	66.0
Nebraska	65.3	5.74%	92.2
Nevada	32.3	2.87%	38.4
New Hampshire	55.2	3.89%	69.7
New Jersey	35.1	4.75%	46.7
New Mexico	33.1	3.46%	40.8
New York	31.8	6.34%	46.6
North Carolina	38.9	3.57%	48.2
North Dakota	78.6	3.07%	94.5
Ohio	50.6	3.63%	62.9
Oklahoma	68.8	4.92%	92.4
Oregon	65.1	2.28%	74.7
Pennsylvania	39.4	3.86%	49.6
Rhode Island	49.7	2.93%	59.3
South Carolina	28.4	4.89%	38.1
South Dakota	67.0	5.62%	93.9
Tennessee	24.2	6.46%	35.6
Texas	49.2	6.82%	74.0
Utah	54.6	0.37%	53.3
Vermont	59.9	4.39%	78.0
Virginia	30.2	5.36%	41.6
Washington	58.8	7.11%	90.1
West Virginia	11.9	11.31%	23.4
Wisconsin	57.6	10.01%	105.0
Wyoming	34.7	8.92%	59.4
SOURCE: Calculated from published data from the 1967 and 1973 MFI Surveys. U.S. Department of Health, Education and Welfare, National Center for Health Statistics, *Vital and Health Statistics* Series 14 Number 4, “Inpatient Health Facilities as Reported from the 1967 MFI Survey,” U.S. Government Printing Office, Washington, D.C., 1972. U.S. Department of Health, Education and Welfare, Health Services and Mental Health Administration, National Center for Health Statistics, *Vital and Health Statistics*, Series 14 Number 16, “Inpatient Health Facilities as Reported from the 1973 MFI Survey,” U.S. Government Printing Office, Washington, D.C., 1976.

TABLE 94. Ownership Distribution of Nursing and Personal Care Homes
	Proprietary		Non-Profit		Government		Total
	Patients	Percent of Total	Patients	Percent of Total	Patients	Percent of Total	Patients	Percent of Total
1950¹	110,070	37.2%	71,430	24.2%	114,060	38.6%	295,560	100%
1960¹	272,422	58.0%	104,752	22.3%	92,543	19.7%	469,717	100%
1970¹	661,888	71.4%	159,887	17.2%	105,739	11.4%	927,514	100%
1976²	880,012	68.4%	275,030	21.3%	138,234	10.7%	1,293,285	100%
SOURCE: U.S. Department of Health, Education and Welfare, National Center for Health Statistics, *Inpatient Health Facilities Statistics, United States, Hyattsville, Maryland 1980. U.S. Bureau of the Census, U.S. Census of Population: 1950. Vol. IV, Special Reports, Part 2, Chapter C, Institutional Population. U.S. Government Printing Office, Washington, D.C., 1953. U.S. Bureau of the Census, U.S. Census of Population: 1960. Subject Reports: Final Report PC(2)-8A: Inmates of Institutions. U.S. Government Printing Office, Washington, D.C., 1963. U.S. Bureau of the Census, U.S. Census of Population: 1970. Subject Reports*: Final Report PC(2)-4E: Persons in Institutions and Other Group Quarters. U.S. Government Printing Office, Washington, D.C., 1973. Based on data from Census of Population Based on data from Master Facility Inventory

TABLE 95. Counts of Medicare and/or Medicaid Certified Nursing Home Facilities and Beds 1980 (MMACS Bed and Facility Counts, Tables by Type and State)
State	Total Facilities	Medicare Beds	Medicaid Skilled Beds	Medicaid ICF Beds¹	IMR Certified Beds²	Total Beds
TOTAL	14,615	445,440	645,208	916,987	59,453	1,502,990
Alabama	230	12,940	12,966	7,984	578	21,486
Alaska	14	323	518	540	5	653
Arizona	23	815	0	0	0	2,595
Arkansas	213	315	8,821	10,778	1,720	21,248
California	1,200	90,423	101,683	24,325	215	116,787
Colorado	209	5,671	11,008	15,235	817	21,382
Connecticut	246	18,443	19,586	3,772	0	24,865
Delaware	36	957	771	1,998	0	3,612
District of Columbia	7	326	276	582	0	1,356
Florida	353	22,131	30,796	29,602	804	39,014
Georgia	331	5,927	20,628	25,094	819	32,336
Hawaii	37	1,734	1,603	1,101	91	3,695
Idaho	65	3,265	4,449	4,630	0	5,071
Illinois	812	8,141	26,306	79,208	6,222	102,009
Indiana	468	6,415	7,185	30,288	1,955	46,843
Iowa	428	692	708	29,873	0	35,458
Kansas	373	1,264	2,926	23,867	14	26,115
Kentucky	224	4,227	4,227	12,804	1,112	23,503
Louisiana	233	1,561	1,359	22,503	3,926	28,109
Maine	143	367	349	8,183	198	9,674
Maryland	197	8,943	5,615	18,840	837	23,763
Massachusetts	520	6,504	13,419	23,960	0	43,656
Michigan	492	21,174	22,737	40,086	4,661	53,894
Minnesota	729	3,841	21,761	22,695	5,878	57,558
Mississippi	182	549	10,185	10,006	907	15,671
Missouri	248	4,534	8,484	20,801	0	27,449
Montana	100	2,872	3,337	6,163	17	6,711
Nebraska	221	1,087	2,040	16,747	136	18,467
Nevada	28	1,802	1,802	2,019	0	2,067
New Hampshire	74	809	809	5,576	0	6,808
New Jersey	255	15,847	25,019	27,978	0	34,371
New Mexico	44	223	223	3,176	482	4,290
New York	601	67,717	67,759	25,773	0	99,642
North Carolina	229	7,747	8,138	10,877	929	23,609
North Dakota	73	3,635	3,635	4,516	0	5,536
Ohio	911	31,249	38,736	59,631	3,417	78,090
Oklahoma	360	411	0	27,263	1,456	31,617
Oregon	191	2,900	2,996	10,665	1,978	16,771
Pennsylvania	629	38,622	50,813	14,484	3,863	82,388
Rhode Island	121	1,848	1,869	6,026	94	9,053
South Carolina	159	6,877	6,768	9,296	742	12,859
South Dakota	108	472	3,731	5,829	905	8,082
Tennessee	241	2,969	2,796	22,158	2,295	27,724
Texas	1,003	2,358	14,615	82,744	7,622	110,226
Utah	91	1,511	2,198	4,879	1,217	6,845
Vermont	46	665	736	2,174	0	3,088
Virginia	174	1,647	1,466	17,401	0	25,125
Washington	326	9,338	22,860	23,632	0	31,721
West Virginia	80	2,693	2,693	5,214	0	5,980
Wisconsin	511	8,494	40,403	52,107	3,541	62,143
Wyoming	26	170	1,400	1,904	0	1,905
SOURCE: Medicare and Medicaid Automated Certification System, Tabulated Data. ICF means intermediate care facility. IMR means intermediate care facility for the mentally retarded.

TABLE 96. Total Medicare or Medicaid Certified Nursing Home Beds per Elderly Persons, By State
	Beds Per Elderly Person	Total Elderly Population	Total Beds
Arizona	0.01	306,971	2,595
District of Columbia	0.02	74,202	1,356
West Virginia	0.03	237,868	5,980
Florida	0.02	1,684,972	39,084
Nevada	0.03	65,767	2,067
Alaska	0.06	11,530	653
New Mexico	0.04	115,690	4,290
North Carolina	0.04	602,273	23,609
New Jersey	0.04	859,682	34,371
Hawaii	0.05	76,230	3,695
South Carolina	0.05	287,287	12,859
Missouri	0.04	648,289	27,449
New York	0.05	2,160,558	99,642
California	0.05	2,414,755	116,787
Virginia	0.05	505,204	25,125
Wyoming	0.05	37,218	1,905
Alabama	0.05	439,938	21,486
Vermont	0.05	58,166	3,088
Tennessee	0.05	517,524	27,724
Mississippi	0.05	289,357	15,671
Idaho	0.05	93,680	5,071
Pennsylvania	0.05	1,531,107	82,388
Maryland	0.06	395,594	23,763
Oregon	0.06	303,284	16,771
Michigan	0.06	912,321	53,894
Delaware	0.06	59,284	3,612
Kentucky	0.06	409,853	23,503
Utah	0.06	109,220	6,845
Georgia	0.06	516,808	32,336
Massachusetts	0.06	726,531	43,656
Ohio	0.07	1,169,437	78,090
New Hampshire	0.07	102,967	6,808
Louisiana	0.07	403,939	28,109
Connecticut	0.07	364,864	24,865
Maine	0.07	140,918	9,674
North Dakota	0.07	80,447	5,536
Arkansas	0.07	312,331	21,248
Washington	0.07	431,417	31,721
Rhode Island	0.07	126,922	9,053
Texas	0.08	1,317,040	110,226
Indiana	0.08	585,425	46,843
Montana	0.08	84,559	6,711
Illinois	0.08	1,261,160	102,009
Colorado	0.09	247,261	21,382
Kansas	0.09	306,179	26,115
Oklahoma	0.08	376,042	31,617
South Dakota	0.09	91,014	8,082
Nebraska	0.09	205,576	18,467
Iowa	0.09	387,498	35,458
Wisconsin	0.11	564,228	62,143
Minnesota	0.12	479,746	57,558
SOURCE: Tabulated data from the 1980 Medicare and Medicaid Automated Certification System file.

TABLE 97. Number of Long-Term Care Facilities and Beds by Certification Level, MMACS 1980
	Total Facilities	Medicare Beds	Medicaid Skilled Beds	Medicaid ICF Beds	IMR Beds	Total Beds
Medicare SNF	183	10,716	--	--	--	18,291
Medicaid SNF	851	--	71,045	--	--	79,600
Medicare/Medicaid SNF	2,028	202,367	202,411	--	--	234,760
Medicaid ICF	6,463	--	--	502,290	--	550,760
Medicare SNF/Medicaid SNF-ICF	2,591	214,470	215,088	252,103	--	335,491
Medicaid SNF/ICF	1,596	--	143,238	151,252	--	183,909
Medicare SNF-ICF	48	3,472	--	4,786	--	7,144
ICF-IMR	25	--	--	3,065	3,654	4,585
IMR	533	--	--	--	55,799	55,799
Hospital	297	14,415	13,426	3,491	--	32,639
TOTAL	14,615	445,440	645,208	916,987	59,453	1,502,990
SOURCE: Tabulated data from the 1980 Medicare - Medicaid Automated Certification System file. SNF - Skilled nursing facility ICF - Intermediate care facility IMR - Intermediate care facility for mentally retarded

TABLE 98. Distribution of Facilities by Total Bed Size and Certification, MMACS
	Less than 3	3-9	10-24	25-49	50-74	75-99	100-199	200-299	300-499	500+	Total Facilities	Total Beds
Medicare SNF	--	2 (1.09)	5 (2.73)	31 (16.94)	34 (18.58)	27 (14.75)	70 (38.25)	10 (5.46)	4 (2.19)	-- --	183	18.291
Medicaid SNF	--	--	30 (3.50)	154 (17.99)	214 (25.00)	146 (17.06)	277 (32.36)	26 (3.04)	4 (0.47)	5 (0.58)	856	80,240
Medicare & Medicaid SNF	--	--	19 (0.94)	218 (10.73	357 (17.57)	485 (23.87)	742 (36.52)	151 (7.43)	42 (2.07)	18 (0.89)	2,032	235,177
Medicare ICF	--	12 (0.19)	328 (5.07)	1,328 (20.52)	1,826 (28.37)	969 (14.97)	1,740 (26.89)	179 (2.77)	51 (0.79)	28 (0.43)	6,471	551,631
Medicare & Medicaid SNF, ICF	--	--	24 (0.93)	141 (5.45)	321 (12.40)	444 (17.15)	1,311 (50.64)	268 (10.35	60 (2.32)	20 (0.77)	2,589	335,326
Medicaid SNF & ICF	--	1 (0.06)	18 (1.13)	129 (8.08)	324 (20.30)	277 (17.36)	701 (43.92)	99 (6.20)	40 (2.51)	7 (0.44)	1,596	183,709
Medicare SNF & Medicaid ICF	--	--	--	--	5 (10.42)	4 (8.33)	29 (60.42)	8 (16.67)	2 (4.17)	--	48	7,144
ICF - IMR	--	--	4 (16.67)	2 (8.33)	4 (16.67)	7 (29.17)	2 (8.33)	2 (8.33)	1 (4.17)	2 (8.33)	24	4,503
IMR	--	168 (31.40)	118 (22.06)	59 (11.03)	41 (7.66)	28 (5.23)	56 (10.47)	17 (3.18)	18 (3.36)	30 (5.61)	535	55,896
Hospital	--	4 (1.35)	41 (13.80)	91 (30.64)	50 (16.84)	38 (12.79)	40 (13.47)	11 (3.70)	11 (3.70)	11 (3.70)	297	32,639
TOTAL	--	187 (1.28)	587 (4.01)	2,153 (14.72)	3,186 (21.78)	2,425 (16.57)	4,968 (33.96)	771 (5.27)	233 (1.59)	121 (0.83)	14,631	1,504,556
* When certified long term care beds are part of a facility serving other purposes, such as a hospital, they may report total beds for both long term care and other purposes. This is most pronounced for hospitals, but may happen for others, e.g. retirement centers.

TABLE 99. Distribution of Beds by Total Bedsize and Certification, MMACS*
	Less than 3	3-9	10-24	25-49	50-74	75-99	100-199	200-299	300-499	500+	Total Facilities	Total Beds
Medicare SNF	--	15 (0.08)	90 (0.49)	1,233 (6.74)	1,984 (10.85)	2,416 (13.21)	8,983 (49.11)	2,253 (12.32)	1,317 (7.20)	--	183	18,291
Medicaid SNF	--	--	611 (0.77)	5,693 (7.15)	12,890 (16.19)	12,484 (15.68)	35,701 (44.85)	6,026 (7.57)	1,293 (1.62)	4,902 (6.16)	851	79,600
Medicare & Medicaid SNF	--	--	351 (0.15)	8,602 (3.66)	21,511 (9.16)	43,663 (18.60)	99,960 (42.58)	34,112 (14.53)	14,649 (6.24)	11,912 (5.07)	2,028	234,760
Medicare ICF	--	88 (0.16)	6,385 (1.16)	50,431 (9.16)	109,678 (19.91)	83,603 (15.18)	219,388 (39.83)	41,162 (7.47)	18,530 (3.36)	21,507 (3.90)	6,463	550,772
Medicare & Medicaid SNF & ICF	--	--	434 (0.13)	5,702 (1.70)	19,542 (5.82)	39,346 (11.73)	174,013 (51.87)	62,145 (18.52)	21,857 (6.51)	12,452 (3.71)	2,591	335,491
Medicaid SNF & ICF	--	9 (0.00)	333 (0.18)	4,920 (2.67)	19,743 (10.74)	24,239 (13.18)	92,343 (50.21)	23,326 (12.68)	14,307 (7.78)	4,689 (2.55)	1,596	183,909
Medicare SNF & Medicaid ICF	--	--	--	--	292 (4.09)	333 (4.66)	4,024 (56.33)	1,830 (25.62)	665 (9.31)	--	48	7,144
ICF-IMR	--	--	68 (1.48)	72 (1.57)	230 (5.02)	697 (15.20)	293 (6.39)	457 (9.97)	348 (7.59)	2,420 (52.78)	25	4,585
IMR	--	1,130 (2.02)	1,609 (2.88)	2,178 (3.90)	2,518 (4.51)	2,435 (4.36)	7,874 (14.11)	4,234 (7.59)	6,962 (12.48)	26,859 (48.13)	533	55,799
Hospital	--	20 (0.06)	691 (2.12)	3,334 (10.21)	2,932 (8.98)	3,250 (9.96)	5,358 (16.42)	2,806 (8.60)	3,988 (12.22)	10,260 (31.43)	297	32,639
TOTAL	--	1,122 (0.07)	10,220 (0.68)	81,499 (5.42)	190,158 (12.65)	211,451 (14.07)	643,874 (42.84)	175,619 (11.68)	79,677 (5.30)	74,125 (4.93)	14,615	1,502,990
SOURCE: Tabulated data from the 1980 MMACS file. * When certified long term care beds are part of a facility serving other purposes, such as a hospital, they may report total beds for both long term care and other purposes. This is most pronounced for hospitals, but may happen for others, e.g. retirement centers.

TABLE 100. Facilities by MFI Level of Care and Certification, 1976
	Total	Percent of Facilities Classified as
	Total	Nursing Care	Personal Care with Nursing	Personal Care	Domiciliary Care
TOTAL	20,505	65.51%	14.76%	19.44%	0.29%
Skilled:
Medicare SNF	1,115	30.49%	19.01%	50.31%	0.18%
Medicaid SNF	1,383	92.99%	3.83%	3.11%	0.07%
Medicare & Medicaid SNF	2,038	95.00%	3.68%	1.32%	0
Skilled-Intermediate:
Medicare SNF/ Medicaid SNF-ICF	1,478	91.81%	7.17%	1.01%	0
Medicaid SNF/ ICF	1,591	92.39%	5.41%	2.20%	0
Medicare SNF/ Medicaid ICF	374	53.21%	20.05%	26.74%	0
Intermediate:
Medicaid ICF	5,114	84.20%	9.41%	6.37%	0.02%
Uncertified	7,412	34.24%	26.15%	38.84%	0.76%
SOURCE: Tabulated data from the 1976 MFI Survey.

TABLE 101. Uncertified Nursing Home and Beds by State, 1978 MFI
	Facilities	Beds
TOTAL	6,641	246,148
Alabama	24	1,825
Alaska	2	274
Arizona	65	4,884
Arkansas	37	3,614
California	1,882	44,687
Colorado	9	700
Connecticut	89	2,757
Delaware	11	346
District of Columbia	30	914
Florida	28	1,609
Georgia	64	5,285
Hawaii	66	631
Idaho	1	16
Illinois	125	8,739
Indiana	98	7,532
Iowa	135	7,948
Kansas	38	2,602
Kentucky	112	6,482
Louisiana	8	554
Maine	219	2,714
Maryland	42	2,673
Massachusetts	281	8,941
Michigan	123	8,580
Minnesota	48	1,913
Mississippi	19	3,913
Missouri	650	21,827
Montana	8	150
Nebraska	20	1,203
Nevada	9	338
New Hampshire	32	964
New Jersey	267	9,933
New Mexico	18	757
New York	412	23,559
North Carolina	420	8,982
North Dakota	14	646
Ohio	133	8,785
Oklahoma	21	1,625
Oregon	52	1,811
Pennsylvania	88	4,440
Rhode Island	5	169
South Carolina	71	2,016
South Dakota	34	1,621
Tennessee	56	2,017
Texas	65	3,866
Utah	9	211
Vermont	164	1,734
Virginia	203	6,132
Washington	227	9,178
West Virginia	73	2,551
Wisconsin	28	1,274
Wyoming	6	226
SOURCE: Tabulated data from the 1978 Master Facility Inventory.

TABLE 102. Uncertified Nursing Homes and Beds by Bed Size 1978 MFI
Bed Size	Facilities		Beds
Bed Size	Number	Percent	Number	Percent
1-2	14	0.21	26	0.01
3-9	2020	30.42	11,210	4.55
10-24	1946	29.30	31,153	12.66
25-49	1201	18.08	42,411	17.23
50-74	622	9.37	36,784	14.94
75-99	292	4.40	25,593	10.40
100-199	427	6.43	56,293	22.87
200-299	70	1.05	16,393	6.66
300-499	30	0.45	11,070	4.50
500+	18	0.27	15,215	6.18
TOTAL	6641	100.0	246,148	100.0
SOURCE: Tabulated data from the 1978 Master Facility Inventory.

TABLE 103. Uncertified Nursing Homes and Beds by Type of Ownership 1978 MFI
	Facilities		Beds
	Number	Percent	Number	Percent
Proprietary	5,271	79.37	152,289	61.87
Nonprofit	1,077	16.22	61,171	24.85
Gov’t - Non-Fed	258	3.88	28,279	11.49
Gov’t - Federal	35	0.53	4,409	1.79
TOTAL	6641	100.0	246,148	100.0
SOURCE: Tabulated data from the 1978 Master Facility Inventory.

TABLE 104. Uncertified Nursing Homes by Type of Ownership and Bed Size 1978 MFI
Bed Size	Proprietary		Nonprofit		Gov’t - Non-Fed		Federal
Bed Size	Number	Percent	Number	Percent	Number	Percent	Number	Percent
1-2	11	0.21	2	0.19	1	0.39	--	--
3-9	1882	35.70	108	10.03	19	7.36	11	31.43
10-24	1622	30.77	275	25.53	48	18.60	1	2.86
25-49	839	15.92	289	26.83	67	25.97	6	17.14
50-74	403	7.65	177	16.43	41	15.89	1	2.86
75-99	204	3.87	68	6.31	15	5.81	5	14.29
100-199	270	5.12	115	10.68	36	13.95	6	17.14
200-299	32	0.61	27	2.51	9	3.49	2	5.71
300-499	6	0.11	12	1.11	11	4.26	1	2.86
500+	1	0.02	4	0.37	11	4.26	2	5.71
TOTAL	5271	100.0	1,077	100.0	258	100.0	35	100.0
SOURCE: Tabulated data from the 1978 Master Facility Inventory.

TABLE 105. Beds in Uncertified Nursing Homes by Size of Facility 1978 MFI
Bed Size	Proprietary		Nonprofit		Gov’t - Non-Fed		Federal
Bed Size	Number	Percent	Number	Percent	Number	Percent	Number	Percent
1-2	21	0.01	3	0	2	0.01	--	--
3-9	10,387	6.82	662	1.08	102	0.36	59	1.34
10-24	25,724	16.89	4,617	7.55	792	2.80	20	0.45
25-49	29,120	19.12	10,471	17.12	2,581	9.13	239	5.42
50-74	23,863	15.67	10,503	17.17	2,360	8.35	58	1.32
75-99	18,024	11.84	5,860	9.58	1,278	4.52	431	9.78
100-199	35,186	23.10	15,579	25.47	4,806	16.99	722	16.38
200-299	7,378	4.84	6,366	10.41	2,248	7.95	401	9.10
300-499	2,077	1.36	4,698	7.68	3,902	13.80	393	8.91
500+	509	0.33	2,412	3.94	10,208	36.10	2,086	47.31
TOTAL	152,289	100.0	61,171	100.0	28,279	100.0	4,409	100.0
SOURCE: Tabulated data from the 1978 Master Facility Inventory.

TABLE 106. Number of Medicare Certified Home Health Agencies by Type of Agency and Division, 1974-1980
	All Agencies			Visiting Nurse Association			Combined Gov’t Voluntary
	1974	1980	Pct. Change	1974	1980	Pct. Change	1974	1980	Pct. Change
All Areas	2,343	2,859	22.0%	533	511	-4.1%	52	50	-3.8%
United States	2,329	2,830	21.5	532	510	-4.1	52	50	-3.8%
New England	343	317	-7.6	238	212	-10.9	9	3	-66.7
Middle Atlantic	282	281	0.0	93	92	-1.1	5	5	0.0
East North Central	335	433	29.2	86	85	-1.2	11	11	0.0
West North Central	244	345	41.4	25	20	-20.0	5	11	120.0
South Atlantic	338	404	19.5	27	40	48.1	12	7	-41.7
East South Central	298	410	37.6	9	9	0.0	--	5	-41.7
West South Central	254	305	20.1	11	11	0.0	1	3	200.0
Mountain	91	127	39.6	12	10	-16.6	5	5	0.0
Pacific	144	207	43.8	31	31	0.0	4	0	-100.0
	Government			Hospital Based			Proprietary, Private Non-Profit, Other
	1974	1980	Pct. Change	1974	1980	Pct. Change	1974	1980	Pct. Change
All Areas	1,299	1,274	-1.9%	277	349	26.0%	182	674	270.3%
United States	1,298	1,272	-2.0	269	344	27.9	178	653	266.8
New England	68	54	-2.0	25	21	-16.0	3	27	800.0
Middle Atlantic	90	74	-17.8	86	80	-6.9	8	30	275.0
East North Central	189	205	8.5	33	48	45.4	16	84	425.0
West North Central	174	240	37.9	37	47	27.0	3	27	800.0
South Atlantic	250	157	-37.2	20	30	50.0	29	170	486.2
East South Central	254	264	3.9	22	36	63.6	13	96	638.5
West South Central	178	171	-3.9	7	14	100.0	57	106	85.9
Mountain	51	67	31.4	13	23	76.9	10	22	120.0
Pacific	44	40	-9.1	26	45	73.1	39	91	133.3
SOURCE: Health Care Financing Administration unpublished statistics.

TABLE 107. Home Health Agencies, Persons Served, Visits Charges, and Reimbursements Under the Medicare Program by Geographic Area, 1974-1980
Geographic Area and Year	Persons Served		Visits			Charges					Reimbursements
	Persons Served		Visits			Total	Visit Charges				Reimbursements
	Number	Per 1,000 Enrollees	Number	Per Person Served	Per 1,000 Enrollees	Total	Total	Per Visit	Per Person Served	Per 1,000 Enrollees	Amount	Per 1,000 Enrollees
Total, All Areas
1974	392.7	16.5	8,070	20.6	340	$147,499	$137,406	$17	$350	$5.8	$141,464	$5.9
1975	499.6	20.2	10,805	21.6	436	227,001	211,994	20	424	8.6	215,497	8.7
1976	588.7	22.9	13,335	22.7	520	312,325	292,697	22	497	11.4	289,851	11.3
1977	689.7	26.1	15,548	22.5	587	407,827	385,224	25	559	14.6	363,785	13.8
1978	769.7	28.3	17,345	22.5	639	500,747	474,498	27	617	17.5	435,322	16.0
1979	836.7	30.0	19,159	22.9	688	601,476	572,263	30	683	20.5	518,272	18.6
1980	957.4	33.6	22,428	23.4	788	770,703	734,718	33	767	25.8	662,133	23.3
Percent Change 1974-1980	143.8%	103.6%	177.9%	13.3%	131.8%	422.5%	434.7%	94.1	119.1%	344.8%	368.0%	294.9%
Northeast
1974	143.8	24.4	2,899	20.2	493	50,376	47,166	16	328	8.0	48,492	8.2
1975	175.9	29.2	3,655	20.8	607	71,259	67,848	19	386	11.3	68,226	11.3
1976	198.1	32.2	4,201	21.2	683	89,853	85,617	20	434	13.9	84,938	13.8
1977	229.7	36.5	5,106	22.2	810	118,723	113,094	22	492	18.0	110,928	17.6
1978	253.5	39.6	5,846	12.1	912	145,426	138,754	24	547	21.7	134,378	21.0
1979	272.4	41.7	6,393	23.5	N.A.	169,524	162,681	25	597	N.A.	154,704	N.A.
1980	308.7	46.5	7,596	24.6	1,145	225,268	216,535	29	701	32.6	200,022	30.3
Percent Change 1974-1980	114.7%	90.6%	162.0%	21.8%	132.2%	347.2%	359.1%	81.2%	113.7%	307.5%	414.1%	269.5%
North Central
1974	82.8	12.7	1,527	18.4	234	25,486	25,082	16	303	3.8	24,298	3.7
1975	101.5	15.2	1,958	19.3	293	37,315	36,012	18	355	5.4	35,186	5.3
1976	118.6	17.4	2,446	20.6	358	54,195	52,498	21	443	7.7	50,579	7.4
1977	142.2	20.4	3,029	21.3	435	76,974	74,720	25	525	10.7	69,640	10.0
1978	161.9	22.9	3,486	21.5	493	97,300	94,412	27	583	13.4	84,472	11.9
1979	177.8	24.7	3,829	21.5	N.A.	116,755	113,088	30	636	N.A.	101,157	N.A.
1980	206.9	28.3	4,528	21.9	619	148,467	143,936	32	696	19.7	129,925	17.8
Percent Change 1974-1980	149.9%	122.8%	196.5%	19.0%	164.5%	482.5%	473.9%	100.0%	129.7%	418.4%	434.7%	381.1%
South
1974	102.3	13.6	2,417	23.6	321	47,274	42,332	18	414	5.6	45,338	6.0
1975	139.0	17.7	3,519	25.3	448	81,060	72,831	21	524	9.3	75,675	9.6
1976	171.7	21.2	4,519	26.3	558	115,434	104,877	23	611	12.9	103,794	12.8
1977	199.3	23.7	4,870	24.4	578	137,432	127,148	26	638	15.1	117,713	14.0
1978	218.8	25.1	5,223	23.9	600	163,692	152,703	29	698	17.5	136,498	15.7
1979	240.6	26.8	6,022	25.0	N.A.	206,376	194,002	32	806	N.A.	168,966	N.A.
1980	279.9	30.3	7,0871	25.3	767	262,765	247,603	35	885	26.8	213,037	23.1
Percent Change 1974-1980	173.6%	122.8%	192.9%	7.2%	138.9%	455.8%	484.9%	94.4%	113.8%	378.6%	369.9%	285.0%
West
1974	60.2	15.9	1,087	18.1	288	21,425	20,199	19	336	5.3	20,415	5.4
1975	78.4	19.9	1,495	19.1	380	32,908	31,523	21	402	8.0	31,656	8.0
1976	93.1	22.8	1,916	20.6	470	46,732	44,756	23	481	11.0	44,640	10.9
1977	108.3	25.5	2,188	20.2	515	60,183	57,686	26	533	13.6	56,317	13.3
1978	121.9	27.7	2,334	19.1	530	72,829	69,239	30	568	15.7	66,948	15.2
1979	131.8	29.0	2,526	19.2	N.A.	89,068	85,295	34	647	N.A.	80,492	N.A
1980	148.1	31.7	2,851	19.3	609	114,485	109,053	38	736	23.3	104,530	22.3
Percent Change 1974-1980	146.0%	99.4%	162.3%	6.6%	111.4%	434.3%	439.9%	100.0%	119.0%	339.6%	412.0%	312.9%
Other Areas
1974	3.7	13.2	140	38.3	506	2,938	2,627	19	710	9.4	2,918	10.4
1975	4.9	16.3	177	36.0	587	4,459	3,732	21	762	12.4	4,254	14.2
1976	7.3	23.0	252	34.7	798	6,111	4,948	20	678	15.6	5,894	18.6
1977	10.2	29.9	355	34.8	1,040	14,514	12,575	35	1,233	36.9	9,187	26.9
1978	13.6	20.9	457	33.6	703	22,040	19,384	42	1,425	29.8	13,026	20.0
1979	14.0	24.5	389	27.8	N.A.	19,753	17,197	44	1,411	N.A.	12,052	N.A.
1980	13.8	23.5	372	27.0	632	19,720	17,592	47	1,275	29.9	13,819	23.5
Percent Change 1974-1980	272.9%	78.0%	165.7%	-29.5%	24.9%	571.2%	569.7%	174.4%	79.6%	218.1%	373.6%	125.9%
SOURCE: Health Care Financing Administration, *Health Care Financing Statistics*, “Medicare Use of Home Services,” series.

TABLE 108. Persons Served, Visits, Visit Charges, Average Visits per Person Served, Average Visit Charges per Person Served, Average Charge per Visit, Under the Medicare Program by Home Health Agency Type, 1974-1980
	All Agencies	Visiting Nurse Association	Combined Gov’t & Voluntary	Government	Hospital Based	Proprietary	Private Non-Profit	Other
Persons Served (000’s)
1974	392.7	189.0	18.4	90.0	47.0	12.0	36.4
1975	499.6	231.7	20.8	112.5	57.7	18.9	50.5	7.5
1976	588.7	245.8	18.7	124.0	63.3	24.5	103.6	8.8
1977	689.7	273.2	19.6	141.8	74.4	31.8	133.9	14.9
1978	769.3	297.4	21.3	152.1	87.8	37.5	160.8	12.5
1979	836.7	332.5	15.4	155.9	95.1	47.9	177.8	12.2
1980	957.4	376.9	16.2	173.5	113.8	61.7	201.6	13.7
Percent Change 1974-1980	143.8%	99.4%	-11.9%	92.8%	142.1%	414.2%	399.2%*	82.7%*
Visits (000’s)
1974	8,070	3,565	280	1,843	905	375	1,102
1975	10,805	4,555	322	2,331	1,159	603	1,656	177
1976	13,335	4,901	317	2,556	1,318	724	3,285	233
1977	15,548	5,655	366	2,968	1,565	846	3,800	347
1978	17,345	6,335	391	3,053	1,877	925	4,464	300
1979	19,159	7,223	279	3,110	2,013	1,221	5,023	290
1980	22,428	8,434	303	3,568	2,417	1,588	5,796	323
Percent Change 1974-1980	177.9%	164.6%	8.2%	93.6%	167.1%	323.5%	250.0%*	82.5%*
Visiting Charges (000’s)
1974	$137,406	$55,973	$5,054	$27,365	$19,382	$7,303	$22,329
1975	211,944	80,578	6,477	39,448	28,631	13,801	39,682	3,326
1976	292,697	93,925	7,140	47,500	35,229	18,461	85,376	5,066
1977	385,223	121,701	8,815	59,781	45,997	24,078	117,570	7,911
1978	474,498	149,159	10,028	67,511	58,949	29,353	151,557	7,942
1979	572,263	188,579	7,834	74,840	68,862	42,369	181,218	8,562
1980	734,718	244,102	9,777	94,189	92,088	60,580	223,639	10,343
Percent Change 1974-1980	434.7%	336.1%	93.5%	244.2%	375.1%	729.5%	463.6%*	210.9%*
Average Visits per Persons Served
1974	20.6	18.9	15.2	20.5	19.3	31.2	30.3
1975	21.6	19.7	15.5	20.7	20.1	32.0	32.8	23.8
1976	22.7	19.9	16.9	20.6	20.8	29.6	31.7	26.4
1977	22.5	20.7	18.7	20.9	21.0	26.6	28.4	23.4
1978	22.5	21.3	18.3	20.1	21.4	24.7	27.8	24.1
1979	22.9	21.7	18.1	20.0	21.2	25.5	28.3	23.8
1980	23.4	22.4	18.7	20.6	21.2	25.7	28.8	23.6
Percent Change 1974-1980	13.6%	18.5%	23.0%	0.0%	9.8%	-17.6%	-12.2%*	0.0%*
Average Visit Charges Per Person Served
1974	$350	$296	$275	$304	$413	$608	$614
1975	424	348	311	351	497	731	786	445
1976	497	382	381	383	556	754	824	574
1977	559	443	450	422	618	757	878	532
1978	617	501	470	444	671	784	942	636
1979	684	567	509	480	724	885	1,019	704
1980	767	647	605	543	809	981	1,109	755
Percent Change 1974-1980	110.0%	118.6%	120.0%	78.6%	95.9%	61.3%	41.1%*	69.7%*
Average Charge Per Visit
1974	$17	$16	$18	$15	$21	$20	$20
1975	20	18	20	17	25	23	24	19
1976	22	19	23	19	27	26	26	22
1977	25	21	24	20	29	28	31	23
1978	27	24	26	22	31	32	34	26
1979	30	26	28	24	34	35	36	30
1980	33	29	32	26	38	38	39	32
Percent Change 1974-1980	94.1%	81.2%	77.8%	73.35	80.9%	90.0%	62.5%*	68.4%*
SOURCE: Health Care Financing Administration, Health Care Financing Program Statistics, “Medicare Use of Home Health Services” series. * Percent change 1975-1980.

TABLE 109. Persons Served, Percent of Persons Receiving Visiting, Visits, Percent of Visits and Visit Charges for Home Health Agency Services Under the Medicare Program by Type of Visit, 1975
	All Agencies	Visiting Nurse Association	Combined Gov’t & Voluntary	Government	Hospital Based	Proprietary	Private Non- Profit	Other
Persons Served (000’s)*
Total	499.6	231.7	20.8	112.5	57.7	18.9	50.5	7.5
Nursing Care	479.5	224.1	20.0	108.4	55.4	17.5	47.1	6.9
Home Health Aide	137.4	56.7	4.3	27.2	11.9	10.0	25.1	2.3
Physical Therapy	100.9	43.9	3.1	18.2	15.6	4.5	13.6	1.8
Other	43.2	16.4	0.7	5.2	8.4	3.0	8.1	1.3
Percent of Persons Receiving Visit*
All Visits	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Nursing Care	96.0	96.7	96.2	96.4	51.2	92.6	93.3	92.0
Home Health Aide	27.5	24.5	20.7	24.2	10.6	52.9	49.7	30.7
Physical Therapy	20.2	18.9	14.9	16.2	13.9	23.8	26.9	24.0
Other	8.6	7.1	3.4	4.6	7.5	15.9	16.0	17.3
Visits (000’s)
Total	10,805	4,555	322	2,331	1,159	603	1,656	177
Nursing Care	6,647	2,942	213	1,493	743	262	889	104
Home Health Aide	2,840	1,095	74	610	206	256	552	47
Physical Therapy	1,037	407	30	188	160	70	166	18
Other	281	112	5	39	51	16	49	9
Percent of Visits
All Visits	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Nursing Care	61.5	64.6	66.1	64.0	64.1	43.4	53.7	58.8
Home Health Aide	26.3	24.0	23.0	26.2	17.8	42.5	33.3	26.6
Physical Therapy	9.6	8.9	9.3	8.1	13.8	11.6	10.0	10.2
Other	2.6	2.5	1.6	1.7	4.4	2.7	3.0	5.1
Visit Charges (000’s)
Total	$211,944	$80,578	$6,477	$39,448	$28,631	$13,801	$39,682	$3,326
Nursing Care	133,200	53,171	4,685	27,181	18,167	6,260	21,679	2,056
Home Health Aide	48,230	16,673	1,089	8,118	4,812	5,239	11,550	749
Physical Therapy	23,530	8,103	605	3,409	4,259	1,846	4,969	337
Other	6,984	2,631	98	740	1,393	456	1,484	184
Percent of Visit Charges
All Visits	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Nursing Care	62.8	65.9	72.3	68.9	63.5	45.4	54.6	61.2
Home Health Aide	22.8	20.7	16.8	20.6	16.8	38.0	29.1	22.5
Physical Therapy	11.1	10.1	9.3	8.6	14.9	13.4	12.5	10.1
Other	3.3	3.3	1.5	1.9	4.9	3.3	3.7	5.5
Average Number of Visits Per Person Served
All Persons	21.6	19.7	15.5	20.7	20.1	32.0	32.8	23.8
Nursing Care	13.9	13.1	10.6	13.8	13.4	15.0	18.9	15.0
Home Health Aide	20.7	19.3	17.2	22.5	17.4	25.6	22.0	20.4
Physical Therapy	10.3	9.3	9.5	10.3	10.2	15.3	12.2	9.8
Other	6.5	6.8	7.5	7.5	5.9	5.3	6.1	6.6
Average Charge Per Visit
All Visits	$20	$18	$20	$17	$25	$23	$24	$19
Nursing Care	20	18	22	18	25	24	24	20
Home Health Aide	17	15	15	13	23	21	21	16
Physical Therapy	23	20	21	18	27	27	30	19
Other	25	23	19	19	27	29	30	21
Average Visit Charges Per Person Served
All Persons	$424	$348	$311	$351	$497	$731	$786	$445
Nursing Care	278	237	234	251	328	358	460	297
Home Health Aide	351	294	252	299	405	524	460	328
Physical Therapy	233	184	194	187	273	407	364	187
Other	162	161	142	141	165	153	183	137
SOURCE: U.S. Department of Health, Education, and Welfare, Health Care Financing Administration, Office of Policy, Planning and Research, *Research and Statistics Note, No. 2, “Medicare: Utilization of Home Health Services, 1975,” Table 4. Numbers do not add to totals since persons served may receive more than one type of visit.

TABLE 110. Persons Served, Percent of Persons Receiving Visiting, Visits, Percent of Visits and Visit Charges for Medicare Home Health Agency Services, by Type of Visit, 1980
	All Agencies	Visiting Nurse Association	Combined Gov’t & Voluntary	Government	Hospital Based	Proprietary	Private Non- Profit	Other
Persons Served (000’s)¹
Total	957.4	376.9	16.2	173.5	113.8	61.7	20.16	13.7
Nursing Care	909.1	362.7	15.8	166.4	108.8	55.8	186.8	12.8
Home Health Aide	346.6	126.7	4.4	53.4	34.1	30.6	93.5	3.9
Physical Therapy	243.3	93.8	3.2	32.7	31.8	19.1	59.8	3.0
Other²	135.4	53.1	1.2	10.9	19.4	12.0	37.3	1.5
Percent of Persons Receiving Visit¹
All Visits	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Nursing Care	95.0	96.2	97.5	95.9	95.6	90.4	92.7	93.4
Home Health Aide	36.2	33.6	27.2	30.8	30.0	49.6	46.4	28.5
Physical Therapy	25.4	24.9	19.8	18.8	27.9	31.0	29.7	21.9
Other²	14.1	14.1	7.4	6.3	17.0	19.4	18.5	10.9
Visits (000’s)
Total	22,428	8,434	303	3,568	2,417	1,588	5,796	323
Nursing Care	11,848	4,628	185	1,987	1,361	724	2,761	202
Home Health Aide	7,197	2,624	75	1,200	643	565	2,011	79
Physical Therapy	2,491	852	31	298	299	233	750	28
Other²	892	330	12	84	114	66	275	12
Percent of Visits
All Visits	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Nursing Care	52.8	54.9	61.1	55.7	56.3	45.6	47.6	62.5
Home Health Aide	32.1	31.1	24.8	33.6	26.6	35.6	34.7	24.5
Physical Therapy	11.1	10.1	10.2	8.4	12.4	14.7	12.9	8.7
Other²	4.0	3.9	4.0	2.4	4.7	4.2	4.7	3.7
Visit Charges (000’s)
Total	$734,718	$244,102	$9,777	$94,189	$92,088	$60,580	$223,639	$10,343
Nursing Care	409,206	142,491	6,717	58,948	53,641	29,527	111,058	6,825
Home Health Aide	200,512	63,245	1,641	24,232	21,188	18,390	69,805	2,012
Physical Therapy	90,442	26,632	990	8,467	12,151	9,692	31,466	1,045
Other²	34,558	11,732	430	2,542	5,108	2,972	11,310	462
Percent of Visit Charges
All Visits	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Nursing Care	55.7	58.4	68.7	62.6	58.2	48.7	49.7	66.0
Home Health Aide	27.3	25.9	16.8	25.7	23.0	30.4	31.2	19.5
Physical Therapy	12.3	10.9	10.1	9.0	13.2	16.0	14.1	10.1
Other²	4.7	4.8	4.4	2.7	5.5	4.9	5.1	4.5
Average Number of Visits Per Person Served
All Persons	23.4	22.4	18.7	20.6	21.2	25.7	28.8	23.6
Nursing Care	13.0	12.8	11.7	11.9	12.5	13.0	14.8	15.8
Home Health Aide	20.8	20.7	17.1	22.5	18.9	18.5	21.5	20.0
Physical Therapy	10.2	9.1	9.7	9.1	9.4	12.2	12.6	9.5
Other²	6.7	6.4	10.8	7.7	6.1	5.5	7.4	8.6
Average Charge Per Visit
All Visits	$33	$29	$32	$26	$38	$38	$39	$32
Nursing Care	35	31	36	30	39	41	40	34
Home Health Aide	28	24	22	20	33	33	35	25
Physical Therapy	36	31	32	28	41	42	42	37
Other²	38	35	35	30	43	45	41	35
Average Visit Charges Per Person Served
All Persons	$767	$647	$605	$543	$809	$981	$1,109	$755
Nursing Care	450	393	426	354	493	529	595	533
Home Health Aide	578	499	374	454	622	601	747	510
Physical Therapy	372	284	314	259	382	506	527	348
Other²	256	222	374	233	263	247	304	302
SOURCE: Preliminary unpublished Health Care Financing Administration data. Numbers do not add to totals since each person may receive more than one type of visit. Includes speech or occupational therapy, medical social services, and other health disciplines.

TABLE 111. Distribution of Home Health Agencies by Geographic Division Within Agency Type 1974 and 1980
	All Agencies		Visiting Nurse Associations		Combined Gov’t & Voluntary		Government		Hospital Based		Proprietary, PNP, Other
	1974	1980	1974	1980	1974	1980	1974	1980	1974	1980	1974	1980
United States	2,329 (100.0%)	2,830 (100.0%)	532 (100.0%)	510 (100.0%)	52 (100.0%)	50 (100.0%)	1,298 (100.0%)	1,272 (100.0%)	269 (100.0%)	344 (100.0%)	178 (100.0%)	653 (100.0%)
New England	14.7	11.2	44.7	41.6	17.3	6.0	5.2	4.2	9.3	6.1	1.7	4.1
Middle Atlantic	12.1	9.9	17.5	18.0	9.6	10.0	6.9	5.8	31.9	23.2	4.5	4.6
East North Central	14.4	15.3	16.2	16.7	21.2	22.0	14.6	16.1	12.3	13.9	8.9	12.9
West North Central	10.5	12.2	4.7	3.9	9.6	22.0	13.4	18.9	13.8	13.7	1.9	4.1
South Atlantic	14.5	14.3	5.1	7.8	23.1	14.0	19.3	12.3	7.4	8.7	16.3	26.0
East South Central	12.8	14.5	1.7	1.8	0.0	10.0	19.6	20.8	8.2	10.5	7.3	14.7
West South Central	10.9	10.8	2.1	2.2	1.9	6.0	13.7	13.4	2.6	4.1	32.0	16.2
Mountain	3.9	4.5	2.2	1.9	9.6	10.0	3.9	5.3	4.8	6.7	5.6	3.4
Pacific	6.2	7.3	5.8	6.1	7.7	0.0	3.4	3.1	9.7	13.1	21.9	13.9
SOURCE: Health Care Financing Administration unpublished statistics.

TABLE 112. Distribution of Home Health Agencies by Agency Type Within Geographic Division 1974 and 1980
	All Agencies		Visiting Nurse Associations		Combined Gov’t & Voluntary		Government		Hospital Based		Proprietary, PNP, Other
	1974	1980	1974	1980	1974	1980	1974	1980	1974	1980	1974	1980
All Areas	2,343 (100.0%)	2,859 (100.0%)	22.7%	17.9%	2.2%	1.7%	55.4%	44.6%	11.8%	12.2%	7.8%	23.6%
United States	2,329 (100.0%)	2,830 (100.0%)	22.8	18.0	2.2	1.8	55.7	44.9	11.6	12.2	7.6	23.1
New England	343 (100.0%)	317 (100.0%)	69.4	66.9	2.6	0.0	19.8	17.0	7.3	6.6	.01	8.5
Middle Atlantic	282 (100.0%)	281 (100.0%)	32.9	32.7	1.7	1.8	31.9	26.3	30.5	28.5	2.8	10.7
East North Central	335 (100.0%)	433 (100.0%)	25.7	19.6	3.3	2.5	56.4	47.3	9.8	11.1	4.8	19.4
West North Central	244 (100.0%)	345 (100.0%)	10.2	5.8	2.0	3.2	71.3	69.6	15.2	13.6	1.2	7.8
South Atlantic	338 (100.0%)	404 (100.0%)	7.9	9.9	3.6	1.7	73.9	38.9	5.9	7.4	8.6	42.1
East South Central	298 (100.0%)	410 (100.0%)	3.0	2.2	0.0	1.2	85.2	64.4	7.4	8.8	4.4	23.4
West South Central	254 (100.0%)	305 (100.0%)	4.3	3.6	0.0	0.0	70.1	56.1	2.7	4.6	22.4	34.8
Mountain	91 (100.0%)	127 (100.0%)	13.2	7.9	5.5	3.9	56.0	52.8	14.3	18.1	10.9	17.3
Pacific	144 (100.0%)	207 (100.0%)	21.5	14.9	2.8	0.0	30.6	19.3	18.0	21.7	27.1	43.9
SOURCE: Health Care Financing Administration unpublished statistics.

TABLE 113. Relative Shares of Persons Served, Visits, and Visit Charges Under the Medicare Program by Type of Home Health Agency 1974-1980
	All Agencies (000’s)	Visiting Nurse Association	Combined Gov’t & Voluntary	Government	Hospital Based	Proprietary	Private Non- Profit	Other
Persons Served
1974	392.7	48.1%	4.7%	22.9%	11.9%	3.0%	9.3%
1975	499.6	46.4	4.2	22.5	11.5	3.8	10.1	1.5
1976	588.7	41.8	3.2	21.1	10.8	4.2	17.6	1.5
1977	689.7	39.6	2.8	20.6	10.8	4.6	19.4	2.2
1978	769.3	38.6	2.8	19.8	11.4	4.9	20.9	1.6
1979	836.7	39.7	1.8	18.6	11.4	5.7	21.2	1.5
1980	957.4	39.4	1.7	18.1	11.9	6.4	21.0	1.4
Visits
1974	8,070	44.2%	3.5%	22.8%	11.2%	4.6%	13.6%
1975	10,805	42.2	3.0	21.6	10.7	5.6	15.3	1.6
1976	13,335	36.8	2.4	19.2	9.9	5.4	24.6	1.7
1977	15,548	36.4	2.4	19.1	10.1	5.4	24.4	2.2
1978	17,345	36.5	2.2	17.6	10.8	5.3	25.7	1.7
1979	19,159	37.7	1.5	16.2	10.5	6.4	26.2	1.5
1980	22,428	37.6	1.4	15.9	10.8	7.1	25.8	1.4
Visiting Charges
1974	137,406	40.7%	3.7%	19.9%	14.1%	5.3%	16.2%
1975	211,944	38.0	3.0	18.6	13.5	6.5	18.7	1.6
1976	292,697	32.1	2.4	16.2	12.0	6.3	29.2	1.7
1977	385,223	31.6	2.3	15.5	11.9	6.3	30.5	2.1
1978	474,498	31.4	2.1	14.2	12.4	6.2	31.9	1.7
1979	572,263	32.9	1.4	13.1	12.0	7.4	31.7	1.5
1980	734,718	33.2	1.3	12.8	12.5	8.2	30.4	1.4
SOURCE: Health Care Financing Administration, Health Care Financing Program Statistics, “Medicare Use of Home Health services” series.

TABLE 114. Factors Explaining the Growth Rate in Medicare Home Health Services 1974-80
	1974	1980	Growth Rate (g)	Percent of Growth Explained by Each Factor
ALL AGENCIES
Total Visit Charges	137,406	734,718	.2794	1.0000
Visits/Person Served	20.6	23.4	.0212	.0760
Charges/Visit	17	33	.1105	.3955
Persons Served	392.7	957.4	.1485	.5315
COMBINED GOV’T & VOLUNTARY
Total Visit Charges	5,054	9,777	.1099	1.0000
Visits/Person Served	18.9	22.4	.0283	.2575
Charges/Visit	18	32	.0959	.8726
Persons Served	18.4	16.2	-.0212	-.1929
HOSPITAL BASED
Total Visit Charges	19,382	92,088	.2597	1.0000
Visits/Person Served	19.3	21.2	.0156	.0601
Charges/Visit	21	38	.0988	.3804
Persons Served	47	113.8	.1474	.5676
VNA’s
Total Visit Charges	55,973	244,102	.2454	1.0000
Visits/Person Served	18.9	22.4	.0283	.1153
Charges/Visit	16	29	.0991	.4038
Persons Served	189.0	376.9	.1150	.4686
GOVERNMENT
Total Visit Charges	27,365	94,189	.2060	1.0000
Visits/Person Served	20.5	20.6	.0008	.0039
Charges/Visit	15	26	.0917	.4451
Persons Served	90	173.5	.1094	.5311
PROPRIETARY
Total Visit Charges	7,303	60,580	.3526 (.3849)	1.0000*
Visits/Person Served	31.2	25.7	-.0323	-.0916
Charges/Visit	20	38	.1069	.3032 (.2777)
Persons Served	12	61.7	.2729	.7739 (.7090)
OTHER
Total Visit Charges	3,326	10,343	.1891	1.0000
Visits/Person Served	23.8	23.6	.0014	.0074
Charges/Visit	19	32	.0869	.4595
Persons Served	7.5	13.7	.1004	.5310
PRIVATE NON-PROFIT
Total Visit Charges	39,682	223,639	.2882	1.0000
Visits/Person Served	32.8	28.8	-.0217	-.0753
Charges/Visit	24	39	.0809	.2807 (.2610)
Persons Served	50.5	201.6	.2307	-8006 (.7444)
SOURCE: 1974 data: U.S. Department of Health, Education, and Welfare, Office of Research and Statistics, *Health Insurance Statistics, “Medicare Utilization of Home Health Services, 1974,” HI-79, November 2, 1977, Table 5, p.6. 1975 data: U.S. Department of Health, Education, and Welfare, Office of Policy Planning and Research, Research and Statistics Note, No. 2, “Medicare: Utilization of Home Health Services, 1975,” Table 4. 1980 data: Unpublished Health Care Financing Administration statistics. NOTE: Total visit Charge = Visits/Persons Served Charges/Visit * Persons Served This table examines the growth rate in total visit charges between 1974 and 1980 (1975-1980 where 1974 data are unavailable) and disaggregates that growth according to each component of total visit charges, by agency type. For example, overall growth in total visit charges acorss all agency types was 27.9 percent between 1974 and 1980. Increased visits per persons served accounted for 7.6 percent of that growth; 39.5 percent was due to increased charges per visit; and 14.8 percent was explained by increases in the number of persons served.

TABLE 115. State and County Psychiatric Hospitals, by State, 1978 NIMH
	Hospitals
U.S. Total	287
Alabama	4
Alaska	1
Arizona	1
Arkansas	1
California	6
Colorado	3
Connecticut	6
Delaware	2
D.C.	1
Florida	6
Georgia	8
Hawaii	1
Idaho	2
Illinois	15
Indiana	8
Iowa	5
Kansas	3
Kentucky	4
Louisiana	4
Maine	2
Maryland	5
Massachusetts	9
Michigan	12
Minnesota	7
Mississippi	2
Missouri	8
Montana	1
Nebraska	4
Nevada	2
New Hampshire	1
New Jersey	10
New Mexico	1
New York	37
North Carolina	4
North Dakota	1
Ohio	18
Oklahoma	3
Oregon	3
Pennsylvania	20
Rhode Island	1
South Carolina	3
South Dakota	1
Tennessee	5
Texas	10
Utah	1
Vermont	1
Virginia	10
Washington	2
West Virginia	7
Wisconsin	14
Wyoming	1
SOURCE: NIMH Survey of State and County Mental Hospitals, page vi.

TABLE 116. Number of Psychiatric Hospitals and Beds by Type of Ownership 1978 MFI
Type of Ownership	Hospitals	Beds
Federal Psychiatric Hospitals	24	23,056
Non-Federal Psychiatric Hospitals	476	189,375
Non-Government, Non-Profit	90	9,346
Church	12	1,173
Other	78	8,173
Proprietary	124	10,297
State & Local Government	262	169,732
TOTAL	500	212,431
SOURCE: U.S. Department of Health and Human Services, National Center for Health Statistics, *Inpatient Health Facilities, 1978*, Hyattsville, Maryland. March 1981. Tables 19 and 20, page 30.

TABLE 117. Psychiatric Hospitals, Beds, Admissions, by Type of Ownership, 1978
Ownership	Hospitals	Beds	Admissions
Federal Psychiatric Hospitals	24	23,158	72,362
Non-Federal Psychiatric Hospitals*	576	239,795	611,514
Non-Gov’t, Non-Profit	94	9,778	71,024
Investor Owned (for Profit)	139	10,267	102,234
State & Local Gov’t	293	214,865	406,944
TOTAL	600	262,953	683,976
SOURCE: American Hospital Association, *Hospital Statistics, Chicago, Illinois, 1979. Table 3, p. 13 and Table 13, p. 212. Includes non-registered facilities (i.e. those facilities without AHA registration status). There were no non-registered Federal psychiatric hospitals in 1978. The non-federal, non-registered hospitals are included only in the total since ownership classification is not reported.

TABLE 118. Long-Term Psychiatric Hospitals, Beds, Admissions, Inpatient Days and Occupancy Rates by Type of Ownership, 1978
	Hospitals	Beds	Admissions	Inpatient Days	Occupancy Rate
Federal Psychiatric Hospitals	24	22,773	69,095	7,167,524	86.2%
Non-Federal Psychiatric Hospitals	364	212,783	357,912	65,048,841	83.8
Non-Gov’t, Non-Profit	48	6,820	20,566	2,142,533	86.1
Investor-Owned (for-profit)	57	5,458	29,929	1,483,881	74.5
State and Local Gov’t	259	200,505	307,417	61,422,427	83.9
TOTAL	388	235,556	426,007	72,216,365	84.0
SOURCE: American Hospital Association, *Hospital Statistics*, Chicago, Illinois. 1979 Table 4B, p. 15 and Table 13, p. 212.

TABLE 119. Number of Psychiatric Hospitals by Bed Size 1978
Bed Size	Number of Hospitals
All sizes	550
Less than 25 beds	16
25-49 beds	65
50-99 beds	112
100-199 beds	88
200-299 beds	30
300-499 beds	53
500 beds or more	191
1,000 beds or more	80
SOURCE: U.S. Department of Health and Human Services, National Center for Health Statistics, *Inpatient Health Facilities 1978*, Hyattsville, Maryland. March 1981. Table 18, page 30.

TABLE 120. Total Psychiatric Hospitals by Type of Ownership and Size, 1978¹
Ownership & Size	Hospitals	Beds	Admissions	Occupancy	Avg. Daily Census
Non-Government, Nonprofit	94	9,778	71,024	89.2	8,723
6-24 beds	7	140	3,422		108
25-49	19	738	7,853		579
50-99	36	2,607	25,390		2,002
100-199	21	2,796	22,582		2,338
200-299	6	1,491	4,881		1,301
300-399	1	325	1,412		285
400-499	2	791	5,183		715
500+	2	890	301		1,395
Investor Owned, For-Profit	139	10,267	102,234	71.0	7,290
6-24 beds	9	161	4,096		119
25-49	37	1,329	17,931		916
50-99	57	3,804	45,576		2,594
100-199	31	3,959	26,907		2,904
200-299	5	1,014	7,724		757
Local Government	16	4,385	18,124	--	3,602
25-49 beds	4	105	3,245		82
50-99	3	235	2,439		172
100-199	4	589	2,150		471
200-299	1	295	214		263
300-399	1	337	4,773		337
400-499	1	460	1,037		361
500+	2	2,364	4,266		1,955
State Government	277	210,480	388,820	--	170,312
25-49 beds	5	193	1,603		123
50-99	16	1,236	8,228		917
100-199	32	5,353	39,227		3,892
200-299	18	4,434	22,064		3,632
300-399	26	9,320	31,442		7,743
400-499	20	9,175	23,571		7,344
500+	160	180,769	262,685		146,921
Federal Government	24	23,158	72,362	85.7	19,855
300-399 beds	1	333	1,492	82.9	276
400-499	1	470	3,881	89.8	422
500+	22	22,355	66,989	85.7	19,157
TOTAL PSYCHIATRIC²	550	262,953	683,876	--	213,531
SOURCE: American Hospital Association, *Hospital Statistics*, Chicago, Illinois, 1979. Table 2A, pp. 8-9, Table 2B, pp.10-11, and Table 13, p. 212. Excludes 1 non-government, nonprofit hospital, 3 investor-owned, for-profit hospitals, and 9 state or local hospitals, for unstated reasons, presumably due to lack of information or bed size. Includes non-registered facilities (i.e., those facilities without AHA registration status). There were no non-registered Federal psychiatric hospitals in 1978. The non-federal, non-registered hospitals are included only in the total, since ownership classification is not reported.

TABLE 121. Facilities for the Mentally Impaired as Reported by the Master Facility Inventory 1971-1976
	Facilities			Beds			Patients
	1971	1973	1976	1971	1973	1976	1971	1973	1976
Psychiatric Hospitals	533	508	502	418,487	338,574	244,358	347,958	282,634	202,632
Institutions for Mentally Impaired	2111	2630¹	3462	249,905	277,262	248,300	226,217	242,629	219,608
Alcohol and Drug Abuse	166	809²	833	13,341	33,128	28,156	10,625	24,702	22,427
Total	2,810	3,947	4797	681,733	648,964	520,814	584,800	549,965	444,667
SOURCE: U.S. Department of Health, Education & Welfare National Center for Health Statistics, *Inpatient Health Facilities. Hyattsville, Maryland, 1974. U.S. Department of Health, Education & Welfare National Center for Health Statistics, Inpatient Health Facilities. Hyattsville, Maryland, 1976. U.S. Department of Health, Education & Welfare National Center for Health Statistics, Inpatient Health Facilities*. Hyattsville, Maryland, 1980. Halfway houses for the emotionally disturbed included in this category for the first time accounting for some of the increase. Halfway houses for alcoholics and drug abusers included in this category for the first time accounting for some of the increase.

TABLE 122. V.A. Medical Centers--Nursing Home Care Units: Selected Data by State Fiscal Year 1979
State	Number of Facilities	Total Operating Beds	Total Patients Treated	Statewide Average Daily Census
Alabama	2	232	296	221
Arizona	2	161	236	137
Arkansas	1	200	252	193
California	5	650	1105	512
Colorado	2	79	102	75
Connecticut	1	90	106	87
Delaware	1	60	83	46
Florida	3	250	452	240
Georgia	2	126	165	120
Illinois	2	310	406	295
Indiana	3	183	251	169
Iowa	1	200	281	183
Kansas	2	124	155	116
Kentucky	1	100	122	27
Louisiana	1	93	112	84
Maine	1	60	79	58
Maryland	2	127	166	121
Massachusetts	3	312	375	302
Michigan	3	317	380	300
Minnesota	1	44	58	41
Mississippi	2	155	189	147
Missouri	3	196	331	186
Montana	1	26	40	25
Nebraska	1	42	64	38
Nevada	1	22	30	21
New Hampshire	1	120	341	118
New Jersey	2	150	245	146
New Mexico	1	47	102	46
New York	8	991	1430	956
North Carolina	3	214	327	207
North Dakota	1	50	114	47
Ohio	4	705	1049	672
Oregon	1	75	119	72
Pennsylvania	6	575	812	532
South Carolina	1	72	138	70
South Dakota	1	75	103	72
Tennessee	2	106	133	103
Texas	5	337	554	323
Utah	1	46	143	39
Vermont	1	30	126	30
Virginia	2	140	223	135
Washington	1	76	89	73
West Virginia	1	42	55	40
Wisconsin	2	300	377	291
Wyoming	1	47	66	45
SOURCE: Veterans Administration, *1979 Annual Report* (Washington, D.C.: GPO, 1980); and *Veterans Administration Summary of Medical Programs* (Washington, D.C.: Veterans Administration, September 1979). N/A Not available.

TABLE 123. Veterans Administration Community Nursing Home Program: Selected Data by State Fiscal Year 1979
State	Number of VAMCs	Total Patients Treated	Statewide Average Daily Census
Alabama	4	470	142
Alaska	1	39	10
Arizona	3	686	215
Arkansas	2	349	119
California	11	2386	656
Colorado	3	314	112
Connecticut	2	266	67
Delaware	1	242	78
District of Columbia	1	223	70
Florida	5	1800	476
Georgia	3	804	224
Hawaii	1	37	10
Idaho	1	172	31
Illinois	6	1828	503
Indiana	3	426	130
Iowa	3	659	175
Kansas	3	348	98
Kentucky	2	434	117
Louisiana	3	493	116
Maine	1	130	43
Maryland	3	230	81
Massachusetts	5	613	220
Michigan	5	683	201
Minnesota	2	620	179
Mississippi	2	311	102
Missouri	4	870	216
Montana	2	171	46
Nebraska	3	306	55
Nevada	1	66	17
New Hampshire	1	134	40
New Jersey	2	417	167
New Mexico	1	204	45
New York	12	443	174
North Carolina	4	557	182
North Dakota	1	80	24
Ohio	4	1231	386
Oklahoma	2	577	96
Oregon	2	599	159
Pennsylvania	9	1197	467
Rhode Island	1	149	38
South Carolina	2	394	114
South Dakota	3	149	33
Tennessee	4	597	205
Texas	10	2522	599
Utah	1	144	35
Vermont	1	48	13
Virginia	3	472	163
Washington	5	903	244
West Virginia	4	761	210
Wisconsin	3	503	150
Wyoming	2	117	35
TOTALS	164	28,369	8131
SOURCE: Veterans Administration, *1979 Annual Report* (Washington, D.C.: GPO, 1980); and *Veterans Administration Summary of Medical Programs* (Washington, D.C.: Veterans Administration, September 1979).

TABLE 124. VA Medical Centers--Domiciliary Care Units: Selected Data by State Fiscal Year 1979
State	Number of Facilities	Total Operating Beds	Total Patients Treated	Average Daily Census
Arizona	1	237	440	221
California	1	450	634	370
Florida	1	322	492	295
Georgia	1	361	627	373
Kansas	1	775	1874	700
Mississippi	1	439	820	41
New York	1	660	1121	606
Ohio	1	840	1478	759
Oregon	1	1165	2123	1043
South Dakota	1	485	991	417
Tennessee	1	833	1444	705
Texas	2	779	1585	684
Virginia	1	700	1036	629
West Virginia	1	550	813	521
Wisconsin	1	793	1124	714
TOTALS	16	9.389	16,602	8,449
SOURCE: Veterans Administration, *1979 Annual Report* (Washington, D.C.: GPO, 1980); and *Veterans Administration Summary of Medical Programs* (Washington, D.C.: Veterans Administration, September 1979).

TABLE 125. V.A. Medical Centers--Hospital-Based Home Care: Selected Data by State Fiscal Year 1979¹
State	Number of Facilities	Total Patients Treated	Total Number Visits	Average Length of Stay (Days)²
Alabama	1	106	4398	253
Arkansas	1	204	6673	276
California	3	655	11768	106
District of Columbia	1	74	4401	760
Florida	2	340	10684	164
Georgia	1	145	4545	190
Illinois	1	131	4575	76
Indiana	1	185	4273	138
Iowa	1	174	5063	51
Louisiana	1	197	6243	127
Massachusetts	1	164	5688	169
Michigan	1	136	4928	234
Minnesota	1	143	5020	190
Missouri	1	217	4614	92
New Jersey	1	128	4801	101
New Mexico	1	264	4235	87
New York	2	349	11341	215
Ohio	1	145	3414	217
Oregon	1	202	5233	145
Pennsylvania	2	235	8434	232
Texas	2	279	13004	276
Vermont	1	149	4167	190
Virginia	1	170	5608	122
Washington	1	192	4171	122
TOTALS	30	4,984	147,281	168
SOURCE: Unpublished data compiled by Mary Shiraishi of the VA Hospital Based Home Care Program. State level source data were presented by facility rather than in aggregated form. Consequently, weighting was necessary in some cases to compute statewide average length of stay. Weighted by total patients treated in states with more than on facility.

TABLE 126. State Veterans’ Homes--Nursing Homes: Selected Data by State Fiscal Year 1979
Contribution State	Number of Facilities	Total Veteran Days of Care	Total Authorized Veteran Beds
California	1	117,689	397
Colorado	2	46,410	150
Georgia	2	109,842	324
Illinois	1	113,286	456
Indiana	1	54,876	303
Iowa	1	93,310	338
Kansas	1	18,363	88
Massachusetts	2	103,860	327
Michigan	1	182,272	588
Minnesota	1	29,866	85
Missouri	1	35,526	150
Montana	1	14,005	40
Nebraska	1	134,636	468
New Hampshire	1	31,993	100
New Jersey	2	181,186	580
New York	1	10,256	84
Ohio	1	8,201	300
Oklahoma	5	202,768	590
Pennsylvania	2	36,136	110
Rhode Island	1	81,496	244
South Carolina	1	36,985	150
South Dakota	1	9,985	41
Vermont	1	43,518	135
Washington	2	53,242	236
Wisconsin	1	150,092	649
TOTALS	35	1,809,799	6,933
SOURCE: *National Association of State Veterans Homes, 1979-1980*; and unpublished data compiled by the VA State Home Program.

TABLE 127. State Veterans’ Homes--Domiciliaries: Selected Data by State Fiscal Year 1979
State	Number of Facilities	Total Veteran Days of Care	Total Authorized Veteran Beds
California	1	235,400	926
Colorado	1	26,167	130
Connecticut	1	157,427	756
District of Columbia	1	61,857	250
Georgia	1	99,306	288
Idaho	1	40,094	126
Illinois	1	35,980	391
Indiana	1	32,428	186
Iowa	1	32,503	130
Kansas	1	22,588	312
Louisiana	1	39,404	132
Massachusetts	2	105,423	324
Michigan	1	60,202	175
Minnesota	2	176,479	694
Missouri	1	22,861	77
Montana	1	28,618	100
Nebraska	1	51,502	247
New Jersey	2	47,762	185
New York	1	11,997	158
North Dakota	1	38,751	135
Ohio	1	252,860	844
Oklahoma	4	126,573	469
Pennsylvania	2	35,905	151
Rhode Island	1	37,254	128
South Dakota	1	36,123	284
Vermont	1	4,437	24
Washington	2	76,972	315
Wisconsin	1	17,952	54
Wyoming	1	17,426	63
TOTALS	37	1,932,251	8,054
SOURCE: *National Association of State Veterans Homes, 1979-1980*; and unpublished data compiled by the VA State Home Program.

TABLE 128. Percent of Elderly Housing Projects Offering Special Facilities, Services and Amenities
Item	Housing Program¹
Item	Section 202	Section 231	Section 236
Airconditioning	54%	44%	67%
Laundry Facilities	91	97	88
Community Rooms	94	84	91
Dining Rooms	22	44	20
Infirmaries	3	31	--
Recreation Facilities	86	87	63
Meals	7	38	4
Physical Therapy	3	25	--
Medical Care	4	31	2
Nursing Care	4	38	--
Maid and Linen Service	4	31	3
SOURCE: Office of Policy Development and Research, U.S. Department of Housing and Urban Development, *Housing for the Elderly and Handicapped* (Washington, D.C.: GPO, 1979), p. 49. Data are based on samples of projects in each program. Brief descriptions of these programs are contained in Table 172

IX. INFORMAL CARE

TABLE 129. Various Indicators of the Availability of Informal Care Providers by Long-Term Care Status and Select Sociodemographic Characteristics (Weighted Base Numbers in Parentheses)
Indicators of Availability of Informal Caregivers	Long-Term Care (LTC) Status^a		Total Elderly
Indicators of Availability of Informal Caregivers	Not in LTC Population	In Long Term Care Population	Total Elderly
Panel A: ALL ELDERLY
% Kinless^b	5.1% (5299)	8.1% (457)	5.3% (5756)
% Childless	21.0% (5299)	16.8% (457)	20.7% (5756)
% of All Elderly Without Daughters	38.9% (5299)	34.4% (457)	38.5% (5756)
% of Elderly with Children without Daughters	22.8% (4186)	21.1% (380)	22.6% (4566)
Panel B: BY MARITAL STATUS
UNMARRIED
% Kinless^b	6.7% (2479)	10.0% (271)	6.8% (2750)
% Childless	28.4% (2479)	19.2% (271)	27.3% (2750)
% of All Elderly Without Daughters	44.3% (2479)	35.8% (271)	43.2% (2750)
% of Elderly with Children without Daughters	22.1% (1775)	20.5% (219)	21.9% (1995)
MARRIED ELDERLY
% Kinless	3.7% (2820)	5.9% (186)	3.8% (1995)
% Childless	14.5% (2820)	14.5% (186)	14.5% (3006)
% of All Elderly Without Daughters	34.0% (2820)	33.3% (186)	14.5% (3006)
% of Elderly with Children without Daughters	22.8% (2411)	22.0% (159)	23.1% (2571)
Panel C: BY AGE
75
% Kinless^b	4.8% (3542)	7.1% (193)	4.9% (3735)
% Childless	21.8% (3542)	17.6% (193)	21.6% (3735)
% of All Elderly Without Daughters	33.4% (3542)	36.7% (193)	39.3% (3735)
% of Elderly with Children without Daughters	18.1% (2772)	23.3% (159)	22.6% (2930)
75+
% Kinless^b	5.8% (1757)	8.7% (264)	6.2% (2021)
% Childless	19.5% (1757)	16.2% (264)	19.1% (2021)
% of All Elderly Without Daughters	38.2% (1757)	32.1% (264)	37.5% (2021)
% of Elderly with Children without Daughters	23.2% (1416)	18.6% (221)	22.7% (1637)
Panel D: BY SEX
MALE
% Kinless^b	4.8% (2209)	13.9% (106)	5.2% (2315)
% Childless	19.5% (2209)	22.4% (106)	19.6% (2315)
% of All Elderly Without Daughters	38.2% (2209)	51.3% (106)	38.8% (2315)
% of Elderly with Children without Daughters	23.2% (1777)	37.8% (82)	23.8% (1859)
FEMALE
% Kinless^b	5.3% (3090)	6.3% (351)	5.4% (3441)
% Childless	22.1% (3090)	15.2% (351)	21.4% (3441)
% of All Elderly Without Daughters	39.6% (3090)	28.9% (351)	38.5% (3441)
% of Elderly with Children without Daughters	22.5% (2409)	16.1% (298)	21.8% (2707)
Panel E: BY RACE^c
WHITE
% Kinless^b	4.7% (4811)	7.7% (385)	4.9% (5197)
% Childless	20.6% (4811)	15.4% (385)	20.2% (5197)
% of All Elderly Without Daughters	39.0% (4811)	33.5% (385)	38.6% (5197)
% of Elderly with Children without Daughters	23.1% (3819)	21.8% (326)	23.0% (4147)
BLACK
% Kinless^b	9.8% (400)	11.2% (64)	10.0% (464)
% Childless	27.6% (400)	29.2% (64)	27.8% (464)
% of All Elderly Without Daughters	43.0% (400)	41.7% (64)	42.8% (464)
% of Elderly with Children without Daughters	21.0% (290)	17.8% (45)	20.7% (334)
SOURCE: Special Tabulations form the 1975 National Survey of the Aged, conducted by Dr. Ethel Shanas (AoA Grant No. 90-A-389). * Weighted base number equals number of persons interviewed in survey adjusted for probability of inclusion in survey. Long-Term Care Status distinguishes bedfast elderly and those with moderate to severe incapacities for self-care from all other elderly. Defined as elderly without a surviving spouse, children or siblings. Nonwhite-nonblack elderly excluded because of an insufficient number of cases.

TABLE 130: Percent of All Elderly With at Least One Daughter Who Do Not Have Frequent Contact with at Least One or Who Do Not Live Nearby at Least One, by Number of Daughters and Marital Status, and Place of Residence
Number of Daughters, by Marital State; Place of Residence	% of All Elderly with at Least One Daughter
Number of Daughters, by Marital State; Place of Residence	Who Do Not Have Frequent Contact with at Least One^a	Who Do Not Live Nearby at Least One^b
Panel A: ALL ELDERLY WITH AT LEAST ONE DAUGHTER
Total	41.4%	33.9%
1 Daughter	55.9%	47.9%
2 Daughters	32.4%	25.7%
3+ Daughters	22.5%	15.5%
Panel B: BY MARITAL STATUS
Unmarried	41.9%	40.0%
1 Daughter	55.2%	48.6%
2 Daughters	31.9%	22.9%
3+ Daughters	26.2%	20.7%
Married	39.7%	33.1%
1 Daughter	54.3%	47.3%
2 Daughters	32.4%	29.0%
3+ Daughters	19.6%	10.8%
Panel C: BY PLACE OF RESIDENCE
Place of Residence
Rural Small Town	48.8%	35.9%
Medium Size City	65.6%	34.3%
Large City (including suburbs of)	38.7%	29.9%
SOURCE: Special Tabulations from the 1975 National Survey of the Aged, conducted by Dr. Ethel Shanas (AoA Grant No. 90-A-369) Defined as not having seen at least one daughter within last week. Defined as not living within one hour’s distance from at least one daughter.

TABLE 131. Percent of All Elderly With at Least One Daughter Who Do Not Have Either Frequent Contact with at Least One or Live Nearby at Least One, by Marital Status and Living Arrangements
Marital Status and Living Arrangements	% of All Elderly With at Least 1 Daughter Who Have Neither Frequent Contact^a or Live Nearby at Least One^b
TOTAL	30.5%
MARITAL STATUS
Unmarried	31.9%
Married	29.4%
LIVING ARRANGEMENTS
Alone	24.1%
Unmarried Person with Others	45.4%
Married Couple with Spouse	25.8%
Married Couple with Others	33.8%
SOURCE: Special Tabulation for the 1975 National Survey of the Aged, conducted by Dr. Ethel Shanas (AoA) Grant No. 90-A-369). Defined as not having seen at least one daughter within last week. Defined as not living within one hour’s distance from at least one daughter.

TABLE 132. Percent of All Elderly with Surviving Children Who Do Not have Frequent Contact with at Least One and Percent Who Do Not Live Nearby at Least One, by Family Composition
Frequency of Contact and Proximity to Children	Family Composition
Frequency of Contact and Proximity to Children	Only Daughter	Only Sons	Both Sons and Daughters
% Without Frequent Contact with at Least One Daughter^a	41.8%	--	41.2%
% Without Frequent Contact with at Least One Son^b	--	43.7%	40.5%
% Not Living Nearby at Least One Daughter^a	32.4%	--	33.4%
% Not Living Nearby at Least One Son^b	--	33.8%	38.1%
SOURCE: Special Tabulations from the 1975 National Survey of the Aged, conducted by Dr. Ethel Shanas (AoA Grant No. 90-A-369). Defined as not having seen at least one child within last week. Defined as not living within one hour’s distance from at least one child.

TABLE 133. Percentage Distribution of ADL Service Use Pattern by Sex Composition of Surviving Children Among the Elderly with Moderate to Severe Incapacities for Self-Care, by Marital Status^a (Weighted Base Numbers in Parentheses)
ADL Service Use Patterns	Number of Surviving Daughters			Total
ADL Service Use Patterns	None	One	Two+	Total
UNMARRIED ELDERLY
ADL Services Not Received^b	48.2%	32.5%	30.1%	33.7%
Informal Services Only	34.5	60.5	69.9	62.3
Formal Services or Mix of Formal and Informal	(c)	(c)	0.0	(c)
Total	100.0% (29)	100.0% (43)	100.0% (103)	100.0% (175)
MARRIED ELDERLY
ADL Services Not Received^b	35.0%	33.0%	34.0%	34.0%
Informal Services Only	65.0	67.0	66.0	66.0
Formal Services or Mix of Formal and Informal	0.0	0.0	0.0	0.0
Total	100.0% (23)	100.0% (30)	100.0% (56)	100.0% (109)
SOURCE: Special Tabulations from the 1975 National Survey of the Aged, conducted by Dr. Ethel Shanas (AoA Grant No. 90-A-369). Excludes the bedfast and those without any surviving children. Includes both those who report no need for ADL services and those who report unmet ADL service needs. This latter group accounts for 19 percent of the elderly with surviving children in this category of ADL service use. Cell frequency less than 5 percent of total.

TABLE 134. Percentage Distribution of ADL Service Use Pattern by Type of Living Arrangement Among Elderly with Severe to Moderate Incapacities for Self-Care^a (Weighted Base Numbers in Parentheses)
ADL Service Use Pattern	Alone	Type of Living Arrangement		Total
ADL Service Use Pattern	Alone	Unmarried with Others	Married with Spouse^b	Total
ADL Services Not Received^c	60.5%	21.4%	36.6%	40.2%
Informal Services Only, from Within Same Household	--	56.3	42.2	32.3
Informal Services Only, from Outside Household Only or Mix from Within and Without Household	35.8	21.4	20.3	26.0
Formal Services or Mix of Formal and Informal	(d)	(d)	(d)	(d)
TOTAL	100.0% (115)	100.0% (102)	100.0% (123)	100.0% (340)
SOURCE: Special Tabulations from the 1975 National Survey of the Aged, conducted by Dr. Ethel Shanas (AoA Grant No. 90-A-369). Excludes the bedfast. Includes those living with others as well as spouse. Includes both those who report no need for ADL services and those who report unmet ADL service needs. This latter group accounts for only 14.6% of the elderly included in this ADL service use category. Cell frequency less than 5 percent of total.

TABLE 135. Percentage Distribution of ADL Service Use Pattern by Sex Composition of Surviving Children Among the Elderly with Moderate to Severe Incapacities for Self-Care, by Marital Status^a (Weighted Base Numbers in Parentheses)
ADL Service Use Patterns	Number of Surviving Daughters			Total
ADL Service Use Patterns	None	One	Two+	Total
UNMARRIED ELDERLY
ADL Services Not Received^b	48.2%	32.5%	30.1%	33.7%
Informal Services Only	34.5	60.5	69.9	62.3
Formal Services or Mix of Formal and Informal	(c)	(c)	0.0	(c)
Total	100.0% (29)	100.0% (43)	100.0% (103)	100.0% (175)
MARRIED ELDERLY
ADL Services Not Received^b	35.0%	33.0%	34.0%	34.0%
Informal Services Only	65.0	67.0	66.0	66.0
Formal Services or Mix of Formal and Informal	0.0	0.0	0.0	0.0
Total	100.0% (23)	100.0% (30)	100.0% (56)	100.0% (109)
SOURCE: Special Tabulations from the 1975 National Survey of the Aged, conducted by Dr. Ethel Shanas (AoA Grant No. 90-A-369). Excludes the bedfast and those without any surviving children. Includes both those who report no need for ADL services and those who report unmet ADL service needs. This latter group accounts for 19 percent of the elderly with surviving children in this category of ADL service use. Cell frequency less than 5 percent of total.

TABLE 136. Percentage Distribution of IADL Service Use Pattern by ADL Service Use Pattern Among Elderly with Moderate to Severe Incapacities for Self-Care^a (Weighted Base Numbers in Parentheses)
IADL Service Use Pattern	ADL Service Use Pattern
IADL Service Use Pattern	ADL Services Not Received^b	Informal Services Only, from Within Same Household	Informal Services Only, from Outside Household Only or Mix from Within and Without Household	Formal Service Only, or Mix of Formal and Informal	Total
IADL Services Not Received^c	83.6%	(d)	(d)	(d)	100.0% (67)
Informal Services Only, from Within Same Household	21.0%	64.1%	15.0%	0.0	100.0% (39)
Informal Services Only, from Outside Household Only or Mix from Within and Without Household	37.8%	(d)	53.4%	(d)	100.0% (79)
Formal Services Only, or Mix of Formal and Informal	50.3%	47.3%		(d)	100.0% (40)
Total^a	42.6%	32.4%	34.7%	(d)	100.0% (306)
SOURCE: Special Tabulations from the 1975 National Survey of the Aged, conducted by Dr. Ethel Shanas (AoA Grant No. 90-A-369). Excludes the bedfast. Includes both those who report no need for ADL services and those who report unmet ADL service needs. This latter group accounts for 14.6% of the elderly included in this ADL service category. Includes both those who report no need for IADL services and those who report unmet IADL service needs. This group accounts for one third of the elderly included in this IADL service use category. Cell frequency less than 5 percent of total.

TABLE 137. Percentage Distribution of IADL Service Use Pattern by Number of Surviving Children Among Elderly with Moderate to Severe Incapacities for Self-Care^a (Weighted Base Numbers in Parentheses)
IADL Service Use Pattern	Number of Surviving Children
IADL Service Use Pattern	None	One or Two	Three+	Total
IADL Services Not Received^a	30.8%	30.6%	11.8%	22.1%
Informal Services Only, from Within Same Household	19.2	54.6	34.0	39.0
Informal Services Only, from Outside Household or Mix from Within and Without Household	19.2	14.8	36.1	25.8
Formal Services Only, or Mix of Formal and Informal	25.0	(c)	17.4	13.1
Total	100.0% (52)	100.0% (108)	100.0% (144)	100.0% (304)
SOURCE: Special Tabulations from the 1975 National Survey of the Aged, conducted by Dr. Ethel Shanas (AoA Grant No. 90-A-369). Excludes bedfast. Includes both those who report no need for IADL services and those who report unmet IADL service needs. This latter group accounts for one-third of the elderly included in this IADL service use category. Cell frequency less than 5 percent of total.

TABLE 138. Percentage Distribution of Supportive Service Use Pattern by Number of Surviving Children Among the Bedfast Elderly (Weighted Base Numbers in Parentheses)
Supportive Service Use Pattern	Number of Surviving Children
Supportive Service Use Pattern	None	One or Two	Three+	Total
Informal Services Only, from Within Same Household	(a)	40.5%	36.2%	34.0%
Informal Services Only, from Outside Household or Mix from Within and Without Household	(a)	31.0	27.7	27.5
Formal Services Only, or Mix of Formal and Informal	65.0	28.6	36.1	38.5
Total	100.0% (20)	100.0% (42)	100.0% (47)	100.0% (109)
SOURCE: Special Tabulations from the 1975 National Survey of the Aged, conducted by Dr. Ethel Shanas (AoA Grant No. 90-A-369). Cell frequency less than 5 percent of total.

X. SPENDING FOR LONG-TERM CARE SERVICES

TABLE 139. Public Expenditures on Long-Term Care Services by Program, Fiscal Year 1980**
Service Category	Total Reported Expenditures in U.S. ($ in thousands)	Percentage Distribution by Program
Service Category	Total Reported Expenditures in U.S. ($ in thousands)	Medicaid	Medicare	Older Americans Act	Supplemental Security Income	Title XX***	Veterans Administration¹
Total	$13,454,224.2	76.3%	6.9%	5.2%	2.7%	5.4%	3.5%
Nursing Home	8,586,008.0	92.3	3.6²	*³	--	--	4.1
Intermediate Care Facility for the Mentally Retarded	1,976,730.9	100.0	--	--	--	--	--
Non-Medical Facility	505,991.4	--	--	--	73.1	4.0⁴	22.9
Foster Care	12,627.2	--	--	--	--	100	--
Day Care	20,585.9	3.3	--	--	--	96.7	--
Home Health	775,383.3	18.2	80.8⁵	--	--	--	1.0
In-Home	667,602.4	32.6	--	6.3	--	61.1⁶	--
Community	462,147.2	--	--	45.2⁷	--	54.8⁸	--
Meals	447,147.9	--	--	98.0	--	2.0	--
SOURCE: Medicaid: Medicaid Program Data Branch, Health Care Financing Administration, “Medicaid State Tables: Fiscal Year 1980,” (unpublished Draft); and telephone calls to State Medicaid agencies. Medicare: Martin Ruther, “Medicare: Use of Skilled Nursing Facilities, 1979” in Health Care Financing Notes (Washington, D.C.; GPO, 1981); and unpublished preliminary data from the Office of Research, Health Care Financing Administration. Older Americans Act: Unpublished data from the Bureau of Program Operations, Administration on Aging. Supplemental Security Income: Unpublished data from the Office of Research and Statistics, Social Security Administration; and telephone calls to state welfare agencies. Title XX: Unpublished data from the Office of Human Development Services, Department of Health and Human Services. Veterans Administration: Veterans Administration, 1979 Annual Report (Washington, D.C.: GPO, 1980); and Veterans Administration Summary of Medical Programs (Washington, D.C.: Veterans Administration, September 1979); National Association of State Veterans Homes, Report for 1979-1980; unpublished data from the Hospital Based Home Care Program and the State Home Program of The Veterans Administration. * Less than 0.05 percent. Includes federal, state and local spending under the six programs listed. Data are the most recent available at the time they were compiled, in some cases for a time period other than fiscal year 1980. Since expenditures are generally rising over time, this means amounts may be somewhat understated if data are for a time period prior to FY ’80, and somewhat overstated if they are for a time period later than FY ’80. * Includes only Title XX expenditures on services to SSI recipients. Expenditures for fiscal year 1979 Expenditures for calendar year 1979. Nursing home ombudsman services -- $3,789.0 thousand. Residential care and treatment services. Expenditures for calendar year 1980. Includes services reported under the following categories: homemaker, chore, and home management. Includes access, community (other than legal), and in-facility services. Includes services reported under the following Title XX categories: special services for the blind, education and training, transportation, health related, special services for the disabled, other, socialization, transitional case mangement, protective services for adults, placement, housing, improvement, counseling, recreational, diagnosis and evaluation, and emergency.

TABLE 140. Public Expenditures on Long-Term Care Related Services by Program and State, Fiscal Year 1980¹
State	Total Reported Expenditures ($ in thousands)	Percentage Distribution by Program²						Total Reported Expenditures Per Person Age 65 and Over
State	Total Reported Expenditures ($ in thousands)	Medicaid	Medicare	Older Americans Act	Supplemental Security Income	Title XX	Veterans Administration	Amount	Rank
U.S.	$13,454,224.2	76.3%	6.9%	5.2%	2.7%	5.4%	3.5%	$539.74
Alabama	171,705.6	77.4	8.7	4.6	N/A	5.5	3.8	$404.20	43
Alaska	2,112.3		83.0	0.7	16.3	--	--	--	1,954.841
Arizona	20,796.8	--	23.0	31.1	N/A	24.6	21.2	74.43	51
Arkansas	146,424.6	84.5	3.6	4.4	--	4.0	3.5	486.78	28
California	1,229,077.2	52.2	8.6	6.9	12.1	18.6	1.6	519.56	23
Colorado	138,321.8	74.1	6.5	5.5	1.3	8.9	3.6	570.16	16
Connecticut	199,755.4	83.4	8.2	4.9	--	1.2	2.4	547.57	22
Delaware	28,984.7	69.5	6.3	12.4	1.6	2.9	7.2	509.39	25
District of Columbia	44,533.9	66.9	5.8	8.3	0.4	11.8	6.7	608.38	12
Florida	286,335.8	52.6	27.6	9.7	0.5	4.5	5.0	175.70	50
Georgia	281,540.8	73.3	5.6	3.2	--	12.1	5.8	574.33	15
Hawaii	54,238.0	76.6	6.8	5.0	5.8	5.4	0.5	748.11	6
Idaho	40,446.1	75.2	7.6	8.5	4.9	1.7	2.0	440.58	36
Illinois	447,456.4	73.6	12.8	8.9	--	1.0	3.7	363.01	46
Indiana	253,941.7	83.4	4.9	6.7	0.8	0.8	3.4	442.79	35
Iowa	171,800.6	77.7	4.6	6.4	*	4.8	6.4	451.51	33
Kansas	131,409.8	77.8	4.5	7.0	--	3.6	7.2	434.69	39
Kentucky	168,847.4	73.1	7.3	6.1	7.3	5.0	1.2	424.45	40
Louisiana	258,175.2	83.2	5.4	3.0	--	6.4	2.0	670.06	9
Maine	81,889.1	79.9	7.3	3.8	3.3	3.8	1.9	608.38	12
Maryland	135,445.0	79.4	10.5	9.1	0.3	N/A	0.8	340.82	48
Massachusetts	502,946.0	80.2	6.4	3.6	1.7	5.1	3.0	700.18	8
Michigan	585,605.0	68.3	5.5	4.9	7.8	10.3	3.2	656.72	10
Minnesota	436,837.4	90.3	2.1	2.1	--	3.8	1.7	936.01	3
Mississippi	122,771.1	72.3	13.3	5.5	--	2.4	6.4	447.91	34
Missouri	236,495.5	57.2	13.6	9.4	12.4	3.7	3.7	373.78	45
Montana	48,146.4	72.3	4.0	8.2	1.3	10.2	4.0	569.77	17
Nebraska	94,744.6	66.3	5.2	6.6	N/A	14.4	7.5	465.57	30
Nevada	31,695.5	70.7	7.1	12.7	1.2	4.7	3.6	560.98	18
New Hampshire	62,505.5	77.9	7.4	5.4	N/A	2.2	7.1	641.08	11
New Jersey	443,213.0	78.8	9.8	5.3	1.7	1.5	2.9	513.09	24
New Mexico	39,147.2	61.9	8.0	10.6	0.5	14.1	4.8	362.47	47
New York	2,420,464.9	90.7	3.3	1.9	3.0	0.9	0.3	1,127.10	2
North Carolina	250,586.1	68.9	6.4	5.3	7.6	9.4	2.4	434.89	38
North Dakota	34,883.0	73.1	4.8	10.1	2.5	4.1	5.5	434.95	37
Ohio	472,092.7	74.8	9.3	5.4	--	3.9	6.6	407.85	42
Oklahoma	181,523.9	83.9	3.9	3.8	--	1.5	6.9	498.55	27
Oregon	149,227.7	62.9	8.7	10.8	N/A	9.3	8.3	503.12	26
Pennsylvania	629,071.2	77.7	12.2	5.7	N/A	0.7	3.6	416.65	41
Rhode Island	96,051.2	80.3	6.5	4.8	--	4.0	4.4	775.23	5
South Carolina	150,355.2	81.3	6.1	4.0	1.4	4.5	2.8	555.22	20
South Dakota	54,087.1	70.9	2.4	7.8	1.1	4.9	13.0	596.32	14
Tennessee	236,237.4	75.6	7.8	7.9	--	4.4	4.3	478.60	29
Texas	728,611.3	81.8	4.8	5.1	--	5.8	2.6	552.03	21
Utah	58,400.4	80.1	5.8	7.1	--	4.4	2.6	555.66	19
Vermont	40,663.2	73.3	6.3	8.3	3.9	1.6	6.6	733.99	7
Virginia	230,831.6	77.5	3.6	5.3	1.8	7.0	4.8	463.70	31
Washington	188,063.5	73.3	8.1	4.8	--	9.0	4.8	461.84	32
West Virginia	56,212.2	57.1	11.0	11.3	--	7.0	13.5	245.25	49
Wisconsin	490,041.6	86.0	2.4	3.9	0.7	2.8	4.2	876.63	4
Wyoming	15,374.6	55.5	6.2	24.6	--	1.5	12.2	400.38	44
SOURCE: State totals do not sum to U.S. total because some Veterans Administration expenditures could not be allocated by state. Medicaid: Medicaid Program Data Branch, Health Care Financing Administration, “Medicaid State Tables: Fiscal Year 1980,” (unpublished Draft); and telephone calls to State Medicaid agencies. Medicare: Martin Ruther, “Medicare: Use of Skilled Nursing Facilities, 1979” in Health Care Financing Notes (Washington, D.C.; GPO, 1981); and unpublished preliminary data from the Office of Research, Health Care Financing Administration. Older Americans Act: Unpublished data from the Bureau of Program Operations, Administration on Aging. Supplemental Security Income: Unpublished data from the Office of Research and Statistics, Social Security Administration; and telephone calls to state welfare agencies. Title XX: Unpublished data from the Office of Human Development Services, Department of Health and Human Services. Veterans Administration: Veterans Administration, 1979 Annual Report (Washington, D.C.: GPO, 1980); and Veterans Administration Summary of Medical Programs (Washington, D.C.: Veterans Administration, September 1979); National Association of State Veterans Homes, Report for 1979-1980; unpublished data from the Hospital Based Home Care Program and the State Home Program of The Veterans Administration. * Less than 0.05 percent. N/A Not available. Veterans Administration expenditures are for fiscal year 1979, Medicare nursing home expenditures are for calendar year 1979, and Medicare home health expenditures are for calendar year 1980. May not add to 100% due to rounding.

TABLE 141. Public Expenditures on Long-Term Care Related Services by Service Category and State, Fiscal Year 1980¹
State	Total Reported Expenditures ($ in thousands)	Percentage Distribution by Service²
State	Total Reported Expenditures ($ in thousands)	Nursing Home	Intermediate Care Facility for the Mentally Retarded	Non- Medical Facility	Foster Care	Adult Day Care	Home Health	In- Home	Community	Mean
U.S.	$13,454,224.2	63.8%	14.7%	3.8%	0.1%	0.2%	5.8%	5.0%	3.4%	3.3%
Alabama	171,705.6	77.9	4.4	0.4	0.1	0.3	7.6	0.6	5.2	3.4
Alaska	21,112.3	55.6	27.7	--	--	--	0.5	0.7	6.5	9.1
Arizona	20,796.8	26.5	--	13.3	--	1.3	9.1	5.1	19.7	25.1
Arkansas	146,424.6	69.6	17.5	0.3	--	1.2	3.5	1.1	3.8	2.9
California	1,229,077.2	53.7	2.7	12.9	--	--	5.4	17.4	3.5	4.4
Colorado	138,321.8	59.9	18.6	1.6	0.3	--	5.4	4.1	6.6	3.5
Connecticut	199,755.4	83.4	0.2	1.1	--	*	9.2	0.4	2.3	3.4
Delaware	28,984.7	54.8	22.5	1.6	0.3	0.5	5.8	3.3	5.0	6.2
District of Columbia	44,533.9	39.3	21.3	4.8	--	--	11.0	13.1	4.4	6.0
Florida	286,335.8	58.3	4.7	1.6	--	0.1	21.3	1.3	6.2	6.3
Georgia	281,540.8	62.6	13.7	2.5	--	*	5.5	1.8	11.7	2.2
Hawaii	54,238.0	64.0	16.6	5.8	*	0.9	3.3	1.8	4.4	3.2
Idaho	40,446.1	59.3	17.9	6.1	--	--	6.6	1.3	3.6	5.3
Illinois	447,456.4	81.5	N/A	0.2	--	*	8.4	1.6	3.3	5.0
Indiana	253,941.7	78.2	10.2	1.4	--	--	3.0	0.4	2.8	4.1
Iowa	171,800.6	62.7	23.0	1.2	1.4	0.3	2.5	2.2	2.8	4.1
Kansas	131,409.8	56.5	25.2	5.5	--	0.1	3.7	1.1	3.0	4.9
Kentucky	168,847.4	63.3	12.3	7.5	--	0.1	6.1	1.1	5.5	4.1
Louisiana	258,175.2	59.7	25.4	0.6	0.1	--	4.8	5.0	2.2	2.1
Maine	81,889.1	83.3	N/A	3.3	--	--	5.9	1.1	4.0	2.5
Maryland	135,445.0	82.6	N/A	0.3	--	--	8.0	0.6	3.1	5.3
Massachusetts	502,946.0	58.2	24.1	3.8	--	--	7.0	1.5	2.8	2.6
Michigan	585,605.0	55.7	17.4	7.9	--	--	3.8	7.2	4.9	3.1
Minnesota	436,837.4	64.9	26.6	0.9	*	*	1.9	1.0	3.2	1.5
Mississippi	122,771.1	67.6	7.9	3.3	--	0.7	13.2	0.6	3.5	3.1
Missouri	236,495.5	51.8	12.9	12.5	--	*	9.7	1.7	6.0	5.3
Montana	48,146.4	67.4	9.4	2.1	0.2	--	2.7	2.3	10.8	5.1
Nebraska	94,744.6	58.0	16.1	1.5	0.1	0.2	3.1	2.9	13.1	5.1
Nevada	31,695.5	65.0	11.6	1.4	--	--	4.2	3.0	6.1	8.8
New Hampshire	62,505.5	81.5	6.5	--	*	0.1	4.5	0.8	3.5	3.1
New Jersey	443,213.0	56.2	25.6	2.0	*	0.1	9.3	1.3	2.4	3.0
New Mexico	39,147.2	49.3	16.6	0.6	--	0.6	9.0	9.7	9.3	4.9
New York	2,420,464.9	69.2	11.9	3.2	*	--	5.1	8.3	1.0	1.3
North Carolina	250,586.1	55.9	17.7	7.6	0.5	0.1	4.2	4.9	5.9	3.2
North Dakota	34,883.0	79.8	--	4.4	--	1.0	2.2	2.2	3.7	6.7
Ohio	472,092.7	68.6	14.7	2.7	*	0.2	4.7	1.0	4.4	3.6
Oklahoma	181,523.9	65.9	15.2	2.0	--	*	2.1	10.0	1.6	3.2
Oregon	149,227.7	43.7	24.7	5.8	4.0	0.8	5.5	3.7	4.9	6.8
Pennsylvania	529,071.2	51.9	32.7	0.2	--	*	8.9	0.5	2.2	3.6
Rhode Island	96,051.2	61.3	24.3	0.9	--	*	4.9	2.3	3.5	2.9
South Carolina	150,355.2	63.5	21.2	1.4	--	0.1	5.5	1.8	3.7	2.8
South Dakota	54,087.1	54.8	20.7	9.9	--	--	1.7	2.1	6.4	4.4
Tennessee	236,237.4	60.2	18.6	2.5	*	2.8	6.5	0.9	2.6	5.9
Texas	728,611.3	61.6	21.9	0.8	--	--	4.3	4.9	3.3	3.2
Utah	58,400.4	58.9	27.4	--	0.1	0.1	2.2	0.8	5.6	4.9
Vermont	40,663.2	54.2	23.2	4.5	--	--	8.7	1.1	3.0	5.2
Virginia	230,831.6	57.4	23.5	4.2	*	0.5	2.6	4.5	4.3	3.0
Washington	188,063.5	77.3	1.0	1.0	--	0.1	6.8	8.2	2.6	3.0
West Virginia	56,212.2	64.5	1.9	7.6	0.8	--	8.2	4.3	6.4	6.4
Wisconsin	490,041.6	77.3	11.4	2.2	--	0.6	2.3	0.6	2.6	3.0
Wyoming	15,374.6	65.9	--	3.0	*	*	5.2	2.5	7.9	15.5
SOURCE: See tables in each program description. State totals do not sum to U.S. total because some Veterans Administration expenditures could not be allocated by state. * Less than 0.05 percent. N/A Amount of expenditures not available. -- No expenditures reported. Veterans Administration expenditures are for fiscal year 1979, Medicare nursing home expenditures are for calendar year 1979, and Medicare home health expenditures are for calendar year 1980. May not add to 100% due to rounding.

TABLE 142. Percent of Total Reported Medicaid Expenditures Used to Finance Long-Term Care Services, Fiscal Year 1980
State	Total Medicaid Payments (thousands)	Percent of Total
State	Total Medicaid Payments (thousands)	All Long-Term Care	Skilled and Intermediate Nursing Care	Intermediate Care Facility for the Mentally Retarded	Home Health	Other Long-term Care Services¹
Alabama	$23,188,586.2	44.2	34.2	8.5	0.6	0.9
Alaska	263,459.8	50.5	47.0	2.9	0.6	--
Arizona	26,663.2	65.6	43.7	21.9	*	--
Arkansas	234,660.3	52.7	41.1	10.9	0.1	0.6
California	2,728,153.7	23.5	22.2	1.2	0.1	N/A
Colorado	181,713.0	56.4	41.8	14.2	0.4	--
Connecticut	349,673.3	47.6	46.4	*	1.2	--
Delaware	45,250.2	44.5	29.4	14.4	0.7	--
District of Columbia	168,476.0	17.7	9.4	5.6	1.7	1.0
Florida	392,018.0	38.4	34.7	3.5	0.2	--
Georgia	462,444.4	44.7	35.4	8.4	0.6	0.3
Hawaii	96,161.5	43.2	33.5	9.4	0.3	--
Idaho	51,972.1	58.6	44.2	14.0	0.4	--
Illinois	1,191,914.7	27.6	27.4	N/A	0.2	--
Indiana	354,228.1	59.8	52.1	7.3	0.4	--
Iowa	230,231.4	57.9	40.6	17.1	0.2	--
Kansas	201,771.3	50.6	33.9	16.4	0.3	*
Kentucky	295,606.7	41.8	33.4	7.0	1.4	--
Louisiana	415,232.0	51.7	35.8	15.8	0.1	--
Maine	131,319.8	49.8	49.0	N/A	0.8	--
Maryland	319,577.9	33.7	33.4	N/A	0.3	--
Massachusetts	997,909.4	40.5	27.1	12.2	1.2	N/A
Michigan	1,071,681.0	37.3	27.5	9.5	0.3	--
Minnesota	590,361.6	66.9	46.7	19.7	0.5	N/A
Mississippi	211,044.5	42.1	37.1	4.6	0.4	--
Missouri	295,051.6	45.9	35.3	10.3	0.3	--
Montana	62,339.1	55.9	48.0	7.3	0.5	0.1
Nebraska	108,782.0	57.7	43.1	14.0	0.4	0.2
Nevada	44,889.6	50.0	40.6	8.2	0.7	0.5
New Hampshire	71,894.3	67.7	61.1	5.7	0.9	*
New Jersey	755,928.9	46.2	29.9	15.0	1.2	0.1
New Mexico	70,257.2	34.5	24.6	9.2	0.7	--
New York	4,542,635.4	48.3	36.3	6.4	1.4	4.2
North Carolina	401,066.1	43.0	31.6	11.1	0.3	--
North Dakota	46,742.0	54.6	54.5	--	0.1	--
Ohio	809,431.9	43.6	34.9	8.6	0.1	--
Oklahoma	265,433.4	57.4	40.5	10.4	*	6.5
Oregon	178,936.6	52.5	31.6	20.6	0.1	0.2
Pennsylvania	1,058,194.5	46.2	26.6	19.4	0.2	--
Rhode Island	160,378.5	48.1	33.4	14.5	0.2	--
South Carolina	259,172.3	47.2	34.4	12.3	0.5	--
South Dakota	54,906.6	69.8	49.2	20.4	*	0.2
Tennessee	379,507.0	47.0	35.0	11.6	0.4	--
Texas	980,854.3	60.7	43.9	16.3	0.1	0.4
Utah	79,564.6	58.7	38.5	20.1	0.1	--
Vermont	59,267.1	50.3	32.5	16.0	1.8	--
Virginia	358,961.8	49.9	34.4	15.1	0.4	--
Washington	328,947.1	42.0	40.7	0.6	0.6	0.1
West Virginia	103,591.0	30.9	29.8	1.0	0.1	--
Wisconsin	685,881.1	61.5	52.8	8.2	0.5	*
Wyoming	14,448.3	59.1	59.0	--	0.1	--
SOURCE: Medicaid Program Data Branch, Health Care Financing Administration, “Medicaid State Tables: Fiscal Year 1980” Unpublished Draft), and telephone calls to State Medicaid agencies. * Less than 0.1 percent. N/A = Not available. Expenditures on personal care and adult day care may be for state rather than federal fiscal year.

TABLE 143. Nursing Home Spending Growth by Source and Year, 1948-1981 (billions of dollars)
	1981	1980	1979	1978	1977	1976
NURSING HOME CARE -- NATIONAL TOTAL	24,200	20,600	17,807	15,102	12,810	11,390
Private Funds	10,600	9,100	7,705	6,462	5,478	5,054
Consumer Payments*	10,500	9,000	7,705	6,372	5,402	4,984
Out of pocket	10,300	8,800	7,481	6,268	5,312	4,894
Private insurance	200	200	117	105	90	91
Other Private Funds	100	100	107	90	76	70
Business/Inplant Services	--	--	0	0	0	0
Philanthropic Funds	--	--	107	90	76	70
Public Funds**	13,600	11,500	10,102	8,639	7,332	6,336
Federal Funds	7,500	6,200	5,461	4,792	4,161	3,606
Medicare	400	400	373	353	365	334
Medicaid (federal share)	6,600	5,500	4,775	4,157	3,548	3,064
Veterans Administration	400	400	313	282	248	208
State and Local Government Funds	6,100	5,300	4,642	3,848	3,171	2,730
Public Assistance	6,100		4,642	3,848	3,171	2,730
Medicaid (state share)	5,400	4,700	4,021	3,328	2,740	2,359
Other Public Aid	700	700	621	520	430	371
ADDENDUM: TOTAL MEDICAID	12,000	10,400	8,796	7,485	6,288	5,423
	1975	1974	1973	1972	1971	1970
NURSING HOME CARE -- NATIONAL TOTAL	10,105	8,567	7,217	6,457	5,635	4,697
Private Funds	4,424	3,960	3,581	3,418	2,798	2,421
Consumer Payments*	4,362	3,906	3,529	3,370	2,759	2,387
Out of pocket	4,284	3,841	3,512	3,359	2,746	2,375
Private insurance	78	64	17	11	13	12
Other Private Funds	61	55	52	48	39	34
Business/Inplant Services	0	0	0	0	0	0
Philanthropic Funds	61	55	52	48	39	34
Public Funds**	5,681	4,607	3,636	3,039	2,837	2,276
Federal Funds	3,186	2,603	2,051	1,670	1,692	1,339
Medicare	291	244	192	175	195	259
Medicaid (federal share)	2,720	2,218	1,740	1,396	1,042	779
Veterans Administration	174	141	120	99	82	58
State and Local Government Funds	2,496	2,003	1,585	1,369	1,144	938
Public Assistance	2,496	2,003	1,585	1,369	1,144	938
Medicaid (state share)	2,150	1,710	1,356	1,184	884	644
Other Public Aid	346	293	229	185	261	294
ADDENDUM: TOTAL MEDICAID	4,870	3,928	3,096	2,580	1,026	1,422
	1969	1968	1967	1966	1965	1964
NURSING HOME CARE -- NATIONAL TOTAL	3,805	3,380	2,776	2,356	2,072	1,214
Private Funds	1,760	1,640	1,404	1,400	1,360	834
Consumer Payments*	1,734	1,616	1,382	1,378	1,339	814
Out of pocket	1,721	1,607	1,375	1,375	1,337
Private insurance	13	9	7	3	2
Other Private Funds	26	24	22	22	21	20
Business/Inplant Services	0	0	0	0	0
Philanthropic Funds	26	24	22	22	21
Public Funds**	2,045	1,740	1,372	956	712	380
Federal Funds	1,227	1,037	794	538	460
Medicare	336	356	223	35	0
Medicaid (federal share)	650	566	444	236	0
Veterans Administration	44	37	30	21	6
State and Local Government Funds	817	703	579	418	251
Public Assistance	817	703	579	418	251
Medicaid (state share)	585	570	463	252	0
Other Public Aid	232	132	115	166	251
ADDENDUM: TOTAL MEDICAID	1,234	1,137	908	488	0
	1963	1962	1961	1960	1959	1958
NURSING HOME CARE -- NATIONAL TOTAL	891	695	606	526	434	383
Private Funds	554	420	432	419	343	314
Consumer Payments*
Out of pocket
Private insurance
Other Private Funds	14	11	10	8	7	6
Business/Inplant Services
Philanthropic Funds
Public Funds**	337	275	174	108	91	69
Federal Funds
Medicare
Medicaid (federal share)
Veterans Administration
State and Local Government Funds
Public Assistance
Medicaid (state share)
Other Public Aid
ADDENDUM: TOTAL MEDICAID
	1957	1956	1955	1954	1953	1952
NURSING HOME CARE -- NATIONAL TOTAL	368	358	312	270	248	228
Private Funds	300	297	260	227	211	197
Consumer Payments*	295	293	257	224	208	195
Out of pocket
Private insurance
Other Private Funds	5	4	3	3	3	2
Business/Inplant Services
Philanthropic Funds
Public Funds**	68	61	52	43	37	31
Federal Funds
Medicare
Medicaid (federal share)
Veterans Administration
State and Local Government Funds
Public Assistance
Medicaid (state share)
Other Public Aid
ADDENDUM: TOTAL MEDICAID
	1951	1950	1949	1948
NURSING HOME CARE -- NATIONAL TOTAL	207	187	168	150
Private Funds	182	170	162	150
Consumer Payments*	180	168	160	148
Out of pocket
Private insurance
Other Private Funds	2	2	2	2
Business/Inplant Services
Philanthropic Funds
Public Funds**	25	17	6	--
Federal Funds
Medicare
Medicaid (federal share)
Veterans Administration
State and Local Government Funds
Public Assistance
Medicaid (state share)
Other Public Aid
ADDENDUM: TOTAL MEDICAID
SOURCE: 1975-1981, D.R. Waldo and R.M. Gibson, “National Health Expenditures, 1981,” *Health Care Financing Review* Vol. 4, No. 1, September 1982; 1948-1974, Compendium of *National Health Expenditures Data, HEW (ORS/SSA); January 1976. Includes direct payments and insurance benefits for years 1948-1964. ** Public assistance money. Federal and State/Local funds are not separate in this source prior to 1965.

TABLE 144. Distribution of Medicaid Nursing Home Days Between Skilled and Intermediate Care by State, Fiscal Year 1979
State	Skilled Day of Care Per Thousand Elderly (Age 65 and Over)		Intermediate Days of Care Per Thousand Elderly (Age 65 and Over)
State	Amount	Percent of Total	Amount	Percent of Total
Alabama	5,641.4	43.7	7,278.7	56.3
Arkansas	3,817.5	20.3	14,999.2	79.7
California	10,531.3	94.0	677.7	6.0
Connecticut	13,716.7	84.4	2,539.0	15.6
Delaware	326.5	5.3	5,796.6	94.7
District of Columbia	435.3	12.7	2,998.9	87.3
Florida	1,180.1	44.4	1,479.8	55.6
Georgia	6,916.2	36.4	12,070.5	63.6
Hawaii	5,480.7	49.0	5,701.1	51.0
Idaho	3,670.9	36.8	6,297.3	63.2
Illinois	3,147.6	21.2	11,730.7	78.8
Indiana	2,218.6	16.5	11,215.9	83.5
Iowa	100.2	0.7	14,888.3	99.3
Kansas	375.9	2.8	12,112.9	97.2
Kentucky	2,194.6	21.1	8,194.1	78.9
Louisiana	494.1	2.7	17,886.2	97.3
Michigan	7,432.1	54.8	6,119.0	45.2
Minnesota	10,873.7	49.3	11,172.1	50.7
Mississippi	6,687.8	72.4	2,546.9	27.6
Missouri	153.0	2.2	6,747.4	97.8
Montana	1,172.6	7.9	13,709.5	92.1
Nebraska	1,032.9	7.4	12,903.9	92.6
Nevada	621.8	6.8	8,500.5	93.2
New Hampshire	493.1	3.4	14,079.1	96.6
New Jersey	458.7	4.3	10,140.1	95.7
New Mexico	180.3	2.7	6,439.0	97.3
North Carolina	2,700.9	37.1	4,580.6	62.9
North Dakota	8,463.4	56.7	6,746.4	43.3
Ohio	6,501.6	58.5	4,606.3	41.5
Oklahoma	7.6	0.0	18,920.0	100.0
Oregon	781.1	8.0	8,989.4	92.0
Pennsylvania	3,098.4	64.1	1,732.7	35.9
South Carolina	4,112.4	38.8	6,480.3	61.2
South Dakota	1,949.2	11.1	15,566.0	88.9
Tennessee	259.9	2.2	11,341.2	97.8
Texas	1,271.1	7.1	16,657.8	92.9
Utah	3,664.5	30.4	8,388.7	69.6
Vermont	532.3	4.2	12,107.8	95.8
SOURCE: Covered Days -- Unpublished data provided by the Medicaid Program Data Branch, Office of Research, Demonstrations, and Statistics, Health Care Financing Administration. Population Age 65 and Over -- U.S. Bureau of the Census, *Current Population Reports*, Series P-25, No. 796, “Illustrative Projections of State Populations by Age, Race, and Sex: 1975 to 2000.” GPO, Washington, D.C., 1979; Table 6, Series IIb. Data not available for Alaska, Colorado, Maine, Maryland, Massachusetts, New York, Rhode Island, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

TABLE 145. Medicaid Nursing Home Days of Care and Certified Beds Per Thousand Elderly, Fiscal Year 1979
	Days of Skilled and Intermediate Nursing Home Care Per Thousand Persons Age 65 and Over	Number of Skilled and Intermediate Nursing Facility Beds Per Thousand Persons Age 65 and Over
Alabama	12,920.1	49.3
Arkansas	18,816.7	65.2
California	11,208.9	53.3
Connecticut	16,255.7	64.0
Delaware	6,123.1	48.7
District of Columbia	3,434.2	11.7
Florida	2,659.9	37.1
Georgia	18,986.7	93.3
Hawaii	11,181.7	37.3
Idaho	9,968.2	98.9
Illinois	14,878.3	85.6
Indiana	13,434.6	65.3
Iowa	14,988.5	80.4
Kansas	13,488.8	88.6
Kentucky	10,388.7	42.8
Louisiana	18,380.2	61.9
Michigan	13,511.1	70.6
Minnesota	22,045.7	95.5
Mississippi	9,234.7	73.7
Missouri	6,900.4	46.3
Montana	14,882.1	112.24
Nebraska	13,936.8	92.3
Nevada	9,122.2	67.6
New Hampshire	14,572.2	65.5
New Jersey	10,598.7	61.4
New Mexico	6,619.3	31.5
North Carolina	7,281.5	33.0
North Dakota	14,939.8	101.6
Ohio	11,107.9	85.1
Oklahoma	18,927.6	74.9
Oregon	9,770.5	46.1
Pennsylvania	4,831.1	43.2
South Carolina	10,592.7	60.2
South Dakota	17,515.3	105.4
Tennessee	11,601.1	50.6
Texas	17,928.9	73.8
Utah	12,053.2	67.3
Vermont	12,640.2	52.5
SOURCE: Covered Days -- Unpublished data provided by the Medicaid Program Data Branch, Office of Research, Demonstrations, and Statistics, Health Care Financing Administration. Beds -- Medicare/Medicaid Automated Certification System (MMACS). Population Age 65 and Over -- U.S. Bureau of the Census, *Current Population Reports*, Series P-25, No. 796, “Illustrative Projections of State Populations by Age, Race, and Sex: 1975 to 2000.” GPO, Washington, D.C., 1979; Table 6, Series IIb. Data not available for Alaska, Colorado, Maine, Maryland, Massachusetts, New York, Rhode Island, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

TABLE 146. Medicaid Nursing Home Services: Recipients, Days of Care, and Cost, by Fiscal Year (Skilled and Intermediate Care Facilities¹)
Yes	Recipients (thousands)	Days of Care (thousands)	Cost Per Day	Expenditures (thousands)
1975	1,273.6	276,258.7	$15.61	$4,312,873.7
1976	1,265.8	275,580.4	16.97	4,677,480.2
1977	1,341.3	288,848.8	18.47	5,334,828.2
1978	1,344.9	283,706.7	21.92	6,219,203.3
1979	1,359.8	302,933.0	23.59	7,147,051.0
% 1975-1979	6.7	9.7	51.1	65.7
Annual Compound Rate of Growth	1.6%	2.3%	10.9%	13.5%
SOURCE: Health Care Financing Administration, Office of Research and Demonstrations, “The Medicare and Medicaid Data Book, 1981” (Baltimore, MD: HCFA, April 1982), Tables 2.15 and 2.16, p. 31. Comparable data for 1980 were not yet available. Excludes intermediate care facilities for the mentally retarded.

*TABLE 147. Medicaid Nursing Home Recipients and Expenditures, Fiscal Year 1980**
State	Skilled and Intermediate Care Facilities		Intermediate Care Facilities for the Mentally Retarded
State	Recipients	Payments (thousands)	Recipients	Payments (thousands)
Total Reported	1,397,275	$7,928,390.0	124,583	$1,976,730.9
Alabama	23,744	123,796.6	697	7,596.1
Alaska	1,198	11,660.3	200	5,840.6
Arkansas	21,689	96,443.2	2,206	25,655.4
California	138,960	605,169.2	3,580	33,445.4
Colorado	15,854	76,020.1	1,674	25,740.2
Connecticut	26,013	162,086.7	46	339.1
Delaware	1,520	13,297.9	454	6,517.1
D.C.	7,407	15,918.3	445	9,491.2
Florida	34,505	136,076.0	1,248	13,547.7
Georgia	34,380	163,708.6	1,739	38,653.8
Hawaii	4,036	32,218.4	N/A	9,019.4
Idaho	4,422	22,984.5	444	7,254.3
Illinois	79,111	326,601.1	N/A	N/A
Indiana	32,372	184,702.4	1,890	25,784.8
Iowa	23,295	93,538.0	1,680	39,428.8
Kansas	15,656	68,395.8	3,648	33,124.2
Kentucky	21,544	98,635.5	637	20,715.6
Louisiana	25,918	148,697.3	3,822	65,638.0
Maine	8,729	64,319.7	N/A	N/A
Maryland	16,304	106,631.5	N/A	N/A
Massachusetts	42,081	270,593.9	4,976	121,437.5
Michigan	58,893	295,018.5	5,363	101,870.2
Minnesota	47,041	275,686.1	12,790	116,214.5
Mississippi	14,759	78,279.5	896	9,719.6
Missouri	21,293	104,012.9	2,152	30,532.8
Montana	5,451	29,898.3	276	4,523.7
Nebraska	10,505	46,909.9	1,005	15,217.4
Nevada	2,973	18,228.2	204	3,665.4
New Hampshire	5,348	43,950.8	299	4,070.4
New Jersey	29,989	225,954.7	5,078	113,566.2
New Mexico	3,374	17,270.2	486	6,493.0
New York	155,589	1,650,079.2	16,017	288,595.9
North Carolina	25,484	126,897.0	1,933	44,466.1
North Dakota	5,337	25,451.6	--	--
Ohio	61,229	282,394.1	4,423	69,573.2
Oklahoma	22,680	107,522.5	1,898	27,540.9
Oregon	19,850	56,517.7	4,157	36,823.8
Pennsylvania	48,209	281,212.2	9,905	205,699.7
Rhode Island	7,366	53,546.1	1,033	23,328.4
South Carolina	24,984	89,099.1	2,179	31,899.0
South Dakota	5,518	27,022.6	807	11,202.3
Tennessee	27,293	132,839.9	2,443	44,018.8
Texas	94,681	430,717.6	11,901	159,781.4
Utah	5,530	30,663.2	1,307	16,028.3
Vermont	3,327	19,278.0	481	9,453.6
Virginia	19,547	123,362.9	4,939	54,186.4
Washington	23,280	133,841.8	667	1,882.5
West Virginia¹	277	30,913.1	N/A	1,058.1
Wisconsin	67,607	361,808.3	2,558	56,090.1
Wyoming	1,123	8,519.0	--	--
SOURCE: Medicaid Program Data Branch, Health Care Financing Administration, “Medicaid State Tables, Fiscal Year 1980” (Unpublished Draft). * Unduplicated count of number of persons for whom under payments were made during the year. N/A = Not available. SNF recipients only. Number of ICF recipients was not reported.

TABLE 148. Percentage Change in Medicare Covered Days Per Person Age 65 and Over, 1977-1979, by State
North Dakota	176.2
Alaska	170.3
South Carolina	92.6
Delaware	29.2
Kentucky	26.9
Virginia	24.4
Alabama	24.2
New Mexico	19.1
Hawaii	18.8
Tennessee	14.7
Oklahoma	9.5
Pennsylvania	4.7
Illinois	1.6
Montana	-0.4
West Virginia	-1.7
Indiana	-2.6
Florida	-3.0
Maryland	-3.7
Ohio	-4.5
Iowa	-5.2
Utah	-6.0
Louisiana	-7.0
District of Columbia	-7.4
Missouri	-8.0
Oregon	-10.5
Mississippi	-10.7
Idaho	-11.7
Arkansas	-13.1
Nebraska	-15.2
Wisconsin	-17.3
North Carolina	-17.4
South Dakota	-17.7
Wyoming	-17.7
Georgia	-18.9
Arizona	-19.0
Washington	-22.4
New Hampshire	-24.3
California	-24.6
Nevada	-24.7
Michigan	-27.2
New Jersey	-28.7
Rhode Island	-30.4
Massachusetts	-31.7
Maine	-36.0
Kansas	-36.3
Texas	-39.7
Colorado	-41.3
New York	-48.1
Vermont	-49.2
Minnesota	-51.4
Connecticut	-68.0
United States	-17.2
SOURCE: Covered Days -- Unpublished data from Current Utilization Series, Office of Statistics and Data Management, Office of Research, Demonstrations and Statistics, Health Care Financing Administration. Population Age 65 and Over -- U.S. Bureau of the Census, *Current Population Reports*. Series P-25, No. 796, “Illustrative Projects of State Populations by Age, Race, and Sex: 1975 to 2000.” GPO Washington, D.C., 1979; Table 6, Series IIb.

TABLE 149. Medicare Covered SNF Days Per 1,000 Persons Age 65 and Over: 1979
Hawaii	691.0
Ohio	561.0
Kentucky	552.6
North Dakota	548.0
Nevada	533.5
New Hampshire	512.7
Michigan	499.1
Pennsylvania	475.8
Illinois	465.0
North Carolina	463.8
Montana	459.7
Oregon	425.9
Utah	419.9
Alabama	419.8
Rhode Island	414.0
South Carolina	401.6
Indiana	381.4
Florida	381.4
California	378.0
Washington	343.2
Maryland	340.2
New Jersey	335.6
Delaware	333.5
Tennessee	320.0
Missouri	301.6
Nebraska	278.2
Vermont	275.9
Idaho	268.3
Maine	264.1
New York	262.9
Virginia	243.4
District of Columbia	234.1
Arizona	230.5
Iowa	224.1
West Virginia	219.7
Massachusetts	198.5
Wisconsin	187.4
Connecticut	181.3
Colorado	172.0
Georgia	160.3
South Dakota	156.0
Wyoming	149.5
Minnesota	148.5
Kansas	144.7
Louisiana	141.0
Oklahoma	118.4
Alaska	110.4
Texas	95.3
New Mexico	94.1
Arkansas	58.5
Mississippi	57.9
United States	326.2
SOURCE: Covered Days -- Unpublished data from Current Utilization Series, Office of Statistics and Data Management, Office of Research, Demonstrations and Statistics, Health Care Financing Administration. Population Age 65 and Over -- U.S. Bureau of the Census, *Current Population Reports*. Series P-25, No. 796, “Illustrative Projects of State Populations by Age, Race, and Sex: 1975 to 2000.” GPO Washington, D.C., 1979; Table 6, Series IIb.

TABLE 150. Medicare Covered Days, Total Reimbursements, and Reimbursement Per Day for Skilled Nursing Facility Services for the Aged, by State, Calendar Year 1979¹
State	Medicare Covered Days of Care (thousands)	Total Reimbursement
State	Medicare Covered Days of Care (thousands)	Amount (thousands)	Per Day
Alabama	8,055	$304,819	$38
Alaska	160	3,595	22
Arizona	63	2,892	46
Arkansas	18	692	38
California	863	43,344	50
Colorado	40	2,183	55
Connecticut	69	2,017	29
Delaware	19	473	25
District of Columbia	18	644	36
Florida	636	19,708	31
Georgia	81	3,255	40
Hawaii	47	2,239	48
Idaho	23	599	26
Illinois	620	22,342	36
Indiana	216	6,492	30
Iowa	91	4,421	49
Kansas	44	1,683	38
Kentucky	206	6,068	29
Louisiana	53	2,026	38
Maine	36	2,262	63
Maryland	133	4,187	31
Massachusetts	145	8,521	59
Michigan	439	13,793	31
Minnesota	71	4,157	59
Mississippi	15	865	58
Missouri	191	10,004	52
Montana	40	956	24
Nebraska	56	2,362	42
Nevada	31	1,206	39
New Hampshire	53	2,506	47
New Jersey	275	11,513	42
New Mexico	9	384	43
New York	587	23,245	40
North Carolina	260	6,929	27
North Dakota	45	971	22
Ohio	630	22,912	36
Oklahoma	40	3,222	81
Oregon	125	5,184	41
Pennsylvania	697	23,697	34
Rhode Island	46	1,865	41
South Carolina	100	2,086	21
South Dakota	15	396	26
Tennessee	150	4,861	32
Texas	122	5,582	46
Utah	46	2,201	48
Vermont	16	492	31
Virginia	107	3,807	36
Washington	136	4,612	34
West Virginia	53	1,715	32
Wisconsin	113	3,421	30
Wyoming	5	167	33
SOURCE: Martin Ruther, “Medicare” Use of Skilled Nursing Facilities, 1979,” in *Health Care Financing Notes* (Washington, D.C.; GPO, 1981). Aged beneficiaries accounted for 96 percent of both covered days and total reimbursements in 1979.

TABLE 151. Total Reimbursements for Home Health Care, Number of Home Visits, and Reimbursement Per Visit, 1972-1980
Year	Total Reimbursement (millions)	Percent of Total Medicare Reimbursements	Visits (millions)	Reimbursement Per Visit
1972	$66.2	0.80	5.2	$12.73
1973	93.3	0.96	6.4	14.58
1974	138.6	1.21	7.9	17.54
1975	214.9	1.47	10.8	19.89
1976	296.7	1.65	13.6	21.82
1977	370.6	1.75	15.8	23.46
1978	442.8	1.81	17.6	25.16
1979	541.3	1.89	19.9	27.20
1980	662.1	1.92	22.4	29.56
% 1972-1980	900.2%		330.8%	132.2%
Annual Compound Rate of Growth	33.3%		20.0%	11.1%
SOURCE: Unpublished data from Office of Research, Health Care Financing Administration, Bureau of Data Management and Statistics.

TABLE 152. Home Health Visits, Total Reimbursements, and Reimbursement Per Visit by State, 1980
State	Number of Visits	Visits Per Thousands Elderly	Total Reimbursements (thousands)	Reimbursement Per Visit¹
Alabama	448.8	1,056	$11,411	$25.43
Alaska	2.4	222	82	34.17
Arizona	53.8	193	1,892	35.17
Arkansas	124.9	415	4,588	36.73
California	1,613.1	682	62,648	38.84
Colorado	211.9	873	6,839	32.27
Connecticut	602.2	1,651	14,286	23.72
Delaware	71.7	1,260	1,349	18.81
District of Columbia	61.3	837	1,942	31.68
Florida	1,972.9	1,211	59,452	30.13
Georgia	407.1	830	12,558	30.85
Hawaii	38.9	537	1,472	37.84
Idaho	74.7	814	2,478	33.17
Illinois	1,097.2	890	34,724	31.65
Indiana	230.4	402	6,019	26.12
Iowa	211.3	555	3,467	16.41
Kansas	180.5	597	4,172	23.11
Kentucky	190.9	480	6,261	32.80
Louisiana	420.4	1,091	11,831	28.14
Maine	143.1	1,063	3,737	26.11
Maryland	284.9	717	9,972	35.00
Massachusetts	1,117.4	1,556	23,555	21.08
Michigan	521.8	585	18,884	36.19
Minnesota	185.7	398	5,184	27.92
Mississippi	545.2	1,989	15,469	28.37
Missouri	860.8	1,361	22,107	25.68
Montana	37.0	438	981	26.51
Nebraska	83.2	409	2,561	30.78
Nevada	32.5	575	1,044	32.12
New Hampshire	107.4	1,102	2,150	20.02
New Jersey	1,092.2	1,264	31,839	29.15
New Mexico	87.7	812	2,759	31.46
New York	1,840.1	857	56,216	30.55
North Carolina	321.9	559	9,157	28.45
North Dakota	32.8	409	713	21.74
Ohio	719.0	621	21,039	29.26
Oklahoma	122.2	336	3,805	31.14
Oregon	200.3	675	7,802	38.95
Pennsylvania	2,123.1	1,406	53,231	25.07
Rhode Island	167.4	1,351	4,417	26.39
South Carolina	215.2	795	7,025	32.64
South Dakota	43.2	476	902	20.88
Tennessee	441.4	894	13,580	30.77
Texas	930.4	705	29,370	31.57
Utah	52.9	503	1,187	22.44
Vermont	97.1	1,753	2,080	31.42
Virginia	143.0	287	4,401	30.78
Washington	309.0	759	10,590	34.27
West Virginia	175.0	764	4,475	25.57
Wisconsin	307.7	550	8,179	26.58
Wyoming	30.8	802	786	25.52
SOURCE: Unpublished preliminary data from the Office of Research, Health Care Financing Administration. Includes reimbursement for some home health services not related to visits. Ninety-five percent of total home health charges were for visits.

TABLE 153. Total Medicare Reimbursement, Reimbursement for Home Health Services and Number of Home Health Visits (in millions): Calendar Years 1967-1980 (in millions)
Year	Total Medicare Reimbursement	Home Health Agency Reimbursement		Home Health Visits
Year	Total Medicare Reimbursement	Amount	As Percent of Total Medicare Reimbursement	Home Health Visits
1967	$4,239.0	$43.0	1.01	--
1969	6284.0	81.1	1.29	8.5
1970	6,772.4	62.7	0.92	6.0
1971	7,486.9	57.2	0.76	4.8
1972	8,216.5	66.2	0.80	5.2
1973	9,639.2	93.3	0.97	6.4
1974	11,920.1	138.6	1.17	7.9
1975	14,749.3	214.9	1.46	10.8
1976	17,939.5	296.7	1.76	13.6
1977	21,094.3	370.6	1.76	15.8
1978	24,402.8	442.8	1.81	17.6
1979	28,267.0	541.3	1.91	19.9
1980	33,389.4	662.1	1.98	22.4
SOURCE: Health Care Financing Administration, Bureau of Data Management and Statistics, unpublished utilization statistics. Amounts are for year in which expenses were incurred, based on bills processed through June 1981. Thus, data for most recent years are less complete than data for earlier years.

TABLE 154. Medicare Reimbursements for Home Health Services by Program and Type of Enrollee, Selected Years
	1967	1974	1978	1980
Total Reimbursements - All Enrollees	$43	$136	$435	$640
Part A (in millions)	26	96	317	467
Percent Distribution	60.5%	70.6%	72.9%	72.9%
Part B (in millions)	17	40	118	173
Percent Distribution	39.5%	29.4%	27.1%	27.1%
Total Reimbursements - Aged Enrollees	$43	$127	$400	$589
Part A (in millions)	26	90	293	431
Percent Distribution	60.5%	70.9%	73.2%	73.3%
Part B (in millions)	17	37	107	157
Percent Distribution	39.5%	29.1%	26.8%	26.7%
Total Reimbursements - Disabled Enrollees	N.A.	$9	$35	$51
Part A (in millions)	N.A.	6	24	36
Percent Distribution	N.A.	66.6%	68.6%	70.6%
Part B (in millions)	N.A.	3	11	15
Percent Distribution	N.A.	33.3%	31.4%	29.4%
SOURCE: Health Care Financing Administration, Office of Research, Demonstrations, and Statistics, *Health Care Financing Notes*, “Medicare: Summary of Use and Reimbursement by Person, 1978,” Baltimore, Maryland. August 1981, p. 3. These data differ slightly from those presented in Table 153 which incorporate the most recent estimates of Medicare home health reimbursements. The more recent estimataes did not identify reimbursement distributions by program or enrollee types, and therefore the less recent estimates have been used here.

TABLE 155. Medicaid Home Health Services, Recipients and Expenditures, 1975-1980¹
Fiscal Year	Total Recipients (thousands)	Total Payments (millions)	% of Total Medicaid Payment
1975	195	$70.3	0.6
1976	232	134.3	1.0
1977	370	180.0	1.1
1978	377	209.8	1.2
1979	356	263.6	1.3
1980	394	331.8	1.4
% 1975-1980	102.1	372.0
Average Annual Compound Rate of Growth	15.1%	36.4%
SOURCE: Health Care Financing Administration, Unpublished Data. Figures include personal care expenditures reported to HCFA under the home health category.

TABLE 156. Medicaid Non-institutional Long-Term Care Recipients and Expenditures, Fiscal Year 1980 (payments in thousands)
	Home Health		Personal Care		Adult Day Care
	Recipients	Payments	Recipients	Payments	Recipients	Payments
Total Reported	358,068	140,836.2	46,473	217,457.5	759	688.4
Alabama	3,389	1,493.9
Alaska	41	16.6
Arkansas	657	257.7	1,784	1,350.0
California	15,000	2,832.3			N/A	N/A
Colorado	1,400	687.0
Connecticut	28,359	4,086.8
Delaware	559	337.8
District of Columbia	3,703	2,781.5	N/A	1,613.3
Florida	13,626	923.1
Georgia¹	3,884	2,662.6	682	1,270.6	N/A	N/A
Hawaii	633	298.2
Idaho	316	182.9
Illinois	6,558	2,747.4
Indiana	1,494	1,407.1
Iowa	1,647	569.5
Kansas¹	795	654.5	60	33.0	N/A	N/A
Kentucky	5,031	4,098.3
Louisiana	2,203	477.1
Maine	2,262	1,085.1
Maryland²	1,858	879.1
Massachusetts	16,872	11,553.9	N/A	N/A	N/A	N/A
Michigan³	5,380	2,917.8
Minnesota⁴	9,525	2,755.0	N/A	N/A
Mississippi	2,719	769.8
Missouri	2,113	768.8
Montana⁵	696	317.3	68	57.9
Nebraska	730	412.0	406	259.5
Nevada	265	296.8	996	227.5
New Hampshire⁶	1,743	638.2	6	2.5
New Jersey	6,381	9,219.6			171	440.0
New Mexico	807	466.9
New York⁷	156,139	65,641.7	35,000	190,600.0	N/A	N/A
North Carolina	2,716	1,377.3
North Dakota	386	45.2
Ohio	5,142	958.3
Oklahoma	112	5.4	5,887	17,296.1
Oregon	669	208.8	N/A	288.1
Pennsylvania	26,533	1,981.0
Rhode Island	1,481	257.7
South Carolina	2,995	1,205.4
South Dakota⁸	46	15.6	52	91.0
Tennessee	3,350	1,693.6
Texas	4,140	1,045.6	1,368	4,248.4
Utah	214	114.5
Vermont	1,819	1,058.9
Virginia	2,357	1,355.7
Washington	3,426	1,932.4			588	248.4
West Virginia	305	135.0
Wisconsin	5,497	3,194.6	164	119.6
Wyoming	95	14.9
SOURCE: Medicaid Program Data Branch, Health Care Financing Administration, “Medicaid State Tables - Fiscal Year 1980” (Unpublished Draft); and telephone calls to state Medicaid agencies. For states reporting personal care data under home health in the State Tables, personal care amounts were subtracted from reported home health expenditures. Data obtained directly from the states are in some cases for the state fiscal year, generally July 1 - June 30. N/A = Not available. Personal care data include adult day care. Maryland began personal care and adult day care programs in FY81. For the last 3 quarters of that year expenditures were in personal care - $89.5 thousand, adult day care - $99.5 thousand. Michigan began operating a personal care program in FY81. The program has three parts: adult home help, adult foster care, and personal care in mental health facilities. Total expenditures for FY81 were $32,030.0 thousand; however, the full program was not in operation through the entire fiscal year. Home health data include personal care. Personal care data for July 1 - June 30 1981. Personal care program began in FY80. Data are for one quarter only. Figure for personal care recipients is an estimate. Figure for personal care recipients is a monthly average.

TABLE 157. Expenditures Under Title III of the Older Americans Act, by Service Category, Fiscal Year 1980 ($ in thousand)
State	Total	Service Category
		Access	In-Home	Community		In Facilities		Nursing Home Ombudsman	Meals
		Access	In-Home	Legal	Other	Care Providing	Senior Centers	Nursing Home Ombudsman	Home Delivered	Congregate
United States	$709,953.7	$101,378.6	$42,213.7	$16,539.3	$82,771.0	$3,300.1	$21,658.3	$3,789.0	$48,497.5	$389,806.1
Alabama	$7,988.0	1,334.1	382.7	61.1	759.3	0	66.5	41.4	368.5	4,974.5
Alaska	3,481.5	1,012.4	147.6	33.8	304.7	26.0	20.4	18.1	167.8	1,750.8
Arizona	6,573.9	613.2	304.9	101.1	564.0	0	257.1	28.6	736.5	3,968.4
Arkansas	6,603.0	1,609.6	54.5	121.3	486.4	153.4	233.7	19.4	415.4	3,509.2
California	88,499.2	12,949.5	1,997.9	3,320.3	14,488.7	0	1,430.5	326.1	7,173.8	46,812.3
Colorado	7,819.9	1,243.2	607.4	158.4	836.0	31.7	41.6	24.4	389.9	4,487.4
Connecticut	10,079.5	913.4	542.1	321.5	1,187.1	0	381.8	27.8	1,172.9	5,532.8
Delaware	3,674.4	52.7	626.2	71.8	804.0	37.5	258.5	24.6	172.1	1,627.1
D.C.	3,878.6	195.6	137.9	164.5	642.3	0.4	0	48.5	157.9	2,531.4
Florida	28,522.4	3,056.3	1,958.2	625.5	3,972.3	0	697.1	351.7	359.3	17,502.0
Georgia	9,324.9	1,229.7	932.0	271.6	798.1	45.4	338.4	87.6	123.3	5,499.0
Hawaii	2,760.6	479.2	99.9	73.9	309.0	0	55.7	21.7	94.8	1,626.4
Idaho	3,462.1	796.7	109.1	23.5	172.2	0	180.7	32.5	327.3	1,821.0
Illinois	41,053.2	6,186.9	4,435.6	1,101.6	6,257.0	0	504.9	124.7	988.3	21,454.3
Indiana	17,243.8	3,106.0	696.7	227.9	1,951.7	0	707.6	174.4	1,418.9	8,960.5
Iowa	11,295.1	221.0	732.1	247.0	788.5	0	360.4	4.2	543.7	6,368.2
Kansas	9,392.7	1,034.9	505.5	240.1	763.8	12.6	412.9	48.6	668.3	5,706.1
Kentucky	10,321.6	2,021.7	459.2	54.1	609.0	0.6	136.9	34.9	348.3	6,656.9
Louisiana	7,995.1	1,428.0	750.9	138.5	215.6	0	0	28.0	601.9	4,832.2
Maine	3,191.1	758.2	330.4	65.3	105.3	0	0	20.9	724.9	1,186.0
Maryland	12,671.5	2,002.9	759.8	381.0	913.4	191.6	1,124.7	106.7	773.8	6,417.6
Massachusetts	19,249.5	1,535.6	1,544.3	907.5	1,462.4	439.9	172.3	60.8	2,955.3	10,171.4
Michigan	29,214.1	2,445.2	1,861.0	740.6	5,415.7	178.5	460.8	107.6	2,330.9	15,673.9
Minnesota	9,490.2	628.2	802.2	409.5	1,376.3	0	69.9	23.0	*	6,181.3
Mississippi	6,798.5	1,519.6	117.3	19.3	768.0	0	585.3	5.7	287.8	3,495.5
Missouri	22,635.8	2,207.8	1,327.1	332.8	2,538.4	21.3	4,287.8	155.4	1,925.1	9,840.2
Montana	3,965.1	404.7	367.1	25.9	648.0	8.6	7.6	41.4	418.8	2,043.0
Nebraska	6,378.7	554.8	763.4	91.6	544.4	0	323.0	31.9	339.3	3,730.3
Nevada	4,125.4	322.3	350.2	106.4	344.0	0	233.9	24.0	349.6	2,395.1
New Hampshire	3,499.2	673.1	229.0	145.1	371.8	0	167.2	14.6	317.3	1,581.1
New Jersey	24,703.5	3,516.4	2,504.0	1,058.0	2,407.5	1,081.3	693.3	141.1	1,447.9	11,854.1
New Mexico	4,254.3	1,024.0	242.0	108.0	813.7	44.8	47.1	47.6	194.9	1,732.1
New York	45,773.9	6,301.6	3,160.7	922.8	3,558.4	100.4	46.5	297.7	6,006.2	25,379.7
North Carolina	13,392.0	3,167.2	997.9	176.1	662.1	0	468.2	80.6	394.0	7,445.8
North Dakota	3,572.0	299.7	165.1	64.4	338.2	6.3	330.7	21.7	65.1	2,280.8
Ohio	25,774.0	3,998.2	1,275.4	306.8	2,544.4	222.3	524.6	182.0	1,930.9	14,789.5
Oklahoma	7,330.8	883.0	247.9	481.1	648.9	0	588.3	28.6	295.2	4,157.9
Oregon	16,326.3	3,262.7	1,419.3	268.7	1,000.8	88.4	159.3	29.9	1,694.6	8,402.6
Pennsylvania	36,431.4	3,563.8	2,932.2	262.2	6,452.3	322.4	40.7	355.3	1,681.4	20,821.0
Rhode Island	4,657.4	75.5	162.9	81.4	911.8	55.5	607.1	15.1	290.5	2,457.5
South Carolina	6,062.4	1,322.2	168.0	44.3	422.5	0	87.3	21.4	144.3	3,852.4
South Dakota	4,213.1	860.9	661.6	5.7	166.1	66.4	34.9	20.2	412.6	1,984.8
Tennessee	19,183.4	2,391.7	669.6	540.6	1,106.0	0	1,055.6	149.0	913.9	12,357.0
Texas	37,530.9	6,780.7	1,219.4	352.7	4,908.5	105.8	1,813.2	69.4	1,438.5	20,842.6
Utah	4,171.8	384.9	226.4	46.6	559.9	3.2	110.5	7.3	769.7	2,063.3
Vermont	3,517.8	701.1	231.1	128.8	291.4	0	0	62.9	493.3	1,609.1
Virginia	12,304.7	2,630.3	506.1	140.4	2,027.9	0	43.1	47.0	714.1	6,195.8
Washington	9,577.4	2,059.0	158.6	468.3	1,024.2	0	178.7	52.5	788.3	4,847.9
West Virginia	6,511.5	1,377.4	417.5	159.4	524.4	56.0	337.6	43.9	907.1	2,866.3
Wisconsin	19,622.9	1,586.6	623.4	267.6	1,631.7	0	886.0	38.8	981.6	13,607.1
Wyoming	3,852.3	655.5	262.2	72.9	372.9	0	88.6	17.7	281.6	2,100.8
SOURCE: Data based on quarterly reports submitted by states to the Administration on Aging. For the first quarter of 1980 expenditure data on each state were not available. Consequently, total expenditures for that quarter were allocated among states based on each state’s percentage on total expenditures in other quarters. Totals may not exactly equal the sums of components due to rounding. * = Less than $50.

TABLE 158. Payment Levels and Maximum State Payments in States with Optional SSI Supplements for Non-Medical Long-Term Care, as of October 1, 1980 (payment amounts per month)
State	Type of Facility	State Payment Level		Maximum State Payment
State	Type of Facility	Individual	Couples	Individual	Couples
Alabama	Living Independently with Personal Care	$298.00	$477.00	$60.00	$120.00
Arizona	Licensed Supervisory Home Care Facility	263.00	407.00	25.00	50.00
California	Nonmedical Board & Care	465.00	930.00	227.00	573.00
Colorado	Home Care	553.00	N/A	260.00	N/A
Colorado	Adult Foster Care	433.00	N/A	140.00	N/A
Delaware	Certified Adult Residential Care Home	339.00	678.00	101.00	321.00
District of Columbia	Certified Adult Foster Care Homes: (a) 50 or less beds	365.20	715.50	127.20	358.50
District of Columbia	(b) more than 50 beds	475.20	935.50	237.30	578.50
Florida	Adult Foster Home Care	316.00	632.00	78.00	275.00
Florida	Room & Board with Personal Care	335.00	670.00	97.00	313.00
Hawaii	DCF I	328.20	656.40	90.20	299.40
	DCF II	378.20	756.40	140.20	399.40
	DCF III	440.20	800.40	202.20	523.40
Idaho	Room & Board Facility	415.00	830.00	177.00	473.00
Indiana	Residential Care Facility	Up to 430.50	N/A	Up to 165.50	N/A
Iowa	Family Life Home	291.20	602.40	53.20	245.40
Iowa	Residential Care	From 320.00 Up to 455.00		From 82.00 Up to 217.00
Kentucky	Personal Care Facility	Up to 409.00	Up to 818.00	Up to 171.00	Up to 461.00
	Family Care Home	322.0	644.00	84.00	287.00
	Individual Requiring a Caretaker in the Home	276.00	395.00	38.00	38.00
	Both Requiring Care	N/A	433.00	N/A	76.00
Maine	Foster Home	285.00	570.00	47.00	213.00
Maine	Licensed Boarding Home	335.00	670.00	97.00	313.00
Maryland	DCF	355.00	710.00	132.80	368.80
	Project Home Facilities: Minimal Supervision	298.80	597.60	60.80	240.60
	General Supervision	390.80	781.60	152.80	424.60
	Special Services	735.80	1471.60	497.80	1114.60
Massachusetts¹	DCF-Licensed Rest Home	350.21	700.42	112.21	348.42
Michigan	DCF	354.10	708.42	116.10	351.20
	Personal Care	442.60	885.20	204.60	528.20
	Home for Aged	462.13	924.26	224.13	567.26
Missouri	Licensed Residential Care Home	463.00	807.00	Up to 225.00	Up to 450.00
	Licensed Intermediate Skill Home	538.00	957.00	Up to 300.0	Up to 600.0
	Licensed Adult Boarding Facility	358.00	597.00	Up to 120.00	Up to 240.00
Montana	Adult Foster Care & Boarding Care	287.00	455.00	49.00	98.00
	Licensed Developmentally Disabled Homes/Level V Certified Personal Care Services	342.00	565.00	104.00	208.00
	Level II Certified Personal Care Services	300.75	482.50	62.75	125.50
	Level III Certified Personal Care Services	314.50	510.00	76.50	153.00
	Level IV Certified Personal Care Services	328.25	537.50	90.25	180.50
Nebraska	Licensed Boarding Home for the Aged	295.00	590.00	57.00	233.00
	Certified Adult Family Home	320.00	640.00	82.00	283.00
	Licensed Custodial Foster Home	325.00	650.00	87.00	293.00
Nevada²	DCF	441.00	882.00	203.00	525.00
New Hampshire	Shared Home for Adults	347.00	N/A	122.00	N/A
New Jersey	Licensed Boarding Home for Sheltered Care	369.00	738.00	131.00	381.00
New Mexico	Licensed Adult Residential Care Home	303.00	487.00	65.00	130.00
New York	Congregate Care I New York City	364.26	713.62	126.26	356.62
	All other counties	326.26	637.62	88.26	280.62
	Congregate Care II	495.16	975.42	257.16	618.42
	Congregate Care III New York City	723.26	1431.62	485.26	1074.62
	All other counties	699.26	1383.62	461.26	1026.62
North Carolina³	DCF: Ambulatory	440.00	N/A	211.00	N/A
	Situation A²	N/A	555.00	N/A	207.00
	Situation B²	N/A	517.00	N/A	169.00
	Semi-Ambulatory	450.00	N/A	221.00	N/A
	Situation A²	N/A	565.00	N/A	217.00
	Situation B²	N/A	527.00	N/A	179.00
	Non-Ambulatory	460.00	N/A	231.00	N/A
	Situation A²	N/A	575.00	N/A	227.00
	Situation B²	N/A	537.00	N/A	189.00
	Situation A: With spouse maintaining a home Situation B: With spouse in multiple household
North Dakota	Licensed Rest Homes and Foster Homes	238.00	357.00	Program optional with counties
Oregon⁴	Adult or Group Foster Care	250.00	500.00	12.00	143.00
Oregon⁴	In Board & Room Facility	250.00	500.00	12.00	143.00
Pennsylvania	Certified Domiciliary Care Facility	385.00	730.40	147.30	373.40
South Carolina	Licensed Boarding Facility	345.00	690.00	107.00	333.00
South Dakota	Supervised Personal Care	365.00	N/A	152.00	N/A
South Dakota	Adult Foster Care Home	285.00	N/A	72.00	N/A
Vermont	Licensed Home--Custodial Care	356.00	660.00	118.00	303.00
	Unlicensed Home--Custodial Care	302.00	561.00	64.00	204.00
	Supervised Licensed Custodial Care	376.00	670.00	138.00	313.00
Virginia⁵	Licensed Home for Aged and Domiciliary Institutions	Up to 409.00	Up to 819.00	Up to 171.00	Up to 462.00
Wisconsin⁶	Private Non-medical Group Home	377.50	745.20	139.50	388.20
SOURCE: U.S. Department of Health and Human Services; Social Security Administration; Office of Operational Policy and Procedures; Office of Assistance Programs, “Supplemental Security Income for the Aged, Blind and Disabled: Summary of State Payment Levels, State Supplementation, and Medicaid Decisions,” (rev.) October 1, 1980. N/A - Not applicable. State payment levels for the blind are $396.14 for individuals and $792.28 for couples. Does not include the disabled. State payment levels for blind individuals in licensed boarding facilities are: for the ambulatory $425.00, for the semi-ambulatory $435.00, and for the non-ambulatory $445.00. State payment levels for the blind in adult or group foster care are $262.00 for individuals and $524.00 four couples. Maximum state payments for couples are determined by treating each member as an individual. State payment levels for the blind are up to $400.10 for individuals and up to $800.20 for couples; for the disabled the payment level for couples is up to $818.00. State payment levels for the mentally retarded are $435.20 for individuals and $860.80 for couples.

TABLE 159. Federal and State Expenditures on Optional State Supplements to Recipients in Non-Medical Long-Term Care Living Arrangements for States with Federally Administered Supplement Programs, 1982 (based on April 1982 data)
State	Recipients (April 1982)	Federal and State Expenditures¹ (in thousands)	State Expenditures (in thousands)	Average State Monthly Payment
Total	126,017	494,124	294,468	194.74
California	59,748	246,036	147,792	206.13
Delaware	343	1,020	420	103.28
District of Columbia	746	2,125	1,344	149.60
Hawaii	1,570	5,544	3,048	161.78
Iowa	95	240	60	49.62
Maine	2,552	6,804	2,712	88.50
Massachusetts	4,174	13,980	8,052	160.73
Michigan	17,899	63,480	34,176	159.13
Montana	703	2,136	696	82.74
Nevada	245	660	492	170.29
New Jersey	4,704	15,036	7,176	127.19
New York	28,637	120,000	80,488	234.10
Pennsylvania	1,265	4,260	2,052	135.35
Vermont	1,422	4,176	1,788	104.85
Wisconsin	1,914	7,680	4,212	183.41
SOURCE: Unpublished data from Office of Research and Statistics, Social Security Administration. This figure equals Total Monthly Payments x 12, using data from April 1982.

TABLE 160. State Expenditures on Optional State Supplement to Recipients in Non-medical Long-Term Care Living Arrangements For States with State Administered Supplement Programs, Fiscal Year 1980 (state fiscal year data)
State	Average Monthly Recipients	State Expenditures
Total Reported	37,814	$76,140,717
Alabama	N/A	N/A
Arizona¹	N/A	N/A
Colorado	758	1,800,908
Florida	3,062	1,406,589
Idaho	1,031	1,995,762
Indiana	830	2,000,033
Kentucky	8,757	12,311,000
Maryland	370	467,946
Missouri	9,932	29,250,655
Nebraska²	N/A	N/A
New Hampshire	N/A	N/A
New Mexico	295	229,255
North Carolina	8,041	18,953,119
North Dakota³	439	861,554
Oregon	N/A	N/A
South Carolina	1,600	2,068,992
South Dakota	397	569,518
Virginia	2,302	4,225,386
SOURCE: Telephone calls to State Welfare Agencies. N/A - Not Available For January 1982, Arizona spent $12,450 on 498 recipients in supervisory home care facilities. For December 1981, Nebraska had 2,320 recipients in non-medical facilities. Expenditures were not available. Data for fiscal year 1981.

TABLE 161. Percent Utilization of Federal Social Services Allocations by State, Fiscal Years 1972-1979
	1972	1973	1974	1975	1976	1977	1978	1979
Alabama	28	40	48	58	71	84	90	99
Alaska	108	151	79	79	100	99	100	100
Arizona	12	14	13	16	26	80	81	80
Arkansas	14	26	23	37	49	74	95	99
California	81	93	95	100	100	90	100	100
Colorado	67	78	88	100	100	90	100	100
Connecticut	25	56	103	100	100	100	100	100
Delaware	184	97	72	86	94	89	91	100
District of Columbia	117	92	98	99	100	100	100	100
Florida	49	50	33	153	97	100	100	100
Georgia	57	85	64	81	92	95	100	100
Hawaii	9	24	63	84	83	95	100	100
Idaho	17	52	73	100	100	87	100	98
Illinois	140	91	64	60	70	68	89	100
Indiana	10	11	11	9	14	28	55	93
Iowa	28	37	45	71	100	100	100	100
Kansas	23	26	28	47	65	92	95	97
Kentucky	32	77	63	123	100	97	99	100
Louisiana	66	47	46	52	71	86	99	95
Maine	52	70	53	62	83	88	100	100
Maryland	43	55	61	78	91	96	100	100
Massachusetts	33	24	42	75	93	100	100	100
Michigan	26	44	84	83	95	100	100	100
Minnesota	57	65	88	116	100	100	100	100
Mississippi	7	43	19	23	31	63	91	95
Missouri	23	27	31	37	50	75	83	93
Montana	34	44	45	63	100	97	100	100
Nebraska	40	51	66	99	100	84	100	100
Nevada	26	28	36	48	59	75	82	79
New Hampshire	31	44	46	72	75	79	90	100
New Jersey	42	50	56	82	94	92	100	100
New Mexico	29	62	67	62	80	93	99	99
New York	267	91	105	101	100	98	100	100
North Carolina	31	39	33	48	66	89	100	98
North Dakota	44	52	44	54	74	96	100	93
Ohio	15	32	36	42	48	78	92	100
Oklahoma	45	78	55	66	84	100	100	100
Oregon	97	78	53	100	96	100	100	100
Pennsylvania	36	62	67	84	81	98	92	100
Rhode Island	57	81	92	91	100	100	100	100
South Carolina	19	31	36	58	85	87	100	95
South Dakota	29	30	19	43	79	100	100	100
Tennessee	29	49	32	36	58	70	91	87
Texas	38	68	56	101	100	99	100	100
Utah	30	41	41	57	75	99	100	100
Vermont	44	58	54	88	100	100	100	100
Virginia	28	38	40	52	67	83	96	100
Washington	83	137	103	97	100	100	99	100
West Virginia	35	38	49	63	91	100	100	100
Wisconsin	70	100	81	96	100	100	100	100
Wyoming	14	24	28	41	89	75	98	94
Number of States at or above 95%	6	4	4	14	20	26	39	44
SOURCE: Bill Benton, Tracey Feild and Rhona Millar, *Social Services: Federal Legislation vs. State Implementation* (Washington, D. C.: The Urban Institute, 1978), p. 52; and data from Office of Social Services Policy, DHHS, *Technical Notes*, Fiscal Years 1979 and 1980, (Washington, D.C.: GPO, 1980 and 1981).

TABLE 162. Percent of State Median Income at White Title XX Income Eligibility Levels Set, by State, Fiscal Year 1980
	Maximum Level	Level for Most Services
Alabama	65	65
Alaska	Universal	Universal
Arizona	80	80
Arkansas	80	80
California	115	80
Colorado	74	74
Connecticut	80	80
Delaware	67	67
District of Columbia	85	80
Florida	54	50
Georgia	80	61
Hawaii	60	60
Idaho	80	80
Illinois	115	80
Indiana	80	80
Iowa	62	50
Kansas	80	80
Kentucky	80	80
Louisiana	58	58
Maine	115	80
Maryland	115	80
Massachusetts	76	51
Michigan	80	80
Minnesota	115	60
Mississippi	115	80
Missouri	68	68
Montana	80	80
Nebraska	57	43
Nevada	80	80
New Hampshire	115	80
New Jersey	115	80
New Mexico	80	39
New York	100	62
North Carolina	91	73
North Dakota	115	115
Ohio	80	80
Oklahoma	56	56
Oregon	115	115
Pennsylvania	115	50
Rhode Island	75	40
South Carolina	80	80
South Dakota	115	115
Tennessee	115	70
Texas	70	70
Utah	115	67
Vermont	79	65
Virginia	70	50
Washington	80	80
West Virginia	115	80
Wisconsin	70	70
Wyoming	50	50
SOURCE: Office of Social Services Policy, U. S. Department of Health and Human Services, *Technical Notes: Summaries and Characteristics of States’ Title XX Social Services Plans for Fiscal Year 1980* (Washington, D. C.: GPO, 1981), p.20.

TABLE 163. States Use of Fees for Title XX Services, FY 80 Final CASP Plans
	Fees Charged at Incomes Below 80%	Fees Charged For
	Fees Charged at Incomes Below 80%	All Services	Most Services	Few Services
Arizona	X			X
California	X			X
Colorado	X			X
Connecticut	X			X
Delaware	X			X
District of Columbia	X			X
Florida	X			X
Georgia	X			X
Illinois	X			X
Indiana	X			X
Iowa	X			X
Kansas	X			X
Kentucky	X			X
Louisiana	X			X
Maine	X			X
Maryland	X			X
Michigan	X			X
Minnesota	X	X
Mississippi	X			X
Missouri	X			X
Nebraska	X			X
New Hampshire	X			X
New Jersey	X		X
New Mexico	X			X
New York	X			X
North Carolina	X			X
North Dakota	X	X
Ohio	X	X
Oklahoma	X			X
Oregon	X			X
Pennsylvania	X			X
South Dakota	X		X
Tennessee	X			X
Texas	X			X
Utah	X		X
Vermont	X			X
Virginia	X			X
Washington	X			X
West Virginia	X			X
Wisconsin	X		X
Wyoming	X			X
SOURCE: Office of Social Services Policy, U. S. Department of Health and Human Services, *Technical Notes: Summaries and Characteristics of States’ Title XX Social Services Plans for Fiscal Year 1980* (Washington, D. C.: GPO, 1981), p 67.

TABLE 164. Expenditures Under Title XX On Potential Long-Term Care Related Services¹ for SSI Recipients, Fiscal Year 1980
Service	Number of States Reporting Expenditures	Services Provided to SSI Recipients
Service	Number of States Reporting Expenditures	Total Spending (thousands)	Spending (thousands)	Percent of Total Spending on Service
TOTAL		$1,998,550.4	$722,621.3	36.2
Homemaker	44	410,928.0	288,654.8	70.2
Foster Care for Adults	21	18,507.7	12,627.8	68.2
Chore	28	195,616.7	110,559.6	56.5
Day Care for Adults	35	37,039.7	19,897.5	53.7
Special Services for Blind	3	3,481.3	1,632.0	46.9
Education and Training	44	196,074.9	83,107.5	42.4
Home Delivered/Congregate Meals	29	21,528.8	8,844.3	41.1
Transportation	36	63,947.5	21,418.1	33.5
Health Related	37	98,833.1	30,009.4	30.4
Special Services for the Disabled	7	26,811.7	7,119.4	26.6
Other	19	44,482.3	10,883.9	24.5
Home Management	29	38,300.2	8,716.8	22.8
Socialization	18	37,439.6	7,919.3	21.2
Transitional	4	3,571.2	697.8	19.5
Case Management	13	81,190.6	15,268.9	18.8
Protection Services for Adults	43	104,154.9	18,733.5	18.0
Placement Services	27	126,649.4	20,163.7	15.9
Housing Improvement	29	36,433.8	4,721.0	13.0
Counseling	44	239,913.4	28,445.0	11.9
Recreational	19	6,930.9	792.1	11.4
Diagnosis and Evaluation	9	7,798.4	880.9	11.3
Residential Care and Treatment	27	181,151.8	20,281.9	11.2
Emergency	17	17,714.5	1,246.7	7.0
SOURCE: Unpublished data from Office of Human Development Services, Department of Health and Human Services. Includes expenditures in 49 states and the District of Columbia. Data for Maryland were not available. Services were defined as potentially long-term care related if at least 5 percent of the total expenditures in a service category were for services provided to SSI recipients.

TABLE 165. Percentage of Total Expenditures Allocated to SSI Recipients by Service and State, Fiscal Year 1980
	Total Expenditures all Long-Term Care Related Services	Percent SSI of Total	Percent SSI by Service Category
	Total Expenditures all Long-Term Care Related Services	Percent SSI of Total	Homemaker Services	Foster Care for Adults	Chore Services	Day Care for Adults	Special Services for Blind	Education & Training	Home/Delivered Cong. Meals
United States	$1,998,550,526	36.16	70.24	68.23	56.52	53.72	46.88	42.39	41.08
Alabama	$23,316,019	40.24	49.35	85.69	100	53.70	--	69.57	57.78
Alaska	$1,634,728	0.00	--	--	--	--	--	--	--
Arizona	$14,569,742	35.16	41.28	--	0.00	34.51	--	33.24	55.91
Arkansas	$26,261,570	22.29	0.00	--	33.43	69.36	50.43	9.28	35.55
California	$316,086,835	72.26	90.94	--	--	--	--	49.81	--
Colorado	$23,496,558	52.53	67.40	18.00	--	--	--	6.48	--
Connecticut	$41,444,844	5.87	--	0.00	--	100	--	15.29	--
Delaware	$1,586,065	53.86	91.21	76.64	--	37.86	--	56.65	23.11
Washington, DC	$9,819,792	53.39	80.09	--	91.59	--	--	--	--
Florida	$72,213,585	17.83	39.42	--	--	70.77	--	6.62	44.51
Georgia	$60,820,916	55.93	60.66	--	--	52.21	--	76.28	50.41
Hawaii	$10,750,724	27.32	37.32	34.30	38.54	17.58	--	30.28	0.00
Idaho	$2,439,057	28.58	32.55	--	--	--	--	--	88.34
Illinois	$66,241,422	6.75	17.70	--	57.83	18.69	--	8.81	0.00
Indiana	$13,151,739	14.70	28.67	--	--	--	--	15.61	--
Iowa	$21,598,167	38.32	23.63	79.60	37.46	62.36	--	3.72	29.53
Kansas	$27,147,188	17.46	16.81	--	--	39.61	--	57.34	16.97
Kentucky	$40,218,292	20.95	39.28	--	--	30.29	--	33.13	--
Louisiana	$34,619,818	47.90	80.46	54.62	100	0.00	--	2.59	49.99
Maine	$13,127,248	23.52	26.62	--	--	--	--	63.26	25.66
Massachusetts	$102,154,990	25.01	23.59	--	46.03	--	--	64.38	--
Michigan	$140,149,968	43.20	11.82	--	72.80	--	--	58.05	--
Minnesota	$64,375,881	25.67	26.47	52.87	38.97	30.58	--	48.59	39.18
Mississippi	$13,727,037	21.91	46.22	--	--	33.91	--	17.60	4.63
Missouri	$61,407,547	14.31	47.02	--	--	75.33	--	14.50	44.21
Montana	$7,721,087	63.49	42.69	71.98	--	--	--	70.62	--
Nebraska	$24,153,483	56.63	29.69	54.30	33.59	44.53	--	76.73	28.84
Nevada	$3,795,441	39.44	54.93	--	--	--	--	53.77	56.55
New Hampshire	$6,908,922	20.13	10.45	46.98	76.12	13.69	--	42.27	9.12
New Jersey	$67,454,893	10.12	35.05	2.51	7.74	8.99	--	0.87	79.73
New Mexico	$11,072,723	49.77	70.29	--	42.91	58.82	--	45.22	--
New York	$106,441,567	21.22	25.59	77.53	46.52	--	--	1.84	--
North Carolina	$52,847,410	44.42	45.70	60.17	56.31	53.78	58.62	23.66	40.61
North Dakota	$8,753,753	16.19	23.38	--	--	42.13	--	10.19	--
Ohio	$91,046,256	20.42	37.97	39.64	46.46	32.86	--	15.85	32.23
Oklahoma	$18,620,330	15.02	--	--	--	54.08	--	5.25	47.37
Oregon	$35,776,476	38.94	97.74	98.94	96.66	97.28	--	70.71	93.36
Pennsylvania	$26,324,030	15.98	19.10	--	19.56	50.63	--	24.18	28.01
Rhode Island	$12,920,784	29.41	90.24	--	--	91.49	--	2.66	--
South Carolina	$19,330,332	34.97	51.51	--	--	53.22	--	67.51	51.16
South Dakota	$8,938,143	29.84	19.63	--	--	--	--	43.45	--
Tennessee	$22,357,272	46.64	49.11	15.51	45.17	74.80	--	--	50.61
Texas	$105,826,065	39.63	49.95	--	49.37	--	--	42.70	49.19
Utah	$11,520,093	22.34	--	31.96	--	49.30	--	40.24	--
Vermont	$1,208,484	52.39	--	--	82.70	--	--	--	--
Virginia	$42,653,904	38.02	81.49	50.03	81.21	65.91	36.13	6.11	--
Washington	$51,609,083	32.69	20.26	--	46.36	0.00	--	--	--
West Virginia	$9,793,984	40.35	41.53	98.82	86.75	0.00	--	1.64	--
Wisconsin	$46,493,187	29.38	--	--	74.97	66.90	--	2.61	59.17
Wyoming	$2,623,092	8.62	16.41	2.35	17.41	8.56	--	--	--
	Percent SSI by Service Category
	Transportation Services	Health Related Services	Special Services for Disabled	Other	Home Management Services	Socialization Services	Transitional Services	Case Management Services	Protective Services for Adults
United States	33.49	30.35	26.55	24.47	21.15	19.54	18.81	22.76	17.99
Alabama	42.15	--	--	--	--	--	--	--	39.25
Alaska	--	--	--	--	--	--	--	--	0.00
Arizona	34.94	--	--	--	30.06	--	27.58	28.12	0.00
Arkansas	37.24	26.30	17.20	0.00	28.31	--	--	--	43.50
California	--	42.39	--	0.00	--	--	--	14.45	53.43
Colorado	30.93	47.43	80.56	--	--	--	--	58.80	17.72
Connecticut	3.74	--	--	--	--	--	--	7.03	3.86
Delaware	30.73	--	--	0.00	76.52	--	--	--	--
D.C.	0.00	60.82	--	--	--	--	24.16	0.00	84.90
Florida	33.70	27.75	6.50	45.71	28.70	--	19.55	26.92	19.25
Georgia	49.74	46.56	--	--	--	--	--	33.24	28.21
Hawaii	--	9.53	--	--	--	--	--	--	19.25
Idaho	--	20.95	--	--	--	--	--	--	33.40
Illinois	13.59	4.69	--	2.35	0.85	--	--	6.54	0.27
Indiana	54.83	6.42	--	--	--	--	--	--	0.13
Iowa	50.30	59.50	--	67.41	--	--	--	17.90	31.87
Kansas	--	--	--	--	--	--	--	--	4.25
Kentucky	--	30.78	--	--	--	30.54	--	--	34.89
Louisiana	22.29	37.70	--	--	1.17	--	0.00	5.66	30.96
Maine	37.93	--	--	16.66	2.23	--	7.73	18.73	--
Massachusetts	29.70	--	--	--	--	0.00	15.74	--	--
Michigan	--	22.34	--	--	--	--	--	16.63	11.80
Minnesota	25.20	34.54	--	--	--	--	--	27.97	30.11
Mississippi	33.52	--	--	1.67	32.48	--	--	15.98	37.86
Missouri	30.59	0.00	--	--	29.12	0.00	14.72	--	0.00
Montana	97.05	50.08	--	0.00	--	--	94.28	--	41.38
Nebraska	39.90	0.00	--	0.00	--	--	--	0.00	27.05
Nevada	52.45	43.90	--	--	--	--	--	30.33	10.66
New Hampshire	34.36	46.35	--	--	--	--	--	36.67	--
New Jersey	21.05	8.18	56.73	18.55	9.25	--	2.32	--	12.42
New Mexico	--	58.45	--	--	--	--	--	--	22.14
New York	28.96	35.53	--	--	3.11	--	--	15.12	0.00
North Carolina	32.95	30.72	56.66	68.99	--	--	--	--	33.09
North Dakota	--	--	--	--	9.96	--	--	--	--
Ohio	46.57	18.05	--	33.03	45.65	--	--	34.53	8.19
Oklahoma	0.00	5.79	--	17.54	--	--	--	96.83	24.57
Oregon	61.67	53.98	--	--	55.60	--	50.55	84.67	8.33
Pennsylvania	19.84	--	--	--	14.84	--	16.43	--	10.42
Rhode Island	89.61	32.56	--	0.00	--	--	--	--	15.47
South Carolina	54.47	36.36	--	--	42.94	--	--	26.85	42.58
South Dakota	--	12.10	--	--	--	11.56	--	12.04	26.70
Tennessee	41.33	37.39	--	--	42.30	--	--	--	0.00
Texas	--	34.38	--	5.58	--	--	67.4	--	29.25
Utah	10.13	16.17	--	--	--	--	--	40.73	3.82
Vermont	--	--	--	--	--	--	--	31.96	--
Virginia	29.12	11.15	47.14	--	--	--	--	31.18	12.81
Washington	--	35.86	0.00	11.54	--	--	0.00	--	53.90
West Virginia	--	50.93	--	--	--	--	--	33.48	3.87
Wisconsin	21.16	30.81	--	60.20	--	--	--	30.91	35.37
Wyoming	8.83	--	--	7.27	6.09	--	--	37.23	0.00
	Percent SSI by Service Category
	Placement Services	Housing Improvement Services	Counseling Services	Recreational Services	Diagnosis & Evaluation Services	Residential Care & Treatment	Emergency Services
United States	15.92	12.96	11.86	11.43	11.30	11.20	7.04
Alabama	--	--	28.27	--	26.40	11.91	--
Alaska	--	--	--	--	--	--	--
Arizona	--	42.28	26.83	92.72	21.71	61.41	--
Arkansas	41.29	--	25.31	2.48	--	5.22	1.23
California	--	27.59	3.70	--	13.37	5.72	--
Colorado	--	48.64	22.22	--	--	--	--
Connecticut	--	20.36	5.02	1.70	--	0.64	--
Delaware	--	--	14.94	--	--	--	8.42
D.C.	--	0.00	1.43	--	--	1.76	14.53
Florida	50.29	27.07	12.58	--	0.76	4.35	5.12
Georgia	4.90	--	--	--	--	--	--
Hawaii	--	--	30.35	--	--	--	--
Idaho	--	--	17.38	--	--	--	--
Illinois	--	7.05	--	--	--	0.13	--
Indiana	--	12.09	11.91	--	7.78	19.60	4.24
Iowa	--	0.00	0.00	--	--	84.80	--
Kansas	--	--	1.00	--	--	14.42	--
Kentucky	71.83	21.16	10.27	--	--	3.14	0.46
Louisiana	--	2.26	13.31	5.28	--	--	--
Maine	12.38	--	4.97	5.04	--	1.71	0.01
Massachusetts	6.68	15.35	10.42	6.60	--	62.55	0.00
Michigan	40.98	10.77	15.90	--	--	--	--
Minnesota	--	28.03	9.27	19.82	--	6.93	--
Mississippi	0.00	--	26.77	1.24	--	1.58	3.68
Missouri	9.12	10.13	5.94	--	17.59	--	--
Montana	34.86	--	0.00	--	--	--	--
Nebraska	--	--	--	--	--	--	--
Nevada	74.93	--	7.00	--	--	6.93	--
New Hampshire	9.19	--	10.19	3.25	--	--	--
New Jersey	8.69	5.57	3.56	5.22	--	13.50	--
New Mexico	--	--	6.10	--	--	--	--
New York	--	10.01	11.05	--	--	--	--
North Carolina	--	37.16	35.33	27.73	--	2.06	--
North Dakota	9.74	--	6.24	--	8.47	50.61	0.23
Ohio	3.62	10.95	15.44	6.67	--	2.39	--
Oklahoma	0.00	22.76	4.24	1.91	--	--	0.16
Oregon	3.51	82.92	26.45	47.84	--	--	--
Pennsylvania	6.82	14.10	14.89	56.00	--	--	--
Rhode Island	18.29	20.36	21.14	--	10.67	1.05	1.40
South Carolina	8.55	52.40	4.41	58.05	--	--	--
South Dakota	24.33	--	--	--	--	0.00	--
Tennessee	0.00	24.83	16.64	--	--	7.39	--
Texas	73.05	--	2.78	--	--	--	4.58
Utah	--	--	7.36	12.08	--	--	--
Vermont	88.72	--	35.03	--	--	39.83	--
Virginia	--	17.08	18.60	15.21	--	34.60	17.69
Washington	28.06	--	--	--	--	--	--
West Virginia	51.04	53.04	14.45	--	--	33.98	3.76
Wisconsin	11.64	22.76	10.46	0.11	5.30	--	0.00
Wyoming	--	0.00	4.67	--	--	--	0.00

TABLE 166. Selected Social Service Expenditures Under Title XX, by Service and Recipient Category, Fiscal Year 1980 ($ in thousands)
	Recipient Category			Total Expenditures
	SSI	AFDC	Income Eligible and Without Regard to Income	Total Expenditures
Total	$722,621.3	$405,523.6	$870405.5	$1,998,550.4
Homemaker	288,654.8	22,664.8	99,608.4	410,928.0
Foster Care for Adults	12,627.2	830.7	5,049.8	18,507.7
Chore	110,559.6	7,282.1	77,775.0	195,616.7
Day Care for Adults	19,897.5	2,514.5	14,627.7	37,039.7
Special Services for the Blind	1,632.0	53.6	1,795.7	3,481.3
Education and Training	83,107.5	30,481.8	82,485.6	196,074.9
Home Delivered/Congregate Meals	8,844.3	101.8	12,582.7	21,528.8
Transportation	21,418.1	16,400.3	26,129.1	63,947.5
Health Related	30,009.4	36,980.7	31,893.0	98,883.1
Special Services for the Disabled	7,119.4	934.3	18,758.0	26,811.7
Other	10,883.9	9,291.1	24,307.3	44,482.3
Home Management	8,716.8	16,418.9	13,164.5	38,300.2
Socialization	7,919.3	6,927.5	22,592.8	37,439.6
Transitional	697.8	57.5	2,815.9	3,571.2
Case Management	15,268.9	26,523.1	39,398.6	81,190.6
Protective Services for Adults	18,733.5	21,693.3	63,728.1	104,154.9
Placement Services	20,163.7	41,922.4	64,563.3	126,649.4
Housing Improvement	4,721.0	24,002.7	7,710.1	36,433.8
Counseling	28,445.0	76,813.3	134,655.1	239,913.4
Recreational	792.1	2,206.7	3,932.1	6,930.9
Diagnosis and Evaluation	880.9	3,739.8	3,177.7	7,798.4
Residential Care and Treatment	20,281.9	51,009.7	109,860.2	181,151.8
Emergency	1,246.7	6,673.0	9,794.8	17,714.5
SOURCE: Unpublished data from Office of Human Development Services, Department of Health and Human Resources.

TABLE 167. Title XX SSI Recipient Long-Term Care Service Related Expenditures, by Service and State, Fiscal Year 1980
State	Total SSI Recipient Long-Term Care Related Expenditures	Percent of Total by Service Category
State	Total SSI Recipient Long-Term Care Related Expenditures	Homemaker Services	Chore Services	Education & Training Services	Health Related Services	Counseling Services	Transportation Services	Residential Care & Treatment
United States	$722,621,330	39.95	15.30	11.50	4.15	3.04	2.96	2.81
Alabama	$9,382,302	6.51	0.19	43.87	--	19.29	4.67	6.50
Alaska	$0	--	--	--	--	--	--	--
Arizona	$5,122,371	10.99	0.00	13.14	--	2.56	7.98	18.06
Arkansas	$5,852,906	0.00	4.04	3.07	0.49	3.37	5.06	7.36
California	$228,400,187	92.79	--	1.44	1.69	0.11	--	1.13
Colorado	$12,341,634	37.28	--	0.15	4.84	6.54	1.95	--
Connecticut	$2,431,380	--	--	38.84	--	35.90	0.13	2.30
Delaware	$854,216	39.60	--	10.80	--	2.53	1.04	--
Washington, DC	$5,242,761	31.79	46.30	--	8.68	0.02	0.00	0.32
Florida	$12,872,977	11.06	--	5.82	13.50	22.51	17.32	1.65
Georgia	$34,020,117	6.72	--	74.33	0.81	--	2.89	--
Hawaii	$2,937,459	8.75	20.53	16.60	1.91	33.22	--	--
Idaho	$697,163	57.02	--	--	5.45	13.47	--	--
Illinois	$4,471,276	29.69	32.39	25.86	2.79	--	0.76	0.51
Indiana	$1,933,434	10.96	--	62.52	0.91	5.57	3.13	13.80
Iowa	$8,275,514	24.42	7.11	0.74	7.00	0.00	1.84	9.91
Kansas	$4,739,139	20.09	--	32.29	--	0.31	--	41.49
Kentucky	$8,427,498	17.33	--	35.43	10.94	7.27	--	4.77
Louisiana	$16,582,465	72.62	0.07	0.15	10.81	2.26	10.21	--
Maine	$3,087,941	17.27	--	52.81	--	2.44	10.78	0.52
Massachusetts	$25,547,183	21.80	2.32	14.92	--	6.35	1.20	35.75
Michigan	$60,546,226	0.21	65.59	4.03	1.81	5.01	--	--
Minnesota	$16,523,711	8.52	9.45	43.77	9.70	6.73	3.30	6.12
Mississippi	$3,007,632	21.51	--	3.37	--	17.96	13.69	0.67
Missouri	$8,788,170	31.71	--	0.64	0.00	11.92	8.08	--
Montana	$4,902,469	13.74	--	55.84	2.86	0.00	10.54	--
Nebraska	$13,676,965	0.90	11.76	71.38	0.00	-	8.84	--
Nevada	$1,496,777	21.45	--	42.30	16.04	0.83	7.74	3.61
New Hampshire	$1,391,832	10.02	5.53	42.67	2.43	8.69	10.39	--
New Jersey	$6,828,745	44.02	1.45	0.12	4.39	4.44	9.05	8.54
New Mexico	$5,511,099	57.85	6.71	20.91	6.67	1.85	--	--
New York	$22,584,656	7.28	23.23	0.28	34.52	11.51	7.11	--
North Carolina	$23,476,365	9.21	38.88	1.51	12.14	5.40	6.94	0.19
North Dakota	$1,417,381	42.05	--	3.12	--	13.45	--	10.82
Ohio	$18,588,911	14.86	1.11	13.21	1.64	7.17	19.44	2.09
Oklahoma	$2,797,301	--	--	0.34	7.24	14.46	0.00	--
Oregon	$13,932,138	2.78	23.85	0.26	6.16	1.55	2.30	--
Pennsylvania	$4,205,385	3.41	2.07	8.71	--	27.81	13.97	--
Rhode Island	$3,799,812	54.04	--	0.23	13.72	15.92	3.50	0.65
South Carolina	$6,759,553	25.77	--	32.55	0.97	1.67	6.66	--
South Dakota	$2,666,897	11.09	--	58.18	0.77	--	--	0.00
Tennessee	$10,427,890	12.49	0.50	--	3.62	3.62	4.74	0.86
Texas	$41,941,299	6.76	65.14	2.64	0.05	0.02	--	--
Utah	$2,573,621	--	--	70.17	1.55	9.15	0.64	--
Vermont	$633,163	--	21.70	--	--	16.16	--	30.64
Virginia	$16,215,909	59.33	0.26	0.49	5.32	10.57	4.51	0.20
Washington	$16,868,855	8.00	82.62	--	2.81	--	--	--
West Virginia	$3,952,308	26.13	23.16	0.25	22.55	3.21	--	5.64
Wisconsin	$13,661,131	--	5.45	0.35	3.45	6.00	2.69	--
Wyoming	$226,006	45.90	3.21	--	--	12.11	4.83	--
State	Percent of Total by Service Category
State	Placement Services	Day Care for Adults	Protective Services for Adults	Case Management Services	Foster Care for Adults	Other	Home Delivered/ Cong. Meal	Home Management Services
United States	2.79	2.75	2.59	2.11	1.75	1.51	1.22	1.21
Alabama	--	6.28	3.80	--	2.35	--	5.21	--
Alaska	--	--	--	--	--	--	--	--
Arizona	--	5.17	0.00	21.58	--	--	10.01	3.89
Arkansas	0.02	30.82	0.22	--	--	0.00	5.39	--
California	--	--	2.48	--	--	0.00	--	0.12
Colorado	--	--	2.40	--	2.85	--	--	3.27
Connecticut	--	0.83	7.34	--	0.00	--	--	10.24
Delaware	--	15.96	--	--	10.04	0.00	0.02	--
Washington, DC	--	--	4.50	0.08	--	--	--	0.00
Florida	6.59	2.51	0.81	0.82	--	4.77	2.17	3.74
Georgia	0.76	0.32	10.58	--	--	--	1.74	1.84
Hawaii	--	16.63	1.53	--	0.83	--	0.00	--
Idaho	--	--	23.59	--	--	--	0.46	--
Illinois	--	0.01	0.17	--	--	1.57	0.00	0.26
Indiana	--	--	0.07	--	--	--	--	--
Iowa	--	5.84	2.40	--	29.30	5.95	0.71	4.76
Kansas	--	1.63	2.83	--	--	--	1.35	--
Kentucky	9.85	1.08	3.95	--	--	--	--	--
Louisiana	--	0.00	1.27	0.00	2.02	--	0.01	0.47
Maine	1.08	--	--	9.29	--	1.54	3.86	0.16
Massachusetts	4.36	--	--	12.73	--	--	--	--
Michigan	16.98	--	4.55	--	--	--	--	1.18
Minnesota	--	0.64	5.52	--	0.85	--	1.10	2.60
Mississippi	0.00	29.42	0.32	--	--	0.03	1.36	0.36
Missouri	17.91	0.11	0.00	16.44	--	--	9.32	--
Montana	0.68	--	6.38	8.13	1.83	0.00	--	--
Nebraska	--	1.18	0.33	--	0.35	0.00	5.26	0.00
Nevada	2.44	--	0.45	--	--	--	2.46	2.69
New Hampshire	7.38	3.92	--	--	0.35	--	4.65	3.96
New Jersey	0.31	1.71	3.59	8.19	0.48	4.01	1.10	--
New Mexico	--	4.32	1.69	--	--	--	--	--
New York	--	--	0.00	--	4.72	--	--	4.54
North Carolina	--	1.21	0.79	--	5.23	11.97	1.09	--
North Dakota	0.67	23.92	--	--	--	--	--	--
Ohio	2.62	5.61	1.10	--	0.47	0.23	0.96	2.49
Oklahoma	0.00	2.85	3.75	--	--	0.91	49.54	19.00
Oregon	4.86	9.02	0.55	4.00	42.52	--	0.85	0.38
Pennsylvania	5.81	1.55	0.85	23.45	--	--	3.83	--
Rhode Island	0.00	0.14	1.31	--	--	0.00	--	--
South Carolina	4.91	3.24	6.49	--	--	--	2.31	12.43
South Dakota	26.29	--	0.37	--	--	--	--	2.27
Tennessee	0.00	64.14	0.00	--	0.41	--	5.62	--
Texas	1.54	--	1.79	15.66	--	2.87	3.05	--
Utah	--	1.36	3.28	--	1.87	--	--	10.39
Vermont	18.88	--	--	--	--	--	--	2.62
Virginia	--	6.62	0.80	--	0.03	--	--	1.28
Washington	1.81	0.00	2.82	0.00	--	1.94	--	--
West Virginia	2.67	0.00	0.87	--	11.59	--	--	1.23
Wisconsin	10.27	20.87	1.73	--	--	36.17	2.55	9.00
Wyoming	--	0.15	0.00	--	1.30	15.21	--	4.82
State	Percent of Total by Service Category
State	Socialization Services	Special Services for Disabled	Housing Improvement Services	Special Services for Blind	Emergency Services	Diagnosis & Evaluation Services	Recreational Services	Transitional Services
United States	1.19	0.99	0.65	0.23	0.17	0.12	0.11	0.10
Alabama	--	-	--	--	--	1.33	--	--
Alaska	--	--	--	--	--	--	--	--
Arizona	59.96	--	0.37	--	--	0.18	0.11	--
Arkansas	17.92	16.31	--	5.88	0.02	--	0.02	--
California	--	--	0.13	--	--	0.11	--	--
Colorado	--	39.10	1.62	--	--	--	--	--
Connecticut	--	--	4.13	--	--	--	0.29	--
Delaware	17.42	--	--	--	1.79	--	--	--
Washington, DC	--	--	0.00	--	8.30	--	--	--
Florida	1.36	3.01	1.49	--	0.85	0.00	--	--
Georgia	--	--	--	--	--	--	--	--
Hawaii	--	--	--	--	--	--	--	--
Idaho	--	--	--	--	--	--	--	--
Illinois	2.72	--	3.27	--	--	--	--	--
Indiana	--	--	0.97	--	1.43	0.64	--	--
Iowa	--	--	0.00	--	--	--	--	--
Kansas	--	--	--	--	--	--	--	--
Kentucky	--	--	1.40	--	0.03	--	--	7.96
Louisiana	0.02	--	0.06	--	--	--	0.03	--
Maine	0.19	--	--	--	0.00	--	0.07	--
Massachusetts	--	--	0.44	--	0.00	--	0.13	0.00
Michigan	--	--	0.65	--	--	--	--	--
Minnesota	--	--	1.15	--	--	--	0.55	--
Mississippi	9.23	--	--	--	1.49	--	0.63	--
Missouri	2.21	--	0.22	--	--	1.44	--	0.00
Montana	--	--	--	--	--	--	--	--
Nebraska	--	--	--	--	--	--	--	--
Nevada	--	--	--	--	--	--	--	--
New Hampshire	--	--	--	--	--	--	0.01	--
New Jersey	1.08	2.98	4.07	--	--	--	0.46	--
New Mexico	--	--	--	--	--	--	--	--
New York	0.19	--	6.61	--	--	--	--	--
North Carolina	--	1.28	0.50	3.07	--	--	0.59	--
North Dakota	0.58	--	--	--	0.09	5.30	--	--
Ohio	26.41	--	0.23	--	--	--	0.36	--
Oklahoma	--	--	1.84	--	0.05	--	0.03	--
Oregon	0.30	--	0.33	--	--	--	0.28	--
Pennsylvania	3.36	--	3.72	--	--	--	1.48	--
Rhode Island	--	--	5.77	--	0.11	4.60	--	--
South Carolina	0.15	--	0.57	--	--	--	2.27	--
South Dakota	--	--	--	--	--	--	--	1.03
Tennessee	3.65	--	0.36	--	--	--	--	--
Texas	--	--	--	--	0.49	--	--	--
Utah	--	--	--	--	--	--	1.59	--
Vermont	--	--	--	--	--	--	--	--
Virginia	--	2.76	1.33	3.49	2.44	--	0.57	--
Washington	--	0.00	--	--	--	--	--	--
West Virginia	--	--	2.65	--	0.06	--	--	--
Wisconsin	--	--	0.74	--	0.00	0.74	0.00	--
Wyoming	12.47	--	0.00	--	0.00	--	--	--
SOURCE: Unpublished data from Office of Human Development Services, Department of Health and Human Services. Data for Maryland not available.

TABLE 168. Older Americans Act Title III Appropriations, Fiscal Year 1980
	Amount ($ in million)
State Administration	$22.5
Social Services and Senior Centers	247.0
Home Delivered Nutrition Services	50.0
Congregate Nutrition Services	270.0
Nutrition Services Subtotal	320.0
Title III Total	589.5
SOURCE: U.S. Senate, Special Committee on Aging, *Developments In Aging: 1980-Part 1*, p. 136.

TABLE 169. Older Americans Act Title IV Appropriations, Fiscal Year 1980
	Amount ($ in million)
Training	$17.0
Research	8.5
Discretionary Projects and Programs	25.0
Multidisciplinary Centers	3.8
Title IV Total	54.3
SOURCE: U.S. Senate, Special Committee on Aging, *Developments In Aging: 1980-Part 1*, p. 136.

TABLE 170. Veterans Administration Community Nursing Home Program: Expenditures by State (Fiscal Year 1979¹)
State	Average Per Diem Cost²	Total Expenditures³
Alabama	$27.96	$1,449,167
Alaska	N/A	N/A
Arizona	32.91	2,582,612
Arkansas	26.44	1,148,421
California	35.05	8,392,372
Colorado	32.21	1,316,745
Connecticut	34.32	839,296
Delaware	31.97	910,186
District of Columbia	35.26	900,893
Florida	30.59	5,314,707
Georgia	30.10	2,460,976
Hawaii	67.20	245,280
Idaho	31.17	352,688
Illinois	36.68	6,734,265
Indiana	31.81	1,509,384
Iowa	29.46	1,881,758
Kansas	31.41	1,123,536
Kentucky	31.12	1,328,980
Louisiana	32.24	1,365,042
Maine	33.56	526,724
Maryland	34.40	1,017,036
Massachusetts	32.05	2,573,615
Michigan	36.70	2,692,496
Minnesota	34.24	2,237,070
Mississippi	31.39	1,168,650
Missouri	33.02	2,603,297
Montana	33.07	555,245
Nebraska	30.45	611,284
Nevada	37.32	231,571
New Hampshire	32.90	480,340
New Jersey	36.62	2,232,172
New Mexico	35.18	577,832
New York	N/A	N/A
North Carolina	31.66	2,103,174
North Dakota	31.64	277,166
Ohio	30.36	4,277,420
Oklahoma	25.67	899,477
Oregon	34.51	2,002,788
Pennsylvania	34.79	5,930,130
Rhode Island	31.59	2,378,687
South Carolina	31.33	1,303,641
South Dakota	29.81	359,062
Tennessee	31.79	2,378,687
Texas	27.80	6,078,053
Utah	33.71	430,645
Vermont	35.48	168,353
Virginia	35.41	2,106,718
Washington	33.82	3,012,009
West Virginia	31.99	2,402,034
Wisconsin	35.21	1,927,748
Wyoming	39.97	395,642
TOTALS	$32.76	$96,845,486⁴
SOURCE: Veterans Administration, *1979 Annual Report* (Washington, D.C.: GPO, 1980), and *Veterans Administration Summary of Medical Programs* (Washington, D.C.: Veterans Administration, September 1979). N/A Not available. State level source data were presented by facility rather than in aggregated form. Consequently, weighting was necessary in some cases to compute statewide average per diem costs. Weighted by average daily census in states with more than one VAMC (Veteran Administration Medical Centers). Total expenditures were computed as: Statewide Average Daily Census x Average per Diem Cost x 365. $2,610,813 in total expenditures could not be allocated between Alaska and New York because of missing average per diem cost data for those states.

TABLE 171. V.A. Medical Centers--Nursing Home Care Units: Expenditures by State (Fiscal Year 1979¹)
State	Average Per Diem Cost²	Total Expenditures³
Alabama	$60.60	$4,888,299
Arizona	N/A	N/A
Arkansas	51.49	3,627,213
California	N/A	N/A
Colorado	76.09	2,082,963
Connecticut	52.87	1,678,887
Delaware	69.97	1,174,796
Florida	62.28	5,455,728
Georgia	50.51	2,212,338
Illinois	48.17	5,186,704
Indiana	59.55	3,673,341
Iowa	62.55	4,178,027
Kansas	57.15	2,419,731
Kentucky	74.48	734,000
Louisiana	66.55	2,040,423
Maine	50.05	1,059,558
Maryland	N/A	N/A
Massachusetts	54.10	5,963,443
Michigan	64.65	7,079,175
Minnesota	54.88	821,279
Mississippi	50.64	2,717,089
Missouri	71.83	4,876,539
Montana	73.09	666,946
Nebraska	64.07	888,651
Nevada	117.88	903,550
New Hampshire	69.71	3,002,410
New Jersey	62.58	3,388,178
New Mexico	61.02	1,024,526
New York	N/A	N/A
North Carolina	53.09	4,011,215
North Dakota	65.28	1,119,878
Ohio	56.30	13,809,264
Oregon	58.77	1,544,476
Pennsylvania	66.93	12,996,467
South Carolina	73.05	1,866,428
South Dakota	57.59	1,513,465
Tennessee	50.04	1,881,254
Texas	54.87	6,468,899
Utah	75.66	1,077,020
Vermont	82.48	903,156
Virginia	63.41	3,124,528
Washington	60.89	1,622,414
West Virginia	81.33	1,187,418
Wisconsin	55.80	5,926,797
Wyoming	62.77	1,030,997
TOTALS	$63.73	$180,532,113⁴
SOURCE: Veterans Administration, *1979 Annual Report* (Washington, D.C.: GPO, 1980), and *Veterans Administration Summary of Medical Programs* (Washington, D.C.: Veterans Administration, September 1979). N/A Not available. State level source data were presented by facility rather than in aggregated form. Consequently, weighting was necessary in some cases to compute statewide average per diem costs. Weighted by average daily census in states with more than one facility. Total expenditures were computed as: Statewide Average Daily Census x Average per Diem Cost x 365. $48,704,643 in total expenditures could not be allocated among Arizona, California, Maryland, and New York because of missing average per diem cost data for those states.

TABLE 172. Summary of Publicly Financed Housing Assistance for the Elderly and Handicapped
Program	Type of Assistance	Number of Projects	Approximate Value ($ in thousands)	Total Number Units	Estimated Number of Elderly & Handicapped Units	Percent of Total Elderly & Handicapped Units	Reporting Period
HUD
Section 8 Existing	Rental Assistance Payments	9,446	$N/A	821,418	240,742	29%	Cumulative through 5/31/80
New Construction	Rental Assistance Payments	8,393	N/A	538,561	290,447	54	Cumulative through 5/31/80
Substantial Rehabilitation	Rental Assistance Payments	1,650	N/A	112,828	40,107	35	Cumulative through 5/31/80
Low-Rent Public Housing	Annual Debt Service and Operating Subsidy Payments	10,750	N/A	1,200,000	552,000	46	Cumulative through 9/30/79
Section 202	Direct Construction Loans	1,679	4,000,000	116,000	116,000	100	Cumulative through 9/30/80
Section 236¹	Mortgage Interest Subsidy Payments and Mortgage Insurance	4,234	7,962,003	462,951	82,105	18	Cumulative through 12/31/78
Section 221(d)(3) and (d)(4)	Mortgage Insurance	7,945	16,000,000	865,151	61,000	7	Cumulative through 9/30/80
Section 231	Mortgage Insurance	1,490	1,000,000	65,318	65,318	100	Cumulative through 9/30/80
Section 232	Mortgage Insurance	1,291	2,000,000	147,000²	100	100	Cumulative through 9/30/80
Section 312	Direct Rehabilitation	67,681³	685,266	101,885	N/A	N/A⁴	Cumulative through 12/31/79
FmHA
Section 502	Direct Low-Interest Loans	1,300,000⁵	25,000,000	--	39,000⁵	3	Fiscal years 1965 through 1980
Section 504	Direct Rehabilitation Loans and Grants	16,159⁶	45,900	--	9,695⁶	60	Fiscal year 1980
Section 515	Direct Loans, Some with Low Interest	12,671	4,181,415	224,894	76,708	34	Cumulative through 9/30/80
SOURCE: Raymond J. Struyk and Beth J. Soldo, *Improving The Elderly’s Housing* (Cambridge, MA: Ballinger Publishing Company, 1980); U.S. Department of Agriculture, Farmers Home Administration, *Housing Program Statistics: 1950-1975* (Washington, D.C.: GPO, 1978), Housing Program Statistics: 1976-1977 Supplement (Washington, D.C.: GPO, 1978), and unpublished data from the Farmers Home Administration, U.S. Department of Housing and Urban Development, Office of Policy Development and Research, Housing for the Elderly and Handicapped, (Washington, D.C.: GPO, 1979), and 1974 Statistical Year Book, 1980--Part 1 and Part 2, (Washington, D.C.: GPO, 1981). -- Not applicable N/A Not available Includes Section 202 conversions. Number of beds. Number of residential loans. The percentage of loans going to the elderly and handicapped has been estimated at about 20 percent. Number of loans. Number of loans and grants.

TABLE 173. Property Tax Relief Across States
State	Homestead Exemption or Credit		Circuit-Breaker Program
State	Eligibility	Amount	Eligibility	Amount
Alabama	General	First $2,000 of valuation	No Program
	Elderly, blind, disabled	First $5,000 of valuation. Total exemption for those with incomes below $7,500
	Elderly	Exempt from state property taxes
Alaska	Elderly	Exempt from property taxes	No Program
Alaska	General	Municipalities may enact general exemption of up to $10,000	No Program
Arizona	Veterans, widows widows, disabled	Up to $1,500 for homestead with assessed value of $5,000 or less. Income limits for all but veterans
Arkansas	No Program		Elderly homeowners with incomes below $10,000	Income tax credit of up to $250
California	General	$7,500 of full cash value when state has sufficient funds to reimburse local governments	Elderly and disabled homeowners and renters with gross income of $20,000 or less	Between 4% and 96% of taxes on first $34,000 of valuation
Colorado	No Program		Elderly or disabled homeowners or renters with total income up to $11,200 if married or $7,500 if single	Income tax credit of up to $500 less 20% of income in excess of $8,700 if married, $5,000 if single
Connecticut	Elderly with incomes below $6,000	$1,000 from valuation and taxes frozen at 1966 level or level at age 65	Elderly homeowners and renters with incomes below $12,000	State payment of up to $600 for property taxes in excess of 5% of income
Delaware	Elderly with incomes below $3,000 in municipalities which adopt the program	First $5,000 of value	No Program
District of Columbia	General	$9,000 of estimated market value	Homeowners and renters renters with incomes up to $20,000	Income tax credit up to $750 for property taxes in excess of set percentages. Elderly, blind, and disabled receive larger credit
Florida	General	$20,000, not applicable for school taxes unless resident for at least 5 years. Additional amounts for aged, blind, disabled	No Program
Georgia	General	$2,000 of valuation	No Program
Georgia	Elderly with incomes below $8,000	$4,000, $10,000 if they live in an independent or county school district	No Program
Hawaii	General Over 60 Over 70	$12,000 of valuation $24,000 $30,000	No Program
Idaho	No Program		Elderly, disabled and certain other homeowners with incomes below $8,750	Up to $400, adjusted to increases in the cost of living
Illinois	General	$3,000	Elderly homeowners and renters with incomes below $12,000	Up to $700 less 5% of income for property taxes exceeding a set percentage of income
Illinois	65 or over	An additional $1,500	Elderly homeowners and renters with incomes below $12,000
Indiana	General	8% of property taxes in 1981, reduced by 2% in each following year with last payments in 1984	Low-income elderly homeowners and renters	Income tax credit up to $500
Indiana	Low-income elderly	Those meeting specified criteria receive total exemption	Low-income elderly homeowners and renters	Income tax credit up to $500
Iowa	General	Credit for actual levy on first $4,850 of valuation. Minimum amount $62.50	Elderly homeowners and renters with incomes below $10,000	Credit on up to $1,000 of property taxes
Kansas	No Program		Elderly and households with children under 18 with income under $7,000. Homeowners and renters	Maximum based on $400 of taxes or tax share of rent
Kentucky	Elderly	$6,500	No Program
Louisiana	General	$7,500 of assessed value, not applicable to municipal non-school taxes except in Orleans Parish	No Program
Maine	No Program		Elderly homeowners and renters with household incomes below $6,000 ($5,000 for individuals)	$5 to $400
Maryland	General	Tax credits in years when residential values rise 15% or more	All homeowners and aged or disabled renters	Tax credit up to $900 for homeowners and $450 for reners for taxes in excess of a certain percentage of income
Massachusetts	General	With city or town approval the first 10% of class I residential property is exempt from taxation	No Program
Michigan	No Program		All homeowners and renters	Credit of up to $1,200 for 60% of the property taxes over 3.5% of income. More generous formula for those over 65
Minnesota	General	In qualified municipalities credit for 66% of taxes up to maximum of $385. Smaller credits for non-qualified municipalities	All homeowners and renters	Income adjusted credit up to a maximum of $650 less amount received under homestead credit
Mississippi	General	$5,000 for state property and some local taxes	No Program
Mississippi	Elderly, disabled	$5,000 for all property taxes	No Program
Missouri	No Program		Elderly homeowners and renters. Income ceiling of $9,500 in 1981	Income tax credit based on property taxes or share of rent up to $500
Montana	Widows or widowers with dependent children, or 62 years old or more	Up to 90% of the first $35,000 of value with the percentage varying with adjusted gross income	No Program
Nebraska	Elderly-Income ceiling of $10,400 for married couples	Income adjusted exemption varying between 100% and 20% of the first $35,000 of valuation	No Program
Nevada	Widows, orphans	$1,000	Elderly with household incomes below $11,000	Up to $500
Nevada	Totally blind	$3,000	Elderly with household incomes below $11,000	Up to $500
New Hampshire	Elderly, if program adopted by cities and towns. Income maximums $9,000 married, $7,000 single	Maximum $20,000 of valuation for those 80 years old	No Program
New Jersey	General	Rebate calculated at $1.50 per $100 of equalized value plus 12.5% of the equalized tax rate times the first $10,000 or 2/3 of equalized value. Maximum payment is 50% of taxes. Those over 65 receive an additional $50	No Program
New Mexico	General	$200 property tax exemption	Elderly homeowners and renters. Income ceiling of $16,000 of modified gross income	Income tax credit of up to $250
New Mexico	Veterans and surviving spouses	$2,000 property tax exemption		Income tax credit of up to $250
New York	Elderly, if granted by municipalities	Up to 50% of residential value. Abatement on rent controlledproperty for the elderly	Homeowners with income below $13,500	Income tax credit of up to $250 for the elderly, $75 for others based on set percentages of income
North Carolina	Elderly and disabled with disposable incomes not above $9,000	$7,500 of valuation	No Program
North Dakota	Elderly and disabled with incomes below $9,000	Up to $4,000	Elderly and disabled renters with incomes below $9,000 and rent in excess of 4% of income	Up to $475
Ohio	Elderly and disabled with incomes below $15,000	$5,000	No Program
Oklahoma	General	$1,000	Elderly and disabled homeowners with gross household income below $7,200	Income tax credit of up to $200
Oklahoma	Those with incomes of $5,000 or less	An additional $1,000		Income tax credit of up to $200
Oregon	General	Credit for 30% of taxes up to maximum of $800	All homeowners and renters with incomes below $17,500	Income adjusted payment of between $36 and $750. Supplemental payment for renters
Pennsylvania	No Program		Elderly disabled homeowners and renters with low incomes	Payments up to a maximum of $400
Rhode Island	Cities and towns may elect to freeze property taxes for homeowners over 65 with household incomes below $4,000		Elderly homeowners and renters. Income ceiling of $10,000	Income tax credit for taxes in access of set percentage of income. Maximum credit $500
South Carolina	Elderly, blind and disabled	$15,000 of fair market value	No Program
South Dakota	General	Homesteads exempt from state property taxation	Elderly and disabled household heads. Income ceiling of $7,375 for two member household	Income adjusted credit for up to 55% of taxes
Tennessee	Elderly and disabled with incomes of $4,800 or less	Credit for taxes on the first $12,000 of market value	No Program
Texas	General	$3,000 of assessed value for county purposes,$5,000 of appraised value for school purposes	No Program
Texas	Elderly and disabled	$15,000 of appraised value for school purposes. Minimum exemption of $3,000 for all local purposes	No Program
Utah	Counties may adopt program for elderly with incomes under $7,500 for individuals or $8,000 for married couples	Up to $300 of taxes. Maximum reduction is 50% of taxes.	Elderly and widowed homeowners and renters with incomes below $9,000	Tax refund or credit of up to $300
Vermont	No Program		All homeowners and renters. Income ceiling of $16,000	Income tax credit for taxes in excess of between 4% and 6% of income. Maximum credit of $500.
Virginia	Counties, cities and towns may provide exemption or deferral of taxes for homeowners over 65 with incomes below $15,000 or net worth below $55,000	The increase in taxes since homeowner was 65 or since enactment of the law, whichever is later.	No Program
Washington	Elderly with incomes below $10,000	First $15,000 of value of homestead	No Program
Washington	Elderly with incomes of $14,000 or less	Exemption from all excess levies	No Program
West Virginia	Elderly	First $10,000 of assessed valuation	Elderly homeowners and renters with household incomes below $5,000	Income adjusted payment for the first $125 of taxes or share of rent counted as taxes
Wisconsin	General	Not specified, state financed credit to all property owners	All homeowners and renters with household incomes below $14,000	Tax credit based on up to $1,000 of taxes
Wyoming	Homes with an assessed value of less than $10,200 if state has appropriated sufficient funds to reimburse local governments	Credit based on mill rate times assessed value	No Program
SOURCE: Advisory Commission On Intergovernment Relation, *Significant Features of Fiscal Federalism 1980 - 81 Edition* (Washington, D.C.: GPO, 1981), pp. 98-199.

TABLE 174. Benefit Amounts and Property Tax Relief Under State Circuit-Breaker Programs: Number of Claimaints¹
State	Fiscal Year	Number of Claimants	Avg. Benefit Per Claimant	Total Program Cost ($ in thousands)
Arkansas	1976	8,916	$75.76	$676
California	1979 (est.)	440,000	193.18	85,000
Colorado	1977	58,875	187.00	11,003
Connecticut	1977	101,574	243.70	24,754
Dist. of Col.	1977	18,632	225.42	4,200
Idaho	1978 (est.)	17,323	231.00	4,000
Illinois	1979 (est.)	405,000	250.00	100,000
Indiana	1977	28,665	29.45	844
Iowa	1977	83,800	114.56	9,600
Kansas	1977	62,955	140.17	8,824
Maine	1977	20,786	209.10	4,347
Maryland	1978	83,863	248.12	20,808
Michigan	1977	1,234,800	223.18	275,582
Minnesota	1977	857,277	156.54	134,200
Missouri	1977	56,260	124.57	7,008
Nevada	1977	10,560	127.84	1,350
New Mexico	1978	40,000	37.50	1,500
New York	*	N.A.	N.A.	N.A.
No. Dakota	1977	9,969	120.2	1,198
Oklahoma	1977	4,159	85.93	357
Oregon	1978	502,575	147.52	74,140
Pennsylvania	1977	413,974	142.32	58,918
Rhode Island	1/104/10,78	249	51.92	12
So. Dakota	1977	15,095	98.51	1,487
Utah	1978	10,000	95.00	950
Vermont	1977	36,516	210.05	7,670
West Virginia	1977	1,265	13.94	18
Wisconsin	1977	234,201	205.55	48,139
SOURCE: Advisory Commission on Intergovernmental Relations, *Significant Features of Fiscal Federalism 1978-79 Edition, (Washington, D.C.: GPO, May 1979), Tables 43 and 44. New York’s program was new in 1978, therefore data were not available at the time the survey was made. Circuit-breaker programs are state operated programs, primarily for the lower income aged and disabled, for reducing property taxes.

TABLE 175. V.A. Medical Centers--Hospital-Based Home Care: Expenditures by State (Fiscal Year 1979¹)
State	Average Cost Per Visit²	Total Expenditures³
Alabama	$37.79	$166,200
Arkansas	49.19	328,111
California	57.31	674,424
District of Columbia	39.27	172,827
Florida	63.14	674,588
Georgia	65.55	297,925
Illinois	55.23	252,677
Indiana	52.28	223,392
Iowa	38.67	195,786
Louisiana	31.79	198,465
Massachusetts	44.00	250,272
Michigan	47.64	234,770
Minnesota	60.79	305,166
Missouri	32.21	148,617
New Jersey	40.79	195,833
New Mexico	67.34	285,185
New York	48.80	553,441
Ohio	113.05	385,953
Oregon	37.08	194,040
Pennsylvania	63.16	532,691
Texas	48.12	625,752
Vermont	98.61	410,908
Virginia	61.39	344,275
Washington	54.61	227,778
TOTALS	$53.24	$7,879,076
SOURCE: Unpublished data compiled by Mary Shiraishi of the VA Hospital Based Home Care Program. State level source data were presented by facility rather than in aggregated form. Consequently, weighting was necessary in some cases to compute statewide average cost per visit. Weighted by total number of visits in states with more than one facility. Total expenditures computed as: Total Number of Visits x Average Cost Per Visit.

TABLE 176. VA Medical Centers--Domiciliary Care Units: Expenditures by State (Fiscal Year 1979)
State	Average Per Diem Cost	Total Expenditures¹
Arizona	$22.75	$1,835,129
California	27.67	3,736,834
Florida	27.93	3,007,363
Georgia	18.98	2,584,032
Kansas	19.78	5,053,790
Mississippi	26.57	3,995,597
New York	24.47	5,412,519
Ohio	30.32	8,399,701
Oregon	22.78	8,672,232
South Dakota	27.44	4,176,505
Tennessee	22.98	5,913,329
Texas	22.33²	5,475,057
Virginia	24.12	5,537,590
West Virginia	21.15	4,021,990
Wisconsin	25.18	6,562,160
TOTALS	$24.82	$74,482,828
SOURCE: Veterans Administration, *1979 Annual Report* (Washington, D.C.: GPO, 1980); and *Veterans Administration Summary of Medical Programs* (Washington, D.C.: Veterans Administration, September 1979). Total expenditures computed as: Average Daily Census x Average Per Diem Cost x 365. Weighted by average daily census.

TABLE 177. State Veterans Home -- Domiciliaries: Expenditures by State (Fiscal Year 1979)
State	Average Per Diem Cost¹	Total Veteran Cost (State and Federal)	Total Grants-in-Aid by VA (Federal)	VA Contribution (Federal) %
California	$17.91	$4,216,014	$1,294,700	30.7
Colorado	15.45	404,280	143,919	35.6
Connecticut	14.18	2,232,315	865,849	38.8
D.C.	31.00	1.917,567	340.849	17.7
Georgia	44.14	4,383,367	546,183	12.5
Idaho	11.53	462,284	220,517	47.7
Illinois	22.51	809,910	178,354	15.1
Indiana	36.68	1,189,459	178,767	15.9
Iowa	34.54	1,122,654	124,234	47.1
Kansas	11.67	263,602	216,722	14.8
Louisiana	37.12	1,462,676	579,827	39.7
Massachusetts	13.87	1,462,237	331,111	32.4
Michigan	16.96	1,021,026	970,635	33.5
Minnesota	16.41	2,896,681	970,635	39.2
Missouri	14.04	320,968	125,736	42.7
Montana	12.87	368,314	157,399	20.2
Nebraska	27.26	1,403,945	283,261	25.3
New Jersey	21.74	1,038,349	262,691	25.3
New York	39.01	468,003	65,984	14.1
North Dakota	13.38	518,488	213,131	41.1
Ohio	15.69	3,967,373	1,390,730	35.1
Oklahoma	29.12	3,685,914	696,152	18.9
Pennsylvania	37.61	1,350,413	197,478	14.6
Rhode Island	20.01	819,961	204,897	25.1
South Dakota	17.11	618,065	198,677	32.1
Vermont	15.04	66,732	24,624	36.9
Washington	25.06	1,929,334	423,347	21.9
Wisconsin	18.97	340,549	98,736	29.0
Wyoming	26.16	455,864	95,843	21.0
TOTALS	$21.32	$41,196,344	$10,627,609	25.8
SOURCE: *National Association of State Veterans Homes, 1979-1980*; and unpublished data compiled by the VA State Home Program. Weighted by total veteran days of care in states with more than one facility.

TABLE 178. State Veterans’ Home -- Nursing Homes: Costs and Expenditures by State (Fiscal Year 1979)
Contribution State	Average Per Diem Cost¹	Total Veteran Cost (State and Federal)	Total VA Grants-in-Aid (Federal)	VA Contribution (Federal) %
California	>$23.85	$2,806,883	$1,235,735	44.0
Colorado	26.81	1,244,446	487,305	39.2
Georgia	40.23	4,419,967	1,153,354	26.1
Illinois	32.09	3,635,348	1,189,503	32.7
Indiana	36.29	1,991,523	576,219	29.0
Iowa	38.99	3,638,157	979,755	27.0
Kansas	32.39	594,778	192,812	32.0
Massachusetts	45.95	4,772,528	1,090,530	22.9
Michigan	41.78	4,615,324	1,913,856	25.3
Minnesota	32.68	976,021	313,593	47.9
Missouri	21.92	778,730	373,023	47.9
Montana	23.96	335,560	147,053	43.8
Nebraska	30.86	4,154,867	1,413,543	34.0
New Hampshire	30.00	959,790	335,926	35.0
New Jersey	32.86	5,954,194	1,902,453	32.0
New York	54.50	558,952	107,688	19.3
Ohio	39.02	320,003	86,111	26.0
Oklahoma	38.96	7,899,376	2,129,066	27.0
Pennsylvania	57.18	2,066,080	379,428	18.4
Rhode Island	36.85	3,003,128	855,708	28.5
South Carolina	27.69	1,024,115	388,343	37.9
South Dakota	34.70	346,480	104,939	30.3
Vermont	26.39	1,148,440	456,939	39.8
Washington	41.07	2,186,814	559,042	25.6
Wisconsin	38.61	5,795,052	1,575,966	27.2
TOTALS	$35.91	$68,226,556	$19,947,794	29.2
SOURCE: *National Association of State Veterans Homes, 1979-1980*; and unpublished data compiled by the VA State Home Program. Weighted by total veteran days of care in states with more than one facility.

TABLE 179. States With SSI Supplements to Nonmedical Facilities, With Levels of Income Support and Amount of State Payment
State	Income Support Level		State Payment
State	Individual	Couples	Individual	Couples
Arizona	$263.00	407.00	25.00	50.00
California	465.00	930.00	227.00	573.00
Colorado	433.00 to 553.00	N/A	140.00 to 260.00	N/A
Delaware	339.00	678.00	101.00	321.00
District of Columbia	365.20 to 475.20	715.50 to 935.50	127.20 to 237.20	358.50 to 578.50
Florida	316.00 to 335.00	632.00 to 670.00	78.00 to 97.00	275.00 to 313.00
Hawaii	328.20 to 440.20	656.00 to 800.40	90.20 to 202.20	299.40 to 523.40
Idaho¹	415.00	830.00	177.00	473.00
Indiana	430.50³	N/A	165.50³	N/A
Iowa	291.20 to 455.00	602.40	53.20 to 217.00	245.40
Kentucky	322.00 to 409.00	644.00 to 818.00	84.00 to 171.00	287.00 to 461.00
Maine	285.00 to 335.00	570.00 to 670.00	47.00 to 97.00	213.00 to 313.00
Maryland	298.80 to 735.80	597.60 to 1,471.60	60.80 to 497.80	240.60 to 1,114.60
Massachusetts²	350.21	700.42	112.21	343.42
Michigan	354.10 to 462.13	708.42 to 924.26	116.10 to 224.13	351.20 to 567.26
Missouri	358.00 to 538.00	597.00 to 957.00	300.00³	600.00³
Montana	287.00 to 342.00	455.00 to 565.00	49.00 to 104.00	98.00 to 208.00
Nebraska	275.00 to 325.00	550.00 to 650.00	37.00 to 87.00	193.00 to 293.00
Nevada²	441.00	882.00	203.00	525.00
New Hampshire	347.00	N/A	122.00	N/A
New Jersey	369.00	738.00	131.00	381.00
New Mexico¹	303.00	487.00	65.00	130.00
New York	326.00 to 723.26	637.62 to 1,431.62	88.26 to 485.26	280.62 to 1,074.62
North Carolina	440.00 to 460.00	517.00 to 575.00	211.00 to 231.00	179.00 to 227.00
North Dakota	238.00	357.00	None	None
Oregon	250.00	500.00	12.00	143.00
Pennsylvania¹	385.30	730.40	147.30	373.40
South Carolina	345.00	690.00	107.00	333.00
South Dakota	285.00 to 365.00	N/A	72.00 to 152.00	N/A
Vermont	302.00 to 376.00	561.00 to 670.00	64.00 to 138.00	204.00 to 313.00
Virginia²	409.00³	819.00³	171.00³	462.00³
Wisconsin	377.50	745.20	139.50	388.20
SOURCE: U.S. Department of Health and Human Services; Social Security Administration; Office of Operational Policy and Procedures; Office of Assistance Programs, Supplemental Security Income for the Aged, Blind and Disabled: Summary of State Payment Levels, Stae Supplementation, and Medicaid Decisions, (rev.) October 1, 1980 and, *Security Bulletin*, Volume 40, Number 12, December 1977, Tables 2 and 3, p. 19. N/A Not Applicable. State did not report SSI supplemental payments to nonmedical facilities in July 1975. SSI supplemental payments differ for the blind and/or disabled. This figure represents a maximum amount allowable for payment.

XI. COST

TABLE 180. Amount Per Resident Day and Percent Distribution of Nursing Home Revenues and Costs, According to Ownership and Certification: United States, 1976
Revenue and Cost Component	All Nursing Homes	Ownership			Certification
Revenue and Cost Component	All Nursing Homes	Proprietary	Voluntary Nonprofit	Government	Skilled Nursing Facility Only	Skilled Nursing Facility and Intermediate Care Facility	Intermediate Care Facility Only	Not Certified
AMOUNT PER RESIDENT DAY
REVENUE
Total	$23.89	$22.63	$26.91	$26.66	$30.29	$26.34	$18.50	$16.71
Patient care	22.78	22.33	24.37	22.68	29.35	25.07	17.86	14.72
Nonpatient care	1.11	0.30	2.53	3.97	0.94	1.27	*	1.98
COST
Total	23.84	21.97	27.56	29.54	29.71	26.53	18.37	16.98
Labor	14.23	12.46	16.93	21.3	17.82	16.03	10.66	9.99
Wages and salaries	12.70	11.19	15.15	18.48	15.69	14.28	9.68	9.06
Nursing payroll	7.77	7.11	8.92	10.22	10.04	8.73	5.84	5.02
Professional payroll	0.40	0.24	0.56	1.19	0.54	0.49	*	*
Other payroll	4.53	3.85	5.68	7.06	5.12	5.06	3.69	3.64
Payroll taxes and fringe benefits	1.53	1.27	1.78	2.86	2.13	1.75	0.98	0.94
Operating	5.14	4.65	6.49	5.80	6.17	5.55	4.09	4.33
Food and other dietary	2.13	1.95	2.69	2.23	2.36	2.23	1.89	1.92
Drugs	0.29	0.25	0.40	0.40	0.43	0.34	0.18	0.19
Supplies and equpment	0.81	0.71	1.04	1.07	0.98	0.97	0.56	0.55
Maintenance of buildings, grounds, and equipment purchased from outside sources	0.41	0.38	0.52	0.40	0.47	0.42	0.37	0.40
Laundry and linen	0.27	0.25	0.30	0.34	0.38	0.30	0.17	0.19
Health-care services purchased from outside sources	0.30	0.28	0.40	0.22	0.52	0.33	0.12	0.21
Nursing	0.06	0.07	*	*	0.09	0.07	*	*
Other health care	0.24	0.21	0.34	0.20	0.43	0.26	0.09	0.17
Utilities	0.92	0.82	1.15	1.15	1.02	0.97	0.80	0.87
Fixed	3.40	3.76	3.03	1.49	4.35	3.78	2.72	1.97
Equipment rental	0.05	0.06	*	*	0.08	0.05	*	*
Insurance	0.28	0.27	0.35	0.19	0.31	0.29	0.27	0.22
Taxes and licenses	0.40	0.55	0.08	*	0.64	0.40	0.28	0.27
Interest and finance charges	0.88	0.89	1.12	0.26	1.08	1.05	0.69	0.38
Depreciation	0.87	0.72	1.36	0.95	1.00	1.03	0.69	0.57
Rent on buildings and land	0.89	1.24	0.08	*	0.21	0.94	0.73	0.49
Amortization of leasehold improvement	0.02	0.03	*	*	*	*	*	*
Miscellaneous	1.08	1.09	1.11	0.92	1.38	1.16	0.89	0.69
PERCENT DISTRIBUTION
REVENUE
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Patient care	95.4	98.7	90.6	85.1	96.9	95.2	96.6	88.1
Nonpatient care	4.6	1.3	9.4	14.9	3.1	4.8	*	11.9
COST
Total	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Labor	59.7	56.7	61.4	72.2	60.0	60.4	58.1	58.9
Wages and salaries	53.3	51.0	55.0	62.5	52.8	53.8	52.7	53.3
Nursing payroll	32.6	32.4	32.3	34.6	33.8	32.9	31.8	29.6
Professional payroll	1.7	1.1	2.0	4.0	1.8	1.9	*	*
Other payroll	19.0	17.5	20.6	23.9	17.2	19.1	20.1	21.4
Payroll taxes and fringe benefits	6.4	5.8	6.5	9.7	7.2	6.6	5.4	5.5
Operating	21.6	21.2	23.5	19.6	20.8	20.9	22.3	25.5
Food and other dietary	8.9	8.9	9.7	7.5	8.0	8.4	10.3	11.3
Drugs	1.2	1.1	1.5	1.4	1.4	1.3	1.0	1.1
Supplies and equpment	3.4	3.2	3.8	3.6	3.3	3.7	3.0	3.2
Maintenance of buildings, grounds, and equipment purchased from outside sources	1.7	1.8	1.9	1.3	1.6	1.6	2.0	2.3
Laundry and linen	1.1	1.1	1.1	1.2	1.3	1.1	0.9	1.1
Health-care services purchased from outside sources	1.3	1.3	1.4	0.7	1.8	1.2	0.7	1.2
Nursing	0.3	0.3	*	*	0.3	0.3	*	*
Other health care	1.0	1.0	1.2	0.7	1.4	1.0	0.5	1.0
Utilities	3.9	3.7	4.2	3.9	3.4	3.6	4.3	5.1
Fixed	14.3	17.1	11.0	5.0	14.6	14.3	14.8	11.6
Equipment rental	0.2	0.3	*	*	0.3	0.2	*	*
Insurance	1.2	1.2	1.3	0.6	1.0	1.1	1.5	1.3
Taxes and licenses	1.7	2.5	0.3	*	2.1	1.5	1.5	1.6
Interest and finance charges	3.7	4.1	4.1	0.9	3.6	4.0	3.8	2.2
Depreciation	3.7	3.3	4.9	3.2	3.4	3.9	3.8	3.4
Rent on buildings and land	3.7	5.7	0.3	*	4.1	3.5	4.0	2.9
Amortization of leasehold improvement	0.1	0.1	*	*	*	*	*	*
Miscellaneous	4.5	4.9	4.0	3.1	4.6	4.4	4.9	4.0
SOURCE: The National Nursing Home Survey: 1977 Summary for the United States, *Vital and Health Statistics, data from the National Nursing Home Survey, Series 13, No. 43, Table 39. NOTES*: Figures may not add to total due to rounding. Nursing home characteristics for 1977.

TABLE 181. Average Total Monthly Charge and Average Paid by Primary Source for Residents of Nursing Homes in 1977 and Discharges in 1976, by Primary Source of Payment and Selected Nursing Home Characteristics: United States
Nursing Home Characteristic	Primary Source of Payment for Residents in 1977
	All Sources		Own Income or Family Support		Medicare		Medicaid Skilled		Medicaid Intermediate		Other Government Assistance or Welfare		All Other Sources
	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source
AVERAGE AMOUNT
All residents	$689	$601	$690	$655	$1,167	$992	$873	$732	$610	$500	$508	$442	$440	$286
OWNERSHIP
Proprietary	670	582	686	651	1,048	889	798	666	596	485	501	436	562	369
Voluntary nonprofit	747	656	721	692	*	*	1,023	847	645	516	*	*	373	256
Government	700	607	619	562	*	*	1,061	928	655	570	*	*	*	*
CERTIFICATION
Skilled nursing facility only	880	780	866	828	1,136	958	955	812	--	--	575	513	606	*
Skilled nursing facility and intermediate care facility	762	656	800	758	1,195	1,022	812	673	671	546	623	533	630	420
Intermediate care facility only	556	484	567	537	--	--	--	--	563	463	479	435	*	*
Not certified	390	351	447	422	--	--	--	--	--	--	401	331	*	*
BED SIZE
Less than 50 beds	546	478	516	490	*	*	909	757	579	472	394	339	*	*
50-99 beds	643	567	689	662	*	*	738	619	566	468	493	424	468	306
100-199 beds	706	611	721	680	1,242	1,062	800	653	618	502	573	504	551	378
200 beds or more	837	725	823	772	*	*	1,110	957	697	574	602	*	370	233
LOCATION
Geographic region:
Northeast	918	806	909	865	1,369	1,160	1,162	993	725	591	*	*	395	*
North Central	640	558	652	620	*	*	770	627	581	472	537	460	524	346
South	585	504	585	548	*	*	706	584	587	486	452	402	342	221
West	653	570	663	633	*	*	697	582	582	475	564	474	*	*
Nursing Home Characteristic	Primary Source of Payment for Residents in 1976
	All Sources		Own Income or Family Support		Medicare		Medicaid Skilled		Medicaid Intermediate		Other Government Assistance or Welfare		All Other Sources
	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source	Monthly Charge	Paid by Primary Source
AVERAGE AMOUNT
All discharges	$789	$720	$747	$716	$1,300	$1,197	$767	$666	$579	$484	$524	$448	$462	$425
OWNERSHIP
Proprietary	432	664	731	705	1,063	949	728	630	569	474	524	446	511	480
Voluntary nonprofit	992	926	781	748	1,811	1,728	873	756	619	520	*	*	508	472
Government	790	704	853	760	1,336	1,246	912	816	593	505	*	*	*	*
CERTIFICATION
Skilled nursing facility only	962	891	902	859	1,349	1,270	853	754	582	476	585	520	558	514
Skilled nursing facility and intermediate care facility	811	729	794	759	1,258	1,126	704	600	636	532	*	*	585	550
Intermediate care facility only	565	511	586	569	*	*	*	*	537	449	*	*	*	*
Not certified	430	405	507	493	*	*	*	*	*	*	*	*	*	*
BED SIZE
Less than 50 beds	807	743	730	685	1,690	1,582	581	495	554	483	*	*	548	498
50-99 beds	705	647	696	673	1,106	1,013	689	601	542	453	514	450	447	406
100-199 beds	809	739	764	737	1,321	1,224	716	616	591	486	*	*	480	446
200 beds or more	878	786	855	807	1,227	1,087	1,012	889	639	538	*	*	*	*
LOCATION
Geographic region:
Northeast	1,098	1,012	983	944	1,681	1,575	1,086	964	702	583	*	*	*	*
North Central	743	682	690	667	1,259	1,162	682	588	576	471	*	*	557	516
South	654	590	629	605	1,191	1,080	663	564	529	444	*	*	*	*
West	695	628	757	714	931	831	633	544	540	471	*	*	409	364
SOURCE: The National Nursing Home Survey: 1977 Summary for the United States, *Vital and Health Statistics*, data from the National Nursing Home Survey, Series 13, No. 43, Table 15.

APPENDIX A. SELECTED ADAPTED TASK ITEMS

TABLE A-1. Selected Adaptive Task Items and Their Use in 16 Major Assessment Instruments
	Laundry	Meals	Housework-General	Light Housework	Heavy Housework	Handling Money	Shopping	Transportation	Drive Car	Use Telephone	Take Own Medications	Taking Care of Personal Possessions	Total Number of the 12 Items in Instrument
1. Long-Term Health Care Minimum Data Set						X	X			X		X	4
2. Chronic Disease Module Study	X	X	X	X			X	X					6
3. 1979 Health Interview Survey		X	X			X	X	X	X	X			7
4. 1977 National Nursing Home Survey													0
5. GAO -- Cleveland -- OARS		X	X			X	X	X		X	X		7
6. 222 Day Care -- Homemaker Experiment	X	X	X			X	X	X		X			7
7. Health Care Needs of Elderly and Disabled of Massachusetts	X	X	X		X		X	X	X				6
8. Continued Care Study													0
9. Survey of Low-Income Aged and Disabled	X	X	X		X		X	X					6
10. CARE	X	X	X			X	X	X					6
11. Approach to Assessment of Long-Term Care													0
12. Survey Institutionalized Persons			X			X						X	3
13. Alternative Health Service Study	X	X	X			X	X	X		X	X		8
14. Triage Study	X	X	X			X	X	X		X	X		8
15. National Survey of Aging		X	X		X		X						4
16. Special Care and Treatment Unit Study	X	X			X			X	X				5
TOTAL NUMBER OF INSTRUMENTS WITH ITEM	8	11	12	1	4	8	11	10	3	6	3	2
X = item present in some form in that instrument

APPENDIX B. USE, SOURCE, CHARGES AND EXPENDITURES FOR NON-LONG-TERM CARE SERVICES BY AGE

TABLE B-1. Use of Inpatient Hospital Services: Percent of Persons Without and With Hospital Admission, Mean Length of Stay, and Mean Number of Hosital Admissions per 1,000 Population and Per Person With at Least One Hospital Admission, by Age (NMCES Household Data: United States, 1977)
Age	Total Population (thousands)	Persons Without Admissions	Persons With at Least One Admission	Mean Length of Stay Per Admission	Hospital Admissions Per 1,000 Population	Hospital Admissions Per Person With Admission
All years	212,098	88.9	11.1	7.1	14.8	1.4
0-64 years	189,814	89.9	10.0	6.3	130.5	1.3
65 or older	22,284	79.9	20.1	10.3	303.0	1.5
SOURCE: National Center for Health Services Research.

TABLE B-2. Use of Prescribed Medicines: Percent of Persons With and Without Prescribed Medicines, Mean Number of Prescribed Medicines Per Person and Per Person Without at Least One Prescribed Medicine, by Age (NMCES household data: United States, 1977)
Age	Total Population (in thousands)	Persons Without Prescribed Medicines	Persons With at Least One Prescribed Medicine	Prescribed Medicines Per Person	Prescribed Medicines Per Person With at Least One Prescribed Medicine
All years	212,098	41.8	58.2	4.3	7.5
0-64 years	189,814	43.8	56.2	3.6	6.4
65 or older	22,284	24.8	75.2	10.7	14.2
SOURCE: National Center for Health Services Research.

TABLE B-3. Usual Sources of Care: Percent Distribution of Persons by Age (NMCES Household Data: United States, 1977)
Age	Total Population (thousands)	No Usual Source	Physician’s Office	Hospital Outpatient Department	Emergency Room	Health Center and Other	Don’t Know/ No Answer
All years	212,822	14.2%	65.7%	4.8%	1.0%*	5.1%	9.2%
0-64 years	190,351	14.6	64.9	20.5	1.0	5.3	9.4
65 or older	22,471	11.4	71.8	5.2	0.6*	3.4	7.6
SOURCE: National Center for Health Services Research. * Relative standard error is equal to or greater than 30 percent.

TABLE B-4. Use of Ambulatory Physician Services: Percent Distribution of Persons With and Without Physician Contracts, by Age (NMCES Household Data: United States, 1977)
Age	Total Population (thousands)	Persons Without Contact	Persons With at Least One Contact	Contacts Per 1,000 Population	Contacts Per Person With Contact
All years	212.098	27.2%	72.8%	4,009	5.5
0-64 years	189,814	27.9	22.1	3,772	5.2
65 or older	22,284	20.6	79.4	6,020	7.6
SOURCE: National Center for Health Services Research.

TABLE B-5. Annual Expenditures and Sources of Payment for Inpatient Hospital Services: Mean Expense per Person with Hospital Expense and Percent Paid by Source of Payment, by Age (NMCES Household Data: United States, 1977)
Age	Total Population With Expense for Hospital Inpatient Care (thousands)	Mean Expense Per Person With Expense	Source of Payment
Age		Mean Expense Per Person With Expense	Family	Private Health Insurance	Medicare	Medicaid	Other^a
All years	23,165	$1,970	8.8%	43.5%	24.9%	11.0%	11.8%
1-64 years	18,772	$1,645	9.8	58.8	4.1	13.1	13.6
65 or older	4,393	$3,359	5.6	11.4	68.3	6.6	8.2
SOURCE: National Center for Health Services Research. Includes CHAMPUS, CHAMPVA, the Indian Health Service, the Veterans Administration, the military, and other federal, state, city, or county payers, philanthropic institutions, and unknown sources of payment.

TABLE B-6. Out of Pocket Expense for Inpatient Hospital Services: Percent Distribution of Persons With and Without Admissions, by Intervals of Out-of-Pocket Expense and Age (NMCES Household Data: United States, 1977)
Age	Total Population (thousands)	Percent Distribution
		Out-of-Pocket Expense				No Admission
		None	$1 - $249	$250 - $999	$100 or more	No Admission
All years	212,098	6.3	3.0	1.2	0.4	89.1
1-64 years	189,820	5.8	2.6	1.9	0.4	90.1
65 or older	22,278	10.3	7.0	1.7	0.8	80.2
SOURCE: National Center for Health Services Research.

TABLE B-7. Charges and Sources of Payment for Inpatient Hospital Services^a: Mean Charge Per Admission and Proportion Paid by Different Sources of Payment, by Age (NMCES Household Data: United States 1977)
Age	Total Number of Admissions (thousands)	Mean Charge Per Admission	Source of Payment (Average Proportion Paid)
Age	Total Number of Admissions (thousands)	Mean Charge Per Admission	Family	Private Health Insurance	Medicare	Medicaid	Other^a
All years	31,395	$1,454	14%	50%	16%	10%	9%
1-64 years	24,681	$1,251	15	59	4	10	10
65 or older	6,714	$2,198	9	13	66	6	6
SOURCE: National Center for Health Services Research. Excludes charges for physician or other services billed separately from the hospital bill. Includes CHAMPUS, CHAMPVA, the Indian Health Services, the Veterans Administration, the military, other federal, state, city, or county payers, philanthropic institutions, and unknown sources of payment.

TABLE B-8. Annual Expenditures and Sources of Payment for Ambulatory Physician Services: Mean Expense per Person with Expense and Percent Paid by Source of Payment, by Age (NMCES Household Data: United States 1977)
Age	Total Population With Expense (thousands)	Mean Expense Per Person With Expense	Source of Payment (Percent Distribution)
Age	Total Population With Expense (thousands)	Mean Expense Per Person With Expense	Family	Private Health Insurance	Medicare	Medicaid	Other^b
All years	149,595	$141	42.6	30.9	7.3	7.7	12.0
1-64 years	132,200	>$132	43.8	34.3	1.1	8.0	12.6
65 or older	17,395	$209	36.8	11.5	35.9	6.4	9.4
SOURCE: National Center for Health Services Research. Includes CHAMPUS, CHAMPVA, the Indian Health Services, the Veterans Administration, the military, other federal, state, city, or county payers, philanthropic institutions, and unknown sources of payment.

TABLE B-9. Out-of-Pocket Expense for Ambulatory Physician Services: Percent Distribution of Persons With and Without Contacts, by Intervals of Out-of-Pocket Expense, by Age (NMCES Household Data: United States 1977)
Age	Total Population (thousands)	Percent Distribution
		Out-of-Pocket Expense					No Contact
		None	$1 - $49	$50 - $99	$100 - $249	$250 or More	No Contact
All years	212,098	16.5	31.3	12.9	9.3	2.8	27.2
1-64 years	189,814	16.9	31.6	12.5	9.6	2.5	27.8
65 or older	22,284	13.7	29.4	16.6	15.8	3.8	20.6
SOURCE: National Center for Health Services Research.

TABLE B-10. Annual Expenditures and Sources of Payment for Ambulatory Non-Physician Services: Mean Expense per Person with Expense and Percent Paid by Source of Payment, By Age (NMCES Household Data: United States, 1977)
Age	Total Population With Expense (thousands)	Mean Expense Per Person With Expense	Source of Payment
Age	Total Population With Expense (thousands)	Mean Expense Per Person With Expense	Family	Private Health Insurance	Medicare	Medicaid	Other
All years	36,703	$98	45.1	20.5	6.9	6.8	20.7
1-64 years	31,354	$82	49.9	14.7	0.5	5.2	14.8
65 or older	5,349	$171	37.6	7.6	25.1	7.0	22.8
SOURCE: National Center for Health Services Research.

TABLE B-11. Annual Out-of-Pocket Expenses for Personal Health Services: Percent of Persons With and Without Out-of-Pocket Expenses, and Means per Person and per Person with Out-of-Pocket Expenses, By Age (NMCES Household Data: United States, 1977)
Age	Total Population (thousands)	Persons Without Out-of-Pocket Expenses	Persons With Out-of-Pocket Expenses	Mean Expense Per Person With Out-of-Pocket Expenses	Mean Out-of-Pocket Expense Per Person
All years	212,098	24.7%	75.3%	%205	$155
1-64 years	189,814	25.5	74.5	193	144
65 or older	22,284	16.7	83.3	326	272

TABLE B-12. Level of Individual Out-of-Pocket Expenses for Personal Health Services: Percent Distribution of Persons With and Without Expense, by Intervals of Annual Out-of-Pocket Expense and Age (NMCES Household Data: United States, 1977)
Age	Total Population (thousands)	Percent Distribution: Annual Out-of-Pocket Expense
Age	Total Population (thousands)	None	$1 - 99	$100 - 249	$250 - 499	$500 - 999	$1000 or More	No Use of Services
All years	212,098	9.8	40.0	19.4	9.2	4.3	2.3	15.0
1-64 years	189,814	10.1	41.4	18.6	8.3	3.9	2.0	15.5
65 or older	22,284	6.1	28.6	25.8	16.4	7.6	4.9	10.6

TABLE B-13. Annual Expenditures and Sources of Payment for Prescribed Medicines: Mean Expense per Person with Expense and Percent Paid by Source of Payment and Age (NMCES Household Data: United States, 1977)
Age	Total Population with Expense for Prescribed Medicines (thousands)	Mean Expense Per Person With Expense	Source of Payment (Percent Distribution)
Age		Mean Expense Per Person With Expense	Family	Private Health Insurance	Medicaid	Other^a
All years	120,424	$46	73.0	13.6	7.7	5.6
1-64 years	103,847	39	71.5	14.9	6.9	6.6
65 or older	16,577	93	77	10.3	9.5	3.2
SOURCE: National Center for Health Services Research. Includes CHAMPUS, CHAMPVA, the Indian Health Services, the Veterans Administration, the military, other federal, state, city, or county payers, philanthropic institutions, and unknown sources of payment.

TABLE B-14. Out-of-Pocket Expenses for Prescribed Medicines: Percent Distribution of Persons With and Without Prescribed Medicine by Out-of-Pocket Expense and Age (NMCES Household Data: United States, 1977)
Age	Total Population (thousands)	Out-of-Pocket Expense (Percent Distribution)					No Prescribed Medicine
Age	Total Population (thousands)	Non	$1 - 49	$50 - 99	$100 - 249	$250 or More	No Prescribed Medicine
All years	212,098	8.0	39.8	5.7	3.9	0.8	41.8
1-64 years	189,932	8.1	40.4	4.6	2.6	0.5	43.1
65 or older	20,180	6.9	34.7	14.8	15.7	3.3	24.8
SOURCE: National Center for Health Services Research.

TABLE B-15. Charges and Sources of Payment for Prescribed Medicine: Mean Charge per Prescribed Medicine and Proportion Paid by Different Sources of Payment, by Age (NMCES Household Data: United States, 1977)
Age	Total Prescribed Medicines with Charge (thousands)	Mean Charge Per Prescribed Medicine	Source of Payment (Average Proportion Paid)
Age	Total Prescribed Medicines with Charge (thousands)	Mean Charge Per Prescribed Medicine	Family	Private Health Insurance	Medicaid	Other^a
All years	895,010	$6.24	0.74	0.12	0.08	0.06
1-64 years	660,457	6.12	0.73	0.13	0.07	0.06
65 or older	234,553	6.58	0.77	0.09	0.10	0.03
SOURCE: National Center for Health Services Research. Includes CHAMPUS, CHAMPVA, the Indian Health Services, the Veterans Administration, and the military.

TABLE B-16. Annual Expenditure and Source of Payment for Medical Equipment and Supplies: Mean Expense per Person with Expense and Percent Paid by Source, by Age (NMCES Household Data: United States, 1977)
Age	Total Population With Expense (thousands)	Mean Charge Per Person With Expense	Source of Payment (Percent Distribution)
Age	Total Population With Expense (thousands)	Mean Charge Per Person With Expense	Family	Private Health Insurance	Other^a
All years	12,919	$72	74.9	8.4	16.7
1-64 years	9,986	60	75.5	11.8	12.8
65 or older	2,933	111	73.8	2.2	24.0
SOURCE: National Center for Health Services Research. Includes CHAMPUS, CHAMPVA, the Indian Health Services, the Veterans Administration, the military, other federal, state, city, or county payers, philanthropic institutions, and unknown sources of payment.

TABLE B-17. Out-of-Pocket Expenses for Medical Equipment and Supplies: Percent Distribution of Persons With and Without Purchase or Rental of Medical Equipment and Supplies, by Intervals of Out-of-Pocket Expense and Age (NMCES Household Data: United States, 1977)
Age	Total Population (thousands)	Out-of-Pocket Expense (Percent Distribution)				No Purchase or Rental
Age	Total Population (thousands)	None	$1 - 24	$25 - 99	$100 or More	No Purchase or Rental
All years	212,098	0.9	3.1	1.7	0.5	93.8
1-64 years	189,814	0.9	2.8	1.2	0.3	94.6
65 or older	22,284	1.5	6.0	3.8	2.0	86.7
SOURCE: National Center for Health Services Research.

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Topics

Long-Term Services & Supports (LTSS) | Long-Term Care Financing

Source Book on Long-Term Care Data

Joel Cohen, Judith Feder, Carol Hamcke, Martha Krieger, Susan O’Loughlin, William Scanlon, Margaret Sulvetta, William Weissert, Sidney Katz, Denise Mahalak, Marilyn Moon, Joseph Papsidero, Beth Soldo and Allan Unger

The Urban Institute, Health Policy Center

July 29, 1983

TABLE OF CONTENTS

CONSULTANT AFFILATIONS

INTRODUCTION

Structure and Content of the Report

DESCRIPTION OF DATA BASES

1. The 1977 Health Interview Survey (HIS)

2. The 1979 Health Interview Survey (HIS)

3. The 1977 National Nursing Home Survey

4. Medicare/Medicaid Automated Certification System (MMACS)

5. National Medical Care Expenditure Survey (NMCES)

6. The 1976 Survey of Income and Education (SIE)

7. The Master Facility Inventory (MFI)

8. Framingham Functional Disability Survey

9. National Survey of the Aged Questionnaire (NSA) 1975

10. NIMH Survey of State and County Mental Hospitals

11. The 1973 Consumer Expenditure Surveys

12. Census of Institutions

13. Older American Resources and Services Instrument (OARS)

NOTES

I. LIST OF TABLES

II. SIZE, GROWTH AND DEMOGRAPHIC CHARACTERISTICS OF THE ELDERLY POPULATION

III. PREVALENCE OF DEPENDENCY

IV. ECONOMIC STATUS OF THE ELDERLY AND IMPAIRED

V. LONG-TERM CARE INSTITUTIONS AND USE OF LONG-TERM CARE INSTITUTIONS

VI. DETERMINANTS OF NURSING HOME USE

VII. CHARACTERISTICS OF NURSING HOME USERS

VIII. PROVIDERS

IX. INFORMAL CARE

X. SPENDING FOR LONG-TERM CARE SERVICES

XI. COST

APPENDIX A. SELECTED ADAPTED TASK ITEMS

APPENDIX B. USE, SOURCE, CHARGES AND EXPENDITURES FOR NON-LONG-TERM CARE SERVICES BY AGE

ASPE.hhs.gov

Source Book on Long-Term Care Data

Joel Cohen, Judith Feder, Carol Hamcke, Martha Krieger, Susan O’Loughlin, William Scanlon, Margaret Sulvetta, William Weissert, Sidney Katz, Denise Mahalak, Marilyn Moon, Joseph Papsidero, Beth Soldo and Allan Unger

The Urban Institute, Health Policy Center

July 29, 1983

TABLE OF CONTENTS

Structure and Content of the Report

1. The 1977 Health Interview Survey (HIS)

2. The 1979 Health Interview Survey (HIS)

3. The 1977 National Nursing Home Survey

4. Medicare/Medicaid Automated Certification System (MMACS)

5. National Medical Care Expenditure Survey (NMCES)

6. The 1976 Survey of Income and Education (SIE)

7. The Master Facility Inventory (MFI)

8. Framingham Functional Disability Survey

9. National Survey of the Aged Questionnaire (NSA) 1975

10. NIMH Survey of State and County Mental Hospitals

11. The 1973 Consumer Expenditure Surveys

12. Census of Institutions

13. Older American Resources and Services Instrument (OARS)

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