Source Book on Long-Term Care Data

07/29/1983

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.


 

TABLE OF CONTENTS

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
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

  1. 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
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.
  1. Resident population as of March. Beginning 1975, excludes institutional population.
  2. Estimated total resident population as of July.
  3. Income for preceding year.
  4. Poverty status based on income in preceding year.
  5. Source: U.S. Bureau of Labor Statistics, Employment and Earnings, monthly.
  6. For 1960 and 1965, includes a small number of “spouse present” in group quarters.
  7. 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
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
  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
  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
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.

  1. Data revised using population controls from the 1970 census.
  2. Covers widows 16 years old and over. Source: U.S. Bureau of Labor Statistics.
  3. 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
  Alone   With
  Non-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
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
  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
  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
  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.
  1. 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.)
  2. 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.)
  3. 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.)
  4. 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
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
  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:
  1. Jette and Branch, 1981.
  2. Needs help from another person and/or special equipment.
  3. 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:
  1. Percent standard error of many of these estimates is quite large. See Table 21A.
  2. Includes those who need assistance in eating, continence, transferring, toileting, bathing and dressing.
  3. 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+
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:
  1. Percent standard error of many of these estimates is quite large See Table 21A.
  2. 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  
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  
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
  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
  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.
  1. 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
  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.
  1. 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)
  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
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
  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
  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
  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)*
  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
  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.
  1. “Other” relative means a relative other than wife or child. In most cases this will be a parent of the head or spouse.
  2. 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
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
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
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
  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
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
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.
  1. 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
  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.
  1. The increase in the rate of institutionalization due to the change in the age composition of the population 65 and over is computed as:

    formula composition = formula
    where formula
    and ui is the utilization rate for persons in the ith age interval (e.g., 65-69) in the base year (1950 or 1960).
    formula is the proportion of the 65+ population that is in the ith age interval in year tk.

  2. 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
1971 1973 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
  Toileting/Feeding     Bathing/Dressing  
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.
  1. Includes mental, disgestive, metabolic, blood, genitourinary, circulatory and skeletal disorders, cancer and injuries.
  2. 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
  Skilled      Intermediate      Skilled      Intermediate   
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
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.
  1. Disease group categories based on Eighth Revision International Classification of Diseases, Adapted for Use in the United States (ICDA).
  2. Only diagnoses of sufficient magnitude are noted.
  3. Includes residents who received no physician visits while in facility.
  4. 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
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.
  1. Unknowns were considered not dependent for the purpose of this index.
  2. Includes residents who were dependent in at least two functions but were not classified into any of these categories.
  3. Includes a small number of unknowns.

 

TABLE 61. Percentage of Nursing Home Residents by Age Within Diagnostic Categorya
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. Diagnostic categories are mutually exclusive. Persons without diagnoses (numbering 57,000) have been excluded.
  2. Subtotal, not included in calculation of total.

 

  TABLE 62. Percentage of Nursing Home Residents by Marital Status Within Diagnostic Categorya  
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. 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 Categorya  
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. 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 Categorya  
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. 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 Categorya  
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. 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 Categorya  
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. Diagnostic categories are mutually exclusive.

 

TABLE 67. Percentage of Nursing Home Residents by Ability to Communicate Within Diagnostic Categorya
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. 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 Categorya  
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. 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 Categorya
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. 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 Categorya  
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. 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 Problema Within Diagnostic Categoryb  
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. Residents may be included in more than one behavioral category. Persons without diagnoses (numbering 57,000) have been excluded.
  2. Diagnostic categories are mutually exclusive.

 

  TABLE 75. Percentage of Nursing Home Residents Receiving Medication for Mental Impairments Within Diagnostic Categorya  
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. 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 Categorya
    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:
  1. Chronic mental - persons with a mental condition (other than senility*) as the primary diagnosis.
  2. Chronic physical - persons with a physical condition as the primary diagnosis and no secondary mental diagnosis.
  3. Physical and mental - persons with a physical condition as the primary diagnosis and a secondary mental diagnosis other than senility.
  4. Senile - persons with senility as the primary diagnosis.
  5. 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.

  1. 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.
  1. New Patients are defined as those with stays less than 60 days.
  2. Includes patients with any support from Medicaid or other government or welfare.
  3. 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.
  1. New Patients are defined as those with stays less than 60 days.
  2. Intervals are defined by quartile (25th percentile, 50th percentile, etc.) values for all certified facilities.
  3. Includes patients with any support from Medicaid or other government assistance or welfare.
  4. 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.
  1. New Patients are defined as those with stays less than 60 days.
  2. Intervals are defined by quartile (25th percentile, 50th percentile, etc.) values for all certified facilities.
  3. Includes patients with any support from Medicaid or other government assistance or welfare.
  4. 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.
  1. New Patients are defined as those with stays less than 60 days.
  2. Intervals are defined by quartile (25th percentile, 50th percentile, etc.) values for all certified facilities.
  3. Includes patients with any support from Medicaid or other government assistance or welfare.
  4. 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.
  1. New Patients are defined as those with stays less than 60 days.
  2. Intervals are defined by quartile (25th percentile, 50th percentile, etc.) values for all certified facilities.
  3. Includes patients with any support from Medicaid or other government assistance or welfare.
  4. 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.
  1. New Patients are defined as those with stays less than 60 days.
  2. Includes patients with support from Medicaid or other government assistance or welfare.
  3. 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  
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.
  1. 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.
  1. Includes those who were dead at discharge or were discharged to other facilities but died shortly thereafter.
  2. 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.
  1. Total cases may vary due to missing cases and rounding.
  2. 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.
  3. Includes widowed, divorced, separated and never married.
  4. 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.
  5. 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+
  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
  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.
  1. 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
  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
  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.
  1. 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
  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)
 
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.
  1. Based on data from Census of Population
  2. 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.
  1. ICF means intermediate care facility.
  2. 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
  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
  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
  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
  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
  Total   Visit Charges
  Number   Per
1,000
  Enrollees   
  Number   Per
Person
  Served   
Per
1,000
  Enrollees   
  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.
  1. Numbers do not add to totals since each person may receive more than one type of visit.
  2. 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.
  1. 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.
  2. 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.
  1. Halfway houses for the emotionally disturbed included in this category for the first time accounting for some of the increase.
  2. 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.
  1. 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.
  2. 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
  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.
  1. 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) Statusa   Total Elderly  
Not in
  LTC Population  
In Long Term
  Care Population  
Panel A: ALL ELDERLY
% Kinlessb 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
% Kinlessb 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
% Kinlessb 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+
% Kinlessb 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
% Kinlessb 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
% Kinlessb 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 RACEc
WHITE
% Kinlessb 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
% Kinlessb 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.

  1. Long-Term Care Status distinguishes bedfast elderly and those with moderate to severe incapacities for self-care from all other elderly.
  2. Defined as elderly without a surviving spouse, children or siblings.
  3. 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
Who Do Not Have
  Frequent Contact with  
at Least Onea
Who Do Not
  Live Nearby at  
Least Oneb
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)
  1. Defined as not having seen at least one daughter within last week.
  2. 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 Contacta or Live Nearby at Least Oneb
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).
  1. Defined as not having seen at least one daughter within last week.
  2. 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
  Only Daughter     Only Sons   Both Sons
  and Daughters  
% Without Frequent Contact with at Least One Daughtera 41.8% -- 41.2%
% Without Frequent Contact with at Least One Sonb -- 43.7% 40.5%
% Not Living Nearby at Least One Daughtera 32.4% -- 33.4%
% Not Living Nearby at Least One Sonb -- 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).
  1. Defined as not having seen at least one child within last week.
  2. 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 Statusa
(Weighted Base Numbers in Parentheses)
ADL Service Use Patterns Number of Surviving Daughters Total
None One Two+
UNMARRIED ELDERLY
ADL Services Not Receivedb 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 Receivedb 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).
  1. Excludes the bedfast and those without any surviving children.
  2. 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.
  3. 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-Carea
(Weighted Base Numbers in Parentheses)
ADL Service Use Pattern Alone Type of Living Arrangement Total
Unmarried
  with Others  
Married
  with Spouseb  
ADL Services Not Receivedc 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).
  1. Excludes the bedfast.
  2. Includes those living with others as well as spouse.
  3. 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.
  4. 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 Statusa
(Weighted Base Numbers in Parentheses)
ADL Service Use Patterns Number of Surviving Daughters Total
None One Two+
UNMARRIED ELDERLY
ADL Services Not Receivedb 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 Receivedb 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).
  1. Excludes the bedfast and those without any surviving children.
  2. 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.
  3. 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-Carea
(Weighted Base Numbers in Parentheses)
IADL Service Use Pattern ADL Service Use Pattern
ADL Services Not Receivedb 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 Receivedc 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)
Totala 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).
  1. Excludes the bedfast.
  2. 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.
  3. 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.
  4. 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-Carea
(Weighted Base Numbers in Parentheses)
IADL Service Use Pattern Number of Surviving Children
None One or Two Three+ Total
IADL Services Not Receiveda 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).
  1. Excludes bedfast.
  2. 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.
  3. 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
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).
  1. 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
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.

  1. Expenditures for fiscal year 1979
  2. Expenditures for calendar year 1979.
  3. Nursing home ombudsman services -- $3,789.0 thousand.
  4. Residential care and treatment services.
  5. Expenditures for calendar year 1980.
  6. Includes services reported under the following categories: homemaker, chore, and home management.
  7. Includes access, community (other than legal), and in-facility services.
  8. 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
  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.

  1. 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.
  2. 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
  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.

  1. 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.
  2. 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
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.

  1. 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)
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.
  1. 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
  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.

  1. 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
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).
  1. 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.
  1. 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
  Amount   As Percent of
  Total Medicare Reimbursement  
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.
  1. 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.

  1. Personal care data include adult day care.
  2. 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.
  3. 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.
  4. Home health data include personal care.
  5. Personal care data for July 1 - June 30 1981.
  6. Personal care program began in FY80. Data are for one quarter only.
  7. Figure for personal care recipients is an estimate.
  8. 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
Legal Other Care
  Providing  
Senior
  Centers  
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
  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
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
   (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
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
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
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
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
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.

  1. State payment levels for the blind are $396.14 for individuals and $792.28 for couples.
  2. Does not include the disabled.
  3. 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.
  4. 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.
  5. 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.
  6. 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.
  1. 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

  1. For January 1982, Arizona spent $12,450 on 498 recipients in supervisory home care facilities.
  2. For December 1981, Nebraska had 2,320 recipients in non-medical facilities. Expenditures were not available.
  3. 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
  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
  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.
  1. 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
  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   $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
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
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
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.

  1. 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.
  2. Weighted by average daily census in states with more than one VAMC (Veteran Administration Medical Centers).
  3. Total expenditures were computed as: Statewide Average Daily Census x Average per Diem Cost x 365.
  4. $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.
  1. 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.
  2. Weighted by average daily census in states with more than one facility.
  3. Total expenditures were computed as: Statewide Average Daily Census x Average per Diem Cost x 365.
  4. $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

  1. Includes Section 202 conversions.
  2. Number of beds.
  3. Number of residential loans.
  4. The percentage of loans going to the elderly and handicapped has been estimated at about 20 percent.
  5. Number of loans.
  6. Number of loans and grants.

 

TABLE 173. Property Tax Relief Across States
State Homestead Exemption or Credit Circuit-Breaker Program
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  
General Municipalities may enact general exemption of up to $10,000
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  
Elderly with incomes below $8,000 $4,000, $10,000 if they live in an independent or county school district
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
65 or over An additional $1,500
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
Low-income elderly Those meeting specified criteria receive total exemption
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  
Elderly, disabled $5,000 for all property taxes
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
Totally blind $3,000
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
Veterans and surviving spouses $2,000 property tax exemption
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
Those with incomes of $5,000 or less An additional $1,000
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  
Elderly and disabled $15,000 of appraised value for school purposes. Minimum exemption of $3,000 for all local purposes
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  
Elderly with incomes of $14,000 or less Exemption from all excess levies
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.

  1. 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.
  1. 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.
  2. Weighted by total number of visits in states with more than one facility.
  3. 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).
  1. Total expenditures computed as: Average Daily Census x Average Per Diem Cost x 365.
  2. 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.
  1. 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.
  1. 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
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.

  1. State did not report SSI supplemental payments to nonmedical facilities in July 1975.
  2. SSI supplemental payments differ for the blind and/or disabled.
  3. 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
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
Family Private Health Insurance Medicare Medicaid Othera
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.
  1. 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
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 Servicesa: 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)
Family Private Health Insurance Medicare Medicaid Othera
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.
  1. Excludes charges for physician or other services billed separately from the hospital bill.
  2. 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)
Family Private Health Insurance Medicare Medicaid Otherb
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.
  1. 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
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
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
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)
Family Private Health Insurance Medicaid Othera
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.
  1. 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
Non $1 - 49 $50 - 99 $100 - 249 $250 or More
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)
Family Private Health Insurance Medicaid Othera
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.
  1. 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)
Family Private Health Insurance Othera
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.
  1. 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
None $1 - 24 $25 - 99 $100 or More
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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