This study uses merged facility and resident data from the 2010 NSRCF, which was sponsored by the U.S. Department of Health and Human Services (the National Center for Health Statistics, the Office of the Assistant Secretary for Planning and Evaluation, the Agency for Healthcare Research and Quality), the U.S. Department of Veterans Affairs, and other federal agencies (Moss, Harris-Kojetin, & Sengupta, 2011). The NSRCF, the first nationally representative survey of United States residential care providers, collected a broad array of data on facilities and residents. To be eligible for the survey, facilities had to be licensed, registered, listed, certified, or otherwise regulated by a state; have four or more beds; and have at least one resident currently living in the facility. The facilities had to provide room and at least two meals a day, round-the-clock onsite supervision, and help with ADLs (e.g., bathing, eating, and dressing) or health-related services (e.g., medication management). Facilities also had to serve primarily an adult population. Facilities that served exclusively people with severe mental illness or people with intellectual and developmental disabilities were excluded because, besides serving a different population than other RCFs, these facilities are believed to offer a different set of services than the facilities included in the NSRCF. As a result, the survey sample excludes a large proportion of RCF residents who are younger than 65 years of age. Because of the varied regulatory framework across states, sampled facilities included those regulated under many names, including assisted living residences, board and care homes, congregate care facilities, enriched housing programs, homes for the aged, and personal care homes.
The NSRCF was conducted between March and November 2010 using a two-stage probability sampling design in which RCFs were sampled first and then, depending on facility size, 3-6 current residents from each facility were sampled. In-person interviews were conducted with facility directors and designated staff members. Information on individual residents was collected from staff knowledgeable about the residents; no interviews were conducted with residents.
Data were collected on 2,302 facilities and 8,094 current residents. The facility weighted response rate was 81 percent and the resident weighted response rate was 99 percent. For this study, we merged the NSRCF facility and resident files so that resident-level analysis could be conducted, including resident and facility characteristics that are not included in the public use file. The merge and data analyses were conducted at the Research Data Center of the National Center for Health Statistics, with the help of its staff. The Research Data Center follows special procedures to protect the confidentiality of respondent facilities and residents.
Comparison data on nursing home resident medical conditions and functional status were obtained from publicly available Centers for Medicare and Medicaid Services (CMS) information from the Minimum Data Set. The Minimum Data Set routinely collects a large amount of functional status measures on all nursing home residents, regardless of source of payment. CMS publishes online Minimum Data Set Active Resident Information Reports, from which we selected data from the third quarter of 2010 to match the time period for the data collection for the NSRCF (CMS, 2011).