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New Survey Data Show Changing Nursing Home Market

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Press Release Date: May 28, 1998

A survey by HHS' Agency for Health Care Policy and Research (AHCPR) shows nearly one in five nursing homes offers care for residents with Alzheimer's disease or other special-need residents in specialized units.

Just over 19 percent of all nursing homes—3,240 facilities—had one or more special-needs nursing units as of January 1, 1996, with over half of these units reserved for residents with Alzheimer's disease or related dementia. Nearly 13 percent of nursing homes—2,130 homes—had units for residents with Alzheimer's. The average Alzheimer's unit housed approximately 34 beds.

"This should be useful information for families of persons with Alzheimer's disease and other forms of dementia," said AHCPR Administrator John M. Eisenberg, M.D. He added that because of the dramatic growth in the number of Americans over age 75, the current nursing home population is more frail than before and requires more specialized care. Almost half (47.7 percent) of all nursing home residents have some form of dementia.

Dr. Eisenberg said that while data for recent years are not strictly comparable, the number of beds in formal Alzheimer's units in 1996 appears to indicate a continuation of the recent pattern of 15- to 20-percent annual increases in the number of such beds. The remaining special care nursing units were for persons who need subacute care (such as those discharged from hospitals but not fully recovered), as well as persons who are on ventilators, need rehabilitation, or are terminally ill.

Based on initial data from the Agency's Medical Expenditure Panel Survey (MEPS), AHCPR also estimates that as of January 1, 1996, nearly 1.6 million persons were receiving care in approximately 16,800 nursing homes and almost 1.8 million certified or licensed beds were available. The occupancy rate for nursing homes as a whole was roughly 89 percent.

A comparison of the 1996 MEPS data with statistics for similar facilities from AHCPR's 1987 National Medical Expenditure Survey indicates that the number of nursing homes has increased by 20 percent in almost a decade and that the number of nursing home beds has risen 19 percent. Most of the increase in the number of nursing homes resulted from a rise in the number of for-profit nursing homes affiliated with a chain (up 20 percent) and from the growth of nonprofit independent nursing homes (up 48 percent). This comparison includes facilities certified by Medicaid and/or Medicare, or licensed by the state as nursing homes and providing 24-hour nursing care.

The survey also found that:

  • The 120,400 beds in special nursing units accounted for 6.9 percent of all nursing home beds.
  • Nearly two-thirds of nursing homes operated for profit, and about 68 percent of these for-profit homes—or 45 percent of all nursing homes—were part of a chain.
  • Nursing home residents experienced a high degree of functional difficulty. About 83 percent required assistance with three or more activities of daily living, such as bathing, eating, and using the toilet.
  • Nonprofit and government-owned nursing homes were more likely than for-profit nursing homes to provide or be affiliated with non-nursing units, such as personal care or independent living. In addition, nonprofit and government-owned nursing homes were more likely to be hospital-based than for-profit nursing homes.
  • Only 58 percent of nursing home residents had some type of advance directive, in the form of a living will, do-not-resuscitate order, do-not-hospitalize order, or other directive with regard to feeding, medication or treatment.

These estimates are based on Round 1 data for 1996 collected in the MEPS Nursing Home Component. AHCPR has released public use data files for these Round 1 data, and soon will publish detailed analyses of topics such as facility characteristics, special care units and resident characteristics. Later this year AHCPR will publish full-year nursing home data for 1996, and in 1999 will publish detailed analyses of specific topics, including functional health status of residents at selected points in time; residents' use of inpatient hospital and physician services and prescription medicines; and use, expenditures and sources of payment for nursing home care.

Free print copies of MEPS Highlights No. 2: Nursing Home Update—1996, (AHCPR Pub. No. 97-0025) are available from the AHCPR Publications Clearinghouse, P.O. Box 8547, Silver Spring, MD 20907, or 800-358-9295.

Other information from the Nursing Home Component is available in MEPS Research Findings No. 4 (AHCPR Pub. No. 98-0006). Select for online versions of Nursing Home Update—1996 and MEPS Research Findings No. 4.

Further information about MEPS, as well as the data files, is available through AHCPR's MEPS Web site at

For additional information, contact AHCPR Public Affairs: Karen Carp, (301) 427-1858 (; Salina V. Prasad, (301) 427-1864 (

The information on this page is archived and provided for reference purposes only.


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