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2004 National Nursing Home Survey

2004 National Nursing Home Survey. Annual AcademyHealth Research Meeting Robin E. Remsburg, APRN, BC Long-term Care Statistics Branch Division of Health Care Statistics National Center for Health Statistics. National Nursing Home Survey (NNHS).

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2004 National Nursing Home Survey

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  1. 2004 National Nursing Home Survey Annual AcademyHealth Research Meeting Robin E. Remsburg, APRN, BC Long-term Care Statistics Branch Division of Health Care Statistics National Center for Health Statistics

  2. National Nursing Home Survey (NNHS) • Component of the National Health Care Survey (NHCS) • Nationally representative sample survey of nursing homes • Collects information • Providers • Recipients of care • Conducted 7 times since 1973 (1973-74, 1977, 1985, 1995, 1997, 1999 and 2004)

  3. 2004 Redesign Process 1. Reviewed documents from expert meetings • Future Directions for Residential LTC Health Services Research (October 1999) • Future Directions for Community-based LTC Health Services Research (June 2000) • Institute of Medicine Report from the Committee on Improving Quality in LTC (2001). 2. Policy and Practice questions • Characteristics of nursing homes residents • Care and services provided by nursing homes • Cost/reimbursement • Quality/outcomes

  4. Process (cont.) 3. Identify data gaps -1999 National Nursing Home Survey (NNHS) -1997 Medicare Current Beneficiary Survey (MCBS) -CMS’ Minimum Data Set (MDS) -CMS’ Online Survey Certification and Reporting Survey (OSCAR) -1996 Medical Expenditures Survey Nursing Home Component (MEPS NHC) -1999 National Long-term Care Survey -National Longitudinal Study of Aging

  5. Conceptual Model StructureProcessOutcomes -Key Personnel -Immunization practices -ED/hospitalizations -Advance practice RNs -Mechanical Lifts -Pressure sores -Turnover -Permanent assignments -Falls -Benefits -Palliative care -Medications

  6. Features of the NNHS Redesign • Computer Assisted Personal Interview (CAPI) • New sample design • New content • Linkage to CMS’ Minimum Data Set • Expanded clinical content • Care episodes • Expanded sample • National Nursing Assistant Survey (NNAS)

  7. Content: Facility • Administrators, Medical Directors, & Directors of Nursing • Preparation • Years of experience • Tenure at the facility • Specialty certification • Nursing Staff • FTEs • RN mix • Specialty certification • New roles----MDS nurses, case managers, QI, infection control personnel • APNs • Entry-level wages • Recruitment/retention strategies • Benefits • Collective bargaining arrangements • Staff turnover and stability

  8. Content: Facility • Accreditation • Medical services • Electronic/computerized information systems • Recreation activities • Dining practices • Mechanical lifts • Immunization policies & practices • End-of-life practices (POLST, Last Acts) • Special care programs (e.g., wound, dementia)

  9. Content: Resident-MDS • Advance directives • Cognitive skills • Mood • Behavioral symptoms • ADLs • Continence • Accidents • Weight change • Nutritional therapy • Pressure ulcers • Restraints

  10. Content: Resident-New • Admission to a specialty unit (e.g., Alzheimer’s, hospice) • Receiving specialty services (e.g., Alzheimer’s, hospice) • Hospitalizations • ED visits • Pain assessment, management, relief • Medications • Recent drug adverse experiences • End-of-life care • Out of pocket charges

  11. 2004 NNHS • Data were collected through onsite interviews with knowledgeable facility staff who refer to medical and facility records • Results are weighted to create national estimates • 1,500 facilities sampled; 1,174 participated • 82% facility response rate • National probability sample survey • 2-stage stratified sample design • Nursing homes (facilities) • Residents, NAs • Licensed or certified; 3 or more beds • Participation is voluntary • Confidentiality protected by Section 308(d) of the Public Health Service Act

  12. National Nurse Assistant Survey (NNAS) • Reduces NNAS costs by utilizing a sub-sample of an existing sample frame and data collection methodology • Enhances response rates and reduces burden • Increases the analytical usefulness of NNAS and NNHS

  13. Plans for Dissemination • Data products • Public use data files • Reports, journal articles • Access data products • Downloadable from the Internet • Data files on CD-ROMS • Research Data Center • NCHS Office of Information Services • Telephone: 866-441-6247 (NCHS) • Fax: 301-458-4027 • Email: nchsquery@cdc.gov • To learn more--- • One way Listserv • www.cdc.gov/nchs/nnhs.htm • LTCSB 301-458-4747

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