About the National Nursing Home Survey

2004 National Nursing Home Survey Description

The 2004 National Nursing Home Survey (NNHS) is one in a continuing series of nationally representative sample surveys of United States nursing homes, their services, their staff, and their residents. The NNHS was first conducted in 1973-1974 and repeated in 1977, 1985, 1995, 1997, 1999, and most recently in 2004. Although each survey has emphasized different topics, they all provide basic information about nursing homes, the services provided, their staff, and their residents. The nursing home survey was preceded by a series of surveys from 1963 through 1969, called the Residents Places Surveys.

The 2004 NNHS, conducted between August and December of 2004, was reintroduced into the field after a five-year break, during which time the survey was redesigned and expanded to collect many new data items. All nursing homes that participated in the NNHS had at least three beds and were either certified (by Medicare or Medicaid) or had a state license to operate as a nursing home. The redesigned survey was administered using a computer-assisted personal interviewing (CAPI) system and included a supplemental survey of nursing assistants employed by nursing homes, the National Nursing Assistant Survey (NNAS), which was sponsored by the Office of the Assistant Secretary for Planning and Evaluation (APSE). Nursing assistants were considered eligible to participate in the survey if they 1) provided assistance with activities of daily living (ADLs); 2) were paid to provide those services; 3) were certified (or in the process of certification) to provide Medicare/Medicaid reimbursable services; 4) worked at least 16 hours per week; and 5) were employees of the nursing home and not contract employees. A sample of up to eight nursing assistants was selected from about half of the nursing home sample at the time of the facility interview. The NNAS was administered after the nursing home visit, using a computer-assisted telephone interview (CATI) system.

The National Nursing Home Survey provides information on nursing homes from two perspectives-that of the provider of services and that of the recipient of care. Data about the facilities include characteristics such as size, ownership, Medicare/Medicaid certification, services provided and specialty programs offered, and charges. For recipients, data were obtained on demographic characteristics, health status and medications taken, services received, and sources of payment.

Data for the survey were obtained through personal interviews with facility administrators and designated staff who used administrative records to answer questions about the facilities, staff, services and programs, and medical records to answer questions about the residents.

The total number of nursing home facilities that participated in the National Nursing Home Survey is 1,174 and the total number of nursing assistants that participated in the National Nursing Assistant Survey is 3,017.