Scientific Data DocumentationInventory of Long Term Care Places, 1986DSN: CC36.ILTCP86 ABSTRACTGeneral Information This material provides documentation for users of the micro-data tape of the Inventory of Long-Term Care Places (ILTCP) Survey conducted by the National Center for Health Statistics (NCHS) in cooperation with the National Center for Health Services Research (NCHSR), and Health Care Financing Administration (HCFA). Section I, "Description of the Inventory of Long-Term Care Places", includes information on the history of the ILTCP, the scope of the survey, data collection procedures, and editing procedures. Section II provides technical details of the tape (number of tracks, record length, etc.). Section III provides a detailed description of the contents of each data record, by location. Introduction This document is to be used with the 1986 ILTCP micro-data tape. This ILTCP data tape contains approximately 26,500 nursing and related-care homes and about 14,500 facilities for the mentally retarded. The total number of homes on this tape is approximately 41,000. History The NCHS in cooperation with HCFA, and the NCHSR employed the Bureau of the Census to conduct the 1986 ILTCP. The purpose of the survey was to provide a current sampling frame for two portions (nursing and related care homes, and facilities for the mentally retarded) of the Institutional Population Component of the 1987 National Medical Expenditure Survey. Construction of ILTCP File The file was constructed by the Long-Term Care Statistics Branch (LTCSB) of NCHS. The starting point for nursing and related-care homes was the final data tape from the 1982 National Master Facility Inventory (NMFI) plus new facilities added through April of 1984. The starting point for facilities for the mentally retarded was a 1982 study by the University of Minnesota's Center for Residential and Community Services (CRCS). There were approximately 26,000 nursing homes, etc. and 15,000 mental retardation (MR) facilities on these two original files. To update the files, letters were sent to over 200 State and national agencies in July of 1985 asking them to send LTCSB any and all listings that they maintained for nursing and related- care homes, and MR facilities. In September, the LTCSB sent follow-up letters to those agencies that had not responded. These follow-up letters would very often name the specific types of facilities that each agency was known to license or regulate. Additional contacts were made to nonresponding agencies during October, November, and December. The Minnesota CRCS file included places that were obtained through contacts with local area MR sources. Because of extremely tight time restraints, LTCSB was unable to contact all of these local area sources. The only ones contacted were those sources that were located in States where the number of MR facilities reported by LTCSB sources was significantly lower than the number reported by CRCS. As the listings and directories of facilities were received, they were manually matched against the 26,000 nursing homes or 15,000 MR facilities. Any facility that could not be found on these two original files was considered "new" and was assigned a unique ID number. This number along with the new facility's name and address were added to the appropriate nursing home or MR file. While working with the CRCS file, almost 1,500 places were found with no names or addresses; they were merely given numbers (e.g., Home #78). The reason for this, apparently, was that certain States wanted to keep the location of these types of places confidential. To do this, the data was collected by the State and given to CRCS with all identifiers removed. Without addresses, these places were useless, so they were removed from the MR file. (We believe that many of these 1,500 places were picked up in the listings obtained from our State sources and therefore added back onto the file as new MR facilities.) Clean-up of File After adding the new facilities, a matching process was begun for removing duplicates from within and between the two files. The nursing home file was sorted three different ways: 1) by State, first 10 positions of city, and first 10 positions of address; 2) by State, first 10 positions of city, and first 10 positions of name; 3) by State, zip, and first 10 positions of address. (In choosing only the first 10 positions of the name, address, and city fields, more matches were created and more duplicates could be caught and removed.) The same procedures were repeated with the MR file. The nursing home and MR files were then merged and the above procedures were repeated once again. If there were any doubts as to whether two places were duplicates, both were kept on the file. Whatever duplicates remained on the file would, in theory, be reported by the respondents (per instructions on the questionnaire). Mailout The first questionnaire mailout was begun by the Bureau of the Census on February 14, 1986, and this was followed by a reminder letter a week later. On March 14, a second questionnaire mailout was sent to all nonresponding facilities, and on April 4 a third mailout was sent to the remaining nonrespondents. By the end of the third mailout, nearly 3,300 post master returns (PMRs) had accumulated. These were reviewed to determine which ones would or would not be eligible for the telephone and personal interview follow-up. As a result of this review, approximately 1,400 cases were declared eligible for follow-up, while about 1,900 were declared ineligible. The 1,900 rejects fell into three main categories: (1) small residential and family care homes, (2) unknown types of facilities from New Jersey, and (3) places with incomplete names and addresses. The first group, with names like "Jane Smith's Guest Home" and "Douglas Family Home", had more than likely gone out-of-business. More than 600 of these were located in California and Michigan. These two States together had more than 8,500 of these small residential care facilities on the 1982 NMFI file, and virtually all of them were retained on the ILTCP file. (Only the duplicates would have been removed). Experience has shown that these types of places are constantly going in and out-of- business. After a four year interval of not being contacted, it is not surprising that 600 of the 8,500 showed up as PMR's. The fact that the post office could not locate them even with complete addresses led to the decision to treat them as out-of- business and not subject to field follow-up. The second group consisted of facilities that were originally obtained from New Jersey's Bureau of Rooming and Boarding House Standards. Their listing included everything from board and care facilities (which were in-scope) to rooming houses and dormitories (which were out-of-scope). While each facility had a classification code, a sizeable number of them had been classified as unknown (because they had not yet been visited and classified). To avoid losing the board and care places in this group, a decision was made to include all the unknowns and remove the out-of-scope during the survey. Approximately 350 of these unknown facilities were found among the PMR's and eliminated from the field follow-up. The third group consisted of places that simply had inadequate and undeliverable names and addresses (e.g., "Resident, Fairfax Street, Putnam, CT 06260" and "Group Home, Marietta, GA 30060"). The field follow-up was completed in July and the final overall response rate was 96 percent. Past NMFI Surveys The inclusion of facilities for the mentally retarded in the 1986 ILTCP represented the first time since the 1976 NMFI that such places were surveyed. All previous NMFI Surveys (1967 1/, 1969 2/, 1971 3/ 1973 4/, 1976 5/, 1978 6/, 1980 7/, and 1982 8/) included nursing and related-care homes. Scope of the Survey This tape contains two broad categories of facilities - (1) nursing and related-care homes, and (2) facilities for the mentally retarded. The first category includes skilled nursing facilities (SNF's), intermediate care facilities (ICF's), licensed but uncertified nursing homes, and residential care facilities (e.g., homes for the aged, personal care homes, board and care homes). The tape includes approximately 26,500 of these nursing and related-care homes. Positions 131-132 on the tape contain the letters "NH" to identify these homes, and positions 133 subclassifies the homes into either "N" for nursing home, "R" for residential care facility and "U" if the information reported did not permit a distinct classification of either "N" or "R". To determine if an 'NH' is also a SNF or ICF you need to check for the existence of SNF beds (positions 156-159 for Medicare SNF, positions 160-163 for Medicaid SNF), and ICF beds (positions 164-167). NCHS classifies any nursing home with SNF beds as a SNF, and any nursing home with ICF beds but no SNF beds as an ICF. Hospital-based nursing homes, which can be either SNF or ICF, can be identified by an "H" that will appear in position 190 for these places only. The second category, facilities for the mentally retarded, includes intermediate care facilities for the mentally retarded (ICF-MR) and all other facilities for the mentally retarded. Positions 131-132 contain "MR" to identify these homes, and position 133 subclassified these into either "I" for ICF-MR's or "R" for residential (all other MR). Positions 141-155 give additional descriptions of each facility. Since respondents were told to mark all that apply, those facilities that provided multiple levels of service and those that served both the elderly and the mentally retarded can be identified here (every category that the respondent checked will have a "1", all categories not marked will have a "0"). Editing All nonresponding facilities were removed from this file. Also removed were facilities that provided day care only, outpatient care only, or served out-of-scope population (e.g., only served blind or deaf, alcoholics, drug abusers, and unwed mothers). Extensive work was done to unduplicate the file, but, inevitably, some duplicates undoubtedly still remain. However, if you spot what you think are duplicate facilities, do not remove any until you have examined them thoroughly. (Very often two places with the same address are not duplicates -they merely have the same mailing address.) If this happens, check the name field to see if they are labelled home #1 and home #2, or home A and home B, etc. Compare also the set-up beds (positions 127-130), because sometimes one address will have two buildings, one for nursing care residents and one for residential care residents. When this occurs the number of beds reported for each building will usually be quite different - a strong indication they are not duplicates. The facility classification codes in positions 131-133 were created by using all available information from the questionnaires. Numerous matrices were used in order to place each facility into a category. Therefore, the facility classification codes will not always appear to coincide with the facility description in positions 141-155. Edits were conducted to correct inconsistencies between data items. For missing items, every attempt was made to impute data from existing information, but when this was not possible, 1982 data was substituted when it was available.RECORD LAYOUT Introduction Tape Record Format This section consists of a detailed breakdown of each tape record, providing a brief description of each item of data included in the records. The data are arranged sequentially according to their physical location on the tape record. Unless otherwise stated in the Item Description, the data are derived from the ILTCP survey form.Tape Positions 1-143 Name Position Format Item Description and Codes Identification 1-9 X(9) NCHS unique ID number Facility 10-55 x(46) Facility name name (left justified and blank filled). Street 56-91 x(36) Street or mailing address Address (left justified and blank filled). City 92-109 x(18) City (left justified and blank filled). State 110-111 x(2) State abbreviation Zip Code 112-116 9(5) Zip code of the facility Telephone 117-126 9(10) Area code and telephone Number number (if reported). Total beds 127-130 9(4) Total number of set-up beds Type of 131-133 x(3) NHN = Nursing care facility code NHB = Board & Care NUU = Unable to classify MRI = ICF-MR facility MRB = Board & Care (Nursing Home = 'NH' Mental Retardation = 'MR') Type of 134 9(1) Type of ownership code: ownership 1 = for Profit 2 = Nonprofit 3 = Federal Government 4 = State/Local Government Age group 135-138 9(4) Age group served 135 9(1) under 18 1 = reported 2 = not reported 136 9(1) 18-20 1 = reported 2 = not reported 137 9(1) 21-64 1 = reported 2 = not reported 138 9(1) 65+ 1 = reported 2 = not reported Types of 139-140 9(2) Types of persons served persons primarily or exclusively: served 01 = Mentally ill only 02 = Mentally retarded or development disabled only 03 = Mentally retarded or mentally ill 04 = Other neurologically or physically handicapped 05 = Blind or deaf 06 = Unwed mothers 07 = Alcoholics or drug abusers 08 = Orphans or other dependent children 09 = Terminally ill 10 = Some other special group (specify) 00 = Does not serve one special group primarily or exclusively Type of (141-155) 9 (15) Description of facility facility (mark all that apply) 141 9 (1) A skilled nursing facility certified under either Medicare or Medicaid 1 = this facility type was marked 2 = this facility type was not marked 142 9(1) An intermediate care facility (ICF) certified under Medicaid 1 = this facility type was marked 2 = this facility type was not marked 143 9(1) An intermediate care facility certified by Medicaid for the mentally retarded (ICF-MR) 1 = this facility type was marked 2 = this facility type was not marked Tape Positions 144-167 144 9(1) A licensed but not certified nursing home 1 = this facility type was marked 2 = this facility type was not marked 145 9(1) A long-term care wing/unit of a licensed hospital 1 = this facility type was marked 2 = this facility type was not marked 146 9(1) A nursing care unit of a retirement center 1 = this facility type was marked 2 = this facility type was not marked 147 9(1) A sheltered or custodial care home, including home for the aged, adult foster care home, board and care home 1 = this facility type was marked 2 = this facility type was not marked 148 9(1) Some other kind of nursing or personal care home 1 = this facility type was marked 2 = this facility type was not marked 149 9(1) A foster home for the mentally retarded/ developmentally disabled 1 = this facility type was marked 2 = this facility type was not marked 150 9(1) A group residence for the mentally retarded/ developmentally disabled 1 = this facility type was marked 2 = this facility type was not marked 151 9(1) A semi-independent living program for the mentally retarded/developmentally disabled 1 = this facility type was marked 2 = this facility type was not marked 152 9(1) A State institution for the mentally retarded/ developmentally disabled 1 = this facility type was marked 2 = this facility type was not marked 153 9(1) Some other kind of place for the mentally retarded/developmentally disabled 1 = this facility type was marked 2 = this facility type was not marked 154 9(1) Day care facility or outpatient facility only 1 = this facility type was marked 2 = this facility type was not marked 155 9(1) None of the above 1 = this facility type was marked 2 = this facility type was not marked Medicare 156-159 9(4) Number of beds certified skilled (SNF) by Medicare as skilled beds beds Medicaid 160-163 9(4) Number of beds certified skilled (SNF) by Medicaid as skilled beds Medicaid 164-167 9(4) Number of beds certified intermediate by Medicaid as (ICF) beds intermediate care beds Tape Positions 168-190 Medicaid 168-171 9(4) Number of beds certified intermediate by Medicaid as (ICF-MR) beds intermediate care beds in a retarded/ developmentally disabled (MR) Admissions 172-175 9(4) Number of residents admitted to homes in 1985. These data have not been edited. There tends to be an overcount of admissions reported for homes that are part of another health facility. For example, when asking for admissions for the nursing care unit, admissions reported included not only the count for the nursing care unit, but also a count for the health facility which the nursing care unit is attached to. Facility 176 9(1) In operation all of 1985 status 1 = yes 2 = no Months in 177-178 9(2) Number of months in operation operation if less than a year Total 179-182 9(4) Number of current residents residents in facility last night Edit flags 183-189 9(7) (A blank in these edit fields means no imputations were made to the field). 183 9(1) Edit flag for ownership 8 = used 1982 data if available 1 = imputed a '1' for all other imputations 184 9(1) Edit flag for set-up beds 8 = Used certified beds, residents, or 1982 data 185 9(1) Edit flag for SNF Medicare beds 8 = Used 1982 data 1 = Rep1aced blanks with zeros 186 9(1) Edit flag for SNF Medicaid beds 8 = Used 1982 data 1 = Replaced blanks with zeros 187 9(1) Edit flag for ICF beds 8 = Used 1982 data 1 = Replaced blanks with zeros 188 9(1) Edit flag for ICF-MR beds 1 = replaced blanks with zeros 189 9 1 Edit flag for residents 3 = used sum of age groups if available Hospital-based 190 X(1) A nursing home that is nursing homes attached to nursing homes a hospital H = hospital-based nursing homes Filler 191-200 X(10) BlanksREFERENCES 1. National Center for Health Statistics: Inpatient health facilities as reported from the 1967 MFI Survey, by A. Sirrocco. Vital and Health Statistics. Series 14, No. 4. DHEW Pub. No. (HSM) 72-1065. Public Health Services and Mental Health Administration. Washington. U.S. Government Printing Office, June 1972. 2. National Center for Health Statistics: Inpatient health facilities as reported from the 1969 MFI Survey, by A. Sirrocco. Vital and Health Statistics. Series 14, No. h. DHEW Pub. No. (HSM) 73-1801. Health Services and Mental Health Administration. Washington. U.S. Government Printing Office, Dec. '972. 3. National Center for Health Statistics: Inpatient health facilities as reported from the 1971 MFI Survey, by A. Sirrocco. Vital and Health Statistics. Series 14, No. 6. DHEW Pub. No. (HSM) 74-1807. Health Services and Mental Health Administration. Washington. U.S. Government Printing Office, Mar. l974. 4. National Center for Health Statistics: Inpatient health facilities as reported from the 1973 MFI Survey, by A. Sirrocco. Vital and Health Statistics. Series 14, No. 16. DHEW Pub. No. (HRA 76-1811. Health Resources Administration. Washington. U.S. Government Printing Office, May 1976. 5. National Center for Health Statistics: Inpatient health facilities as reported from the 1976 MI Survey, by J. F. Sutton and A. Sirrocco. Vital and Health Statistics. Series 14, No. 23. DHEW Pub. No. (PHS) 80-1818. Public Health Service. Washington. U.S. Government Printing Office, Jan. 1980. 6. National Center for Health Statistics: Inpatient health facilities as reported from the 1978 MFI Survey, by G. Strahan. Vital and Health Statistics. Series 14, No. 24. DHHS Pub. No. (PAS) 81-1819. Office of Health Resources Statistics and Technology. Hyattsville, Md. U.S. Government Printing Office. Mar. 1981. 7. National Center for Health Statistics: Nursing and related- care homes as reported from 1980 NMFI Survey, by A. Sirrocco. Vital and Health Statistics. Series 14, No. 29. DHHS Pub. No. (PHS) 84-1824. Public Health Service. Washington. U.S. Government Printing office, Dec. 1983. 8. National Center for Health Statistics: Nursing and related- care homes as reported from the 1982 NMFI Survey, by D. Roper. Vital and Health Statistics. Series 14, No. 32. DHHS Pub. No. (PHS) 86-1824. Public Health Service. Washington. U.S. Government Printing Office, Sept. 1986.
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