N C H S - N N H S - nnhs 2004

What is the National Nursing Home Survey?
The 2004 National Nursing Home Survey (NNHS) is the latest in a series of surveys on this important segment of the American health care system. This survey includes the first-ever nationwide survey of nursing assistants, the group of health care workers who provides the majority of direct care to the country’s 1.6 million nursing home residents.

Like the previous surveys periodically conducted since 1973 and most recently in 1999, the 2004 NNHS uses a national probability sample of nursing homes to collect data on facility characteristics (including information about staffing) and their residents. Based on interviews with the administrators and staff, we collect data on the nursing facilities. This includes bed size, ownership, staffing, number of residents, certification status, services provided, and basic charges. We also collect data on residents: demographic characteristics, functional and health status, diagnoses, services received, medications, and sources of payment.

Why should my nursing facility participate?
The NNHS is a large national study that, because of its size and design, can provide information representative of all nursing homes in the United States. Because the NNHS is a periodic survey, the results can be used to track changes in nursing homes taking place over time.

Your participation in the NNHS is important because without your involvement, your nursing facility and other facilities like yours will not be represented in the national description of nursing homes. Your facility was randomly chosen to represent not only your facility but also other comparably sized facilities located in your geographic region. Your participation will result in more reliable data collection and will permit researchers, policy makers, and the nursing home industry to assess the adequacy of current nursing home care and future long-term care needs. Failure to participate in the survey lessens the accuracy of data.

How are nursing facilities selected?
All nursing homes included in this survey have at least three beds and are either certified by Medicare or Medicaid or have a State license to operate as a nursing home. A representative sample of nursing homes was selected from a total of about 18,000 nursing home facilities in the United States. The 2004 survey sample consists of about 1,500 facilities throughout the United States and up to 12 current residents from each facility. The nursing homes selected to participate were determined by using systematic sampling with probability proportional to bed size.

How do I know this is a legitimate survey?
The National Nursing Home Survey (NNHS) has a long history. It has been in existence since the 1970s with periodic national surveys since that time. The NNHS began as a series of ad hoc surveys conducted by the National Center for Health Statistics (NCHS) in the early 1960s. These surveys collected statistics from long-stay hospitals and resident care institutions such as nursing and convalescent homes. The goal of the early surveys was to objectively evaluate the health status of residents and patients and to determine whether the available facilities and staff were sufficient to meet care needs. Today, nursing facilities continue to provide much needed long-term care services to a large segment of the country’s disabled and elderly population. As the nation’s total population of older adults grows and the average lifespan continues to increase, we need to continue to assess the availability and adequacy of these services.

For more information, call our toll-free 800 number, 1-800-937-8281, to find out more about the National Nursing Home Survey. You can also request to speak with representatives from the Federal agencies that sponsor the survey.

Is information given confidential?
The NNHS is authorized by Congress in Section 306 of the Public Health Service Act (42 USC 242K). In accordance with Section 308(d) (42 U.S.C. 242m) of the Public Health Service Act, no information collected in this survey may be used for any purpose other than the purpose for which it is collected. Such information may not be published or released in any form if the individual or establishment is identifiable unless the individual or establishment has consented to such release. The information you and your staff supply will be used solely for statistical research and reporting purposes. If any federal employee or contractor gives out confidential information not authorized by law, he or she can be fired, fined, and/or imprisoned.

Does the HIPAA Privacy Rule allow my facility to participate in this survey?
Yes. The Privacy Rule permits you to make disclosures of protected health information without patient authorization for public health purposes and for research that has been approved by an Institutional Review Board (IRB). This survey meets both of those criteria. Protected health information includes all medical records and other individually identifiable information used or disclosed by an entity subject to the Privacy Rule. This would include directly identifiable information such as patient names and social security numbers, in addition to other information that could be used to identify an individual.

Also, NCHS' Privacy and Data Release Policies and Current Legislative Authorities Web sites provide required information for you to verify that you are allowed to disclose to NCHS/CDC the information requested by the survey. The Web sites include information on the authority under which NCHS is collecting these data and that the data being collected are the minimum information necessary.

Your facility must keep track of disclosures made for this survey. The interviewer will give you a disclosure form for each resident, as required by law, which contains the disclosures made as part of this survey.

What is involved in participating?
A representative from the contractor conducting the survey will contact you for an appointment. An interviewer will then visit your nursing facility at a time that is most convenient to you. Information is collected primarily by personal interview with administrators and their staff. The survey collects information on facility bed size, ownership, number of residents, certification status, services provided, and basic charges. We will also collect resident data on demographic characteristics, functional and health status, diagnoses, services received, medications, and source of payment. Staff is asked to refer to residents’ medical records to provide information on health and functional status. Residents will not be contacted at any time.

In about half of the sampled nursing home facilities, we will select a sample of up to eight nursing assistants who provide residents with assistance in activities of daily living (ADLs) (eating, transferring, toileting, dressing, and bathing) for a voluntary off-site telephone interview. All information collected is held in the strictest confidence and will be used to prepare statistical summaries only.

Who can I contact if I have additional questions?
You can call our toll-free number, 1-800-937-8281, to talk with a survey representative about the National Nursing Home Survey.

If you have any further questions or comments related to participating in this survey, please contact Robin Remsburg at:

National Center for Health Statistics
Long-term Care Statistics Branch
3311 Toledo Road Room 3431
Hyattsville, Maryland 20782
Phone: 301-458-4416
Fax: 301-458-4693
Email: rqr3@cdc.gov