National Nursing Home Survey

Welcome NNHS Participants

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Approximately 1,500 nursing homes will be selected to participate in an important national health care survey. Between August and December 2004, the National Center for Health Statistics, a part of the Centers for Disease Control and Prevention, will conduct the National Nursing Home Survey (NNHS). The NNHS is a nationally representative sample survey of nursing homes, their residents, and staff. Data from the NNHS have been used to:

  • track changes in nursing home use among the post acute care population
  • identify changes in nursing home services resulting from reform legislation (i.e, OBRA) enacted in 1987
  • estimate lifetime nursing home use among older adults.

As the population of older adults is projected to double in the next 30 years, need for nursing assistants in long-term care also is projected to grow. In 2004, NCHS will conduct the first national survey of nursing assistants to provide much needed information on this long-term care workforce. About half of the nursing facilities selected to participate in the NNHS will be eligible for the National Nursing Assistant Survey (NNAS). This supplemental survey will include a nationally representative sample of nursing assistants who work in nursing facilities and provide residents with assistance in activities of daily living (ADLs).

Information for NNHS Participants

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.

Industry associations, including the American Health Care Association [PDF – 516 KB], the American Association of Homes and Services for the Aging [PDF – 494 KB], and the American College of Health Care Administrators [PDF – 395 KB] support our survey as well.

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 [PDF – 243 KB] 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 [PDF – 8 KB] 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

Information for NNAS Participants

Up to eight nursing assistants from about half of the facilities participating in the National Nursing Home Survey (NNHS) will be selected to take part in a new national survey of nursing assistants. The National Nursing Assistant Survey (NNAS) will help the nursing home industry develop more effective ways to recruit, train, and retain nursing assistants.

What is the National Nursing Assistant Survey?

The National Nursing Assistant Survey (NNAS) is the first national study of nursing assistants working in nursing facilities in the United States. The U.S. Department of Health and Human Services is sponsoring the study. About 6,000 nursing assistants will be chosen for the NNAS from about 800 nursing homes across the country. The NNAS will look at the important role of nursing assistants in providing long-term care services for the growing elderly and chronically ill population.

The NNAS, part of the National Nursing Home Survey, will provide new information needed to recruit, retain, and expand paraprofessional long-term care workforce. We will conduct this first national survey of nursing assistants as a telephone interview with a sample of workers who provide nursing home residents with assistance in activities of daily living (ADLs) (eating, transferring, toileting, dressing and bathing). The survey includes collecting information on whether workers plan to continue working in their present positions and what factors affect their decisions, including job satisfaction, nature of the work environment, training, advancement opportunities, benefits, working conditions, and personal or family demands. The survey will help identify nursing assistants priorities, ways to meet those priorities, and how to prevent staffing shortages in the future.

Why should I participate?

Our Nation is facing a major shortage of nursing assistants who provide for the long-term care needs of residents in nursing homes and other places. As “baby boomers” age, the need for long-term care will increase. The need for nursing assistants will also grow. But today, many nursing assistants are leaving and too few are entering the field.

We need to find out from nursing assistants about their work experiences and the challenges they face. This information will guide changes in policy and practice that can help attract new people to become nursing assistants. Without the voice of nursing assistants to help inform public policy and new programs, it is likely the shortage of nursing assistants will increase.

Therefore, your participation in the National Nursing Assistant Survey is important; without your involvement, nursing assistants like you will not be included in the national description of nursing assistants who work in U.S. nursing homes.

Nursing assistants like you provide care to more than 1.6 million elderly and chronically ill people who live in approximately 18,000 nursing facilities across the United States. We need to keep experienced, dedicated nursing assistants in the field and find new ways to attract more nursing assistants for the future.

Some of the important goals of the NNAS are to provide a better understanding of:

  • What it is like to be a nursing assistant
  • Ways to improve the nursing assistant job
  • How to keep experienced people working in this important health care field
  • Ways to encourage others to become nursing assistants

Several national organizations support the NNAS — including the National Association of Geriatric Nursing Assistants [PDF – 141 KB], the Paraprofessional Healthcare Institute [PDF – 77 KB] and the National Network of Career Nursing Assistants [PDF – 20 KB].

How was I selected?

Nursing assistants are selected from about 800 nursing facilities participating in the 2004 National Nursing Home Survey. About 6,000 nursing assistants will be chosen throughout the United States for this survey. Nursing assistants are randomly selected from a list of all nursing assistants employed by the nursing facilities participating in the NNAS. Up to eight nursing assistants are selected from each facility. The nursing assistants selected from your facility represent your facility as well as other facilities of similar size 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 understand the current and future job-related concerns of nursing assistants who work in nursing homes. Failure to participate in the survey lessens the accuracy of the information collected.

How do I know that the NNAS is a legitamate survey?

The National Nursing Assistant Survey is part of the National Nursing Home Survey (NNHS), which has a long history. The NNHS was first conducted in the 1970s and has been conducted periodically since that time. The 2004 survey was redesigned and expanded to meet the needs of researchers and health care planners who are working to ensure that quality long-term care will be available for the Nation’s increasing senior population.

You can call our toll-free number, 1-800-937-8281, for more information about the National Nursing Assistant Survey.

Is my information kept confidential?

The identity of all survey participants is kept strictly confidential. All information collected in this survey will be held in strict confidence according to law {section 308 (d) of the Public Service Act (42 United States Code 242m)}. By law, information that would identify you to anyone not connected with the survey cannot be released.

All information collected in this survey will be kept private, including your name and the facility where you work. No information will be given to your supervisor or facility. And your job or certification will not be affected.

We assign code numbers in place of names or other facts that could identify you. None of your answers will be reported in any way that identifies you personally. The survey results will only be released in summary tables and reports. No information collected in this survey may be used for any other purpose than the purpose for which it was collected. If any federal employee or contractor gives out confidential information not authorized by law, he or she can be fired and fined and/or imprisoned.

What is involved in participating?

After you are selected to participate in the survey, you will receive a package of information from the nursing home where you work. The package contains information about the survey and a token of appreciation for taking time to learn about the survey. To participate in the survey, please fill in your name and contact information on the postcard and mail it to us in the postage paid envelope or call the toll free number on the postcard to schedule a convenient time to participate in the survey.

After we hear from you, an interviewer will call you to conduct the telephone interview. The interview can be done either in English or Spanish. Most importantly, the interview will be scheduled during nonworking hours, at a time that is convenient for you.

The interview will take about 30 to 40 minutes and will include questions about your:

  • Training
  • Job history
  • Supervision
  • Wages and benefits
  • Other work-related issues

Examples of questions:

  • How did you learn about being a nursing assistant as a possible job?
  • If you had to decide whether to become a nursing assistant again, would you?
  • Aside from lifts, is there any other equipment or devices that your facility does not have or does not have enough of that would make your job safer?
  • Does your current employer offer you paid sick leave?

After completing the interview, you will receive $30 in appreciation for participating in this important survey.

Who can I contact if I have questions?

To discuss any part of the National Nursing Assistant Survey or to learn more about it, you can call our toll-free number, 1-800-937-8281. You can also ask to speak with representatives from the Federal agencies that sponsor this survey.