The National Nursing Home Survey: 2004 overview.

Objective: This report presents estimates for U.S. nursing homes, their current residents, and staff, based on results from the 2004 National Nursing Home Survey (NNHS). Facility data are summarized by facility characteristics and include new data items on special care units and programs, formal contracts with agencies and providers, end-of-life care programs, and electronic information systems. Current residents are presented by characteristics such as demographics, health and functional status, and services received, with new data items on advance directives, falls, use of restraints, hospitalizations, pain management, and medications. The discussion highlights key survey findings, including differences in selected national estimates between the 2004 NNHS and the 1999 survey.

Methods: The 2004 NNHS consisted of a two-stage design with a probability sample of 1,500 nursing facilities in the first stage and up to 12 current residents from each facility in the second stage. This nationally representative sample survey was conducted by the Centers for Disease Control and Prevention's National Center for Health Statistics from August 2004 through January 2005.

Results: In 2004, an estimated 1.5 million current residents received nursing home care in 16,100 facilities, the majority of which were proprietary (61.5%) and were located in the Midwest and in the South. Most full-time equivalent employees of the facilities were nursing staff. Most current residents were aged 65 years and older (88.3%), female (71.2%), and white (85.5%). Nearly one-half (48.2%) of all residents were admitted from a hospital or health care facility other than a nursing home or assisted-living-type facility, and 65.3% of all residents had some kind of advance directive.