Changes in use of voluntary workers in nursing homes: United States, 1985 and 1999.

Objective: This report describes changes in the use of voluntary workers in nursing homes between 1985 and 1999. Statistics are presented on selected characteristics of nursing homes using voluntary workers and the services they perform. Factors that may contribute to the increased use of voluntary workers are also discussed.

Methods: The data presented in this report were collected from the 1985 and 1999 National Nursing Home Surveys (NNHS). NNHS is a part of the National Health Care Survey, which measures health care utilization across various types of providers. Conducted periodically since 1973, NNHS obtains information from a nationally representative sample of nursing home facilities based on interviews with administrators and staff. Sample data are weighted to produce annual national estimates.

Results: In 1999, 87 percent of all nursing homes reported using voluntary workers, up from 78 percent in 1985. In 1985, unpaid workers were most likely found in large nursing homes (100 beds or more). By 1999, about the same proportion of nursing homes, large and small, reported their use. In 1999, the Northeast region had the greatest proportion of nursing homes that used volunteers--93 percent. Chain-affiliated and independent facilities used volunteers with about the same frequency, and about the same percentage of nursing homes not certified by either Medicaid or Medicare used voluntary workers as did dually-certified facilities. However, in 1999, proportionately fewer proprietary (for-profit) nursing homes reported having volunteers (85 percent) than did nonproprietary facilities (93 percent).