Nursing homes--structure and selected characteristics, 1987 and 1996

This paper briefly describes changes in the nursing home market over a nine-year period, 1987 to 1996. Estimates are based on the "Institutional Population Component" of the 1987 National Medical Expenditure Survey (NMES) and the "Nursing Home Component" of the 1996 Medical Expenditure Panel Survey (MEPS). Both surveys were sponsored by the Agency for Health Care Policy and Research. On January 1, 1996, approximately 1.56 million residents were receiving care in 16,840 nursing homes with 1.76 million beds. This compares to 1.36 million residents in 14,050 nursing homes with 1.48 million beds in 1987, increases of 15, 20 and 19 percent, respectively. The average size of a nursing home remained constant. The occupancy rate decreased from 92 percent in 1987 to 89 percent in 1996, in spite of the growth of the elderly population, both in relative and absolute terms. There was also a significant drop in the supply of nursing home beds relative to the elderly population; this decrease was observed in all four regions of the country, with the greatest drop being in the West. In 1987 only 28 percent of nursing homes were certified by both Medicare and Medicaid (dually certified), while this proportion increased to 73 percent in 1996. Conversely, while only 17 percent of nursing homes were certified by only Medicaid in 1996, a full 50 percent were certified as such in 1987. By far the most common type of nursing home in both 1987 and 1996 was the nursing home with only nursing home beds. Such nursing homes represented 87 percent of the market in 1987 but just 77 percent in 1996. The remaining were either hospital-based or nursing homes with personal care and/or independent living beds in addition to nursing home beds or were part of a continuing care retirement community.