NURSING HOME STATISTICAL YEARBOOK, 2015 C. MCKEEN COWLES COWLES RESEARCH GROUP
Acknowledgments We extend our appreciation to Craig Dickstein of Tamarack Professional Services, LLC for optimizing the SAS software routines that generated these tables and graphs and auto formatting the output. Any errors or omissions are those of the author. Copyright 2016 by Cowles Research Group All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the copyright holder. For information, contact: Cowles Research Group 1004 Commercial Ave., #522 Anacortes, WA 98221 Phone: (360) 972-3200 Fax: (509) 984-2403 E-mail: Mick@LongTermCareInfo. com www. LongTermCareInfo. com Notice of Liability: The information in this book is distributed on an As Is basis, without warranty. While every precaution has been taken in the preparation of this book, neither the contributors nor Cowles Research Group shall have any liability to any person or entity with respect to liability, loss, or damage caused or alleged to be caused directly or indirectly by the information contained in this book. ISBN: 0-9721950-9-2 Produced in the United States of America SAS and all other SAS Institute Inc. product or service names are registered trademarks or trademarks of SAS Institute Inc. in the USA and other countries. indicates USA registration. Acknowledgments Page 1 of 165
CONTENTS How the Tables Were Constructed... 5 About the Author... 18 SECTION I RESIDENT ACUITY Table I-1: Four Measures of Resident Acuity by State, 2015...20 Table I-2: ACUINDEX by Class of Ownership, United States, 2015...22 Figure I-A: ACUINDEX by Class of Ownership, United States, 2015...23 Table I-3: ACUINDEX by Urban/Rural, United States, 2015... 24 Figure I-B: ACUINDEX by Urban/Rural, United States, 2015... 25 Table I-4: ACUINDEX by Bedsize, United States, 2015... 26 Figure I-C: ACUINDEX by Bedsize, United States, 2015... 27 Table I-5: Two MDS-based Measures of Resident Acuity by State, 2015... 28 SECTION II RESIDENT ADL CHARACTERISTICS Table II-1: Resident ADL Limitations by ADL and State, 2015... 32 Figure II-A: Resident ADL Limitations by ADL, United States, 2015... 33 Table II-2: Resident Dependence Level by State Bathing, 2015...34 Figure II-B: Resident Dependence Level Bathing, United States, 2015...35 Table II-3: Resident Dependence Level by State Dressing, 2015... 36 Figure II-C: Resident Dependence Level Dressing, United States, 2015... 37 Table II-4: Resident Dependence Level by State Toileting, 2015... 38 Figure II-D: Resident Dependence Level Toileting, United States, 2015... 39 Table II-5: Resident Dependence Level by State Transferring, 2015...40 Figure II-E: Resident Dependence Level Transferring, United States, 2015...41 Table II-6: Resident Dependence Level by State Eating, 2015...42 Figure II-F: Resident Dependence Level Eating, United States, 2015...43 Table II-7: Residents with Multiple Dependencies by State, 2015...44 Figure II-G: Residents with Multiple Dependencies, United States, 2015...45 Table II-8: Resident Continence Characteristics by State, 2015...46 Table II-9: Resident Mobility Characteristics by State, 2015... 48 Figure II-H: Independently Ambulatory Residents, United States, 2006 2015...49 Page 2 of 165
Table II-10: Incidence of Contractures and Use of Restraints by State, 2015...50 Figure II-I: Nursing Home Residents in Restraints, United States, 2006 2015...51 SECTION III OTHER RESIDENT CHARACTERISTICS Table III-1: Use of Psychoactive Medication by State, 2015...54 Table III-2: Other Medication Characteristics by State, 2015...56 Table III-3: Resident Skin Care Characteristics by State, 2015... 58 Table III-4: Resident Special Treatments by State, 2015...60 Table III-5: Communication and Advance Directives by State, 2015... 62 Figure III-A: Nursing Home Residents with Advance Directives, 2006 2015...63 Table III-6: Mental Status by State, 2015...64 Table III-7: Payor Mix and Census by State, 2015... 66 Figure III-B: Payor Mix, Percent Medicare, 2006 2015... 67 SECTION IV SURVEY DEFICIENCIES Table IV-1: Total and Nursing Deficiencies by State, 2015...70 Table IV-2: Total Deficiencies by Class of Ownership and State, 2015...72 Figure IV-A: Total Deficiencies by Class of Ownership, United States, 2015...73 Table IV-3: Survey Deficiency Categories by State, 2015...74 Table IV-4: Top 40 Deficiencies: United States, 2015...76 Table IV-5: Most Frequently Cited Deficiencies, 2015 Alabama... 77 Alaska...78 Arizona...79 Arkansas...80 California...81 Colorado...82 Connecticut...83 Delaware...84 District of Columbia...85 Florida... 86 Georgia... 87 Hawaii... 88 Idaho... 89 Illinois...90 Indiana...91 Iowa...92 Kansas...93 Kentucky... 94 Louisiana... 95 Maine... 96 Maryland... 97 Massachusetts... 98 Michigan... 99 Minnesota...100 Mississippi...101 Missouri...102 Montana...103 Nebraska...104 Nevada...105 New Hampshire...106 New Jersey...107 New Mexico...108 New York...109 North Carolina...110 North Dakota... 111 Ohio... 112 Oklahoma...113 Oregon... 114 Pennsylvania... 115 Rhode Island... 116 South Carolina... 117 South Dakota... 118 Tennessee... 119 Texas... 120 Utah... 121 Vermont... 122 Virginia... 123 Washington... 124 West Virginia... 125 Wisconsin... 126 Wyoming... 127 Table of Contents Page 3 of 165
Table IV-6: Scope and Severity Code Utilization by State, 2015... 128 Figure IV-B: Scope and Severity Code Utilization, United States, 2015... 129 SECTION V FACILITY CHARACTERISTICS Table V-1: Facilities by Type of Certification and State, 2015... 132 Figure V-A: Total Certified Facilities, United States, 2006 2015... 133 Table V-2: Facilities by Class of Ownership and State, 2015... 134 Figure V-B: Facilities by Class of Ownership, United States, 2015... 135 Table V-3: Facilities by Size Category and State, 2015... 136 Figure V-C: Facilities by Size Category, United States, 2015... 137 Table V-4: Beds by Type of Certification and State, 2015... 138 Figure V-D: Total Beds vs. Certified Beds, United States, 2006 2015... 139 Table V-5: Dedicated Special Care Units and Beds by State, 2015... 140 Table V-6: Occupancy Rate as a Percent by State, 2015... 144 Figure V-E: Occupancy Rate as a Percent, United States, 2006 2015... 145 SECTION VI STAFFING INFORMATION Table VI-1: Physical Therapist Staffing by State, 2015... 148 Figure VI-A: Physical Therapist Staffing, United States, 2015... 149 Table VI-2: Occupational Therapist Staffing by State, 2015... 150 Figure VI-B: Occupational Therapist Staffing, United States, 2015... 151 Table VI-3: Speech and Language Pathologist Staffing by State, 2015... 152 Figure VI-C: Speech and Language Pathologist Staffing, United States, 2015... 153 Table VI-4: Contract Labor Usage for Nursing Services by State, 2015... 154 Table VI-5: Nurse Staffing Hours per Patient Day, 2015... 156 Table VI-6: Nurse Aide Staffing Hours per Patient Day, 2015... 158 Table VI-7: Occupational Therapist Hours per Patient Day, 2015... 160 Table VI-8: Physical and Speech Therapist Hours per Patient Day, 2015... 162 Table VI-9: Staffing Hours per Patient Day by Class of Ownership Total U. S., 2015... 164 How to Buy this Book... 165 Page 4 of 165