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ministratorson the basis of information obtainedby questionnaire from the person who was designated as administrator by the owner or operatorof an establishment. The survey was designed sothat one and only one administratorwas designated for each establishment. Assistant administrators were requested to complete a differentquestionnaire and are not included in this report.Since the estimates for RPS-3 are based on asample of administratorsin nursing and personalcare homes rather than all such administrators,they are subject to sampling variability. Tablesof approximate sampling errors are given in appendix I. Definitions of certain terms used in thisreport may be found in appendix II. Also a reviewof the questionnaires and related materials shownin appendix III should be helpful in understandingthe data.“In this report administratorsof nursing andpersonal care homes are described in terms oftheir highest grade completed, undergraduate andgraduate degrees held, Iicensure status as registered nurses and practical or vocational nurses,courses completed in nursing home administration, on-the- job training in nursing home administration, and other education or training receivedin nursing home administration. These data provide a general picture of the levels of knowledgeand skill attained by administrators.The- data on education and training arearrayedby characteristicsof administrators(age, employment status, length of employmentas an administrator,and services performed bythe administrator).The interplay between thesecharacteristicsand education and training is discussed. In addition, the relationshipbetweencharacteristicsof nursing and personal carehomes and the training and education of theiradministratorsis analyzed. More detailed information about administratorsis given in tables1-20, which follow the text of this report.Establishment infomzation.-Toplace the statistics on administratorsin perspective,table Bpresents selected characteristicsof nursing andpersonal care homes. Nursing care homes constituted the majority of the three types of homesand on the average maintained 61 beds as opposedto 40 beds for personal-care-with-nursinghomesand 14 beds for personal care homes. The estimated average size for all types of homes wasabout 49 beds. Approximately 88 percent of nursing and personal care homes had less than 100beds, and the remaining 12 percent had 100 bedsor more.About seven of every nine homes were operated under proprietaryauspices. However, bothnonprofit and government homes were on theaverage larger in size than proprietary homes.The largest proportion of homes were located inthe North Central Region (34 percent) followed bythe South Region (26 percent), Northeast Region(21 percent),and West Region (20 percent).Education and tvakkg.The level ‘of education attained by nursing home administrators isslightly above that of the general population. Basedon 1970 Bureau of the Census data: the mediannumber of school years completed by all persons21 years and older in the United States was 12.2years?2 Based on RPS-3, the median number ofschool years completed by nursing and personalcare home administratorswas 13.1 years.Table C summarizes the data collected onhighest attained educational level for the estimated 18,390 administratorsin the United States,June-August 1969. Slightly more than 20 percenthad less than a 12th grade education, and 29 percent had only a 12th grade education. The highestattained educational level for the remaining 51percent was 1 year or more of nursing school,junior college, or college.Of the 2,380 administratorswho attendednursing school, 1,590 attended for 3 years. However, some administratorsattended junior college or college or by other means prepared themselves for licensure as registered nurses (RN’s),which brought the total number of administratorswho were licensed RN’s to 2,020. Licensed registered nurses represented 49 percent of the 4,140administratorswho were licensed nurses. Theother 51 percent were licensed practical nurses(LPN’s) or licensed vocational nurses (LVN’S).The majorityof administrators(72 percent) did not hold an undergraduate or a graduate degree. However, of the 5,200 administratorswho held a degree, the associate’s degree was thehighest degree held by 50 percent, the bachelor’swas the highest degree held by 36 percent, andthe master’s or doctor’s was the highest degreeheld by 15 percent.3

Table B. Number of nursingsnd. personalcare homes and ean beds, by type ofbed-size,service,ty e of o nership,United States,and geograp- --{ ic region:June-August1969 xcludes Alaska and Hawai HomesCharacteristicAll homes -------Meanbeds18,3904911,580613,7703,0404014Type of serviceNursingPersonalnursingPersonalcare ---------care with-----------care ---------Type of ownershipProprietary----------Nonproff.t ------------Government ------------14,1602,8501,380;;60of these administratorsheld abachelor’s,master’s, ordoctor’sdegree. About llOadministratorsheldtheM.D. or D.O. degree.Although administratorswere requested toindicate their major fields of study in pursuitof undergraduate and graduate degrees, most didnot. However; for those administratorswho indicated amajor field ofst.udyon theundergraduate level, awide cross-sectionofdisciplineswasrepresented,dominated to some extent by thesocial sciences, accounting, business administration, and nursing. On the graduate level amaster’s degree ‘in hospital administrationwastiequently indicated. For doctorates, the majorfields of study frequently included, but were notIimited to,theology, law,andmedicine.distributionTable C. Number and percentof nursingand personalcare home administratorsbyhighestgrade completed:United States,June-August1969, @xeIudes Alaska and Hawai Bed sizeLess than 30 beds ----30-99 beds -----------100-299 beds ---------300 beds or stratorsNumberPercentregionNortheast ------------ or ; Central --------. ---------------West ------------------3,8306,1604,7503,65052Allgrades -------18,390100.0Below 12th grade ------8th grade and below-9th to llth grades---3,8401,7802,06020.912th5,24028.5Nursing school --------1 year --------------2 years -------------3 years-” -------------2,3805502401,59012.93.0Junior college --------1 year --------------2 years asthehighestdegreeheld byagood proportion ofthose administratorswho were licensed nurses (RN’s, LPN’s, orLVN’S). In fact the associate’s degree was thehighest degree held by46percentofthe4,140 administratorswho were licensed nurses, and thebachelor’s degree was the highest degree for5percent of this group. About 48 percent of theadministratorswho were licensed nurses heldno degree. Only a relatively few administratorsin this group held the master’s ordoctor’sdegree.Approximately 3,000 administratorshad attended college4 years or more, and 89 percent4Highest gradecompletedgrade -------------College ---------------1 year --------------2 years -------------3 years -------------4 years -------------5 years or more ------6,2501,0401,4807201,4701,5401?: ;::;:;34.05.68.1i?::8.4

Attained educationalstatus is related tocompletion of a course in nursing home administration and acquisition of on-the-job training orother training or education in nursing home administration. As shown in table D, administratorswho had received formal or informal trainingin nursing home administration were more likelyto have completed at least 12th grade than wereadministratorswho had not received this training. The median number of months for on-thejob training for all administratorswas 12.0months. The duration of this training may haveincluded time spent in a probationary or careerconditional period.Administratorsindicated that other trainingor education in nursing home administration included, but was not limited to, seminars, institutes, workshops, reading, conventions, andhome-study courses.If an administrator-helda degree, the chanceswere greater that he had received training innursing home administrationthan if he did nothold a degree (table E).The relationshipbetween licensureas anFUN,LPN, or LVN and training in nursing homeadministrationis not as marked as the relationship between degree status and training. However,administratorswho received on-the-job trainingTable D. Number and Percentdistributionof administratorsaccordingto type- of trainingor educationin nursingStates,June-August1969@wl.desAlaska and Ekw.iflby highestgradehome administration:Highest gradecompletedAdministratorsType of trainingor educationnursinghome administrationinNumberAllcompleted,Unitedtypes 90100.020.979.1100. O25.974.2CourseNo --------------------------------------11,950Yes 688.411,310100.025.374.77,080100.013.886.2100. O22.377.7100.016.084.0On-the- jobtrainingYes No -----------------Yes . . . . . . .-or education. . . . . . . . . . . ---------. . . . . . . . . . . . . . . . . -----------14,2604,130

TableE.Number and percentof administratorsthn,by degree or li.censurestatus:[ExcludesAlaskaby trainingin nursing home administraUnited States,June-August1969and HawaiflTrainingin nursingadmf.nistrationlDegreeor ntAllstatuses----------------------DegreeDid not holdLicensureNot 21.0status2a degree -------------------Held a degree --------------------------status3as a nurse -----------------as a nurse ---------------------1 administratormay have receivedone ‘o or three typesdegree or cer i.ficate,bachelorfs,z e or more among associatesdegree.SAS an RN, LVN, or LPN.innursing home administration were more likelyto have taken acourse innursing home administration than those who hadnotreceivedthistraining (table F). Detailed tables 3 and 4 presentadditional data on the relationship between attained educational level and training in nursinghome administration.Information onthe Medicare participation bythe sample facilities was obtained in RPS-3.Table G summarizes the educational status of theadministratorsof Medicare-certifiedand noncertified homes, June-August1969. This tableshows that the median years of education were14.8 years for administratorsin Medicare-certifiedhomes and 12.8 years for administratorsinnoncertifiedhomes. In fact, 91 percent of theadministratorsin Medicare-certifiedfacilities6of administratorsof trainin.master Fs,ordoctor had completed at least 12th grade compared with75 percent in noncertified facilities.Futhermore,’46 percent of the administratorsin Medicarecertified homes held a degree, 46 percent hadtaken a course in nursing home administration,50 percent had received on-the-job training innursing home administration,and 30 percenthad receivedother trainingor education innursing home administration.The comparablepercentagesfor training or education of administratorsin noncertified homes are less.Table 5 presents further information on administratorsin Medicare-certifiedand noncertified homes. Also table 1 presents the distribution of these two groups by the proposed criteria for licensing administrators.

Table F. Number and percent distribution of nursing home administratorsby completionof a course in nursing home administration,according to type of training in nursinghome administration:United States, June-August 1969[&cl.desAlaekaandHawaiiAdministratorsType of training in nursingTook a coursehome administrationPercentNumberAll b trainin&No -------------------------------.------------Yes 14,260100.069.330.7--4,130100.049.850.2Other training or educationNo -------Yes --------------------Number and percent of nursing and personal care home administrators,by education or training of administrators and Medicare status of sample homes: UnitedStates. June-Auwst 1969Table tratorsEducation or trainingof edhomesNumberAll administrators--------”-------------- 4Median years of 2012.8PercentPercent completed below 12th grade-----------Percent completed 12th grade and above-------pl rcentheld a degreel------------------------Percent RN, LPN, or LEN----------------------Percent took a course aining25.374.721.920.99!::46.1---- -- -.--Percent received other training or education2-I10neormore among associate’s degreeor certificate,bachelor’s, aster’s,or doctor’sdeg ee.-In nursing home administration.7

EDUCATIONRELATEDANDTRAININGTO OFAgeThe majority of nursing and personal carehome administratorswere between the ages of45 and 65 (figure 1). Generally, administratorsunder 45 years of age had attained a slightlyhigher educational level than administrators45years and over; table H shows that the medianyears of education for these groups were 14.1and 12.9 years, respectively.Table H also shows that 91 percent of theadministratorsunder 45 years of age had completed at least 12th grade, 11 percent had attended nursing school, and 53 percent had attended college. At the other, extreme, only 75percent of the administrators45 years and overhad completed at least 12th grade, about 14 percent had attended nursing school, and 33 percenthad attended college. Table 5 provides additionaldata to examine the relationship between age andeducation.“The completion of 2 or 3 years of nursingschool occurred often among administrators45years and over. In addition, 24 percent of theadministrators45 years and over were licensedas an RN, LPN, or LVN compared with 20 percent under 45 years of age (table J). Furtherexamination of the data reveals t at 4 years ormore of college were completed more often byadministratorsunder 45 years of age and alsothat undergraduateand graduate degrees weremore common for administratorsof this agegroup.Administratorsunder 45 years of age werelikely to have attended a course in nursing homeadministrationand to have pursued two or moresuch courses.Furthermore,administratorsinthis age group were about equally divided as toon-the-job training experience; about 51 percenthad received dn-the-job training in nursing homeadministration,while 49 percent had not. Administrators45 years of age and over ra&edhigher in median months of this training. However, positive responsesto “other training oreducation in nursing home administration” wereAGE‘ d over11.4Iz!iFiaure 1. Percent distribution of nursina and oersonal care home administrators hy a e.“given as often by administratorsof age (table K).Employmentunder 45 yearsStatusEducational level varies markedly with employment status. Namely, employed nursing andpersonal care home administratorsworking forother employers generally showed a higher educational level than the self -employed adminis trators.For example, 86 percent of employedadministratorshad completed at least 12th gradecompared with 70 percent of the self-employedadministrators.Only 26 percent of the self-employed administratorshad attended college, andonly 9 percent had completed 4 years or more.In comparison, 45 percent of the employed administratorshad attended college and 22 percenthad completed 4 years or more. On the otherhand, about the same percent of self-employedadministrator had attended nursing school ashad their salaried counterparts (table L).This relationship between employment statusand education is not altered when an additionalvariable, age, is introduced. Table 6 shows mat

Table H. Number and percent distribution of nursing and personal care home administrators by highest grade completed and median yearsof education,accordtigto age:UnitedStates, June-August 1969&xoludesAlaskaand HwaiflHighest grade completedAdministratorsBelow 12thgradeCollegeMediany:ysAgeNumber PercentAllages- 18,39Q 100.0Under 45years--4,680 100.0Under 35years------1,550 100.035-44 years-3,130 100.012th8thgradeLess9th2 orgrade1thanllth3andyear4years years?below 12.912.9*4 n arsover--- 13,710 100.045-54 years-5,500 100.04.56.734.33.913.422.614.713.555-64 years-6,110 100.017.717.124.7*8.517.612.912.665 years andover-------2,100 r college.,9

Table J. Number and percent distributions ofnursing and personal care home administrators by degrees and licenses held , according to age: United States, June-August t degree heldIw‘1 All ages------- 18,390 100.0Licenses held kIIII71.714.110.14.277.5 11.011,64,680 100.061.913.118.8.6.2 80.5 10,19.51,550 100.035-44 years---------- 3,130/ 100.059.263.213.013.220.318.17.6 83.4 6.55.5 79.1 11.910.19.2Under 45 years---Under 35 years-------H-45 years andover------------ 13,710 100.045-54 years---------- 5,500 100.055-64 years---------- 6,110 100.065 years and over---- 2,100 *I;.;-&.;I3.5 , 76.5 11.312.313.515.110.310.7“* 77:0 1:::Number and percent distributions of nursing and personal care home administrators by trainingin nursing home administrations accordingto age: United States,June-August1969Table K.@xcl.desAlaskaandHmvaijTraining in nursing home administrationAdministratorsCourse in nursinghome cationAgeYeaIhmber Yescoursesor more,8,390 100.065.012.922.2 61.5 38.5years------- 4,680 100.0-58.716.524.8 49.1 50.963.456.419.115.217.5 48.2 51.828.4 49.5 50.574.91::; 73.067.111.621.3 65,8 34.214.2 78 921 171:09:819:2 71:4 28:618:0 78;521:;76.96.316.8 77.1 22,911.9 ‘ B5.114.9All agea-12.0Under 45Under 35 years- 1,550 100.035-44 years---- 3,130 100.045 years andover-------100.0 45-54 years---- w55-64 years---- 6,110.65 years andover------ 2,100 100.0109.6 73.61 26.425.127.0T.

TableL. Number and percentdistributionof nursingand Personalby highestgrade completed and median years–ofeducation,ment status:United States,Uune-August 1969care home administraaccordingto employ-tors(&ludrxAlaskaand HawijHighestAdministratorsEmploymentstatusgra e9thllthbelowgradescompletedIBelow 12thgrade8thgradeI12thgrade1yearT2 or3years“’atuses--l k Selfemployed---Employed---Both ----------8,090100.08,640100.0I 4yearsormoreMedianyearsofeduca 530.924.014.5*sometimes the employed administratorshadgenerally attained a higher educational level thanhad self-employed administrators within the sameage group. (Other variables—i.e.,bedsize,etc.—which affect the relationship betweenemploymentstatus and educational level are discussed insubsequent sections of this report.)As expected, employed administratorshadobtained ahigher educational level snd thereforeheld more formal degrees. This is especiallytrue of the bachelor’s degree, for this degreewas the highest degree heldby 14percent of theemployed administratorscomparedwith5percentof the self-employed administrators(table M).It was of interest

training prepare him to direct and administer a program which provides both the “nursing” and the “home” aspects of patient care.1 Highlights The median number of years of education for the estimated 18,390 nursing and personal care home administrators in the conterminou