Summary: An analysis that indicates that about 7,000 nursing homes may have closed from 1948-1968, while 13,000 new homes were opened.
At the same time that new nursing homes were being added, older facilities were closing down, particularly the small home-based or "mom and pop" operations. Because of these closures, comparisons of the number of total facilities at the beginning and end of any period understate the amount of new facilities that were being added.
There are really no statistics on how many facilities closed and opened, but we can draw some very general conclusions about the level of activity by combining data from a few sources. It is possible that about 3,000 nursing homes may have disappeared in the 1950's and about 4,000 additional facilities may have disappeared in the 1960's. If that is correct, the following table shows the high level of turnover that may have been taking place in the 1950's and 1960's:
| Beginning | Closed | Opened | Ending | |
|---|---|---|---|---|
| TOTAL | 9,000 | -7,000 | 13,000 | 15,000 |
| 1950's | 9,000 | -3,100 | 4,000 | 9,900 |
| 1960's | 9,900 | -3,900 | 9,000 | 15,000 |
Rational and source of data:
A 1969 survey of facilities estimated there were about 18,000 facilities, 15,000 of which were "nursing care" or "personal care with nursing" facilities. In another report, the National Center for Health Statistics (NCHS) Monthly Vital Statistics Report (July 1972, Number 21, Volume 4) reported they had asked each of about 18,000 homes in a 1968 survey to indicate whether they had been in operation 10 years prior (in 1958) and 20 years prior (in 1948). That report found that 60% had been in business for 10 years or less, about 40% of them had been in business in 1958, and only 14% had been in business in 1948. That would seem to indicate that about 13,000 (86% of the 1969 total) were added in either the 1950's or 1960's, and about 9,000 (60% of the 1969 total) must have been added during the 1960's.
In its 1986 report on For-Profit Enterprise in Health Care, the Institute of Medicine (IOM) estimated that there were about 9,000 nursing homes in the country in 1950, and 9,900 in 1961.
Combining all this data, it appears that 3,000 nursing homes may have disappeared during the 1950's and another 4,000 may have disappeared during the 1960's.
Another indication that the high number of closures may be reasonable comes from Inpatient Health Facilities, As Reported from the 1971 MFI Survey (NCHS Series 14, Number 12), which determined that 1,445 nursing homes closed in only two years between 1967 and 1969.
If this is accurate, the increase of 900 nursing homes from 1950 to 1961 and 4,100 beds from 1961 to 1971 reported by the IOM may greatly understate the number of new facilities which were opening. Much of this information is estimated, and there is no way to be sure these numbers reference comparable facilities. Although this information is somewhat speculative, it is provided to illustrate the level of turnover that may have been occurring during this period.