2010 U.S. Census Information for Long Term Care Facilities

The U.S. Census Bureau is gearing up to initiate the 2010 Census, which is required by the U.S. Constitution every 10 years to determine how many seats each State is apportioned in the U.S. House of Representatives; and to obtain critical data used to allocate Federal funds, track changes in the population and measure national changes/trends. In addition, the decennial Census provides the information each community needs to obtain funding for health assistance, services for older adults, employment services, schools, and more. All residents need to be counted in 2010, including those residing in long term care facilities.

Upfront, it is important to understand that Census workers have been carefully instructed that the "2010 census must be conducted in a fashion that minimizes respondent burden, avoids disrupting patient [and resident] care and adheres to adequate confidentiality protections." When a Census worker first appears at the facility, ask to see the worker’s badge and other matching identification, and ensure the worker is from the Census Bureau. Rest assured that Census information is confidential and protected by law. All Census Bureau workers have taken an oath and are subject to a jail term, a fine or both if they disclose any information that could identify the participants. Census data is used only for statistical purposes and is public only after 72 years. Further, note that none of the information requested by the Census Bureau is protected health care information under the Health Insurance Portability and Accountability Act (HIPAA).

The Census Bureau has developed special procedures to count individuals living in "group quarters;" including nursing, assisted living and developmentally disabled (DD) facilities. The Census Bureau will count (enumerate) patients/residents residing in these facilities during its "Group Quarters Operation." The Group Quarters Operation is composed of three phases: 1) Validation; 2) Advance Visit; and 3) Enumeration. Already, facilities should have been contacted by the Census Bureau during the validation phase; which was completed on October 23, 2009. During this phase, Census workers contacted providers to confirm the facility address and the "group quarters" classification. Assisted living facilities were classified either as a "housing unit" or a "skilled nursing facility;" for validation purposes. If the assisted living facility was not affiliated with a SNF, and was classified as a "housing unit," then the residents in that facility will receive a 2010 Census questionnaire in the mail, just like any other individual in the community. These individuals should complete the proper form, and return the completed questionnaire in the enclosed envelope.

Currently, the advance visit phase is on-going and will continue through March 19, 2010. During this phase, Census workers will visit each facility again to meet with a contact person and: 1) describe the upcoming enumeration phase; 2) address privacy, security and confidentiality concerns; 3) request the number of the expected facility population as of April 1; 4) schedule the best date for conducting the enumeration; and 5) verify basic facility information.

On April 1, the enumeration phase will begin. Three different enumeration methods are available to the Census Bureau to enumerate the long term care facility populations. Each facility has the choice of determining the most efficient method for their facility. These methods include: 1) census workers interviewing each patient/resident; 2) self- enumeration, where the facility contact distributes questionnaire packets to each patient/resident to complete the form; or 3) administrative enumeration.

The Census Bureau understands the issue that health care organizations have with limited staff. For that reason, the Census Bureau worker will accept administrative records when counting individuals in long term care settings. If the facility determines that administrative enumeration is the best process for their facility; the Census worker will first ask the facility to generate a list of all the patients/residents in the facility. The Census worker then uses a system of patient identification numbers to identify patients/residents. Each patient/resident, who is capable of the task, will then fill out the census form themselves. If the patient/resident is incapable of completing this task, the enumerator will complete the form using administrative records; not medical records. No long term care provider should feel compelled to use its staff to complete the enumeration process. If, however, the facility is more comfortable "self-enumerating," they may choose to ask the Census Bureau to swear in and train provider staff, who in turn will help the patients/residents to fill out the 2010 Census form.

Questions/concerns can be directed to Dora Durante at dora.b.durante@census.gov; or 301-763-9371.