The committee wishes to express appreciation for the excellent cooperation and assistance it has received from hundreds of individuals and dozens of organizations throughout the country. The staffs of the Health Care Financing Administration, the American Health Care Association, the National Citizens' Coalition for Nursing Home Reform, the National Senior Citizens Law Center, the American Association of Homes for the Aging, the Association of Health Facility Licensure and Certification Directors, and the American College of Health Care Administrators were especially helpful. They received numerous requests from us for various types of information and documents. They always responded promptly and courteously. Other organizations, including the American Association of Retired Persons, the National Council of Senior Citizens, and the National Council on Aging, also were helpful.

Government officials in the six states in which we conducted case studies were generous in allotting time for interviews with our staff. The same was true of representatives of provider associations, consumer groups, ombudsmen, and staff in federal regional offices. We particularly appreciate the cooperation of the 47 state licensure and survey agencies who responded to our survey questionnaire. For many, a major effort was entailed to obtain the information needed to respond to our questions.

A study as complex and technically demanding as this requires competent professional staff. The committee was singularly fortunate in being supported by such a staff, effectively organized and directed by David Tilson. In addition to its deep appreciation for Mr. Tilson's leadership, the committee gratefully acknowledges the work of the other members of the professional staff: Robert Burke, Michael McGeary, Susan Sherman, Jane Takeuchi, and Peter Reinecke (who worked on the staff through January 1985). Don Tiller provided exceptionally effective administrative support. Staff members organized and coordinated conferences and workshops. They reviewed and abstracted hundreds of publications and technical documents. They carried out the survey of state licensure and certification agencies and analyzed the data. They prepared staff papers and drafted this report. In addition to long hours, the IOM professional staff displayed a sensitive commitment to nursing home residents. They never lost sight of the study's principal focus on residents as human beings with special needs for living and for care.