Predictors of Functional Change in a Skilled Nursing Facility Population

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Clinical Outcomes

Background:

• Functional decline in skilled nursing facilities (SNFs) impacts patient recovery and increases adverse event risk.
• Optimizing functional gains during SNF stays is crucial for patient trajectories post-hospitalization.

Purpose of the Study:

• Identify predictors of functional change in patients during SNF stays.
• Inform interventions to improve functional outcomes for older adults after hospitalization.

Main Methods:

• 140 hospitalized patients undergoing SNF rehabilitation were assessed.
• Physical function measured using the Short Physical Performance Battery (SPPB) at evaluation and discharge.
• Data from Minimum Data Set 3.0 and electronic medical records analyzed.

Main Results:

• Patient Health Questionnaire (PHQ-9) depression screening predicted gait speed changes.
• 87% achieved meaningful SPPB improvement; 78% improved gait speed.
• Significant disability remained at discharge (69% low SPPB scores, 57% slow gait speed).

Conclusions:

• Persistent functional deficits post-SNF stay elevate risks like rehospitalization and institutionalization.
• Understanding functional change predictors is key to developing targeted interventions.
• Improving SNF functional trajectories is vital for older adults' long-term health.