Validation of the Standardized Function Data Elements among Medicare Skilled Nursing Facility Residents.

Area of Science:

• Gerontology
• Rehabilitation Medicine
• Health Services Research

Background:

• Skilled nursing facilities (SNFs) provide crucial post-acute care for Medicare beneficiaries.
• Assessing functional status at admission and discharge is vital for patient outcomes and care quality.
• Standardized data on self-care and mobility are used to evaluate patient progress.

Purpose of the Study:

• To analyze the distribution of functional abilities (self-care and mobility) in Medicare fee-for-service beneficiaries during SNF stays.
• To validate standardized discharge self-care and mobility scores by examining their relationship with community discharge rates.

Main Methods:

• An observational study analyzed data from 15,127 Medicare-certified SNFs for Medicare Part A fee-for-service stays in 2017.
• Self-care and mobility scores at admission and discharge were calculated to describe resident functional abilities.
• Discharge scores were analyzed against community discharge percentages to assess construct validity.

Main Results:

• SNF residents demonstrated significant functional improvements in self-care and mobility between admission and discharge.
• For example, independence in toileting hygiene increased from 3.7% to 25.3%, and sit-to-lying from 8.2% to 32.7%.
• Higher discharge scores for self-care and mobility were consistently associated with higher rates of community discharge.

Conclusions:

• Measurable functional improvements in self-care and mobility were observed for SNF Medicare Part A residents.
• A positive association exists between higher discharge functional scores and increased community discharge rates.
• These findings support the validity of SNF self-care and mobility data for assessing functional status.