Transfers among Vulnerable Long-Term Nursing Home Residents.

Area of Science:

• Gerontology
• Health Services Research
• Psychiatry

Background:

• Nursing home residents represent a vulnerable population with complex care needs.
• Transfers between nursing homes can disrupt care continuity and negatively impact resident well-being.
• Specific clinical diagnoses may influence the likelihood of nursing home-to-nursing home transfers.

Purpose of the Study:

• To compare the risk of nursing home transfer among residents with intellectual and developmental disabilities (IDD), serious mental illness (SMI), and/or Alzheimer's disease and related dementias (ADRD).
• To identify factors associated with nursing home transfers overall and for residents with these specific diagnoses.

Main Methods:

• A cross-sectional cohort study analyzed 2019 data from Michigan long-term nursing home residents.
• Residents were categorized into groups based on diagnoses: IDD, SMI and ADRD, ADRD, SMI, and others.
• Adjusted logistic regression models were used to assess transfer odds and identify associated factors.

Main Results:

• The study included 37,638 long-term nursing home residents, with a 2.3% transfer rate.
• Residents with both SMI and ADRD exhibited a 39% higher likelihood of transfer compared to residents without these conditions.
• Factors like advanced age, cognitive impairment, and falls were linked to lower transfer odds, while being married and wandering increased transfer odds.

Conclusions:

• Residents with co-occurring SMI and ADRD are at the highest risk for nursing home transfer.
• These findings highlight the need for targeted interventions to support vulnerable residents and reduce unnecessary transfers.
• Further research is warranted to investigate the specific drivers of transfer for this population.