Factors Associated With Remaining in a Skilled Nursing Facility for Over 90 Days from Admission: Residents' Participation in Therapy and Desire to Return to the Community

Background: To identify the factors associated with stay in a skilled nursing facility (SNF) among new enrollees who did not fully participate in therapy sessions. Methods: Data (n= 36,133) were obtained from the Minimum Data Set version 2.0 in the state of Michigan in 2009. Study participants were new SNF enrollees (n= 699) who did not fully participate in therapy sessions despite their desire to return to the community. Multivariate logistic regressions were performed to identify factors contributing to remaining in a nursing home for 91 days or longer. Results: New SNF enrollees were more likely to remain in nursing home when they were depressed (odds ratio [OR]= 1.41; 95% confidence interval [CI], 1.09-2.08; P= .01), experiencing delirium (OR= 3.20; 95% CI, 1.48-5.92; P < .001), were not in pain (OR= 0.83; 95% CI, 0.60-0.95; P= .03), or in less complex care (OR= 0.57; 95% CI, 0.44-0.81; P < .01). Conclusions: A higher number of new SNF enrollees than previously reported were likely to stay in nursing homes (28.0%). Depression and delirium were associated with stay in an SNF, while pain and higher complexity of care were associated with returning to the community.