title: 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.
abstract: 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.
authors.affiliation: Center for Senior Health and Longevity, Aurora Health Care, Milwaukee, WI; Department of Medicine, School of Medicine and Public Health, University of Wisconsin, Madison, WI. Electronic address: yoojiw@trinity-health.org.
authors.forename: Ji Won
authors.initials: JW
authors.lastname: Yoo
authors.forename: Jong Bum
authors.initials: JB
authors.lastname: Choi
authors.forename: Sun Jung
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hyun P
authors.initials: HP
authors.lastname: Shin
authors.forename: Kyudam
authors.initials: K
authors.lastname: Kim
authors.forename: Woo Sang
authors.initials: WS
authors.lastname: Ryu
authors.forename: Too Jae
authors.initials: TJ
authors.lastname: Min
authors.forename: Sulgi
authors.initials: S
authors.lastname: Kim
authors.forename: Shunichi
authors.initials: S
authors.lastname: Nakagawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003693:Delirium / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008824:Michigan / Q000453:epidemiology; D010147:Pain Measurement; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D012866:Skilled Nursing Facilities
keywords: Nursing home; patient participation; skilled nursing facility