Medicare nursing home residents with a stroke. Characteristics and 90-day outcomes of care.

The objective of this article is to describe the characteristics and outcomes of Medicare patients admitted to nursing homes with a primary diagnosis of stroke. This study used longitudinal clinical information prospectively collected in National Health Corporation (NHC) nursing homes on admission and at discharge or death. In total, 2,345 residents met the following study criteria: age 40 and over, newly admitted from a general hospital to a NHC home under Medicare, and previously living in the community. The outcomes were functional status and discharge disposition within 90 days. By 90-days postadmission, 27.4% remained in the nursing home, 22.4% had gone home, 25.7% had been readmitted to a general hospital, 8.7% had entered another facility, and 15.6% of the patients with stroke had died. Residents who went home showed the greatest improvement in functional status in Barthel Index scores, from 35.2 (SD21.1) to 47 (SD 25.6); 20% were totally dependent and only 34% scored above 60 on the index. Further study is needed to examine the functional outcomes of stroke survivors over the longer term and compare the relative effectiveness of nursing home interventions with other postacute care options.