Rehabilitation in the nursing home: how much, why, and with what results.

Although rehabilitation is considered an important component of long-term care, few studies have looked at the factors associated with the provision of rehabilitation in this setting. The authors examined one State's skilled nursing homes to gain information on their rehabilitation practices. Data for this study came from a mail survey and from the licensing applications filed with the State Division of Facility Services. Sixty-nine percent of the State's nursing homes responded to the survey. All reported that they provided specialized physical therapy, occupational therapy, or speech therapy, or all three, but the numbers of patients reported to be enrolled in such therapies on a daily basis varied from 0 to 64 percent of the facility's census. Factors positively associated with the provision of rehabilitation included the number of full-time registered nurses on the staff and the belief of the facility administrator that the purpose of rehabilitation is to restore function so that patients can be discharged. Facilities that employed their own therapists rather than contract for these services reported significantly more patients enrolled in daily therapies. And a significant positive correlation was observed between the provision of daily rehabilitation services and discharge of patients in those facilities that hired their own rehabilitation staff. These findings suggest that the provision of rehabilitation in nursing homes has different goals and outcomes and that there are facilities with identifiable characteristics that appear more successful in returning patients to their homes.