SHM Converge Scientific Abstract ePoster Gallery-Post-Acute Outcomes of Older Adults With Dysphagia in Skilled Nursing Facilities

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This retrospective cohort study examined post-acute care outcomes for older adults admitted to skilled nursing facilities (SNFs) after hospitalization, focusing on those with dysphagia. Using Medicare claims and Minimum Data Set data, the authors analyzed 598,324 community-dwelling fee-for-service beneficiaries aged 65 and older admitted to SNFs in 2019. Dysphagia was identified from hospital diagnosis codes in the 6 months before SNF admission; 29,891 patients (5%) had documented dysphagia.<br /><br />The study compared delivery of rehabilitative treatments—speech, physical, and occupational therapy, plus oral and nutritional nursing care—between patients with and without dysphagia, and assessed outcomes including improvement in self-feeding, oral hygiene, no weight loss, and discharge to the community. Logistic regression models adjusted for demographics, comorbidities, baseline function and cognition, length of stay, and hospitalization reason.<br /><br />Key findings were that dysphagia was relatively uncommon in claims data, suggesting under-coding and under-recognition. Patients with dysphagia were more likely to receive some therapy and nursing services, but despite receiving fewer interventions overall, they appeared to benefit from certain therapies. In particular, multimodal swallowing rehabilitation was associated with better outcomes than single-modality approaches. The study also found that patients with dysphagia admitted to SNFs were less likely to receive but more likely to benefit from selected supportive treatments.<br /><br />The authors conclude that interventions to improve access to effective swallowing rehabilitation—especially multimodal therapy—are urgently needed in SNFs. They emphasize that better delivery of speech-language pathology, nutrition, physical therapy, and nursing interventions such as oral care and dietary support may improve swallowing function, prevent complications like aspiration and malnutrition, and support recovery and discharge back to the community.

Asset Subtitle

Kira Ryskina

Meta Tag

Author List David Leiman, Kira Ryskina, Seth Cohen

Category Research

Concept Swallowing Impairment

Concept Swallowing-Related Outcomes

Concept Skilled Nursing Facility

Concept Rehabilitative Therapy

Concept Nursing Support

Distinguished Non-Finalist

Presenter Organization University of Pennsylvania

Presenting Author Kira Ryskina

Track Outcomes Research

Keywords

dysphagia

skilled nursing facilities

post-acute care

older adults

Medicare claims

swallowing rehabilitation

speech therapy

occupational therapy

oral care

community discharge

Swallowing Impairment

Swallowing-Related Outcomes

Skilled Nursing Facility

Rehabilitative Therapy

Nursing Support