Table 3.
Predictors of Community Discharge among Short‐ and Long‐Stay Episodes
| Short‐Stay Episodes | Long‐Stay Episodes | |||
|---|---|---|---|---|
| California (N = 93,308) | Florida (N = 98,046) | California (N = 42,605) | Florida (N = 36,571) | |
| Odds Ratio (95% CI) | Odds Ratio (95% CI) | Odds Ratio (95% CI) | Odds Ratio (95% CI) | |
| Market characteristics | ||||
| Herfinadahl index | 0.81 (0.60–1.08) | 0.97 (0.81–1.16) | 1.16 (0.70–1.92) | 1.88 (1.24–2.85) |
| Market occupancy | 1.00 (0.99–1.01) | 0.99 (0.98–1.00) | 1.00 (0.99–1.02) | 1.00 (0.99–1.01) |
| Median income | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) |
| Population density (log) | 0.99 (0.96–1.02) | 0.96 (0.89–1.04) | 1.04 (1.00–1.08) | 1.09 (1.02–1.16) |
| Proportion of residents 65+ | 1.24 (0.98–2.10) | 0.99 (0.99–1.00) | 1.15 (0.99–2.75) | 1.29 (0.64–2.61) |
| Facility characteristics | ||||
| Total deficiency score | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) | 1.00 (1.00–1.00) |
| For‐profit ownership | 0.97 (0.90–1.05) | 0.96 (0.91–1.02) | 1.09 (1.05–1.26) | 1.17 (1.06–1.30) |
| Chain membership | 1.08 (0.96–1.12) | 0.98 (0.94–1.02) | 1.03 (0.95–1.12) | 1.06 (0.98–1.15) |
| Occupancy | 1.39 (1.10–1.74) | 1.61 (1.24–2.09) | 1.41 (0.92–2.17) | 1.25 (0.76–2.06) |
| Number of beds (in 100s) | 1.03 (1.05–1.12) | 1.04 (1.01–1.11) | 0.93 (0.85–1.01) | 1.05 (0.94–1.17) |
| Staffing | ||||
| FTE RN HPRD | 0.96 (0.89–1.05) | 1.04 (0.94–1.16) | 0.85 (0.73–1.00) | 0.98 (0.79–1.22) |
| FTE LPN HPRD | 0.99 (0.95–1.02) | 0.99 (0.91–1.07) | 0.94 (0.88–1.00) | 0.88 (0.76–1.03) |
| FTE CNA HPRD | 1.01 (0.99–1.02) | 1.00 (0.99–1.01) | 1.00 (0.98–1.03) | 1.01 (0.99–1.03) |
| SW per 100 residents | 1.02 (1.00–1.04) | 1.00 (0.99–1.02) | 1.01 (0.98–1.06) | 1.02 (0.98–1.06) |
| Proportion of Medicaid residents | 0.77 (0.67–0.89) | 0.68 (0.56–0.82) | 0.91 (0.87–0.94) | 0.79 (0.55–0.98) |
| Proportion of Medicare residents | 1.22 (0.98–1.52) | 1.27 (0.96–1.29) | 3.14 (2.11–4.68) | 2.30 (1.47–3.60) |
| Proportion of residents admitted from acute care | 1.58 (1.24–2.02) | 1.06 (0.69–1.63) | 1.10 (0.74–1.63) | 0.88 (0.50–1.55) |
| Average episode length | 0.98 (0.97–0.99) | 0.99 (0.98–0.99) | 0.99 (0.98–0.99) | 0.99 (0.97–0.99) |
| Resident characteristics | ||||
| Age at admission | 0.99 (0.99–0.99) | 0.98 (0.98–0.99) | 0.97 (0.96–0.97) | 0.97 (0.97–0.98) |
| Married | 1.29 (1.25–1.34) | 1.34 (1.29–1.39) | 1.06 (0.98–1.14) | 1.01 (0.93–1.09) |
| Caucasian | 1.05 (1.00–1.09) | 1.00 (0.96–1.05) | 0.91 (0.84–1.00) | 0.92 (0.84–1.01) |
| Female | 1.23 (1.19–1.27) | 1.12 (1.08–1.15) | 1.12 (1.05–1.20) | 1.08 (1.01–1.16) |
| Depression | 0.76 (0.70–0.82) | 0.78 (0.73–0.84) | 0.90 (0.76–1.04) | 0.89 (0.77–1.04) |
| CPS score | ||||
| Intact (0–1) | Reference | Reference | Reference | Reference |
| Mild (2–4) | 0.46 (0.45–0.48) | 0.49 (0.47–0.50) | 0.61 (0.57–0.65) | 0.59 (0.54–0.67) |
| Severe (5–6) | 0.20 (0.19–0.22) | 0.29 (0.27–0.31) | 0.27 (0.23–0.31) | 0.22 (0.19–0.39) |
| Lived alone | 1.08 (1.04–1.12) | 1.14 (1.10–1.18) | 1.20 (1.10–1.28) | 1.18 (1.10–1.27) |
| Behavioral problems | 0.70 (0.66–0.74) | 0.69 (0.65–0.73) | 0.70 (0.60–0.78) | 0.70 (0.62–0.80) |
| ADL impairment | 0.90 (0.90–0.91) | 0.93 (0.92–0.93) | 1.00 (0.99–1.02) | 1.02 (1.01–1.04) |
| Urinary incontinence | 0.75 (0.73–0.77) | 0.91 (0.88–0.95) | 0.88 (0.82–0.94) | 0.98 (0.91–1.04) |
| Fecal incontinence | 0.46 (0.43–0.49) | 0.50 (0.48–0.52) | 0.79 (0.73–0.92) | 0.83 (0.71–0.97) |
| Recent fall | 1.08 (1.04–1.11) | 0.98 (0.94–1.01) | 1.23 (1.15–1.32) | 1.06 (0.99–1.14) |
| Recent fracture | 1.47 (1.41–1.53) | 1.32 (1.27–1.38) | 1.49 (1.37–1.63) | 1.85 (1.70–2.01) |
| Mental health diagnosis | 0.79 (0.71–0.87) | 0.92 (0.82–1.03) | 1.42 (1.20–1.68) | 0.87 (0.69–1.11) |
| Diabetes | 0.89 (0.87–0.92) | 0.89 (0.86–0.92) | 1.03 (0.96–1.10) | 1.09 (1.02–1.17) |
| Stroke | 0.92 (0.89–0.96) | 0.90 (0.86–0.93) | 1.11 (1.03–1.21) | 1.24 (1.14–1.34) |
| CHF | 0.85 (0.82–0.88) | 0.82 (0.79–0.85) | 0.88 (0.81–0.95) | 0.86 (0.79–0.93) |
| Parkinson | 0.96 (0.89–1.03) | 0.93 (0.87–0.99) | 1.12 (0.98–1.28) | 1.05 (0.92–1.21) |
| Renal failure | 0.79 (0.75–0.83) | 0.79 (0.75–0.83) | 0.82 (0.74–0.91) | 0.92 (0.83–1.03) |
| Cancer | 0.68 (0.65–0.72) | 0.68 (0.65–0.71) | 0.60 (0.54–0.67) | 0.63 (0.57–0.70) |
| COPD | 0.84 (0.80–0.87) | 0.81 (0.78–0.84) | 0.80 (0.74–0.87) | 0.88 (0.81–0.94) |
Bold represents significant findings (p < .05). ADL, activities of daily living; CHF, congestive heart failure; CNA, certified nurse aid; COPD, chronic obstructive pulmonary disease; CPS, Cognitive Performance Scale; FTE, full‐time equivalent; HPRD, hours per resident day; LPN, licensed practice nurse; RN, registered nurse.