Identification of Functional Limitations and Discharge Destination in Patients With COVID-19.

The study was retrospective and relied on electronic health record documentation, which may be inconsistent or incomplete. Functional deficits were defined by their mention in the chart, not by standardized assessment scores. The matched cohort was small (102 patients), requiring broad grouping of functional variables rather than specific item analysis. All patients were from a single health system in Los Angeles, limiting generalizability. The study cannot establish causality; it is unclear if rehabilitation therapy influenced discharge destination or if therapy was simply more often provided to patients already destined for institutional care. Premorbid functional status was not accounted for, particularly for the 19.5% of patients admitted from assisted living or skilled nursing facilities.

Do not interpret the association between receiving occupational therapy and discharge to an institution as evidence that therapy causes institutional discharge. The study design cannot separate the effect of the therapy from the severity of the patient's condition that prompted the referral in the first place.