Population of Patients With Traumatic Brain Injury in Skilled Nursing Facilities: A Decade of Change.

The traumatic brain injury diagnosis came from the Minimum Data Set item and selected diagnosis codes, so some patients may have been missed or misclassified. The study could not tell whether traumatic brain injury was the primary reason for skilled nursing facility admission or another condition was. Patients with dementia and other comorbidities were not excluded or adjusted for, and dementia diagnoses increased, so changes in Activities of Daily Living or cognitive scores may reflect other conditions. The cognitive scale changed during the decade, so early and later cognitive results are not directly comparable. Length of stay results were reported for a shorter period than the full admission trend. Average Activities of Daily Living score increased slightly while severe Activities of Daily Living impairment decreased, so the overall functional picture is mixed. The study describes admissions and admission severity markers; it does not show whether patients improved after therapy or what caused the trends.

Do not read the drop in severe impairment as evidence that skilled nursing facility patients with traumatic brain injury now need less rehabilitation. The average Activities of Daily Living score increased slightly, dementia diagnoses rose, and the study could not tell whether traumatic brain injury was the primary reason for admission.