Rapid growth of rehabilitation services in traditional community-based nursing homes

Objective: To describe the changes in rehabilitation therapy services in nu rsing homes based in the community during a period of rapid escalation of M edicare payments to nursing homes. Setting: All Medicaid-certified nursing homes in Ohio. Subjects: The 52,705 residents newly admitted to nursing homes in 1994 and 1995. Design: Retrospective trend analysis of administrative data. Main Outcome Measures: For newly admitted residents receiving 90 or more mi nutes of rehabilitation therapy per week, the trends in percentage and in t he amount and type of therapy received were determined for eight quarters. Results: Of all newly admitted residents, 50.5% received 90 or more minutes of therapy. When they received such therapy it averaged 412 minutes per we ek (SD = 259), Those residents who received rehabilitation services increas ed by 2.2% each quarter (p <.001), and the amount of therapy they received increased by 6.4 minutes each quarter (p <.0001). All three types of rehabi litation therapy-physical, occupational, and speech-increased (p <.015) ove r the study period. Conclusions: The traditional nursing home is an important site for the prov ision of rehabilitation therapy services. Rehabilitation specialists should be aware of these trends as they plan for the future of rehabilitation. Th e effectiveness of this increased provision of therapy service in terms of measurable outcomes needs to be evaluated. (C) 1999 by the American Congres s of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.