Claims-Based Frailty Among Newly Admitted Long-Stay Nursing Home Residents - Abstract

Q: How is “long-stay nursing home” defined in this study?

Long-stay nursing home is defined as accumulating at least 30 days within an episode.

Q: How was frailty measured and categorized?

Frailty was measured using a claims-based frailty index (CFI) on claims in the 12 months before admission, then categorized as non-frail (CFI < 0.25), mild (0.25–0.34), moderate (0.35–0.44), and severe (≥0.45).

Q: What did severe frailty correspond to in one-year outcomes?

Compared with non-frail beneficiaries, severe frailty was associated with higher rates of one-year mortality, hospitalization, ED visits, injurious falls, and pressure ulcers based on adjusted hazard or competing-risk models.

Sep 29, 2026

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Claims-based frailty assessment is evaluated for newly admitted long-stay nursing home residents, defined as accumulating at least 30 days within an episode. Using a 7% random sample of fee-for-service Medicare beneficiaries from 2015 to 2019, 66,407 new residents were identified. Frailty measured by a claims-based frailty index in the prior 12 months was classified into non-frail, mild, moderate, and severe groups, and associated one-year risks of mortality, hospitalization, ED use, injurious falls, and pressure ulcers.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages1

Reading Time3 min

AccessFree to download

Study Objectives

Population and Frailty Measurement

Frailty Prevalence at Admission

One-Year Outcomes and Risk Estimates

Conclusions

1298 Innovation in Aging, 2025, Vol. 9, No. S2 examined the association of frailty category with mortality, hospitalization, ED visits, injurious falls, and pressure ulcers over one-year follow-up, using Cox proportional hazards or Fine–Gray competing-risk models adjusted for age, sex, and dual eligibility. Frailty was present in 77.1% at LNH admission, with 46.7% mild frailty, 25.6% moderate frailty, and 4.8% severe frailty. One-year risk of mortality increased with frailty: 20.4% in non-frailty, 26.3% in mild frailty, 30.6% in moderate frailty, and 33.5% in severe frailty. Differences in mortality persisted when stratified by age and sex. Compared with non-frail beneficiaries, those with severe frailty had higher rates of mortality (HR [95% CI], 2.0 [1.8, 2.1]), hospitalization (2.8 [2.6–2.9]), ED visits (1.8 [1.6–1.9]), injurious falls (1.2 [0.9–1.5), and pressure ulcers (3.9 [3.4–4.4]) . These results highlight that a claims-based frailty assessment can be useful for prognostication and risk stratification among newly admitted LNH residents. Abstract citation ID: igaf122.4326 CLAIMS-BASED FRAILTY AMONG NEWLY ADMITTED LONG-STAY NURSING HOME RESIDENTS Kailin Xu1, Chan Mi Park2, Brianne Olivieri-Mui3, Sarah Berry2, Dae Hyun Kim1, and Sandra Shi1, 1. Hebrew SeniorLife, Boston, Massachusetts, United States, 2. Hebrew SeniorLife & Harvard Medical school, Boston, Massachusetts, United States, 3. Northeastern University, Boston, Massachusetts, United States Admission to a long-stay nursing home (LNH, defined as ≥30 accumulative days within an episode) is a sentinel event for older adults, often signaling limited life expectancy or increased risk of adverse health outcomes. However, the prevalence of frailty and its prognostic value at LNH admission remain poorly characterized. In a 7% random sample of fee-for-service Medicare beneficiaries from 2015 to 2019, we identified 66,407 new LNH residents. Frailty was measured using the claims-based frailty index (CFI) on claims in the 12 months prior to LNH admission and categorized as non-frail (CFI < 0.25), mild frailty (0.25-0.34), moderate frailty (0.35-0.44) or severe frailty (≥0.45) . We

FAQs

How is “long-stay nursing home” defined in this study?

Long-stay nursing home is defined as accumulating at least 30 days within an episode.

How was frailty measured and categorized?

Frailty was measured using a claims-based frailty index (CFI) on claims in the 12 months before admission, then categorized as non-frail (CFI < 0.25), mild (0.25–0.34), moderate (0.35–0.44), and severe (≥0.45).

What did severe frailty correspond to in one-year outcomes?

Compared with non-frail beneficiaries, severe frailty was associated with higher rates of one-year mortality, hospitalization, ED visits, injurious falls, and pressure ulcers based on adjusted hazard or competing-risk models.

Sep 29, 2026

Upload by dhado