[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-425194-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-425194-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","cognitive-function-and-30-day-readmission-risk-after-skilled-nursing-facility-to-home-transitions","COGNITIVE FUNCTION AND 30-DAY READMISSION RISK AFTER SKILLED NURSING FACILITY-TO-HOME TRANSITIONS","","Transitions from skilled nursing facilities to home are common for Medicare beneficiaries, yet remain among the least studied and most vulnerable care transitions. Using Health and Retirement Study data linked to Medicare claims and Minimum Data Set assessments from 2000–2019, the study examined the association between cognitive function and 30-day hospital readmission after SNF-to-home discharge. Cognitive function was measured via an MDS-based Cognitive Function Scale. Among 4,527 beneficiaries, cognitive impairment was not significantly associated with 30-day readmission after adjustment (OR 1.17; 95% CI 0.91–1.50). Unadjusted rates were higher for moderate or severe impairment (18.0% vs 15.3%), suggesting unmet discharge readiness needs or community support.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/cognitive-function-and-30-day-readmission-risk-after-skilled-nursing-facility-to-home-transitions/425194/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/cognitive-function-and-30-day-readmission-risk-after-skilled-nursing-facility-to-home-transitions/425194.png","ImageObject",300,407,{"name":42,"@type":43},"Lucas Martin","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-06","2026-09-28",true,{"@type":52,"interactionType":53,"userInteractionCount":55},"InteractionCounter",{"@type":54},"ViewAction",14,{"@type":57,"mainEntity":58},"FAQPage",[59,65,69],{"name":60,"@type":61,"acceptedAnswer":62},"What population and transition did the study focus on?","Question",{"text":63,"@type":64},"The study focused on Medicare beneficiaries transitioning from skilled nursing facilities (SNFs) to home, a care path that is common yet poorly studied.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How was cognitive function measured and analyzed?",{"text":68,"@type":64},"Cognitive function was measured using the Minimum Data Set (MDS)-based Cognitive Function Scale (CFS). The analysis used generalized estimating equations to estimate readmission odds across impairment levels.",{"name":70,"@type":61,"acceptedAnswer":71},"What was the main finding about cognitive function and 30-day readmission?",{"text":72,"@type":64},"After adjusting for demographic and clinical factors, CFS was not significantly associated with 30-day readmission (OR 1.17; 95% CI 0.91–1.50). Unadjusted readmission rates were modestly higher for moderate or severe impairment.","https://schema.org",{"og:url":32,"og:type":75,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":77,"canonical":32},"index,follow",{"doc_id":79,"site_id":7},425194,1790793068,{"code":4,"msg":82,"data":83},"success",[84,88,92,96,101,106,110,115,120,123,127],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":85,"show_sort_weight":86,"slug":87},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":89,"show_sort_weight":90,"slug":91},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":93,"show_sort_weight":94,"slug":95},"Exam",70,"exam",{"id":97,"doc_module":4,"doc_module_name":25,"category_name":98,"show_sort_weight":99,"slug":100},5,"Comic",60,"comic",{"id":102,"doc_module":4,"doc_module_name":25,"category_name":103,"show_sort_weight":104,"slug":105},6,"Technology",50,"technology",{"id":107,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":108,"slug":109},7,40,"healthcare",{"id":111,"doc_module":4,"doc_module_name":25,"category_name":112,"show_sort_weight":113,"slug":114},8,"Research & Report",30,"research-report",{"id":116,"doc_module":4,"doc_module_name":25,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":25,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":25,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":25,"category_name":129,"show_sort_weight":97,"slug":130},19,"General","general",{"code":4,"msg":82,"data":132},{"doc_id":79,"user_id":133,"nickname":42,"user_avatar":134,"doc_module":4,"category_id":107,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":55,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":22,"language":140,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":12,"update_tm":144,"read_time":30,"preview_page_count":4},8796095360427,"https://ap-avatar.wpscdn.com/davatar_994ba38a5ba835b3df7d355c54d3ed8d","Innovation in Aging, 2025, Vol. 9, No. S2 1163  \nAbstract citation ID: igaf122.3897  \nCOGNITIVE FUNCTION AND 30-DAY READMISSION  \nRISK AFTER SKILLED NURSING FACILITY-TO-HOME  \nTRANSITIONS  \nIndrakshi Roy1, Jennifer Carnahan2, James Slaven3, and Emily Fox Ludden4, 1. Indiana University, Bloomington, Bloomington, Indiana, United States, 2. Indiana University Center for Aging Research, Indianapolis, Indiana, United States, 3. Indiana University, Indianapolis, Indiana, United States, 4. Regenstrief Institute, Inc., Indianapolis, Indiana, United States  \nTransitions from skilled nursing facilities (SNFs) to home are common among Medicare beneficiaries, yet they remain one of the least studied and most vulnerable care transitions. Unlike patients discharged directly home from the hospital, those who first receive SNF care are typically more medically complex, experience multiple transitions, and face a heightened risk of adverse events such as hospital readmissions. Because most SNF patients ultimately return home, understanding this second transition is essential for ensuring quality of care, continuity, and patient and caregiver well-being. We used Health and Retirement Study data linked to Medicare claims and Minimum Data Set (MDS) assessments from 2000–2019 to examine the association between cognitive function and 30-day hospital readmission after SNF-tohome discharge. Cognition was measured using the MDS-based Cognitive Function Scale (CFS). Among 4,527 beneficiaries, we applied generalized estimating equations to generate odds of readmission among those with moderate to severe impairment.  \nAfter adjusting for demographic and clinical characteristics, CFS was not significantly associated with 30-day readmission (OR = 1.17; 95% CI = 0.91–1.50). However, patients with moderate or severe cognitive impairment had modestly higher unadjusted readmission rates (18.0%) compared with those with intact or mild cognition (15.3%), suggesting unmet needs in discharge readiness or community support. Our findings indicate that cognition alone may not independently predict short-term rehospitalization, but it remains clinically relevant in transitional care planning. By focusing on SNF-to-home discharges, this study highlights a population where targeted interventions—such as enhanced caregiver engagement and community-based services—may reduce preventable readmissions and improve outcomes for older adults.","cbCaisR1zfwJPwXG","https://ap.wps.com/l/cbCaisR1zfwJPwXG","pdf",1023633,"English","# Background\n# Methods\n# Results\n# Implications","[{\"question\":\"What population and transition did the study focus on?\",\"answer\":\"The study focused on Medicare beneficiaries transitioning from skilled nursing facilities (SNFs) to home, a care path that is common yet poorly studied.\"},{\"question\":\"How was cognitive function measured and analyzed?\",\"answer\":\"Cognitive function was measured using the Minimum Data Set (MDS)-based Cognitive Function Scale (CFS). The analysis used generalized estimating equations to estimate readmission odds across impairment levels.\"},{\"question\":\"What was the main finding about cognitive function and 30-day readmission?\",\"answer\":\"After adjusting for demographic and clinical factors, CFS was not significantly associated with 30-day readmission (OR 1.17; 95% CI 0.91–1.50). Unadjusted readmission rates were modestly higher for moderate or severe impairment.\"}]","COGNITIVE FUNCTION AND 30-DAY READMISSION RISK AFTER SKILLED NURSING FACILITY-TO-HOME TRANSITIONS | PDF",1790636557]