Speech-Language Pathology Services Associated with Improvement in Self-Care and Mobility for Post-Acute Skilled Nursing Facility Residents

Research Objectives: To investigate the relationship between intensity of Speech-Language Pathology (SLP) services and improvements in self-care and mobility for post-acute skilled nursing facility (SNF) residents who have cognitive and communicative impairments.

Design: Secondary analyses of Centers for Medicare & Medicaid Services administrative files from calendar year 2018. Mixed effects logistic regression models evaluated the associations between SLP service intensity (measured in therapy days per week and minutes of therapy per session) with patient functional improvement. Models adjusted for patient-level and facility- level factors including sociodemographic characteristics, physical and occupational therapy (PT/OT) intensity, facility size, location, chain membership, and others.

Setting: Skilled Nursing Facilities

Participants: 275,378 fee-for-service Medicare beneficiaries with deficits in communication and/or cognition receiving post-acute care in SNFs in 2018

Interventions: Not Applicable

Main Outcome Measures: Admission to discharge improvement in (1) self-care and (2) mobility scores calculated from Section G of the Minimum Data Set.

Results: Compared to no SLP services, improvements in self-care were associated with 2 to 3 days (OR=1.11, p=0.014) or 4+ days (OR=1.23, p< 0.001) of SLP Services. Similarly, compared to no SLP services, improvements in mobility were associated with 2 to 3 days (1.25, p< 0.001) or 4+ days (OR=1.33, p< 0.001) of SLP services. Increasing treatment session length was negatively associated with improvement in self-care (OR=0.99, p< 0.001) and mobility (0.98, p< 0.001).

Conclusions: Receiving more days of SLP services is associated with improvements in mobility and self-care over the course of a post-acute SNF stay for residents with cognitive and communicative impairments. This finding suggests that residents with these impairments benefit from SLP support in addition to PT and OT to meet goals for holistic functional improvement.

Author(s) Disclosures: Authors received funding from the Department of Rehabilitation Science at the University of Washington and through the Institute of Translational Health Sciences TL1 Program.