Table 1 Baseline characteristics of long-term care facility residents, 2013–2015

Length of follow-up, days, mean ± SD

112 ± 200

29 ± 20

269 ± 278

Age at index date, years, mean ± SD

81.6 ± 8.2

80.8 ± 8.1

82.9 ± 8.3

 65–74

394,331 (23.0)

281,767 (25.2)

112,564 (19.0)

 75–84

639,132 (37.3)

434,977 (38.9)

204,155 (34.4)

 85+

678,034 (39.6)

401,310 (35.9)

276,724 (46.6)

Female sex

1,191,557 (69.6)

768,633 (68.8)

422,924 (71.3)

 Non-Hispanic White

1,420,689 (83.0)

943,096 (84.4)

477,593 (80.5)

 Non-Hispanic Black

147,231 (8.6)

81,401 (7.3)

65,831 (11.1)

 Hispanic

62,070 (3.6)

36,682 (3.3)

25,388 (4.3)

 Community or home

124,588 (7.3)

37,208 (3.3)

87,380 (14.7)

 Another LTCF or swing bed^a

61,435 (3.6)

19,777 (1.8)

41,658 (7.0)

 Hospital

1,486,083 (86.8)

1,044,083 (93.4)

442,000 (74.5)

LTCF admission is new

1,441,102 (84.2)

1,019,035 (91.1)

422,067 (71.1)

  < 18.5, underweight

117,888 (6.9)

76,489 (6.8)

41,392 (7.0)

 18.5–24.9, normal

656,364 (38.4)

424,751 (38.0)

231,590 (39.0)

 25–29.9, overweight

480,408 (28.0)

313,886 (28.1)

166,511 (28.1)

  ≥ 30, obese

456,890 (26.7)

302,928 (27.1)

153,950 (25.9)

Current tobacco use

47,959 (2.8)

24,811 (2.2)

23,148 (3.9)

 Cancer

141,791 (8.3)

108,447 (9.7)

33,344 (5.6)

 Atrial fibrillation or other dysrhythmias

441,467 (25.8)

307,971 (27.8)

133,496 (22.5)

 Coronary artery disease

452,352 (26.4)

304,647 (27.3)

147,705 (24.9)

 Heart failure

385,850 (22.5)

243,464 (21.9)

142,386 (24.0)

 Hypertension

1,352,541 (79.0)

877,554 (78.5)

474,987 (80.0)

 History of pneumonia

125,660 (7.3)

104,590 (9.4)

21,070 (3.6)

 Diabetes mellitus

554,424 (32.4)

347,402 (31.1)

207,022 (34.9)

 Arthritis

517,064 (30.2)

339,561 (30.4)

177,503 (29.9)

 Alzheimer’s disease

107,700 (6.3)

35,684 (3.2)

72,016 (12.1)

 Cerebrovascular accident, transient ischemic attack, or stroke

197,397 (11.5)

104,438 (9.3)

92,959 (15.7)

 Non-Alzheimer’s dementia

406,597 (23.8)

165,369 (14.8)

241,228 (40.7)

 Depression

595,844 (34.8)

314,369 (28.1)

281,475 (47.4)

 Asthma, chronic obstructive pulmonary disease, chronic lung disease

410,086 (24.0)

269,238 (24.1)

140,848 (23.7)

 Respiratory failure

44,460 (2.6)

33,858 (3.0)

10,602 (1.8)

 Parkinson’s disease

74,036 (4.3)

36,366 (3.3)

37,670 (6.4)

  Intact/mild cognitive impairment (0–1)

1,001,934 (58.5)

778,937 (52.1)

222,997 (37.6)

  Moderate cognitive impairment (2, 3)

680,284 (39.8)

325,810 (29.1)

354,474 (59.7)

  Severe cognitive impairment (4–6)

29,274 (1.7)

13,307 (1.2)

15,972 (2.7)

  None to limited assistance required (0–14)

795,028 (46.5)

582,547 (46.5)

212,481 (38.5)

  Extensive assistance required (15–19)

620,211 (36.2)

385,371 (34.5)

234,840 (39.5)

  Extensive dependency (≥20)

296,258 (17.3)

150,136 (13.4)

146,122 (24.6)

  No instability (0)

990,561 (57.9)

650,661 (58.2)

339,900 (57.3)

  Minimal instability (1, 2)

701,695 (41.0)

456,279 (40.8)

245,416 (41.4)

  Moderate to very high instability (3+)

19,241 (1.1)

11,114 (1.0)

8127 (1.4)

  0

155,594 (9.1)

117,051 (10.5)

38,543 (6.5)

  1–2

719,649 (42.1)

484,120 (43.3)

235,529 (39.7)

   ≥ 3

836,254 (48.9)

516,883 (46.2)

319,371 (53.8)

 Urinary incontinence: frequent/always

529,756 (31.0)

238,989 (21.4)

290,767 (49.0)

 Bowel incontinence: frequent/always

403,981 (23.6)

190,054 (17.0)

403,981 (23.6)

 Shortness of breath

258,935 (15.1)

172,789 (15.5)

86,146 (14.5)

 Swallowing disorder

65,162 (3.8)

46,058 (4.1)

19,104 (3.2)

 Tube feeding

33,988 (2.0)

17,140 (1.5)

16,848 (2.8)

 Ventilator or respirator use

1741 (0.1)

678 (0.1)

1063 (0.2)

 Prognosis: less than 6 months to live

7145 (0.4)

5274 (0.5)

1871 (0.3)

 Died during study period 2013–2015

812,036 (47.4)

459,028 (41.1)

353,008 (59.5)

 Beers criteria medication,^b any use

1,098,173 (64.2)

672,349 (60.1)

425,824 (71.8)

 Antipsychotics, any use

96,289 (5.6)

39,659 (3.6)

56,630 (9.5)

 Opioid analgesics, any use

127,139 (7.4)

99,251 (8.9)

27,888 (4.7)

 Antibiotics, any use^c

704,363 (41.2)

461,537 (41.3)

242,826 (40.9)

 Corticosteroids, any use

99,079 (5.8)

72,409 (6.5)

26,670 (4.5)

 Proton pump inhibitors, any use

328,345 (19.2)

229,345 (20.5)

99,000 (16.7)

 Influenza vaccine received for season of cohort entry

1,021,615 (59.7)

628,356 (56.2)

393,259 (66.3)

 Pneumococcal vaccination up to date

1,177,063 (68.8)

749,307 (67.0)

427,756 (72.1)

 Any hospitalization use

1,388,076 (81.1)

1,037,211 (92.8)

350,865 (59.1)

 Any ICU use

454,699 (26.6)

340,691 (30.5)

114,008 (19.2)

 Urban location

1,298,856 (75.9)

886,434 (79.3)

412,422 (69.5)

   < 100

630,730 (36.9)

415,999 (37.2)

214,731 (36.2)

  100–200

882,091 (51.5)

570,832 (51.1)

311,259 (51.5)

   > 200

198,676 (11.6)

131,223 (11.7)

67,453 (11.4)

 For-profit facility

1,159,613 (67.8)

746,395 (66.8)

413,218 (69.6)

 Ratio of RN to RN + LPN, mean ± SD

0.4 ± 0.2

0.4 ± 0.2

0.3 ± 0.2

 SLP on-staff, hours / 100 Beds, mean ± SD

0.5 ± 1.6

0.6 ± 1.6

0.4 ± 1.4

 LIP on-site

773,827 (45.2)

515,034 (46.1)

258,793 (43.6)

 Total nursing hours/resident/day, mean ± SD

4.9 ± 9.4

5.3 ± 10.5

4.3 ± 6.8

 Antipsychotic use, % of residents, mean ± SD

18.9 ± 11.2

17.2 ± 10.3

22.1 ± 12.2

 Restraint use, % of residents, mean ± SD

2.0 ± 4.5

1.8 ± 4.3

2.4 ± 4.8

 Pressure ulcers, % of residents, mean ± SD

6.5 ± 4.7

6.7 ± 4.8

6.2 ± 4.3