Assessing Health and Wellbeing in Skilled Nursing Facilities for Individuals with Alcohol Use Disorder

Objectives: This study explored social group membership, experiences with alcohol use disorder (AUD), barriers to care as linked to social determinants of health, and functional limitations in Skilled Nursing Facilities (SNFs) in the United States. By leveraging comprehensive data derived from the electronic health records of SNF residents, we provide a detailed analysis of how activities of daily living (ADLs) vary across groups with different chronic and acute health conditions, specifically focusing on individuals with AUD. Design: Cross-sectional, observational study. Setting and Participants: This study relies PointClickCare Life Sciences commercially available deidentified and expert-determined data derived from SNF resident electronic health records (EHR) collected between January 1, 2015, and April 30, 2022. Methods: The study relies on a comparative analysis of ADL outcomes between 196,095 residents with AUD and the broader SNF population of 2,739,470 residents. Central outcome variables include measures of activities of daily living (ADLs) based on EHR data captured by Section G, Function, of the CMS MDS tool. Results: Findings indicate significant gender, age, and race differences in how different individuals experience functional limitations and improvements with those over time. Compared to the general SNF population, residents with AUD generally have a shorter length of stay and fewer conditions on average, but they take as many or more medications and experience less change in ADLs. Conclusions and Implications: These findings underscore the importance of considering the unique characteristics and needs of residents with AUD in SNFs. Tailored interventions and care plans that address gender, racial, and age-related differences, barriers to care, and the complexity of medication management are crucial for improving outcomes for this population. Addressing social barriers to care and ensuring equitable access to resources and support can help mitigate the disparities observed in the study.