Most ABI patients discharged to community after SNF therapy following IRF stay

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Frontiers in Medicine Published April 17, 2026 Medically reviewed April 25, 2026 DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider that most ABI patients achieve community discharge after SNF therapy, but evidence is observational.

This retrospective cohort study included 218 patients aged 18 years or older with acquired brain injury who were admitted to a skilled nursing facility specialized in brain injury care after an inpatient rehabilitation facility stay. The intervention was continued inpatient therapies at the skilled nursing facility, with no comparator group specified. The primary outcomes were functional improvements measured by AM-PAC scores and community discharge.

Main results showed that 191 patients (88%) were discharged to the community, while 27 (12%) went to long-term care. Mean AM-PAC scores improved across all subdomains for the entire sample. Factors associated with community discharge included higher Admission Basic Mobility scores and a diagnosis of ischemic stroke. Patients discharged to long-term care had longer length of stay, longer time since injury, and lower AM-PAC scores.

Safety and tolerability data were not reported. Key limitations include the observational design, lack of a comparator group, and that no previous studies have specifically evaluated this patient population, as noted in the research gap. The study was conducted at a single academic-affiliated facility, which may limit generalizability.

Practice relevance is restrained: patients with acquired brain injury admitted to skilled nursing facilities after inpatient rehabilitation often show functional progress and high rates of community discharge, with admission functional scores and diagnosis as predictive factors. However, these findings should be applied cautiously due to the study's limitations.

Study Details

Study typeCohort

EvidenceLevel 3

PublishedApr 2026

View Original Abstract ↓

IntroductionInpatient rehabilitation (IRF) is beneficial for patients with acquired brain injuries (ABI), yet some require ongoing therapy at a skilled nursing facility (SNF). While previous research has examined factors influencing community discharge from SNFs, no studies have specifically evaluated ABI patients admitted to SNFs after IRF stays. The aims of this study are to evaluate functional improvements of acquired brain injury patients undergoing rehabilitation at SNF after an IRF stay and determine factors associated with community discharge.MethodsThis is a retrospective cohort study at a SNF unit specialized in brain injury patients and affiliated with an academic medical center. It included patients admitted to a SNF unit from an acute IRF between September 2018 to May 2024, age 18 years or older, with an ABI. The main outcome measures included AM-PAC (Basic Mobility, Daily Activity, and Applied Cognitive) scores and a multivariate analysis of factors associated with community discharge.ResultsAmong 218 patients with ABI admitted to SNF, 191 (88%) were discharged to the community and 27 (12%) to long-term care (LTC). Mean AM-PAC scores improved across the entire sample in all subdomains. Patients discharged to LTC had a longer length of stay, time since injury, and lower AM-PAC scores. Admission Basic Mobility scores and a diagnosis of ischemic stroke were predictors of community discharge.DiscussionPatients with ABI admitted to SNF following an IRF demonstrate significant functional progress, with most patients discharged to the community. Admission functional scores and diagnosis are key factors associated with community discharge.