JAMA Netw Open. 2025;8(3):e250860. doi:10.1001/jamanetworkopen.2025.0860
Key Points of this Study
Question Has persistent delirium in skilled nursing facilities (SNFs) decreased since passage of the Improving Medicare Post-Acute Care Transformation (IMPACT) Act?
Findings In this cross-sectional study of 306 998 Medicare beneficiaries admitted to SNF, delirium prevalence at admission decreased from 4.3% in 2014 to 2.5% in 2019. In those with delirium at SNF admission, persistent delirium decreased from 62.3% to 54.7%, whereas delirium resolution increased from 29.1% to 37.4%.
Meaning Although improvements in delirium prevalence and resolution were observed among patients admitted to SNFs following the IMPACT Act, the high rate of persistent delirium underscores the need for improved delirium management in SNF.
Conclusions and Relevance This cross-sectional study found a reduction in the prevalence of delirium at SNF admission and an improvement in delirium resolution during the stay in the 5 years following the IMPACT Act. However, the high prevalence of persistent delirium warrants further efforts to improve delirium management in SNF.
