Advancing Rehabilitation Paradigms for Older Adults in Skilled Nursing Facilities

Each year, millions of older adults experience hospitalization, often leading to significant declines in physical function. For many, rehabilitation in a skilled nursing facility (SNF) is necessary to regain strength and mobility, yet current rehabilitation programs are typically low-intensity and insufficient for full recovery. As a result, only 52% of SNF patients successfully return to their communities. This study aims to evaluate the effectiveness of a high-intensity resistance rehabilitation program compared to usual care across multiple SNFs. Using a cluster randomized pragmatic trial design, we will assess improvements in physical function, particularly gait speed, while also analyzing the factors that influence successful implementation. By identifying barriers and facilitators, this research seeks to transform SNF rehabilitation practices, improve patient independence, and inform future efforts to expand high-intensity rehabilitation across post-acute care settings.