WCPR 2027

While inpatient rehabilitation requires vigorous therapies to restore functional independence, teams face an ongoing clinical tension between encouraging active mobility and preventing safety events like falls and worsening pressure injuries. We conducted a retrospective cohort study of patients discharged from 2018 to 2025 (n = 4,671,231) using data from the Uniform Data System for Medical Rehabilitation to examine the incidence of inpatient falls and new or worsening pressure injuries and their association with functional recovery and length of stay (LOS). Adverse events were identified via standardized quality indicators (QIs) from the Inpatient Rehabilitation Facility Patient Assessment Instrument (IRF-PAI). Generalized linear models evaluated the adjusted associations of these Qis and rehabilitation outcomes: functional gain and LOS. Overall, 5.9% of admissions (n = 273,640) experienced a fall, and 0.6% (n = 26,238) developed or worsened a pressure injury. In adjusted models, experiencing an event significantly prolonged hospitalization: LOS was 21.7% longer for fallers (RR 1.22, 95% CI 1.21–1.22; p < 0.001) and 19.1% longer for pressure injuries (RR 1.19, 95% CI 1.19–1.20; p < 0.001). Risk-adjusted mobility gains were attenuated by only -3.04 points for fallers and -7.87 points for pressure injuries (both p < 0.001). However, affected patients achieved substantial absolute gains (+24.13 and +20.47 points, respectively). While in-stay adverse safety events increase LOS and moderately attenuate recovery, patients still achieve substantial functional gains. Intensive post-acute rehabilitation remains highly effective and restorative despite in-stay clinical complications, indicating that adverse safety events should not trigger defensive immobilization or premature discharge

Margaret A. DiVita, PhD, is an Assistant Professor in the Department of Pharmaceutical Sciences at Binghamton University’s School of Pharmacy and Pharmaceutical Sciences. An epidemiologist and health services researcher, Dr. DiVita specializes in post-acute care outcomes, biostatistics, and quality indicator validation using large national registries. A leading expert in rehabilitation epidemiology, she has authored over 25 peer-reviewed publications utilizing Uniform Data System for Medical Rehabilitation (UDSMR) data. Previously, she served for thirteen years as a Professor of Public Health Science at SUNY Cortland and as a Senior Research Analyst at UDSMR