Assessing Resident Trauma: Evaluating Trauma Informed Practices in Nursing Homes
1
1 School of Health Sciences, Central Michigan University, Michigan, United States, Central Michigan University, Mount Pleasant, Michigan 48859, United States
Popul. Med. 2026;8(Supplement Supplement 1):A15
ABSTRACT
BACKGROUND:
The U.S. Centers for Medicare and Medicaid Services (CMS) mandate the integration of trauma-informed care (TIC) within nursing homes to enhance resident well-being and quality of care. Despite this requirement, gaps persist in the consistent recognition and response to trauma among nursing home residents. This dissertation addressed these gaps by examining the prevalence, implementation, and policy alignment of trauma-informed practices across three nursing homes in Southeastern Michigan.
METHODS:
A retrospective cross-sectional design was employed using secondary data from 400 resident medical records collected between 2020 and 2025. Quantitative analyses were conducted to assess trauma documentation, resident characteristics, and facility-level factors associated with trauma-informed care. The study also incorporated policy and systems-level reviews to evaluate organizational readiness and alignment with CMS trauma-informed care guidelines.
RESULTS:
Findings from the first manuscript revealed inconsistencies in the use of standardized instruments to assess resident trauma. Among the 400 residents studied, 206 had documented trauma histories; however, 61% lacked trauma-informed treatment plans. Males and younger adults (ages 18–44) were more likely to have recorded trauma histories, with post-traumatic stress disorder and stress-related conditions representing the most prevalent diagnoses. The second manuscript identified significant associations between trauma history, resident demographics, and facility characteristics. The third manuscript highlighted barriers to sustained TIC adoption, including limited access to mental health providers, weak referral networks, and inadequate community collaboration.
CONCLUSIONS:
Collectively, the findings indicate that while progress toward trauma-informed care in nursing homes has begun, uniform application remains limited. Advancing trauma-informed long-term care requires leadership engagement, staff education, and alignment of organizational policies with community partnerships to ensure consistent, compassionate, and person-centered approaches to resident care.
The U.S. Centers for Medicare and Medicaid Services (CMS) mandate the integration of trauma-informed care (TIC) within nursing homes to enhance resident well-being and quality of care. Despite this requirement, gaps persist in the consistent recognition and response to trauma among nursing home residents. This dissertation addressed these gaps by examining the prevalence, implementation, and policy alignment of trauma-informed practices across three nursing homes in Southeastern Michigan.
METHODS:
A retrospective cross-sectional design was employed using secondary data from 400 resident medical records collected between 2020 and 2025. Quantitative analyses were conducted to assess trauma documentation, resident characteristics, and facility-level factors associated with trauma-informed care. The study also incorporated policy and systems-level reviews to evaluate organizational readiness and alignment with CMS trauma-informed care guidelines.
RESULTS:
Findings from the first manuscript revealed inconsistencies in the use of standardized instruments to assess resident trauma. Among the 400 residents studied, 206 had documented trauma histories; however, 61% lacked trauma-informed treatment plans. Males and younger adults (ages 18–44) were more likely to have recorded trauma histories, with post-traumatic stress disorder and stress-related conditions representing the most prevalent diagnoses. The second manuscript identified significant associations between trauma history, resident demographics, and facility characteristics. The third manuscript highlighted barriers to sustained TIC adoption, including limited access to mental health providers, weak referral networks, and inadequate community collaboration.
CONCLUSIONS:
Collectively, the findings indicate that while progress toward trauma-informed care in nursing homes has begun, uniform application remains limited. Advancing trauma-informed long-term care requires leadership engagement, staff education, and alignment of organizational policies with community partnerships to ensure consistent, compassionate, and person-centered approaches to resident care.
| eISSN: | 2654-1459 |
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