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OBJECTIVE: To determine the relationship between characteristics of older, long‐term stay nursing home patients and hospitalization.

DESIGN: A cohort study.

SETTING: One hundred three proprietary nursing homes.

PARTICIPANTS: All residents of these nursing homes aged 65 or older admitted between January 1, 1991, and December 30, 1993, who had no transitions out of the nursing home during the first 6 months of their stay.

MEASUREMENTS AND MAIN RESULTS: Among the cohort of 3782 residents, 931 (25%) were hospitalized at least once during the second 6 months of their nursing home stay. In a logistic regression model, severe functional impairment (adjusted odds ratio (AOR) 1.20, 95% confidence interval (CI) 1.01, 1.43), worsening ADL self‐performance (AOR 1.22, 95% CI 1.04, 1.43), presence of a decubitus ulcer (AOR 1.62, 95% CI 1.17, 2.24), presence of a feeding tube (AOR 2.03, 95% CI 1 …