Objectives: This study examines the association between nursing home residents' perceived importance of family involvement in overall care planning and the administration of physical and occupational therapy.

Design: Cross-sectional study.

Setting and participants: The study focused on all newly admitted nursing home residents aged 50 years and older who transferred from acute-care facilities in 2019.

Methods: We analyzed data from the Minimum Data Set 3.0 for 2,112,330 residents aged 50+ years in US nursing homes. We assessed family involvement in care planning based on the resident's perceived importance of family involvement in care planning, ranging from "Not important at all" to "very important." Exclusions were residents in hospice, comatose, or life expectancy of less than 6 months. The outcome was defined as a sum of physical and occupational therapy minutes. Adjusted linear regression models were used.

Results: Residents who reported "very important" family involvement were older (mean age 78 years) and received more therapy minutes compared with other groups. Those with a lesser preference for family involvement were younger and had higher body mass index, better continence, and less functional impairment. Fewer therapy minutes were received by residents with less family involvement. Residents who considered family involvement "Not Important at All" received 15 fewer minutes of therapy (95% CI, -18 to -13) compared with those who deemed it "very important" after adjusting for confounders.

Conclusions and implications: The study highlights a link between family involvement in care planning and increased therapy administration in nursing homes. Residents reporting higher preference for family engagement received more therapy minutes, with this pattern consistent across various demographic and health conditions. This finding underscores the importance of family involvement in receipt of therapy and highlights the need for incorporating family engagement strategies in nursing home care planning to ensure equitable and effective care.