Characteristics and Quality of US Nursing Homes Reporting Cases of Coronavirus Disease 2019 (COVID-19)

Short-stay admissions and lower staffing associated with larger COVID-19 outbreaks in Maryland nursing homes

“…Nursing home metrics reflecting poorer quality, including infection control deficiencies and complaints, have been associated with higher COVID-19 case rates, 3,7,8 while higher star ratings have been associated with lower rates. 9,10 Surprisingly, higher CMS Quality ratings were associated with larger outbreaks in our study (see Table 2), perhaps because larger facilities tended to have higher CMS ratings.…”

“…3,4,9,10 Our study is unique as our outcome variable measures the ability to prevent spread of COVID-19 and we account for community prevalence by county in a single state with a coordinated response to COVID-19 in NHs. Most previous studies have used a binary outcome with any case defined as positive, [3][4][5][7][8][9]12 while only a minority have distinguished between small and large outbreaks. 10,11 We also had a unique measure of quality in the Maryland Health Care Commission's family satisfaction survey.…”

“…Studies to date have shown that various organizational and facility factors such as facility size and occupancy, ratings and quality metrics, staffing, and resident ethnicity are related to the presence of COVID-19 in NHs. [3][4][5][6][7][8][9][10][11][12] The purpose of this study was to assess NH factors that determine the trajectory of COVID-19 outbreaks.…”

Caring for those caring for older adults

“…Nursing home staff have worked through staffing shortages due to staff contracting COVID-19, particularly early on in the pandemic when personal protective equipment was scarce. Several publications [2][3][4][5] have used large-scale administrative data analyses to understand why some LTCFs had larger outbreaks than others; however, much of these analyses did not consider personal protective equipment or staffing shortages, both of which have been major concerns throughout the course of the pandemic.…”

Reply to Comment on COVID‐19 Deaths in Long Term Care Facilities ‐ A Critical Piece of the Puzzle

“…2 This is especially important given that communities with high infection rates also have more reported cases of COVID-19 in LTCFs. 3 When community spread of COVID-19 is lower, it appears there are fewer deaths in LTCFs. Unfortunately, COVID-19 so-called hot spots in the United States are now seeing increasing COVID-19 deaths in LTCFs.…”