High-Minority Nursing Homes Disproportionately Affected by COVID-19 Deaths

Abstract

Racial/ethnic disparities in healthcare have been highlighted by the recent COVID-19 pandemic. Using the Centers for Medicare and Medicaid Services' Nursing Home COVID-19 Public File, this study examined the relationship between nursing home racial/ethnic mix and COVID-19 resident mortality. As of October 25, 2020, high minority nursing homes reported 6.5 COVID-19 deaths as compared to 2.6 deaths for nursing homes that had no racial/ethnic minorities. After controlling for interstate differences, facility-level resident characteristics, resource availability, and organizational characteristics, high-minority nursing homes had 61% more COVID-19 deaths [Incidence Rate Ratio (IRR) = 1.61; p < 0.001] as compared to nursing facilities with no minorities. From a policy perspective, nursing homes, that serve primarily minority populations, may need additional resources, such as, funding for staffing and personal protective equipment in the face of the pandemic. The COVID-19 pandemic has sharpened the focus on healthcare disparities and societal inequalities in the delivery of long-term care.

A systematic review of long‐term care facility characteristics associated with COVID‐19 outcomes

“…With one exception, 27 all studies used facility-level data and did not control for resident-level risk factors. Thirty-four studies examined nursing homes only, [31][32][33][34][35][36][37][38][39][40][41][42][43] one study included nursing homes and ALCs, 29 and one study examined ALCs only. 30 Nine were single-state studies; 11,15,18,[21][22][23]25,27,29 14 were national studies; 10,14,17,19,20,24,31,[36][37][38][40][41][42][43] and the remainder were multi-state studies including between 3 and 30 states.…”

Did the COVID-19 Pandemic Affect the Use of Antipsychotics Among Nursing Home Residents With ADRD?

“…NHs serving a high proportion of minorities are known to have fewer resources, lower quality of care, 27 and have experienced more COVID-19 cases and deaths than low-minority NHs. 28 , 29 , 30 , 31 To date, there is no empirical study on how the pandemic influenced antipsychotic use in NHs serving a high- versus low-proportion of minorities.…”

Restoring resilience through joy: The pursuit of happiness in the midst of unprecedented times

“…Narrowing the focus to age and race, the elderly and children were even more vulnerable to infection. The early days of the pandemic showed that elderly populations were highly vulnerable to infection, with nursing homes that cared for larger populations of non-white residents reporting increased infection rates and deaths weekly ( Li et al, 2020 ; Weech-Maldonad et al, 2021 ). Additionally, nursing home facilities with higher rates of non-white residents faced COVID-19 death rates that were 3.3 times higher than facilities with higher proportions of white elderly residents.…”