Nursing Home Characteristics Associated With COVID-19 Deaths in Connecticut, New Jersey, and New York

Unruh, Mark Aaron; Yun, Hyunkyung; Zhang, Yongkang; Braun, Robert; Jung, Hye–Young

doi:10.1016/j.jamda.2020.06.019

Cited by 48 publications

(69 citation statements)

References 2 publications

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“…3,19,20 Larger nursing homes had a higher risk of larger outbreaks (i.e., cumulative resident cases >10% of licensed beds) perhaps because they employ more staff, thereby increasing the chance of COVID-19 introduction. This is consistent with existing literature suggesting that larger and more fully occupied facilities were more likely to have COVID-19 cases [3][4][5][6] . We also found that facilities with a greater proportion of residents who were short-stay had larger outbreaks.…”

Section: Discussionsupporting

confidence: 92%

“…We did find that facilities with lower family satisfaction scores and fewer CNA staffing hours, two other measures of quality, had larger outbreaks, consistent with existing work. 4,9,11,12 Higher staffing ratios may lead to better adherence to state-mandated infection guidelines, thus preventing spread, for example, allowing for more rapid adoption of infection prevention practices. Finally, after adjusting for other NH characteristics, gender and race of NH residents was no longer associated with larger COVID-19 outbreaks.…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Mattingly¹,

Trinkoff

et al. 2021

Preprint

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Objectives: Identify facility factors associated with a larger COVID-19 outbreak among residents in Maryland nursing homes (NHs). Design: Observational Setting and Participants: All Maryland NHs. Methods: Resident COVID-19 cases were collected for each Maryland NH from January 1, 2020 through July 1, 2020. Cumulative COVID-19 incidence through July 1, 2020 was collected for each county and Baltimore City. Facility characteristics for each Maryland NH were collected from time periods prior to January 1, 2020. NH outbreaks were defined as larger when total resident COVID-19 cases exceeded 10% of licensed beds. Descriptive and multivariable analyses were conducted to assess the strongest predictors for the primary outcome of larger COVID-19 outbreak. Results: NHs located in counties with high cumulative incidence of COVID-19 were more likely to have larger outbreaks (OR 4.5, 95% CI 2.3-8.7, p<0.01). NHs with at least 100 beds were more likely to have larger outbreaks, especially among facilities with >140 licensed beds (100-140 beds vs <100 beds: OR 1.9, 95% CI 0.9-4.1, p=0.09; >140 beds vs <100 beds: OR 2.9, 95% CI 1.3-6.1, p<0.01). NHs with more short-stay residents (OR 2.2, 95% CI 1.1-4.8, p=0.04) or fewer Certified Nursing Assistant hours daily (OR 2.6, 95% CI 1.3-5.3, p<0.01) also were more likely to have larger outbreaks. Resident race and gender were not significant predictors of larger outbreaks after adjustment for other factors. Conclusions: Large NHs with lower staffing levels and many short-stay residents in counties with high COVID-19 incidence were at increased risk for COVID-19 outbreaks. Understanding the characteristics of nursing homes associated with larger outbreaks can help us prepare for the next pandemic.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Mattingly¹,

Trinkoff

et al. 2021

Preprint

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“…Although no previous research that we are aware of has examined PE ownership and outcomes associated with COVID-19, 6 recent studies 4 , 26 , 27 , 28 , 29 , 30 compared outcomes of for-profit nursing homes with nursing homes with other types of ownership. The findings of these studies were inconsistent.…”

Section: Discussionmentioning

confidence: 99%

Comparative Performance of Private Equity–Owned US Nursing Homes During the COVID-19 Pandemic

et al. 2020

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Key Points Question Compared with other nursing homes, are private equity (PE)–owned nursing homes associated with better or worse coronavirus disease 2019 (COVID-19) outcomes? Findings In this cross-sectional study of 11 470 US nursing homes, there were no statistically significant differences in staffing levels, COVID-19 cases or deaths, or deaths from any cause between PE nursing homes and facilities with other ownership types. Compared with PE, all other ownership types were more likely to have at least a 1-week supply of N95 masks and medical gowns. Meaning In this study, PE-owned nursing homes performed comparably with for-profit and nonprofit nursing homes based on COVID-19 cases and deaths and deaths by any cause but had less personal protective equipment than other nursing homes.

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“…Thus, COVID-19 has shown the urgent need for staff training and standards of geriatric care in nursing homes—both in terms of resources as well as expertise [ 10 , 11 ]. It has been suggested that the highest infectivity and mortality rates in nursing homes have been associated with the location and size of nursing homes, shortage of staff, quality of care, high resident density and low socio-economic level of residents [ 4 , 12 – 14 ]. These findings challenge us to rethink the design and management of nursing homes.…”

mentioning

confidence: 99%

COVID-19 has hit nursing homes hard

Pitkälä

2020

Eur Geriatr Med

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Nursing Home Characteristics Associated With COVID-19 Deaths in Connecticut, New Jersey, and New York

Cited by 48 publications

References 2 publications

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

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

Comparative Performance of Private Equity–Owned US Nursing Homes During the COVID-19 Pandemic

COVID-19 has hit nursing homes hard

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