COVID-19 Nursing Home Outbreaks Spark Research Into Quality Concerns

The rapid and disproportionate spread of COVID-19 in nursing homes has led to increased concerns about nursing home quality among researchers. MedTruth has summarized some of the latest findings for our readers:

• Nursing homes with the lowest profit margins were more likely to be cited for problems with infection control and prevention compared to nursing homes with the highest profit margins. Divided into five tiers, nursing homes that made the least money were 54% more likely to be cited in one year and 88% more likely to be cited in all three years than nursing homes that made the most money.

About 75% of all 12,194 nursing homes studied were cited at least once between 2017–2019, while about 10% were cited in all three years. (April 2021)

• There were stark differences among states in the percentage of nursing homes cited for infection control and prevention problems, ranging from a low of 20% of nursing homes in North Carolina cited to nearly 80% of nursing homes in West Virginia. Nursing homes cited two or more times during the 2017–19 study period tended to have higher percentages of Medicaid patients, were for-profit, and had sicker residents. Vermont was the only state with no nursing homes cited more than once. (December 2020)

• Nursing home staffing levels appear to have a “nuanced” relationship to COVID-19 outbreaks. On the one hand, higher nurse staff hours was associated with an increased likelihood of COVID-19 entering the facility. On the other hand, higher nurse and nurse aide staff hours was linked to a lower likelihood of a full-on COVID-19 outbreak as well as with fewer deaths. The strongest predictor of COVID-19 nursing home outbreaks and deaths was the infection rate in the county. (August 2020)

• Nursing homes with at least one COVID-19 case were more likely to be urban, larger facilities, have a higher percentage of African-American residents, not be chain-operated, and operate in certain states (New Jersey and Massachusetts had the highest percentage of nursing homes with COVID-19 cases). No association was found between COVID-19 infections and five-star ratings, percentage of Medicaid patients, prior infection violations or nursing home ownership. (June 2020)

By Carah Wertheimer

Carah Wertheimer is an editor and reporter based in Boulder, Colorado. Her areas of specialization include food, health, environment, social justice and community reporting. Her work has appeared in National Geographic, The Denver Post, The Daily Beast, the Boulder Daily Camera, Boulder Weekly and other publications.