Giving Compass' Take:

• Research indicates that nursing homes with higher concentrations of disadvantaged residents, lower nurse staffing levels, and lower scores on CMS five-star quality measures, had higher rates of confirmed COVID-19 cases and deaths. 

• How can nursing homes ameliorate some of these conditions to make nursing homes safer? What resources would these facilities need to improve? How could donors help? 

• Learn about the impact of undercounting nursing home deaths. 

“In nursing homes, quality and staffing are important factors, and there already exists system-wide disparities in which facilities with lower resources and higher concentrations of socio-economically disadvantaged residents have poorer health outcomes,” says Yue Li, a professor in the University of Rochester Medical Center’s public health sciences department and lead author of the study in the Journal of the American Geriatrics Society.

“These same institutional disparities are now playing out during the coronavirus pandemic.”

Residents of long-term care facilities have been shown to be highly vulnerable to respiratory disease outbreaks, such as influenza or other common human coronaviruses. Current evidence suggests that COVID-19 disproportionately affects older adults and individuals with chronic health conditions. These factors are more concentrated in nursing homes where residents are characterized by advanced age, more frequent and complex chronic disease patterns, and highly impaired physical, cognitive, and immune system functions, putting these populations at greater risk for more severe COVID-19 infections.

The new study examined nursing home level data published on the Connecticut Department of Health and Human Services website. At the time of the study, Connecticut was one of the few states that made this information publicly available. This information was compared to data from the Center for Medicare & Medicaid Service’s Nursing Home Compare website, which tracks quality, staffing, and health outcomes for nursing homes nationwide.

Analyses of the data showed that long-term care facilities with higher concentrations of disadvantaged residents, including Medicaid residents and racial and ethnic minorities, lower nurse staffing levels, particularly registered nurses, and lower scores on CMS five-star quality measures, had higher rates of confirmed COVID-19 cases and deaths. Higher nurse staffing ratios in particular was strongly associated with fewer cases and deaths.

Read the full article about the safety of nursing homes during COVID-19 by Mark Michaud at Futurity.