A 2-year pandemic period analysis of facility and county-level characteristics of nursing home coronavirus deaths in the United States, January 1, 2020-December 18, 2021.
Ayodeji Emmanuel Iyanda, Kwadwo Adu Boakye
PMID 35248837WHAT IT FOUND
Nursing homes with lower overall quality ratings had more resident COVID-19 deaths.
After accounting for ownership and location, the highest-rated facilities had 44% fewer deaths than the lowest.
Key findings
01Nursing homes in the lowest facility-rating quartile had 10.21 resident COVID-19 deaths per 100 beds, compared with 7.48 in the highest quartile.
02After the researchers accounted for ownership and location, the highest-rated quartile had 44% fewer deaths than the lowest-rated quartile.
03For-profit facilities had 9.49 deaths per 100 beds, compared with 8.66 in nonprofit facilities and 8.93 in government-owned facilities.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study compared nursing homes and counties, not individual residents, so it cannot show what happened to a specific patient. Deaths were self-reported by nursing home administrators, and possible misdiagnosis could affect the counts. The models did not include residents' demographics or underlying health conditions, so differences in who lived in the facilities may explain some findings. County-level demographics may not represent the actual residents of each nursing home. The analysis used the overall facility rating rather than separate quality, inspection, staffing, and RN ratings. Associations do not prove that changing facility ownership, rating, or location causes fewer deaths. Some location differences were not significant after adjusting for staff and resident cases and vaccination.
Declared interests
No specific funding was received, and the authors declared no conflict of interest.
The easy way to misread this
Do not read the 44% lower deaths in highest-rated facilities as proof that improving ratings will save lives. The study was observational, used facility-level death counts, and did not control for residents' health conditions or test any intervention.