Is There a Link between Nursing Home Reported Quality and COVID-19 Cases? Evidence from California Skilled Nursing Facilities.
Mengying He, Yumeng Li, Fang Fang
PMID 32674817WHAT IT FOUND
California nursing homes with 5-star quality ratings were less likely to report resident COVID-19 cases and deaths than 3-star homes.
Larger, for-profit homes and homes with lower white resident percentage were more likely to report cases and deaths.
Key findings
01After adjustment, 5-star homes were less likely than 3-star homes to have resident COVID-19 cases and deaths.
02Homes with a lower white resident percentage were more likely to have resident cases and deaths.
03For-profit homes and homes with higher bed occupancy were more likely to have resident cases and deaths.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study analyzed facilities, not individual patients, so it cannot show which facility characteristics caused the differences. It used only California data as of June 2, 2020, so it may not apply to other states or later pandemic periods. Facilities with fewer than 11 cases were masked, so exact case and death counts were not available for many homes. Testing capacity was not measured, so homes that tested more may have found more cases. Staffing, location, and patient comorbidities were not included, so the associations may reflect other facility or community differences. The adjusted model used 1107 of the 1223 facilities, so some facilities were missing data. It compared facilities at one point and over a short period, so it cannot prove cause.
The easy way to misread this
Do not read the 5-star association as proof that better nursing care prevented outbreaks. The study compared facilities, not individual patients, and did not measure testing capacity, staffing, location, or patient comorbidities.