Results of COVID-19, where the number of staff, not ownership, is a predictor of nursing homes

The Journal of the American Geriatrics Society (AGS) recently published Systematic review Results of studies on the characteristics of nursing homes and supportive living communities (ALCs) and how these characteristics determined the outcome of COVID-19 inhabitants.

According to reviews, the strongest and most consistent predictor of COVID-19 results in nursing homes comes from areas with large bed sizes and high rates of COVID-19 incidence. These results included cases and deaths, depending on the racial makeup of the facility and the number of staff. However, as the number of staff increased, the number of cases increased, but the number of deaths decreased. Features that did not correlate consistently with the results included a five-star rating for nursing homes, ownership, and previous infection control citations. The authors included 36 studies of nursing homes and ALC attributes in their reviews.

“We examined evidence for facility-level and community-level factors in nursing home COVID-19 cases and mortality (not including some studies investigating resident-level risk factors).” Said Dr. Tamara Konetsuka, the lead author of the report. Infection control today® Written statement. “We found that the strongest predictions of poor COVID-19 results were the size of the facility (the larger the facility, the worse the results) and the prevalence of COVID-19 at the regional level. Larger facilities at the COVID-19 Hotspot are at higher risk even with the best infection control processes. After an outbreak, increasing staff may help to some extent, but the Nursing Home The traffic of staff in and out of the area also showed a risk of infection. “

Because older people are often frail, the SARS-CoV-2 virus floats in the air and can spread asymptomatically, making it more susceptible to the SARS-CoV-2 virus. In nursing home and ALC situations, it is difficult, if not impossible, to keep a social distance due to the large number of residents and the proximity of each other and caregivers.

Dr. Joseph E. Goggler, Professor, and Robert L. Kane agree to chair the Care and Aging of the University of Minnesota School of Public Health.In a written statement ICT®, He states: “Often we don’t realize that nursing homes aren’t separated from the community, but are part of it. For this purpose, the tragic consequences of a pandemic are that nursing homes actually make residents and families Was it a loss, or was an inadequate public health response failing the nursing home? “

Konetzka et al stated in the report: The overwhelming importance of community COVID-19 prevalence in predicting long-term care cases and mortality suggests that mitigation policies should not focus solely on institutional behavior. All steps to mitigate cases and mortality should previously be initiated at the state and federal levels as ICT®. report..

“The article by Dr. Konetsuka and her colleagues does not exempt the provider of what they did or did not do during the pandemic, but the unprecedented nature and vast range of COVID-19, and A major drawback of our country’s overall pandemic response was that nursing homes were as exposed as our others, “Gaugler wrote. ICT®.. “Unfortunately, these nursing homes in the most infected communities have been blamed for the terrible consequences of a pandemic beyond their ability to control COVID-19.”

However, the lack of effective strategy by the facility itself is not staffing. “Large literature links the level of direct care staffing to the quality of nursing homes, especially in the case of registered nurse (RN) staffing,” the researchers pointed out in the study. “Staffing may be even more important in a pandemic situation. Having the right staff is a prerequisite for implementing measures that are considered best practices for controlling outbreaks. Because it’s a condition. Evidence from our review supports a positive (small / inconsistent) role of staffing in handling outbreaks that occur. “

One aspect of the study that was particularly useful was to compare their overall assessment with cases and mortality at each institution. “Many studies (n = 16) have directly investigated the relationship between the overall 5-star rating of nursing homes and the results of COVID-19,” the researchers reported in a review. “Most of these studies, including all but one of the larger studies using multiple data sources, make virtually sense between the overall 5-star rating and the COVID-19 results. No or statistically significant relationship was found. “

Notable limitations of the data when investigating resident-level risk factors include reduction of time factors and age of study. “In future work, it will be important to investigate resident and staff level risk factors as well as facility level factors,” the author writes in a study.

The results of the review “do not exempt long-term care providers from implementing strict infection control practices or suggest that there are no concerns about the quality of care,” the report said. “Rather, the evidence suggests a wide range of unique challenges, especially in the face of inadequate supply chains for PPE and rapid diagnostics.”

As part of this report, the American Medical Association (AHCA) and the National Center for Supporting Life (NCAL) have sent a letter requesting a meeting with President Joseph Biden, the Department of Health and Human Services (HHS), and Medicare and the Medicaid Center. I did. The Service (CMS) will follow the press release from AHCA to discuss the findings of the report and how to proceed to a future pandemic.