COVID-19 in Nursing Homes: Geographic Diffusion and Regional Risk Factors in the United States

Keywords: COVID-19 and Nursing Homes, Covid-19 and Veteran’s Homes, Covid-19 spatial analysis, United States
Session Type: Virtual Paper Abstract
Day: Saturday
Session Start / End Time: 2/26/2022 03:40 PM (Eastern Time (US & Canada)) - 2/26/2022 05:00 PM (Eastern Time (US & Canada))
Room: Virtual 29

Abstract

Nursing homes in the United States have an enormous responsibility to protect elderly residents from SARS-CoV-2 (COVID-19) infection. This study presents the geographic diffusion of COVID-19 cases and deaths in nursing homes from Week 1 24-May 2020 to Week 10 26-July 2020, while also providing regional explanations for diffusion. Nursing home COVID-19 data was obtained from the Centers for Medicare and Medicaid Services. Using geocoded locations of nursing homes, weekly confirmed COVID-19 case counts (n=173,452) were spatially smoothed with deaths (n=46,173) overlaid to visualize the magnitudes of mortality in relation to infection density. Repeated cross-sectional zero-inflated negative binomial models were estimated within Health and Human Service (HHS) Regions to evaluate facility and neighborhood-level risk factors. The first nursing home resident to die of COVID-19 was in the state of Washington, 28-February 2020. By the end of Week 1 COVID-19 cases/deaths were reported in nursing homes across the country. Epicenters were in the Northeast (HHS Regions 1,2,3) and Midwest (HHS Region 5). Subsequently, COVID-19 diffused to the South and Southwest (HHS Regions 4,6,9). Risk factors for COVID-19 deaths were the discharge of patients from hospitals into nursing homes, staff confirmed with COVID-19, and nursing shortages. Veteran’s deaths were significantly elevated in Region 3. Nursing homes in neighborhoods with high-minority and low-English speaking populations were most affected. Continued statewide preparation to protect nursing home residents is warranted. Communication between HHS administrators and the timely transmission of ‘Lessons Learned’ to state health departments will further prevent nursing home COVID-19 deaths.