Public Health Rep. 2022 Feb 21:333549221074381. doi: 10.1177/00333549221074381. Online ahead of print.

ABSTRACT

OBJECTIVE: The COVID-19 pandemic has had a devastating impact on older adults residing in skilled nursing facilities. This study examined the pathways by which community and facility factors may have affected COVID-19 cases and deaths in skilled nursing facilities.

METHODS: We used structural equation modeling to examine the number of COVID-19 cases and deaths in skilled nursing facilities in Cook County, Illinois, from January 1 to September 30, 2020. We used data from the Centers for Medicare & Medicaid Services, the Illinois Department of Public Health and the Cook County Medical Examiner’s Office to determine the number of cases and resident deaths of COVID-19, the number of cases of personnel, facility-level characteristics and community-level factors.

RESULTS: Poorer facility quality ratings and higher numbers of COVID-19 cases among staff were associated with an increase in the number of COVID-19 resident cases and deaths. For-profit ownership was associated with larger facilities and higher resident-to-staff ratios, which increased the number of COVID-19 cases among staff. Additionally, skilled nursing facilities with a higher percentage of white residents were in areas with low levels of social vulnerability and were less likely to be for-profit and, therefore, were associated with higher quality.

CONCLUSIONS: For-profit ownership was associated with lower facility quality ratings and increased COVID-19 cases among staff, leading to increased COVID-19 cases and deaths among residents. Establishing enforceable regulations to ensure quality standards in for-profit skilled nursing facilities is critical to preventing future epidemics and reducing health disparities in facilities serving racial and ethnic minority populations.

PMID:35184576 | DOI: 10.1177/00333549221074381