​A review of scientific research by leading academic experts in the field found that community spread was the primary driver of COVID-19 outbreaks in long term care facilities. The review examined 36 different studies, and the final analysis was published in the Journal of the American Geriatrics Society. The paper supports prior findings that showed that the size and location of a facility were the strongest and most consistent predictors of COVID-19 outcomes, especially if the facility was located in an area with high COVID-19 rates.

The study concluded that if communities had been better able to control the spread of the virus, nursing homes would have had a better chance at mitigating outbreaks and safeguarding residents. Additionally, the scientific review found that ownership type and quality performance were not strong indicators of how prepared a nursing home was for the pandemic. This means a facility’s rating within the Five-Star Quality Rating System and any previous infection control citations were not associated with COVID cases and deaths. The conclusion of the research stated:

“Given the importance of community COVID-19 prevalence and facility size, studies that failed to control for these factors were likely confounded. Better control of community COVID-19 spread would have been critical for mitigating much of the morbidity and mortality long-term care residents and staff experienced during the pandemic. Traditional quality measures such as Nursing Home Compare 5-Star ratings and past deficiencies were not consistent indicators of pandemic preparedness, likely because COVID-19 presented a novel problem requiring extensive adaptation by both long-term care providers and policymakers.”

Long term care residents are more susceptible to the virus because of their age and underlying medical conditions. And while heroic caregivers did everything they could to help prevent cases, they often lacked support from the public health sector for much-needed resources such as personal protective equipment (PPE), testing, and staff support.

While access to testing and PPE has greatly improved, long term care residents and staff still need support. The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) recently released a State of Skilled Nursing Facility Industry report that showed the dire economic and workforce crises facing the long term care sector due to the pandemic.

AHCA/NCAL sent a letter last week requesting meetings with President Biden, the Department of Health and Human Services (HHS), and the Centers for Medicare and Medicaid Services (CMS) to discuss ways the Administration and providers can work together to implement meaningful change to benefit residents and caregivers.

Long term care providers are committed to learning from this pandemic to help ensure it does not happen again, but as this research shows, they cannot do it alone. We need policymakers to prioritize our most vulnerable and give them full support and cooperation to make meaningful improvements possible. 

Read the full research review HERE.