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Larger Living Areas, More Beds Linked to Reduced COVID-19 Cases in NHs
Larger living areas and the existence of ventilator-dependent units were associated with reductions in COVID-19 deaths among nursing home (NH) residents, leading researchers to recommend that NH regulations and architectural design take these factors into account.
“As of March 2021, about 8% of those living in United States NHs or other long-term care facilities have died of COVID-19, and the rate for NHs is even higher, at nearly 1 in 10," authors wrote. “These striking statistics are sobering reminders about the importance of providing safer environments in NHs.”
The cross-sectional study used nationwide datasets and included 7785 NHs—approximately half (50.8%) of all NHs in the United States that receive funding from Medicare or Medicaid.
Researchers created models to predict COVID-19 cases, deaths, and transmissibility using the following four variables: community factors (eg NH location), resident characteristics, management and performance features, and physical environment attributes.
Findings showed that reductions in COVID-19 transmission and death were significantly linked to increased share of private rooms, larger living areas per bed, and the presence of a ventilator-dependent unit.
After controlling for staff cases and using the number of residents as the exposure variable, researchers also noted that increasing the number of certified beds was linked to reduced cases, deaths, and transmissibility among NH residents.
“Considering the vulnerability of NH residents in congregated living environments, NHs will continue to be high-risk settings for infection outbreaks,” authors concluded. “To improve safety and resilience of NHs against future health disasters, facility guidelines and regulations should consider the need to increase private rooms and living areas.”
Reference:
Zhu X, Lee H, Sang H, et al. Nursing home design and COVID-19: implications for guidelines and regulation [published online ahead of print December 23, 2021]. JAMDA. doi:10.1016/j.jamda.2021.12.026
