No link found between COVID-19 cases, nursing home quality ratings

Local researchers did not find a link between a nursing home having a resident positive for COVID-19 and a facility’s quality rating from the federal government.

A study by Miami University's Scripps Gerontology Center published in June examined resident cases of COVID-19 in Ohio nursing homes and whether the presence of COVID-19 among residents is associated with facility quality.

MORE: Communication is key, nursing home resident families say

John Bowblis, professor of economics and Scripps Research Fellow, and Robert Applebaum, professor of gerontology and sociology and director of the Ohio Long-Term Care Research Project, used weekly reports released by the Ohio Department of Health and found that as of June 3, 28% of Ohio’s nursing homes had at least one resident with COVID-19. They also identified facilities with high caseloads of COVID-19.

Then, they examined those facilities’ quality ratings as reported through the Centers for Medicare and Medicaid Services Nursing Home Compare website, which assigns a star rating to reflect facility quality.

The study found no link between having a resident positive for COVID-19 and a facility’s CMS star rating. And, even for facilities with a high proportion of residents with COVID-19, the study did not find a link to quality.

“To be sure, there are poorly-managed facilities,” the researchers wrote. “But there are also facilities that are well-run and working diligently to protect their residents and staff; yet despite all of their efforts, they have still been hit hard by the virus. Therefore, the simple notion that any nursing home that has had a resident with COVID-19 or even a high number of residents with the virus, is not adequately protecting their residents and staff, is not justified by these study results.”

The authors wrote that the story is more complex and requires an understanding of the unique circumstances of each facility. The wrote that the nature and structure of nursing home care in general appear to be the primary drivers in the spread of COVID-19 in Ohio nursing homes.

MORE: COVID-19 testing for long-term care still lacking

“As long as the pandemic is present and we are without a vaccine or rapid and universal testing, nursing home residents and the individuals who care for them will remain the most vulnerable members of society. Our results provide a first look at this data, but these comparisons will need to be examined over time to better understand prevalence rates and their link to quality and other facility factors,” they wrote.

The authors noted their results provide a first look at this data, but these comparisons will need to be examined over time to better understand prevalence rates and their link to quality and other facility factors.

As of July 2, there were 706 current COVID-19 cases among Ohio long-term care residents and 372 current cases among staff, with long-term care including nursing homes, assisted living facilities and group homes for people with intellectual disabilities.

Since the Ohio long-term care cases started being recorded April 15, there have been 7,117 resident cases and 3,402 staff cases.

There have been 1,653 long-term care deaths from April 15 to July 1 in Ohio.

With the data, Ohio Department of Health noted some facilities have dedicated COVID-19 wings that accept COVID-19 patients for treatment. Additionally, some facilities chose to perform mass-testing on all staff and residents, so counts may include some asymptomatic positives.

About the Author