This cross-sectional study examines associations between county prevalence data and characteristics of 3,357 skilled nursing facilities (SNFs) in 25 states (341 Genesis facilities and 3,016 non-Genesis), including 64 Genesis SNFs which underwent universal testing.
- 118 (35%) Genesis and 640 (21.2%) non-Genesis SNFs had outbreaks (one or more residents testing positive for SARS-CoV-2)
- SNFs with outbreaks were larger, had higher Star-ratings for both overall staffing and RN staffing, and had higher proportions of Black residents; however, in multivariate analyses that included geographic location only facility size remained significant.
- These facilities were most frequently located in counties with higher SARS-CoV-2 prevalence, higher population densities, and larger Black populations.
- A 10-bed increase in facility size was associated with a 0.9% (95% CI: 0.6, 1.2; P<.001) increase in probability of SNF outbreak.
- An increase of 1,000 per 100,000 cases in county SARS-CoV-2 prevalence was associated with a 33.6% (95% CI: 9.6, 57.7; P<.001) increase in probability of SNF outbreak and a difference of 12.5 SNF cases.
The authors conclude that size was the only facility characteristic associated with case count, and this depended significantly on overall county prevalence. There were no consistent relationships between facility quality and outbreak severity. The authors suggest geographic location is a necessary factor when considering the allocation of limited resources and the ability of state health departments to aid in staffing shortages.
White EM, Kosar CM, Feifer RA, et al. Variation in SARS-CoV-2 Prevalence in US Skilled Nursing Facilities. Journal of the American Geriatrics Society. n/a(n/a). doi:10.1111/jgs.16752
This review was posted on behalf of Lauren Albert, IU School of Medicine student, and reviewed by Dr. Kathleen Unroe, IU School of Medicine Associate Professor, geriatrician, and IU Center for Aging Research Scientist.