Assessing the influence of nursing home size and care models on COVID-19 case and mortality rates

Young Y, Liu Y, Shayya A, Chiu WY, Hsu W, O'Grady T

Introduction

This study examines the impact of COVID-19 on older adults in traditional nursing homes, Green Houses (GHs), and Continuing Care Retirement Communities-Nursing Homes (CCRCNHs).

Methods

COVID-19 cases and deaths from CMS and LTCFocus data across 11 states from 6/2020 to 9/2022 were used, and Poisson regressions to compare care settings while adjusting for covariates.

Results

CCRCNH and GH residents were older (84.4 and 83.1 years) than those in traditional NHs (77.5 and 77.6 years, p < 0.0001), with more female and White individuals. COVID-19 risk was higher in CCRCNHs (RR 1.51, 95 % CI 1.10–2.07), large NHs (RR 1.57, 95 % CI 1.14–2.15), and highest in small NHs (RR 1.80, 95 % CI 1.32–2.47). Mortality rates across NH types showed no significant difference.

Conclusion

The study shows that smaller, person-centered GHs are more effective in controlling COVID-19 infection, suggesting a need to rethink care models to incorporating GH features for better outcomes.