Variation in SARS-CoV-2 Prevalence in U.S. Skilled Nursing Facilities

Area of Science:

• Gerontology
• Infectious Disease Epidemiology
• Healthcare Management

Background:

• Skilled nursing facilities (SNFs) are vulnerable to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks.
• Factors influencing outbreak risk within SNFs require identification to inform prevention strategies.

Purpose of the Study:

• To identify county-level and facility-level factors associated with SARS-CoV-2 outbreaks in SNFs.
• To assess the relationship between community prevalence, facility characteristics, and outbreak occurrence.

Main Methods:

• A cross-sectional study design was employed, linking county SARS-CoV-2 prevalence data with SNF administrative and outbreak reports.
• Data included information from a large multistate provider (Genesis HealthCare) and publicly available state reports.
• Outbreaks were defined as one or more resident cases of SARS-CoV-2.

Main Results:

• SNFs in areas with higher SARS-CoV-2 prevalence had a significantly increased probability of outbreaks.
• Larger SNFs (by 10 beds) showed a higher probability of experiencing an outbreak.
• No consistent association was found between Nursing Home Compare Five-Star ratings or past infection control deficiencies and outbreak risk or severity.

Conclusions:

• SNFs situated in regions with high SARS-CoV-2 prevalence and larger facilities are at elevated risk for outbreaks.
• Universal testing is essential for early detection of cases in SNFs.
• Implementing mitigation strategies and universal testing can help prevent further SARS-CoV-2 transmission and complications.