Two new studies have found a close relationship between RN staffing and COVID-19 outbreaks and deaths in nursing homes. The first study reviewed reported COVID-19 infections in California through May 4 and identified three factors associated with increased risk of COVID-19 in nursing homes: higher numbers of past health deficiencies, larger facilities with more residents, and lower federal 5-star ratings. The strongest relationship, however, was RN staffing. Nursing homes with .75 hours of RN staffing per resident per day were half as likely to have a COVID-19 outbreak.
The second study looked at COVID-19 outbreaks and deaths from COVID-19 in Connecticut nursing homes as of April 16. This study found a significant association between the extent of outbreaks (the number of COVID-19 cases a facility had, once it had a case) and four factors: federal 5-star ratings, the concentration of residents on Medi-Cal, the concentration of racial and ethnic minority residents, and RN staffing. RN staffing was also strongly associated with the number of COVID-19 deaths in facilities: every 20 minute increase in RN staffing predicted a 26% reduction in deaths. The study authors concluded that facilities with better compliance with care standards are better able to contain the spread of coronavirus.
The two studies counter the ridiculous narrative, perpetuated by the nursing home industry, that nursing home quality is somehow not related to COVID-19 outbreaks. Of course, quality matters and RN staffing in particular is strongly associated with fewer cases and deaths. Hopefully, our federal and state policymakers are paying attention and will direct RN resources to nursing homes to combat COVID outbreaks among nursing homes.