Is There a Link between Nursing Home Reported Quality and COVID-19 Cases? Evidence from California Skilled Nursing Facilities

Abstract Objectives During the COVID-19 outbreak in the U.S., nursing homes became the hotbed for the spread of COVID-19. States developed different policies to mitigate the COVID-19 risks at nursing homes, including limiting nursing home visitation and mandating staff screening. The purpose of this study is to examine whether COVID-19 cases and deaths are related to the nursing home reported quality. Design We combined the COVID-19 data reported by the California Department of Public Health (CDPH), quality ratings provided by Nursing Home Compare (NHC), and patient racial information from Long-term Care Focus to examine the association between nursing home reported quality and COVID-19 cases and deaths. Settings and Participants: Cross sectional data from 1,223 California Skilled Nursing Facilities with reported quality and longitudinal data of COVID-19 cases were used. Measures The dependent variable is COVID-19 residents’ cases and deaths. The main independent variable is nursing home reported quality. Nursing home ownership, size, years of operation, and patient race composition are also included. Results Nursing home star ratings and greater percentage of residents from different racial and ethnicity groups were significantly (p<.01) related to increased probability of having a COVID-19 residents’ case or death. Conclusion and Implications: Nursing homes with five-star ratings were less likely to have COVID-19 cases and deaths after adjusting for nursing home size and patient race proportion.