ArticlePloS one2021
Interpreting COVID-19 deaths among nursing home residents in the US: The changing role of facility quality over time.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Timing of Goals of Care Discussions in Nursing Homes: A Systematic Review.Journal of the American Medical Directors Association · 2023Pooled it
- Factors Associated With Mortality in Appalachian Nursing Homes During the COVID-19 Pandemic.The Permanente journal · 2026Article
- Place-Based Disparities Among Nursing Homes During the COVID-19 Pandemic: A Systematic Literature Review.Health equity · 2025Review
- Factors influencing long-term care facility performance during the COVID-19 pandemic: a scoping review.BMC health services research · 2024Article
- Cause of Death by Race and Ethnicity in Minnesota Before and During the COVID-19 Pandemic, 2019-2020.Journal of racial and ethnic health disparities · 2024Article
- Stronger Impact of COVID-19 in Nursing Homes of a French Region During the Second Pandemic Wave.Journal of the American Medical Directors Association · 2023Observational
- Cause of Death by Race and Ethnicity in Minnesota Before and During the COVID-19 Pandemic, 2019-2020.medRxiv : the preprint server for health sciences · 2023Article
- The United States public health services failure to control the coronavirus epidemic.Preventive medicine reports · 2023Review
- JUE Insight: Is hospital quality predictive of pandemic deaths? Evidence from US counties.Journal of urban economics · 2023Article
- Modeling of nursing care-associated airborne transmission of SARS-CoV-2 in a real-world hospital setting.GeroScience · 2022Article
- Examining the Impacts of Coronavirus Disease 2019 Mitigation Policies on Health Outcomes of Older Adults: Lessons Learned From Six High-Income or Middle-Income Countries.The Public policy and aging report · 2022Article
- Nursing Home Residents' COVID-19 Infections in the United States: A Systematic Review of Personal and Contextual Factors.Gerontology & geriatric medicineArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A report published last year by the Centers for Medicare & Medicaid Services (CMS) highlighted that COVID-19 case counts are more likely to be high in lower quality nursing homes than in higher quality ones. Since then, multiple studies have examined this association with a handful also exploring the role of facility quality in explaining resident deaths from the virus. Despite this wide interest, no previous study has investigated how the relation between quality and COVID-19 mortality among nursing home residents may have changed, if at all, over the progression of the pandemic. This understanding is indeed lacking given that prior studies are either cross-sectional or are analyses limited to one specific state or region of the country. To address this gap, we analyzed changes in nursing home resident deaths across the US between June 1, 2020 and January 31, 2021 (n = 12,415 nursing homes X 8 months) using both descriptive and multivariable statistics. We merged publicly available data from multiple federal agencies with mortality rate (per 100,000 residents) as the outcome and CMS 5-star quality rating as the primary explanatory variable of interest. Covariates, based on the prior literature, consisted of both facility- and community-level characteristics. Findings from our secondary analysis provide robust evidence of the association between nursing home quality and resident deaths due to the virus diminishing over time. In connection, we discuss plausible reasons, especially duration of staff shortages, that over time might have played a critical role in driving the quality-mortality convergence across nursing homes in the US.
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Registered trials
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