Evidence map›Paper›PMID 40383139›Full record

ArticleJournal of the American Medical Directors Association2025

Lifting Federal Visitation Restriction and COVID-19 Infections in Nursing Homes.

John R Bowblis, Shuang Li, Yong-Fang Kuo, Jennifer Heston-Mullins, James S Goodwin, Huiwen Xu

Abstract read
In one paragraph

Article in Journal of the American Medical Directors Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Nursing home visitor policy and COVID-19 infection rates.American journal of infection control · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

John R BowblisDepartment of Economics, Farmer School of Business, Miami University, Oxford, OH, USA; Scripps Gerontology Center, Miami University, Oxford, OH, USA. Electronic address: jbowblis@miamiOH.edu.
Shuang LiSealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA.
Yong-Fang KuoSealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA; School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA.
Jennifer Heston-MullinsScripps Gerontology Center, Miami University, Oxford, OH, USA.
James S GoodwinSealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA; Department of Medicine, University of Texas Medical Branch, Galveston, TX, USA.
Huiwen XuNell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.

Funding

UTMB OAIC Research Education Component (REC)P30AG024832 · NIA · UNIVERSITY OF TEXAS MEDICAL BR GALVESTON · PI JAMES S. GOODWIN, MD, MELISSA M. MORROW · 2005 to 2026
$26.7M
The effectiveness and consequences of visitation bans in nursing homesR01AG081282 · NIA · UNIVERSITY OF TEXAS MED BR GALVESTON · PI Huiwen Xu · 2023 to 2026
$1.5M
Alzheimer's Special Care Units in Nursing Homes: Racial and Ethnic Disparities, Resident Outcomes, and State PoliciesR01AG087296 · NIA · EMORY UNIVERSITY · PI Huiwen Xu · 2024 to 2026
$1.2M
NIA NIH HHS P30 AG024832NIA NIH HHS R01 AG081282NIA NIH HHS R01 AG087296
6 · The paper itself

Abstract

objectivesEarly in the COVID-19 pandemic, the Centers for Medicare and Medicaid Services (CMS) recommended restricting visitors from entering nursing homes as a precaution. The restriction was lifted on September 17, 2020. This study examines whether COVID-19 infection rates among residents increased after the lifting of the federal restriction, providing indirect evidence on the impact of introducing visitation restrictions.

designWe used a difference-in-differences event-study framework to compare changes in nursing home COVID-19 infection rates in the 4 weeks before (August 23, 2020-September 13, 2020) vs. 8 weeks after (October 4, 2020-November 22, 2020) the lifting of the federal visitation restriction. SETTING AND

participantsThe study cohort included 4823 nursing homes in the 19 treatment states that never had state-level visitation bans and 1654 nursing homes in the 8 control states that implemented state bans but lifted their bans by August 2020. The control group theoretically had the ability to allow visitation before the lifting of the federal restriction.

methodsOur primary outcomes were weekly nursing home COVID-19 infection rates among residents and community-adjusted resident infection rates. The policy change was the lifting of federal visitation restriction on September 17, 2020. All analyses control for other facility characteristics that may impact COVID-19 spread in nursing homes.

resultsNursing home infection rates closely mirrored the trend in community COVID-19 infections. Our regression analyses found no statistically significant increase in nursing home infection rates (ß = 2.4; 95% CI, -6.4 to 11.2) or the community-adjusted infection rates (ß = -5.2; 95% CI, -10.9 to 0.5) associated with the lifting of the federal restriction. CONCLUSIONS AND IMPLICATIONS: Lifting the federal visitation restriction had a negligible impact on nursing home infection rates. Policymakers and nursing home administrators should only consider implementing visitation restrictions under extreme circumstances.

Indexed as

COVID-19Nursing HomesVisitors to PatientsAgedAged, 80 and overCenters for Medicare and Medicaid Services, U.S.FemaleHumansMaleSARS-CoV-2United StatesCOVID-19 infectionsdifference-in-differencesFederal visitation restrictionnursing homes

Identifiers

PMID40383139
PMCPMC12747134

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.