ArticleJournal of the American Medical Directors Association2025
Patterns and Predictors of Reopening Nursing Homes to Visitors During the COVID-19 Pandemic.
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. Not yet cited in PubMed.
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Abstract
objectivesStatewide restrictions on visitors to nursing homes were widely used during the COVID-19 pandemic. This study examines the patterns and predictors of allowing outside visitors after a statewide ban on visitors was lifted.
designA secondary analysis of publicly available data. SETTING AND
participantsA total of 847 Ohio nursing homes that reported visitor policy data.
methodsWe obtained weekly visitor policies (October 29, 2020, to April 15, 2021) from the Ohio Long-Term Care Facility Visitation Dashboard. We merged visitor policies with resident, facility, and COVID-19 factors and conducted 2-level (nursing home, county) Hierarchical Generalized Linear Mixed models with backward variable selection to examine predictors of allowing visitors and reinstating bans.
resultsWithin 3 weeks of lifting the ban in Ohio on December 10, 2020, 51% of the 653 Ohio nursing homes with available data allowed visitors. The proportion of facilities that allowed visitors declined to 36% by November 25, 2020, but began increasing in late February and reached 81% by April 15, 2021. Of the 495 nursing homes that initially opened to visitors, 35% of them later reinstated bans, with half of these later allowing visitors again before March 2021. When nursing homes were first allowed to reopen, facilities with a recent COVID-19 infection among residents or staff were much less likely to allow visitors (relative risk, 0.38; 95% CI, 0.31-0.47). During a statewide increase in community COVID-19 infection rates, nursing homes in counties with higher rates were less likely to allow visitors (relative risk, 0.80; 95% CI, 0.63-0.99). Nursing homes that had more beds (relative risk, 1.61; 95% CI, 1.35-1.92) and higher overall 5-star ratings (relative risk, 1.27; 95% CI, 1.08-1.49) were more likely to reinstate bans. CONCLUSIONS AND IMPLICATIONS: The pattern of reopening nursing homes to visitors was marked by a slow progression and dynamic policy changes over time. The 2 primary predictors associated with reopening were facility and community COVID-19 status.
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