Tuesday, August 04, 2020

Why Nursing Homes Are Covid Hot Spots

Nursing homes account for a disproportionate share of Covid-19 cases and deaths. Covid outbreaks continue to plague nursing homes despite visitor restrictions that began in mid-March. Why are nursing homes such hot spots? A National Bureau of Economic Research study may have the answer: staff linkages.

In a unique study, NBER researchers analyzed the geolocation data of more than 500,000 smartphones observed in at least one of 15,000 nursing homes during the six weeks following the nationwide nursing home visitor restrictions that went into effect March 13. Since visitors were no longer allowed into nursing homes, most of these smartphones belonged to staff. The goal of the study was to discover how interconnected nursing homes are through their staff. Very connected: "We find that 7 percent of individuals entering a nursing home also entered at least one other nursing home in the six-week period," the researchers report. The average nursing home, in fact, has connections with 15 other nursing homes. There are a number of reasons for this high level of connectivity. One, most nursing homes rely on staffing agencies to fill some of their staffing needs, which can vary from day to day. Two, nursing home workers may work at multiple facilities and many do. Three, hospice workers and other specialists travel to multiple nursing homes.

"Eliminating staff linkages between nursing homes could reduce Covid-19 infections in nursing homes by 44 percent," the researchers estimate. "These results provide evidence of the magnitude of the benefits that would derive from compensating nursing home workers to work at only one home and limiting cross-traffic across homes," they conclude.

Source: National Bureau of Economic Research, Nursing Home Staff Networks and Covid-19, Working Paper #27608

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