Differences In Nursing Home Staff COVID-19 Testing Rates And Odds Of Vaccination Across Work Shifts.

COVID-19 vaccination and regular testing of nursing home staff have been critical interventions for mitigating COVID-19 outbreaks in US nursing homes. Although implementation of testing has largely been left to nursing home organizations to coordinate, vaccination occurred through a combination of state, federal, and organization efforts. Little research has focused on structural variation in these processes.

Factors Affecting SARS-CoV-2 Test Discordance in Skilled Nursing Facilities.

Objectives: Reverse transcription polymerase chain reaction (PCR) and antigen tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are sometimes discordant. We evaluated the discordance between antigen and PCR tests sampled in skilled nursing facilities (SNFs) to assess the relationship of symptom presence, timing between tests, and the presence of a facility outbreak.

Design: Observational study using electronic health record data.

Incidence and Outcomes of SARS-CoV-2 in Post-Acute Skilled Nursing Facility Care.

Objectives: To examine the risk of contracting SARS-CoV-2 during a post-acute skilled nursing facility (SNF) stay and the associated risk of death.

Design: Cohort study using Minimum Data Set and electronic health record data from a large multistate long-term care provider. Primary outcomes included testing positive for SARS-CoV-2 during the post-acute SNF stay, and death among those who tested positive.

Adverse events following third dose of mRNA COVID-19 vaccination among nursing home residents who received the primary series.

Background: We sought to compare rates of adverse events among nursing home residents who received an mRNA COVID-19 vaccine booster dose with those who had not yet received their booster.

Methods: We assessed a prospective cohort of 11,200 nursing home residents who received a primary COVID-19 mRNA vaccine series at least 6 months prior to September 22, 2021 and received a third "booster dose" between September 22, 2021 and February 2, 2022. Residents lived in 239 nursing homes operated by Genesis HealthCare, spanning 21 U.

Lessons for deprescribing from a nonessential medication hold policy in US nursing homes.

Background: At the height of the COVID-19 pandemic, a large nursing home chain implemented a policy to temporarily hold potentially unnecessary medications. We describe rates of held and discontinued medications after a temporary hold policy of potentially unnecessary or nonessential medications.

Methods: This retrospective cohort study uses electronic health record (EHR) data on 3247 residents of 64 nursing homes operated by a multistate long-term care provider.

Adverse Events Following One Dose of mRNA COVID-19 Vaccination Among US Nursing Home Residents With and Without a Previous SARS-CoV-2 Infection.

Objectives: To compare rates of adverse events following Coronavirus Disease 2019 (COVID-19) vaccination among nursing home residents with and without previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

Design: Prospective cohort.

Setting And Participants: A total of 20,918 nursing home residents who received the first dose of messenger RNA COVID-19 vaccine from December 18, 2020, through February 14, 2021, in 284 facilities within Genesis Healthcare, a large nursing home provider spanning 24 US states.

Racial Disparities in COVID-19 Vaccine Acceptance: Building Trust to Protect Nursing Home Staff and Residents.

Vaccines are critical to protect both nursing home residents and staff from COVID-19, but some staff have expressed reservations about being vaccinated. In this brief report, we describe interventions that Genesis HealthCare-one of the largest US long-term care providers-implemented after recognizing midway through vaccinations that racial and ethnic disparities existed in vaccine uptake among employees, with black and Hispanic employees having significantly lower rates of vaccination than their peers. Specifically, Genesis engaged its Diversity, Equity, and Inclusion (DEI) Committee to identify ways to augment its already comprehensive vaccine education campaign in order to build confidence among employees from minority communities.

Adverse events following mRNA SARS-CoV-2 vaccination among U.S. nursing home residents.

Background: The devastating impact of the SARS-CoV-2 pandemic prompted the development and emergency use authorization of two mRNA vaccines in early 2020. Vaccine trials excluded nursing home (NH) residents, limiting adverse event data that directly apply to this population.

Methods: To prospectively monitor for potential adverse events associated with vaccination, we used Electronic Health Record (EHR) data from Genesis HealthCare, the largest NH provider in the United States.

Short-term impact of nursing home SARS-CoV-2 vaccinations on new infections, hospitalizations, and deaths.

Objective: To compare rates of incident SARS-CoV-2 infection and 30-day hospitalization or death among residents with confirmed infection in nursing homes with earlier versus later SARS-CoV-2 vaccine clinics.

Design: Matched pairs analysis of nursing homes that had their initial vaccine clinics between December 18, 2020, and January 2, 2021, versus between January 3, 2021, and January 18, 2021. Matched facilities had their initial vaccine clinics between 12 and 16 days apart.

COVID-19 Mortality Rates Among Nursing Home Residents Declined From March To November 2020.

Improved therapeutics and supportive care in hospitals have helped reduce mortality from COVID-19. However, there is limited evidence as to whether nursing home residents, who account for a disproportionate share of COVID-19 deaths and are often managed conservatively in the nursing home instead of being admitted to the hospital, have experienced similar mortality reductions. In this study we examined changes in thirty-day mortality rates between March and November 2020 among 12,271 nursing home residents with COVID-19.

SARS-CoV-2 antibody detection in skilled nursing facility residents.

Objective: To describe the frequency and timing of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody detection in a convenience sample of skilled nursing facility (SNF) residents with and without confirmed SARS-CoV-2 infection.

Design: Retrospective analysis of SNF electronic health records.

Setting: Qualitative SARS-CoV-2 antibody test results were available from 81 SNFs in 16 states.

Risk Factors Associated With All-Cause 30-Day Mortality in Nursing Home Residents With COVID-19.

Importance: The coronavirus disease 2019 (COVID-19) pandemic has severely affected nursing homes. Vulnerable nursing home residents are at high risk for adverse outcomes, but improved understanding is needed to identify risk factors for mortality among nursing home residents.

Objective: To identify risk factors for 30-day all-cause mortality among US nursing home residents with COVID-19.

Asymptomatic and Presymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection Rates in a Multistate Sample of Skilled Nursing Facilities.

This cross-sectional study examines the prevalence of asymptomatic and presymptomatic severe acute respiratory syndrome coronavirus 2 infection in skilled nursing facilities.

Temperature Screening for SARS-CoV-2 in Nursing Homes: Evidence from Two National Cohorts.

Background/objectives: Infection screening tools classically define fever as 38.0°C (100.4°F).

Variation in SARS-CoV-2 Prevalence in U.S. Skilled Nursing Facilities.

Objective: To identify county and facility factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks in skilled nursing facilities (SNFs).

Design: Cross-sectional study linking county SARS-CoV-2 prevalence data, administrative data, state reports of SNF outbreaks, and data from Genesis HealthCare, a large multistate provider of post-acute and long-term care. State data are reported as of April 21, 2020; Genesis data are reported as of May 4, 2020.

An Illustration of SARS-CoV-2 Dissemination Within a Skilled Nursing Facility Using Heat Maps.

Objectives: To illustrate dissemination and asymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during a skilled nursing facility (SNF) outbreak.

Design: Case report.

Setting And Participants: Residents of a 150-bed SNF.

Leveraging remote behavioral health interventions to improve medical outcomes and reduce costs.

Objective: The dramatic rise in healthcare expenditures calls for innovative and scalable strategies to achieve measurable, near-term improvements in health. Our objective was to determine whether a remotely delivered behavioral health intervention could improve medical health, reduce hospital admissions, and lower cost of care for individuals with a recent cardiovascular event.

Study Design: This retrospective observational cohort study included members of a commercial health plan referred to participate in AbilTo’s Cardiac Health Program.

Pharmacist counseling at the start of therapy: patient receptivity to offers of in-person and subsequent telephonic clinical support.

Patients who newly start prescription medications for chronic conditions are often in need of additional support related to both their condition and treatment. When patients initially fill their prescriptions, the offer of pharmacist counseling is considered standard practice from a professional and regulatory standpoint, but little is known about how well this offer actually satisfies patient needs. This was the focus of our study: Within a few weeks of newly starting medications, 100 patients were contacted telephonically by a nurse to engage them in a support program for their conditions.

Geographic variation in drug safety: potentially unsafe prescribing of medications and prescriber responsiveness to safety alerts.

Background: Drug safety issues represent a major cause of morbidity and mortality. Alerting programs are intended to identify patients at potential risk for adverse drug reactions and may provide relevant information to prescribers to support their decision making about clinically appropriate risk reduction. Geographic differences in the incidence of drug safety issues and the responsiveness of prescribers to alerting systems have not been previously studied.