Michael L. Barnett Profile picture
Not really here anymore (RIP pre 2016 Twitter), check me out on the other app. Associate professor studying health care delivery. Primary care physician.

Aug 20, 2020, 9 tweets

New paper out today in @Health_Affairs on shortages of PPE and staff in nursing homes nationally.

We did an in-depth analysis of shortages reported in @CMSGov's COVID-19 nursing home survey (98% of facilities in the US)

healthaffairs.org/doi/abs/10.137…

with @McGarryBE @DavidCGrabowski

@Health_Affairs @CMSGov @McGarryBE @DavidCGrabowski Nursing homes have been devastated by COVID-19 - only 1.3 million older adults in the US but >40% of ALL COVID-19 deaths in the US.

Part of the challenge has been persistent PPE and staff shortages. These are widely reported but there hasn't been much data on what is happening.

@Health_Affairs @CMSGov @McGarryBE @DavidCGrabowski We looked at nursing homes' answers about whether they had 1 week or less of 6 critical PPE supplies (e.g. gloves, N95, gowns) and whether they had shortages of staff in 4 categories (e.g. nurses, nurse aides).

We compared responses in late May to mid-July

@Health_Affairs @CMSGov @McGarryBE @DavidCGrabowski Our results:

By 6/14, 20.7% of nursing homes had a severe PPE shortage in 1 or more categories

This only improved to 19.1% by 7/19, mostly because fewer homes had gown shortages

In 25% of counties, 1 in 3 nursing homes had a PPE shortage

@Health_Affairs @CMSGov @McGarryBE @DavidCGrabowski Results were equally grim for staff shortages:

By 6/14, 20.8% of facilities had a staff shortage (usually nurses or nurse aides).

By 7/19 this was 21.9%, obviously not better.

Lots of geographic variation here too - in 12% counties, >75% nursing homes had a staff shortage.

@Health_Affairs @CMSGov @McGarryBE @DavidCGrabowski Which nursing homes were more likely to report shortages?

For-profit nursing homes way more likely to have PPE shortages. Also nursing homes with any COVID-19 cases.

Homes with higher proportions of Medicaid revenue and lower star ratings had much higher rates of shortages.

@Health_Affairs @CMSGov @McGarryBE @DavidCGrabowski We all have COVID-19 fatigue, but nursing homes are not doing any better right now.

Like @CitizenCohn in @HuffPost says: "COVID Is Still Ravaging Nursing Homes And It’s Not Clear Anyone Really Cares"

How do we get the public and policymakers to care??

huffpost.com/entry/covid-nu…

@Health_Affairs @CMSGov @McGarryBE @DavidCGrabowski @CitizenCohn @HuffPost One other thing. The @CMSGov
nursing home COVID-19 data are very valuable. We need this data. Let's make sure the survey questions can adapt to the changing pandemic too.

Check out @AP coverage:
apnews.com/ff2bbfb4a7431e…

Another link to the paper:
healthaffairs.org/doi/full/10.13…

@Health_Affairs @CMSGov @McGarryBE @DavidCGrabowski @CitizenCohn @HuffPost Closing thoughts

1) This dataset is incredibly valuable - please keep it up @CMSGov. Let's make sure that the questions keep up with the changing pandemic too.

2) It was a huge pleasure to work with @McGarryBE for the first time on this - rockstar! @DavidCGrabowski is OK too.

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