Thread by @ml_barnett

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.