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Mortality, Admissions, and Patient Census at SNFs in 3 US Cities During the COVID-19 Pandemic

Educational Objective
To understand how COVID-19 is affecting skilled nursing facilities
1 Credit CME

Mortality from coronavirus disease 2019 (COVID-19) is disproportionately concentrated in skilled nursing facilities (SNFs). As of June 18, 2020, 50 185 residents died of COVID-19 in the 41 states reporting deaths at SNFs, accounting for 45% of their total COVID-19 deaths statewide.1 In addition to long-term care, SNFs provide short-term care after elective surgeries and hospitalizations. With the decreases in hospital volume for elective surgeries and other services during the pandemic, SNF admissions may also be declining.2

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Article Information

Corresponding Author: Michael L. Barnett, MD, MS, Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Kresge 411, Boston, MA 02115 (mbarnett@hsph.harvard.edu).

Accepted for Publication: June 15, 2020.

Published Online: June 24, 2020. doi:10.1001/jama.2020.11642

Author Contributions: Dr Barnett and Mr Martin had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: All authors.

Acquisition, analysis, or interpretation of data: Barnett, Hu, Martin.

Drafting of the manuscript: Barnett.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Barnett, Martin.

Obtained funding: Barnett.

Administrative, technical, or material support: Hu.

Supervision: Barnett, Hu, Grabowski.

Conflict of Interest Disclosures: Dr Hu reported being the CEO and Mr Martin reported being the director of postacute analytics at CarePort Health. No other disclosures were reported.

Funding/Support: This research was supported by grant K23 AG058806-01 from the National Institute on Aging, National Institutes of Health.

Role of the Funder/Sponsor: The National Institute on Aging had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

References
1.
Henry J. Kaiser Family Foundation. State data and policy actions to address coronavirus. Published June 18, 2020. Accessed June 18, 2020. https://www.kff.org/health-costs/issue-brief/state-data-and-policy-actions-to-address-coronavirus/
2.
Baum  A , Schwartz  MD .  Admissions to Veterans Affairs hospitals for emergency conditions during the COVID-19 pandemic.   JAMA. Published online June 5, 2020. doi:10.1001/jama.2020.9972PubMedGoogle Scholar
3.
McMichael  TM , Currie  DW , Clark  S ,  et al; Public Health–Seattle and King County, EvergreenHealth, and CDC COVID-19 Investigation Team.  Epidemiology of COVID-19 in a long-term care facility in King County, Washington.   N Engl J Med. 2020;382(21):2005-2011. doi:10.1056/NEJMoa2005412PubMedGoogle ScholarCrossref
4.
New York Times. COVID-19 data. Accessed June 2, 2020. https://github.com/nytimes/covid-19-data
5.
Brown University School of Public Health. LTCfocus—long-term care: facts on care in the US. Accessed June 2, 2020. http://ltcfocus.org/2/faq
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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