CDC Adds to Research Suggesting Link Between Nursing Home Outbreaks, Community Rates of COVID

Multiple studies emerged over the course of 2020 suggesting correlations between the incidence of COVID-19 in a community and the rates of infection nursing homes within that community — and a new study from the Centers for Disease Control and Prevention (CDC) joins the list.

The new Morbidity and Mortality Weekly Report (MMWR) found that the trends of COVID-19 cases among nursing home residents and staff members were similar to COVID-19 incidence in the facility’s surrounding community, and noted that mitigation strategies for nursing homes “need to include a comprehensive plan to monitor local SARS-CoV-2 transmission and minimize high-risk exposures within facilities.”

While COVID-19 rates among nursing home residents and staff members varied throughout the weeks ending May 31 to November 22, the trends resembled those in the surrounding communities, the CDC found.

Source: Centers for Disease Control and Prevention

The study drew from data reported by nursing homes certified by the Centers for Medicare & Medicaid Services (CMS) through the CDC’s National Healthcare Safety Network (NHSN). The analysis included 15,342 nursing homes, out of 15,404 total.

Several studies released over the course of last year found that factors such as staffing, demographics, and facility size are related to how a COVID-19 outbreak plays out in the nursing home setting, but in many of those publications, the spread of COVID in a community was considered one of the top predictors of an outbreak.

“The largest magnitude effects we find are for county metropolitan status and county-level number of COVID-19 cases per capita that occur among the general population,” Rebecca Gorges and R. Tamara Konetzka noted in a study published in the Journal of the American Geriatrics Society in August 2020.


The CDC itself noted that increased COVID-19 in communities with nursing homes elevates the risk of staff introducing COVID-19, citing the state of Minnesota — where 34% and more of high-risk exposures among health care staff members involved non-patient contacts, including household and social contacts.

That means staff members need to be educated about the risks of community exposure, while nursing homes need to adhere to the Centers for Medicare & Medicaid Services’ (CMS) testing requirements for staff members and isolate newly admitted or readmitted residents whose COVID-19 status is unknown.

“Guidance and federal requirements could be further improved through assessing factors associated with the incidence of COVID-19 among nursing home staff members and residents, including factors associated with community-acquired infections leading to transmission within nursing home,” the CDC wrote in its report.

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