In a comprehensive review of research surrounding room occupancy at long-term care facilities during the pandemic, evidence suggests single-resident rooms keep patients healthier, happier and is their desired option moving forward.
Converting multi-resident rooms to single-resident rooms is expected to require initial investments in reconstruction and higher ongoing operating and capital costs, but researchers with Michigan-based consulting firm Health Management Associates believe it’s time for organizations like the Centers for Medicare & Medicaid Services (CMS) to step up.
“As the lead federal agency overseeing nursing home quality and safety, CMS should participate in discussions around single-resident rooms and their benefits and costs, as part of nursing home reform,” a report from Health Management Associates says.
CMS isn’t the only government entity that the independent consulting firm, with a focus on health care and human services policy research, thinks should have a seat at the table.
The Department of Housing and Urban Development and the Centers for Disease Control and Prevention should each have an interest in exploring single-resident rooms in nursing facilities, it adds.
Two multi-facility licensed skilled care organizations saw an average increase in operating costs ranging from $16 to $25 per patient day and capital costs increased from $20 to $40 per patient day after transitioning single-resident rooms, according to research from Plante Moran.
The size and layout of the facility, resident acuity, age and quality of HVAC, construction cost, type of financing and interest rate were all key factors in that cost.
In a recent conversation with SNN, Trilogy Health Services CEO Leigh Ann Barney admitted that she expected every operator to be challenged to offer more private rooms rather than semi-private rooms coming out of the pandemic.
“We’ve spent time growing to change our design to have more private rooms. I think post-COVID will see a lot more desire for private rooms,” she said.
As the industry looks for a comprehensive, person-centered, and evidence-based approach to improving nursing home safety, HMA researchers believe that any nursing home reform should start with private rooms.
“Key stakeholders, including nursing home residents and family advocates, providers and staff, owners and administrators, policymakers, and federal agencies that help finance nursing homes and improve public health, need to discuss options for promoting, incentivizing, and financing the movement toward a healthier and safer long-term care environment,” they concluded in a 29-page report.
Evidence for single-occupancy
HMA found that the benefits of single-resident rooms outweigh the potential loss of converting from double to single occupancy.
Single-resident rooms have been shown to improve the health of nursing home residents, particularly during the pandemic, as 31% of coronavirus deaths in long-term care facilities in Ontario could have been prevented if all residents had single-occupancy rooms.
COVID-19 patients in isolation and quarantine in single rooms were also found to have experienced reduced infection risk, according to a study out of Australia.
Additional evidence supporting single-resident rooms suggests that they are associated with decreased risk of facility-acquired infections, medication errors, resident anxiety, and incidence of aggressive behavior.
“The industry would benefit from reimagining and reforming nursing homes to avoid [becoming hotspots again] in future health emergencies or worse,” HMA concluded.
Nosocomial infections (infections acquired while in a facility that were not present at the time of admission) are reduced in single rooms, compared with multiple-occupancy patient rooms, according to clinical studies.
Single rooms also help with isolation needs and seem to be the preferred choice of the residents, as the research suggests, with links made between private rooms and a reduction in stress and improved sleep.
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