The study pulled its facility characteristics, including direct care hours per resident-day, from CMS’ Payroll-Based Journal and Nursing Home Compare databases, finding that higher staffing levels and higher overall star ratings were both associated with greater antiviral use.
Monoclonal Antibody and Oral Antiviral Treatment of SARS-CoV-2 Infection in US Nursing Homes
Despite their high risk, only 1 in 4 nursing home residents with COVID-19 had been treated with evidence-based antiviral treatments by the end of 2022. Over 40% of nursing homes reported never administering any oral antiviral or monoclonal antibody treatment in the 19-month study window. Lower treatment rates in for-profit facilities and those with higher shares of Medicaid and non-White residents suggest that structural barriers may be contributing to underuse and disparities.
— JAMA, July 14, 2023
McGarry, Brian E., et al. Monoclonal Antibody and Oral Antiviral Treatment of SARS-CoV-2 Infection in US Nursing Homes. JAMA, American Medical Association, 14 July 2023, https://jamanetwork.com/journals/jama/fullarticle/2807529.
“I was not assigning that grade to nursing homes or their staff,” Grabowski clarified in an email to McKnight’s. “I assigned a D grade to our overall policy response in protecting nursing home residents and their caregivers. I would include policymakers at all levels (federal and state). They were slow to get facilities personal protective equipment and rapid testing. They kept families out of nursing homes for far too long. They are now slow in getting antivirals to these residents.”
— McKnight’s Long-Term Care News, August 22, 2023
How Nursing Homes Failed to Protect Residents From Covid
Why, then, did fewer than one in five nursing home residents with Covid receive antiviral treatment from May 2021 through December 2022? Brian McGarry, a health economist at the University of Rochester, and David Grabowski, a health care policy researcher at Harvard Medical School, both gave the health care system a D grade overall for nursing homes’ pandemic performance. “I kept waiting for the cavalry to come, and it really hasn’t, even today,” Dr. Grabowski said. “At no time during the pandemic did we prioritize nursing homes.”
— The New York Times, August 19, 2023
‘Alarming’ COVID-19 treatment rates in nursing homes discovered
“Most surprising, we found that by the end of 2022, 40% of nursing homes reported that they had never used any of the antiviral treatments,” McGarry said. “This is alarming, as almost all nursing home residents meet the current clinical guidelines to be considered for treatment.”
— McKnight’s Long-Term Care News, July 17, 2023
