More State Policies Not Always Linked With Less COVID-19 Burden in Nursing Homes

Higher numbers of pandemic policies at the state and territory levels were not consistently associated with fewer COVID-19 cases and deaths in nursing homes or in the community, according to a study published in a research letter in JAMA Network Open.

The finding suggests that “policy effectiveness may depend on implementation and compliance,” wrote corresponding author Patricia W. Stone, PhD, RN, of the Center for Health Policy, Columbia University School of Nursing, New York, New York, and coauthors.

The study identified 1400 COVID-19 policies across 50 states and five territories that were enacted between March 1, 2020, and July 1, 2022. Among them, 846 applied to all health care settings, 486 were specific to nursing homes only, 43 were specific to nursing homes and home health care agencies, and 25 were specific to home health care agencies only.

Preventing virus transmission, the subject of 736 policies, was the most common policy category. Expanding nursing home and home health care agency capacity was next, at 325 policies. Other common categories were relaxing administrative requirements (184 policies), reporting COVID-19 data (79 policies), and admission and discharge (54 policies).

Researchers created a dashboard of the policies linked with community-level and nursing home-specific COVID-19 cases and death counts. The dashboard illustrates variations in policy responses and COVID-19 burden severity that, the authors wrote, “highlight the complexity of pandemic management.”

The research letter also pointed out the limited attention COVID-19 policies paid to home health care agencies compared with nursing homes, despite their serving similar vulnerable patient populations.

“This suggests a gap in public health planning,” the authors wrote, “raising questions about resource allocation and prioritization among health care settings during pandemics.”

Reference

Stone PW, Zhao S, Chastain AM, et al. State- and territory-level nursing home and home health care COVID-19 policies and disease burden. JAMA Netw Open. 2024;7(4):e247683. doi:10.1001/jamanetworkopen.2024.7683