Even in Skilled Nursing Facilities (SNFs), where the Covid-19 outbreak is not active, the pandemic has taken a toll on residents in the form of weight loss and increased depressive symptoms.
These facts come as no surprise to SNF operators who have observed changes in their residents, but thanks to findings by researchers at Harvard University, Brigham and Women’s Hospital, and Washington University in St. Louis, they confirm these trends. We now have data to
“While there is a growing body of literature documenting the impact of Covid-19 on nursing homes, there is little evidence regarding the health outcomes of LTC residents who endured stress and isolation during the pandemic despite not having Covid-19. There is little evidence,” the author wrote in JAMA. Article published online on Monday. “Understanding the impact of pandemic-related policy changes is critical to defining the trade-offs involved when facing future pandemic waves.”
Covid-19-related policy changes include closing buildings to visitors, ending communal meals and other social gatherings, and restricting certain areas, including outpatient, hospital, and surgical care. types of interruptions in care were included.
Noting widespread “speculation” that such changes had adverse effects on SNF residents as the pandemic dragged on, researchers looked at data from Medicare and the Minimal Dataset 3.0 for more than 15,000 facilities. They compared the 2018 and 2019 pre-pandemic data with the 2020 pandemic data.
Key findings include:
- Residents of SNF with a Covid-19 outbreak lost 3.1 more pounds and were 4.4% more likely to have worse depressive symptoms
- Residents of SNFS who had no Covid-19 outbreak lost 1.8 pounds more and were 3.2% more likely to have worse depressive symptoms
Therefore, there was a “significant increase” in SNF weight loss and depressive symptoms in the first year of the pandemic, regardless of whether Covid-19 was present in the building in a given month, the researchers wrote.
They noted that weight loss can exacerbate frailty and sarcopenia, which are risk factors for increased mortality in this population.
However, mortality was worse only in SNFs with Covid-19 outbreaks, whereas SNFs without Covid-19 outbreaks had slightly lower mortality.
The researchers speculate that stricter infection control policies may have played a role in this drop in mortality, and that residents moved less frequently, resulting in fewer falls.
However, the decline in mortality occurred amid a “significant reduction” in hospital admissions and emergency department visits by patients with SNF.
“The changes observed during the pandemic suggest that some hospital use of SNFs does little to improve mortality,” the authors wrote. It relates to initiatives to reduce excessive hospitalizations in SNF, which have been a major focus of quality improvement efforts in nursing homes for decades.”
Limitations of this study included focusing on Medicare service charge data that covered only a subset of long-term residents. As such, the authors cautioned that the findings may not be generalizable to all his SNF residents.
