A Study of the COVID-19 Outbreak and Response in Connecticut Long-Term Care Facilities: Final Report

Publisher: Princeton, NJ: Mathematica
Sep 30, 2020
Patricia Rowan, Reena Gupta, Rebecca Lester, Michael Levere, Kristie Liao, Jenna Libersky, Debra Lipson, Andrea Wysocki, Julie Robison, and Patricia Bowen
  • Nursing homes with a greater incidence of COVID-19 in the surrounding community and those with more residents who received dialysis or cancer treatments—usually delivered off site—had more cases and deaths per licensed bed.
  • The prevalence of symptoms of depression increased by 15 percent and rates of unplanned weight loss nearly doubled right after the peak of the COVID-19 outbreak. These outcomes suggest measuring COVID-19 cases and deaths alone does not capture the full impact of the pandemic on residents’ well-being.
  • After adjusting for facilities’ characteristics, such as size and proximity to Connecticut, cases and deaths per licensed bed in Connecticut did not vary significantly from those in nearby states.

Mathematica has released a final report assessing the COVID-19 outbreak in long-term care (LTC) facilities in Connecticut. The report recommends ways to help the state and LTC facilities prevent future infectious disease outbreaks. The final report describes the impact of COVID-19 in Connecticut: it highlights the specific impact of the virus within the state’s LTC facilities, assesses the state and LTC industry’s preparedness and response to the COVID-19 outbreak, and compares Connecticut with other states in the region and the country. The report also identifies immediate and achievable steps the state and LTC industry can take to prepare for a second wave of COVID-19 and longer-term recommendations to prevent future infectious disease outbreaks.

Mathematica’s final report builds on an interim report released earlier this summer. Based on the study’s findings, Mathematica made 23 short-term recommendations to mitigate a potential second wave of COVID-19 and 22 long-term recommendations to prevent future infectious disease outbreaks.

Key recommendations include:

  • Developing a framework to guide policies on the reopening of LTC facilities to visitors based on a set of criteria at the facility and community levels, rather than a one-size-fits-all statewide visitation policy
  • Considering legislation or regulations to (1) mandate a full-time infection preventionist in nursing homes and (2) increase the minimum required staffing levels in nursing homes
  • Ensuring all LTC facility staff have access to appropriate PPE and guaranteed paid sick leave