July 29 (UPI) -- Nursing homes with COVID-19 outbreaks had nearly 1.5 times as many substantiated complaints during the last three years as those without confirmed infections, an analysis published Wednesday by JAMA Network Open found.
Facilities with outbreaks also had twice as many alleged violations of abuse or neglect filed against them during the same period, the researchers said.
"Nursing homes have struggled financially and been ill-supported for decades, and COVID-19 is shedding light on a host of challenges they've been battling for a long time," co-author Dr. Paula Chatterjee told UPI.
"Chronic under-funding has been a key unaddressed issue that has made it challenging for nursing homes to respond to the pandemic," said Chatterjee, assistant professor of general internal medicine at the University of Pennsylvania.
As of July 12, more than 142,000 confirmed cases of COVID-19 have been reported in nursing homes across the United States, with another 90,000-plus suspected cases and more than 38,000 deaths, according to the Centers for Medicare and Medicaid Services.
Nursing home residents account for 3% of the more than 4.3 million infections across the country, but constitute 26% of the more than 142,000 deaths from the virus, based on figures from Johns Hopkins University.
For their research, Chatterjee and her colleagues collected publicly available data from the last three years on nearly 9,000 nursing homes from state governments and departments of public health that reported COVID-19 cases at nursing homes between April 22 and 29.
The nursing homes included in the analysis were located in the District of Columbia and 23 states -- California, Colorado, Connecticut, Delaware, Florida, Georgia, Iowa, Illinois, Kentucky, Massachusetts, Maryland, Michigan, Minnesota, North Carolina, North Dakota, New Jersey, New Mexico, Nevada, New York, Ohio, Oklahoma, Oregon and Tennessee -- the researchers said.
Thirty-four percent of the facilities included in the analysis had reported cases of COVID-19, they said.
Although nursing homes with and without confirmed cases had similar ratings on the commonly used five-point quality assessment -- about 3.2 -- they differed significantly in other areas, according to the researchers.
In general, the nursing homes with COVID-19 were found to have more deficiencies in the overall health of their residents and in "emergency preparedness" -- plans for staffing and resident care in the event of a crisis -- the researchers said.
Facilities with outbreaks also had, on average, more than two accusations of abuse and neglect reported against them to state agencies as of April 29, while those without outbreaks had half as many, according to the researchers.
Nursing homes with cases of COVID-19 also had an average of nearly six substantiated complaints regarding resident care on file as of April 29, compared to an average of four among facilities with no outbreaks, the researchers said.
In addition, nursing homes with COVID-19 outbreaks were located in communities with overall infection rates that were nearly twice as high -- 428 per 100,000 population versus 231 per 100,000 population -- as those of facilities without cases, they said.
These figures highlight that better control of the outbreak in the local community might help protect nursing homes from virus, Chatterjee said.
"Far and away, the biggest difference between the two groups of nursing homes was in their community infection rates," Chatterjee said. "But in addition to community-level infection control, nursing homes are probably most in need of resources and funding."