{"doi":"10.1111/jgs.16520","title":"<scp>COVID</scp> ‐19 Preparedness in Nursing Homes in the Midst of the Pandemic","abstract":"Nursing homes (NHs) are considered hotspots for coronavirus disease 2019 (COVID-19),1, 2 given their residential environments and patient vulnerabilities.3, 4 We describe the COVID-19 preparedness of NHs across the nation. We used a convenience sample of NHs with available email addresses drawn from national surveys conducted in 2013 and 20175, 6 (N = 942). We used Qualtrics software to email a 30-item survey on March 30, 2020. After two reminder emails, we closed the survey on April 5, 2020. Fifty-six NHs responded nationwide, including respondents from 29 states: Midwest (30%), West (25%), Northeast (23%), and South (22%). Most were for profit (68%), with fewer nonprofit (27%) and government owned (5%). Some (38%) were part of a chain. The sample distribution by ownership was similar to the nation. By region, the Northeast and West, two of the regions hit hard and early by COVID-19, were overrepresented. Nationally, 58% were part of a NH chain (Table 1). On average, NHs used two to five guidance documents for COVID-19. The most common were: Center for Disease Control and Prevention (88%), state or local health departments (84%), corporate (53%), World Health Organization (48%), local hospital/healthcare organization (39%), and the Association for Professionals in Infection Prevention and Epidemiology (27%). Staff responsible for preparedness most often included infection preventionists (39%), directors of nursing (32%), and administrators (27%). Slightly more than half of NHS (54%) had separate COVID-19 plans, and others included COVID-19 in their current disaster preparedness plan (46%). All had: plans for training staff to address COVID-19 (100%), processes to limit/restrict visitors (100%) and outside vendors/consultants (100%), policies regarding ill employees returning to work (100%), and guidance for employees regarding COVID-19 outbreak (100%). Almost all (96%) had policies for screening visitors. Some (29%) conducted COVID-19 outbreak simulations. NHs reported clear lines of communication and relationships with hospitals. Most (68%) indicated they had a local referral hospital accepting their patients under investigation for COVID-19. Most indicated clear lines of communication with public health officials (96%) and nearby hospitals (87%) regarding their role in containing/managing the pandemic. One-fourth (25%) indicated they were counted on as an alternative care site for hospitalized COVID-19 patients, and more than three-fourths (79%) were accepting non–COVID-19 patients as hospital overflow. Few (18%) planned to discharge residents to free beds for hospital patients. Two-thirds reported access to COVID-19 testing (66%), with testing available for patients (100%) and some staff (53%). Nearly three-fourths (72%), however, reported having inadequate supplies. Among those were N-95 respirators (90%), gowns (90%), face guards/eye protection (88%), alcohol-based sanitizer (67%), surgical masks (64%), and gloves (39%). Five-sixths (83%) expected significant staff shortages. Common strategies to address staff shortages included having staff volunteer for extended hours (55%) and nonclinical staff filling different roles (45%). Less common were using contracted/agency staff (19%) and mandating extended hours (16%). When asked their greatest COVID-19 preparedness concern, administrators cited lack of supplies (43%), staff shortage (34%), and resident health and safety (14%). Equipment concerns typically related to availability of personal protective equipment (PPE) (29%), including N-95 masks and respirators, face shields, and plastic zipper tents. One administrator lamented, “Not having enough PPE to keep up with a COVID-19 outbreak and sufficient staffing if staff become ill.” Another noted, “Not enough available supplies for staff, such as an N-95 masks or respirators or face shields; now we are using cotton-made face masks and…sanitary pads as an additional barrier.” Staff shortages focused on licensed staff. One cite","journal":"Journal of the American Geriatrics Society","year":2020,"id":58467,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":72,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.846,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":184667,"name":"Andrew W. Dick","orcid":null,"position":1,"is_corresponding":false},{"id":306054,"name":"Mansi Agarwal","orcid":"0000-0002-0367-7733","position":2,"is_corresponding":false},{"id":306055,"name":"Karen Jones","orcid":"0000-0003-0667-210X","position":3,"is_corresponding":false},{"id":306056,"name":"Lona Mody","orcid":"0000-0002-0260-8007","position":4,"is_corresponding":false},{"id":294952,"name":"Patricia W. Stone","orcid":"0000-0003-4098-8853","position":5,"is_corresponding":false},{"id":294950,"name":"Denise D. Quigley","orcid":"0000-0002-3815-908X","position":0,"is_corresponding":true}],"reference_count":4,"raw_metadata":null,"created_at":"2026-07-18T21:07:11.345501Z","pmid":"32343362","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}