Title: Impact of Disadvantaged Neighborhoods and Nursing Home Quality on COVID-19 rates in Los Angeles Nursing Homes

Importance: In the United States, the COVID-19 pandemic has disproportionally affected nursing home residents who compose 1/300th of the population but account for approximately 1/5th of COVID-19 deaths. Nursing home residents are most susceptible to morbidity to COVID; it is crucial that nursing homes throughout the country have sufficient access to resources to help their residents.

Objective: The objective of this study is to determine the roles that socioeconomic status and nursing home quality play in COVID-19 rates and deaths in Los Angeles nursing homes.  

Design: Weekly COVID-19 rates and deaths were determined using data from the Center for Medicare and Medicaid Services (CMS). The socioeconomic status of nursing homes was based on the address of the nursing home and was tabulated using the University of Wisconsin’s Neighborhood Atlas. Nursing home quality was measured using the CMS five-star quality system. Unpaired t-tests were conducted to compare COVID-19 rates and mortality in more disadvantaged nursing homes to those in more well-resourced neighborhoods.  

Results: No significant difference in COVID-19 rates and deaths were found in nursing homes of different SES statuses, however, there was a correlation between nursing home quality and COVID-19 rates and deaths.

Conclusions: Nursing home quality, not neighborhood SES, plays an important role in the impact of COVID-19 in Los Angeles nursing homes.