Factors Associated With the Ability of US Nursing Homes to Accept Residents With Severe Obesity
Document Type
Article
Publication Date
4-16-2024
Abstract
Objectives
Severe obesity in nursing home (NH) residents is associated with specialized care needs, limited mobility, and challenges in daily living. The COVID-19 pandemic strained NH resources and exacerbated staffing shortages. This study aimed to assess the ability of US NHs to accept and care for residents with severe obesity post-COVID, as well as associated NH factors.
Design
Cross-sectional nationwide survey of NH administrators (2021-2022).
Setting and Participants
290 NHs from a national sample (n = 224) and a targeted sample in Massachusetts and New Jersey (n = 66).
Methods
A survey designed to assess how NHs approach admitting and caring for people with severe obesity before and after COVID was fielded from 2021 to 2022. Responses were linked to facility information from the Certification and Survey Provider Enhanced Reports, Minimum Data Set, Nursing Home Compare, Area Health Resources File, and US Diabetes Surveillance System. Multivariable logistic regression was used to assess the effect of organizational and survey response variables.
Results
Of the 2503 surveys sent to US NHs, 1923 were sent to the national NH stratified sample, and 580 were sent to the MA/NJ sample. Overall, 12% (301 of 2503) of NHs surveyed responded. The response rates were similar between the 2 samples. Of 290 NHs with complete data, 34% reported being unlikely to accept residents with severe obesity after COVID-19, compared with 25% before the pandemic (P< .001). The main barriers to acceptance were staffing shortages and difficulties meeting equipment and space needs. NHs with higher proportions of Black residents were more likely to admit individuals with severe obesity.
Conclusions and Implications
The decline in acceptance of residents with severe obesity during and after COVID-19 highlights potential challenges that this population faces in accessing care. Our results also raise concerns that an intersection of disparities may exist in Black patients with severe obesity.
Publication
Journal of the American Medical Directors Association (JAMDA)
Publisher
Elsevier
Department
College of Business and Management
Recommended Citation
McMahan, C., Shieu, B., Trinkoff, A., Castle, N., Wolf, D. G., Handler, S., & Harris, J. A. (2024). Factors associated with the ability of US nursing homes to accept residents with severe obesity. Journal of the American Medical Directors Association. https://doi.org/10.1016/j.jamda.2024.03.009
