COVID-19 in Nursing Homes: Calming the Perfect Storm

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

I just learned of a new article that will soon be published in the Journal of American Geriatrics Society – COVID-19 in Nursing Homes: Calming the Perfect Storm.  This 31-page article is a definite must-read!  This special article was prepared for JAGS with final submission on July 29, 2020.  The authors are two of my favorite professors, geriatricians and experts: Dr. Joseph G. Ouslander (Professor and Senior Associate Dean for Geriatric Programs, Florida Atlantic University) and Dr. David C. Grabowski (Professor of Health Care Policy, Harvard Medical School).  Anything with either of their names on it gets my attention and gets read as well as widely shared.  (Dr. Grabowski is also a member of the Commission on Safety and Quality in Nursing Homes.  Dr. Ouslander is also Project Director for INTERACT®.)

Here’s the article’s Abstract as a preview of what’s inside the piece:

“The pandemic of viral infection with the Severe Acute Respiratory Syndrome Virus-2 (SARS-CoV-2) that causes COVID-19 disease has put the nursing home industry in crisis. The combination of a vulnerable population that manifests nonspecific and atypical presentations of COVID-19, staffing shortages due to viral infection, inadequate resources for and availability of rapid, accurate testing and personal protective equipment, and lack of effective treatments for COVID-19 among nursing home residents have created a “perfect storm” in our country’s nursing homes. This perfect storm will continue as society begins to reopen, resulting in more infections among nursing home staff and clinicians who acquire the virus outside of work, remain asymptomatic, and unknowingly perpetuate the spread of the virus in their workplaces. Because of the elements of the perfect storm, nursing homes are like a tinderbox, and it only takes one person to start a fire that could cause many deaths in a single facility. Several public health interventions and health policy strategies, adequate resources, and focused clinical quality improvement initiatives can help calm the storm. The saddest part of this perfect storm is that many years of inaction on the part of policymakers contributed to its impact. We now have an opportunity to improve nursing homes to protect residents and their caregivers ahead of the next storm. It is time to reimagine how we pay for and regulate nursing home care in order to achieve this goal.”

I encourage you to review and share this article with your team.  It would be great reading for your area, state and national lawmakers/representatives as well.  There are two (2) great tables at the end of the piece that you will not want to miss.  Table 1: Approaches to Calming the Perfect Storm of COVID-19 in Nursing Homes and Table 2: Key Issues Related to Testing for SARS-CoV-2 in Nursing Homes.

This just-released article was mentioned by Alice Bonner during the August 3, 2020 COVID-19 Rapid Response Network for Nursing Homes national huddle.  You can find more information on this initiative as well as the every-weekday-20-minute-huddle here.  You can also register for the daily huddle on this link as well. 

Benefits of Participation

  • Immediate access to specific, pragmatic guidance on clinical and operational issues confronting the nursing home community today. Guidance will be focused and ready to implement.
  • Ability to speak with collective voice to federal and state policy makers, regulators, health care systems, and others to help remove policy and regulatory barriers to mission-critical operational challenges.
  • Access to tools and materials to help explain the work of nursing homes and promote participation in the COVID-19 Rapid Response Network for Nursing Homes. These tools will help nursing homes communicate with local media outlets about efforts to serve and protect residents and staff.

Week 12 of these huddles began August 3, 2020.  The topic this week is Supporting Persons Living with Dementia.  These huddles have been one of the highlights of my weekdays.  They’re short and full of great information.  You can also access all recordings, slides, and resources on the landing page. You will need to log into your IHI account to access the page, and only those who are registered for the network will have access.  Register for your IHI account at

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