{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:30:40Z","timestamp":1774611040704,"version":"3.50.1"},"reference-count":14,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T00:00:00Z","timestamp":1600646400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["3U54AG063546\u201002S3"],"award-info":[{"award-number":["3U54AG063546\u201002S3"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2020,11]]},"abstract":"\n BACKGROUND\/OBJECTIVES<\/jats:title>\n In April 2020, Massachusetts nursing homes (NHs) became a hotspot for COVID\u201019 infections and associated deaths. In response, Governor Charles Baker allocated $130 million in additional funding for 2 months contingent on compliance with a new set of care criteria including mandatory testing of all residents and staff, and a 28\u2010point infection control checklist. We aimed to describe the Massachusetts effort and associated outcomes.<\/jats:p>\n <\/jats:sec>\n \n DESIGN<\/jats:title>\n Longitudinal cohort study.<\/jats:p>\n <\/jats:sec>\n \n SETTING<\/jats:title>\n A total of 360 Massachusetts NHs.<\/jats:p>\n <\/jats:sec>\n \n PARTICIPANTS<\/jats:title>\n The Massachusetts Senior Care Association and Hebrew SeniorLife rapidly organized a Central Command team, targeted 123 \u201cspecial focus\u201d facilities with infection control deficiencies for on\u2010site and virtual consultations, and offered all 360 facilities weekly webinars and answers to questions regarding infection control procedures. The facilities were also informed of resources for the acquisition of personal protective equipment (PPE), backup staff, and SARS\u2010CoV\u20102 testing.<\/jats:p>\n <\/jats:sec>\n \n MEASUREMENTS<\/jats:title>\n We used two data sources: (1) four state audits of all NHs, and (2) weekly NH reports to the Massachusetts Center for Health Information and Analysis. Primary independent process measures were the checklist scores and adherence to each of its six core competencies. Primary outcomes were the average weekly rates of new infections, hospitalizations, and deaths in residents and staff. We used a hurdle mixed effects model adjusted for county COVID\u201019 prevalence to estimate relationships between infection control process measures and rates of new infections or deaths.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Both resident and staff infection rates started higher in special focus facilities, then rapidly declined to the same low level in both groups. Adherence to infection control processes, especially proper wearing of PPE and cohorting, was significantly associated with declines in weekly infection and mortality rates.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n This statewide effort could serve as a national model for other states to prevent the devastating effects of pandemics such as COVID\u201019 in frail NH residents.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/jgs.16832","type":"journal-article","created":{"date-parts":[[2020,9,16]],"date-time":"2020-09-16T18:34:05Z","timestamp":1600281245000},"page":"2447-2453","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Stemming the Tide of\n COVID<\/scp>\n \u201019 Infections in Massachusetts Nursing Homes"],"prefix":"10.1111","volume":"68","author":[{"given":"Lewis A.","family":"Lipsitz","sequence":"first","affiliation":[{"name":"Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife Boston Massachusetts"},{"name":"Division of Gerontology Beth Israel Deaconess Medical Center Boston Massachusetts"},{"name":"Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alida M.","family":"Lujan","sequence":"additional","affiliation":[{"name":"Sloan School Massachusetts Institute of Technology Cambridge Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alyssa","family":"Dufour","sequence":"additional","affiliation":[{"name":"Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife Boston Massachusetts"},{"name":"Division of Gerontology Beth Israel Deaconess Medical Center Boston Massachusetts"},{"name":"Harvard Medical School Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary","family":"Abrahams","sequence":"additional","affiliation":[{"name":"Massachusetts Senior Care Association Waltham Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Magliozzi","sequence":"additional","affiliation":[{"name":"Massachusetts Senior Care Association Waltham Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laurie","family":"Herndon","sequence":"additional","affiliation":[{"name":"Hinda and Arthur Marcus Institute for Aging Research Hebrew SeniorLife Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5013-7801","authenticated-orcid":false,"given":"Mohammad","family":"Dar","sequence":"additional","affiliation":[{"name":"Massachusetts Medicaid (MassHealth) Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,9,21]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.139292"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2020.03.004"},{"key":"e_1_2_6_4_1","unstructured":"Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID\u201019) 2020.https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/hcp\/long-term-care.html. Accessed July 31 2020."},{"key":"e_1_2_6_5_1","unstructured":"Centers for Medicare & Medicaid Services. Guidance for infection control and prevention of coronavirus disease 2019 (COVID\u201019) in nursing homes (revised) ref: QSO\u201020\u201014\u2010NH.https:\/\/www.cms.gov\/files\/document\/qso-20-14-nh-revised.pdf. Accessed July 31 2020."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119513469"},{"key":"e_1_2_6_7_1","volume-title":"Models for Discrete Longitudinal Data","author":"Molenberghs G","year":"2005"},{"key":"e_1_2_6_8_1","unstructured":"RizopoulosD. GLMMadaptive: Generalized Linear Mixed Models using Adaptive Gaussian Quadrature. R package v. 0.7\u20130. 2020.https:\/\/cran.r-project.org\/package=GLMMadaptive. Accessed July 15 2020."},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.11642"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2005412"},{"key":"e_1_2_6_11_1","unstructured":"Kaiser Family Foundation (KFF). Rising cases in long\u2010term care facilities are cause for concern. KFF Issue Brief 2020.https:\/\/www.kff.org\/coronavirus-covid-19\/issue-brief\/rising-cases-in-long-term-care-facilities-are-cause-for-concern\/. Accessed July 21 2020."},{"key":"e_1_2_6_12_1","unstructured":"MendozaA. Facility location determines COVID outbreaks researchers say. Provider Magazine 2020.http:\/\/www.providermagazine.com\/news\/Pages\/2020\/MAY\/Facility-Location-Determines-COVID-Outbreaks -Researchers-Say.aspx. Accessed May 12 2020."},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16447"},{"key":"e_1_2_6_14_1","doi-asserted-by":"crossref","unstructured":"WernerRM HoffmanAK CoeNB. Long\u2010term care policy after Covid\u201019\u2014solving the nursing home crisis. Kaiser Health News 2020.https:\/\/khn.org\/morning-breakout\/viewpoints-its-past-time-to-shake-up-long-term-care-policies-ease-suffering-of-small-groups-of-family-physicians\/. Accessed July 15 2020.","DOI":"10.1056\/NEJMp2014811"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.13484"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.16832","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jgs.16832","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.16832","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T11:09:33Z","timestamp":1762168173000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.16832"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9,21]]},"references-count":14,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2020,11]]}},"alternative-id":["10.1111\/jgs.16832"],"URL":"https:\/\/doi.org\/10.1111\/jgs.16832","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9,21]]},"assertion":[{"value":"2020-08-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-09-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}