Supplementary Table 1.
Overview of the Data Inputs of the NH Risk Model
| Data Category | Variable Description | Data Source | Number of NH in Training Set without Missing Feature Values (n = 1146), n (%) |
|---|---|---|---|
| Facility's community characteristics | Cumulative number of positive COVID-19 cases per capita in the NH's county on the day of NH COVID-19 case reporting | NYT COVID Tracker | 1133 (98.9) |
| Estimated poverty score of the NH's county (Based on: Household income) | CDC | 1133 (98.9) | |
| Overall comorbidity score of the NH's county (Based on: Obesity, diabetes, hypertension, cardiovascular characteristics from 2018) | CDC | 1133 (98.9) | |
| Overall percentile ranking of social vulnerability index of the NH's county (Based on: Socioeconomic, household composition, minority status/language, and housing type/transportation characteristics) | CDC | 1133 (98.9) | |
| Percent of facility's county who are non-Hispanic White | US Census | 1133 (98.9) | |
| Percentage of family households in the NH's county | Claritas | 1133 (98.9) | |
| Population density of the NH's county (population per square mile) | Claritas | 1133 (98.9) | |
| Community social distancing and population mobility characteristics | Proportion of Safe Graph tracked devices traveling less than 8000 meters per day out of all tracked devices in the facility's Zip code of the week of NH COVID-19 case reporting | Safe Graph | 1096 (95.6) |
| Proportion of Safe Graph tracked devices traveling more than 50,000 meters per day out of all tracked devices in the facility's zip code of the week of NH COVID-19 case reporting | Safe Graph | 1096 (95.6) | |
| Proportion of Safe Graph tracked devices exhibiting full-time employment behavior in the zip code of the week of NH COVID-19 case reporting | Safe Graph | 1101 (96.1) | |
| Proportion of Safe Graph tracked devices traveling less than 8000 meters per day out of all tracked devices in the facility's county of the week of NH COVID-19 case reporting | Safe Graph | 1133 (98.9) | |
| Proportion of Safe Graph tracked devices traveling more than 50,000 meters per day out of all tracked devices in the facility's county of the week of NH COVID-19 case reporting | Safe Graph | 1133 (98.9) | |
| Proportion of Safe Graph tracked devices exhibiting full-time employment behavior in the county of the week of NH COVID-19 case reporting | Safe Graph | 1133 (98.9) | |
| Inflow of Safe Graph tracked devices to the facility's county of the week of NH COVID-19 case reporting | Safe Graph | 1131 (98.7) | |
| Outflow of Safe Graph tracked devices from the facility's county of the week of NH COVID-19 case reporting | Safe Graph | 1132 (98.8) | |
| Percentage of county's population taking public transportation to work | Claritas | 1133 (98.9) | |
| Facility characteristics | Age of the nursing home in years | NIC | 750 (65.4) |
| Standardized hourly cost per clinical worker excluding certified nursing assistants (per patient per day)∗,† | MCDA | 1090 (95.1) | |
| Standardized hourly cost per clinical worker including certified nursing assistant (per patient per day)∗,† | MCDA | 1090 (95.1) | |
| Walk Score measures walkability on a scale from 0‒100 based on walking routes to destinations such as grocery stores, schools, parks, restaurants, and retail | Walk Score | 760 (66.3) | |
| Number of clinical workers per 1000 square feet in the facility prior to the COVID-19 outbreak∗ | MCDA | 999 (87.2) | |
| Number of health deficiencies at the facility as defined by the Centers for Medicare and Medicaid Service since 2014 | CMS | 977 (85.3) | |
| Number of patients per 1000 square feet in the facility prior to the COVID-19 outbreak | MCDA | 999 (87.2) | |
| Overall infection control process and performance index | MCDA | 974 (85.0) | |
| Rate of influenza vaccination for long stay residents | MCDA | 1065 (92.9) | |
| Rate of influenza vaccination for short stay residents | MCDA | 1078 (94.1) | |
| Rate of pneumococcal vaccination for long stay residents | MCDA | 1065 (92.9) | |
| Rate of pneumococcal vaccination for short stay residents | MCDA | 1080 (94.2) | |
| Rate of rehospitalizations of residents due to infection | MCDA | 1091 (95.2) | |
| Index based on CMS health inspection citations related to infection control measures (citations weighted according to scope, severity, and recency) | MCDA | 849 (74.1) | |
| Index based on CMS health inspection citations related to laboratory processes (citations weighted according to scope, severity, and recency) | MCDA | 739 (64.5) | |
| Index based on CMS health inspection citations related to managerial processes (citations weighted according to scope, severity, and recency) | MCDA | 966 (84.3) | |
| Index based on CMS health inspection citations related to physical environment (citations weighted according to scope, severity, and recency) | MCDA | 739 (64.5) | |
| Total number of beds at the facility | CMS, NIC | 1146 (100.0) | |
| Total number of beds for Nursing Care | NIC | 768 (67.0) | |
| Total number of units for assisted living | NIC | 768 (67.0) | |
| Total number of units for independent living | NIC | 768 (67.0) | |
| Total number of units for memory care | NIC | 768 (67.0) | |
| Percent of facility residents who were non-Hispanic white prior to the COVID-19 outbreak | LTCFocus | 961 (83.9) | |
| Percent of facility residents whose primary support was Medicare prior to the COVID-19 outbreak | LTCFocus | 961 (83.9) | |
| Percent of facility residents whose primary support was Medicaid prior to the COVID-19 outbreak | LTCFocus | 961 (83.9) | |
| Facility outcomes | Presence of at least one resident COVID-19 case | State Departments of health | 1146 (100.0) |
CDC, Centers for Disease Control and Prevention; LTCFocus, Long-term Care Focus; MCDA, Muller Consulting and Data Analytics; NIC, National Investment Center for Seniors Housing and Care; NYT, New York Times.
∗
Clinical worker defined as registered nurses, licensed practical nurses, certified nursing assistants, nursing aides, medical aides/technicians, nursing home administrators, medical directors, physicians, physician assistants, nurse practitioners, clinical nurse specialists, pharmacists, dieticians, feeding assistants, occupational therapists, occupational therapy assistants, occupational therapy aides, physical therapists, physical therapist assistants, physical therapist aides, respiratory therapists, respiratory therapy technicians, speech/language pathologists, therapeutic recreation specialists, qualified activities professionals, other activities staff, qualified social workers, other social workers, mental health service workers.
†
Standardized costs based on average hours worked multiplied by Bureau of Labor Statistics national wage rate estimates for respective occupations in skilled nursing facilities.