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The effectiveness and consequences of visitation bans in nursing homes

Award Number: R01AG081282
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 06/01/2023
PERIOD OF PERFORMANCE END DATE: 01/31/2027

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The effectiveness and consequences of visitation bans in nursing homes - The nursing home residents in the U.S. were at high risk of infectious diseases between 2020 and 2022. One of the most widespread mitigation measures implemented by nursing homes was a visitation ban. In March and April 2020, 31 states issued state-wide visitation bans, affecting at least 66% of facilities and 70% of residents in the U.S. Visitation bans may prevent transmission between facilities and the community. Yet, any ban is incomplete because of staff who travel between the facility and the community. To our knowledge, there is no empirical study examining the effectiveness of visitation bans on preventing infections, hospitalizations, and deaths. What also matters are the adverse effects of visitation bans on residents. Visitation bans can substantially reduce informal care, increase social isolation, and disrupt routine care, resulting in adverse events such as decreased function and increases in depression, falls, and hospitalization. Residents with Alzheimer's Disease & Related Dementias (ADRD), who rely more on caregivers, may have a greater risk of adverse events than those without ADRD. Our team has collected visitation data at both the state and facility levels, which document the dates when states initiated and lifted bans, as well as weekly bans data at the facility level in Ohio. We also collect open-ended comments from family members from a state-wide family satisfaction survey in Ohio. By linking data on visitation bans with national Medicare claims and assessment data, we propose a convergent parallel mixed methods study to examine the effectiveness and adverse consequences of visitation bans in nursing homes. We will study the 9,876 nursing homes in the 31 states that banned indoor visitation in March 2020, then lifted those bans between June and November 2020. We will also study the 701 nursing homes in Ohio, where we have weekly data on the presence of bans for each facility. Matched case-control design on prior infection rates and Hierarchical Generalized Linear Mixed Models will examine the association of lifting visitation bans with resident infections and health outcomes. Focus group interviews with direct care staff and analyses of family comments will be conducted to examine the effects of visitation bans on daily care practices and resident health outcomes. Understanding both the benefits and harms of visitation bans can inform future policy responses in nursing homes. The specific aims of this project are: 1) To assess the effectiveness of visitation bans on preventing infections (primary), hospitalization, and deaths among nursing home residents; 2) To evaluate the association of visitation bans with changes in function (primary), mood/behaviors, and adverse events among long-stay residents with or without ADRD; and 3) To understand how visitation bans affected daily care practices within nursing homes and resident health outcomes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $345,536 )
2026	2026	EMORY UNIVERSITY	201 DOWMAN DR NE	ATLANTA	GA	30322	DEKALB	USA	Aging Research	000	4	1/9/2026	NON-COMPETING CONTINUATION	$345,536
														Subtotal = $345,536

Issue Date FY: 2025 ( Subtotal = $404,658 )
2025	2025	EMORY UNIVERSITY	201 DOWMAN DR NE	ATLANTA	GA	30322	DEKALB	USA	Aging Research	003	3	9/17/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$30,726
2025	2025	EMORY UNIVERSITY	201 DOWMAN DR NE	ATLANTA	GA	30322	DEKALB	USA	Aging Research	001	3	1/2/2025	CHANGE OF GRANTEE / TRAINING INSTITUTION / AWARDING INSTITUTION	$373,932
2025	2024	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON	301 UNIVERSITY BLVD	GALVESTON	TX	77555	GALVESTON	USA	Aging Research	002	2	4/2/2025	NON-COMPETING CONTINUATION	$0
2025	2024	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON	301 UNIVERSITY BLVD	GALVESTON	TX	77555	GALVESTON	USA	Aging Research	000	2	12/31/2024	NON-COMPETING CONTINUATION	$0
														Subtotal = $404,658

Issue Date FY: 2024 ( Subtotal = $362,350 )
2024	2024	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON	301 UNIVERSITY BLVD	GALVESTON	TX	77555	GALVESTON	USA	Aging Research	001	2	1/31/2024	NON-COMPETING CONTINUATION	$311,715
2024	2024	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON	301 UNIVERSITY BLVD	GALVESTON	TX	77555	GALVESTON	USA	Aging Research	002	2	6/10/2024	NON-COMPETING CONTINUATION	$34,635
2024	2023	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON	301 UNIVERSITY BLVD	GALVESTON	TX	77555	GALVESTON	USA	Aging Research	000	1	12/28/2023	NEW	$16,000
														Subtotal = $362,350

Issue Date FY: 2023 ( Subtotal = $340,538 )
2023	2023	UNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON	301 UNIVERSITY BLVD	GALVESTON	TX	77555	GALVESTON	USA	Aging Research	000	1	5/31/2023	NEW	$340,538
														Subtotal = $340,538

Grand Total All Awards = $1,453,082

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The effectiveness and consequences of visitation bans in nursing homes

Award Number: R01AG081282

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 06/01/2023

PERIOD OF PERFORMANCE END DATE: 01/31/2027

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