Hostname: page-component-669899f699-qzcqf Total loading time: 0 Render date: 2025-04-26T00:12:16.458Z Has data issue: false hasContentIssue false
  • English
  • Français

Association of Texas Nursing Home Non-COVID-19 Mortality Following Winter Storm Uri: A Mixed-Effects Spline Analysis

Published online by Cambridge University Press:  16 April 2025

Stephen Frochen Open the ORCID record for Stephen Frochen [Opens in a new window] ,
Debra Saliba Open the ORCID record for Debra Saliba [Opens in a new window]  and
Aram Dobalian Open the ORCID record for Aram Dobalian [Opens in a new window]
Stephen Frochen*
Affiliation:
Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA, USA Veterans Emergency Management Evaluation Center (VEMEC), VA Greater Los Angeles Healthcare System, North Hills, CA, USA
Debra Saliba
Affiliation:
Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA, USA VA Greater Los Angeles Healthcare system, Geriatric Research, Education and Clinical Center, West Los Angeles Campus, Los Angeles, CA, USA Borun Center, University of California Los Angeles, UCLA Division of Geriatrics, Los Angeles, CA RAND Health, RAND Corporation, Santa Monica, CA, USA
Aram Dobalian
Affiliation:
Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, North Hills, CA, USA Veterans Emergency Management Evaluation Center (VEMEC), VA Greater Los Angeles Healthcare System, North Hills, CA, USA The Ohio State University, College of Public Health, Division of Health Services Management and Policy, Columbus, OH, USA
*
Corresponding author: Stephen Frochen; Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

Nursing Home residents are among the most at-risk populations during disasters. This study aimed to examine changes in nursing home non-COVID-19 mortality in Texas during Winter Storm Uri.

Methods

Publicly available datasets were examined to determine whether nursing homes in Texas were associated with a change in non-COVID-19 nursing home mortality and a change in non-COVID-19 mortality differences compared to all other states in the 4 weeks following Winter Storm Uri. This study conducted a mixed-effects negative binomial spline analysis of non-COVID-19 mortality during the timeframe.

Results

Although Texas suffered fewer deaths overall compared to the rest of the country, Texas experienced a 20% increase in non-COVID-19 deaths in the first 7 days of Winter Storm Uri, and a reduction in the change of deaths compared to all other states, indicating a 19% decrease in the difference between the 2 directly following the storm.

Conclusions

Texas suffered a significant increase in non-COVID-19 nursing home mortality during Winter Storm Uri, but overall lower levels of mortality compared to the rest of the nation. Future research should examine other states or counties that experienced significant energy outages for a more comprehensive understanding of the storm’s effects.

Keywords

Winter Storm UriTexasnursing homesnon-COVID-19 mortality
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 19 , 2025 , e98
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Senate, US. Left in the Dark: The Impact of the 2021 Texas Blackout on Long-term Care Residents and the Need to Improve Emergency Preparedness. Published February 22, 2023. Accessed February 23, 2024. https://www.finance.senate.gov/imo/media/doc/02222023%20Left%20in%20the%20Dark%20-%20Wyden-Casey%20final.pdf.Google Scholar
Chidambaram, P, Neuman, T. COVID-19 has Claimed the Lives of 100,000 Long-term Care Residents and Staff. Kaiser Family Foundation. Published November 25, 2020. Accessed February 23, 2024. https://www.kff.org/policy-watch/covid-19-has-claimed-the-lives-of-100000-long-term-care-residents-and-staff/.Google Scholar
Dosa, DM, Grossman, N, Wetle, T, et al. To evacuate or not to evacuate: lessons learned from Louisiana nursing home administrators following Hurricanes Katrina and Rita. J Am Med Dir Assoc. 2007; 8(3):142–149. https://doi.org/10.1016/j.jamda.2006.11.004.CrossRefGoogle ScholarPubMed
Hanchey, A, Jiva, S, Bayleyegn, T, et al. Mortality surveillance during Winter Storm Uri, United States – 2021. Disaster Med Public Health Prep. 2023;17:e530. https://doi.org/10.1017/dmp.2023.108.CrossRefGoogle ScholarPubMed
Jester, DJ, Peterson, LJ, Andel, R, et al. Winter Storm Uri reduced availability of daily direct-care nurse staff in Texas nursing homes. J App Gerontol. 2023; 42(10):2148–2157. https://doi.org/10.1177/07334648231175428.CrossRefGoogle ScholarPubMed
[Dataset] Centers for Medicare and Medicaid Services (CMS). COVID-19 Nursing Home Data; 2022. Accessed February 1, 2022. https://data.cms.gov/covid-19/covid-19-nursing-home-data.CrossRefGoogle Scholar
[Dataset] Centers for Medicare and Medicaid Services (CMS). Nursing Homes Including Rehab Services; 2022. Accessed February 1, 2022. https://data.cms.gov/provider-data/topics/nursing-homes.Google Scholar
[Dataset] National Institute of Environmental Health Sciences. Details for PVI Maps; 2023. Accessed February 1, 2022. https://covid19pvi.niehs.nih.gov/.Google Scholar
[Dataset] National Centers for Environmental Information. February 2021 Climate at a Glance County Minimum Temperature Dataset; 2024. Accessed January 26, 2024. https://www.ncei.noaa.gov/access/monitoring/climate-at-a-glance/county/mapping/110/tmin/202102/1/rank.Google Scholar
Cronin, CJ, Evans, WN. Nursing home quality, COVID-19 deaths, and excess mortality. J Health Econ. 2022;82:102592. https://doi.org/10.1016/j.jhealeco.2022.102592.CrossRefGoogle ScholarPubMed
Levere, M, Rowan, P, Wysocki, A. The adverse effects of the COVID-19 pandemic on nursing home resident well-being. J Am Med Dir Assoc. 2021;22(5):948–954. https://doi.org/10.1016/j.jamda.2021.03.010.CrossRefGoogle ScholarPubMed
Office of the Inspector General (OIG). COVID-19 Had a Devastating Impact on Medicare Beneficiaries in Nursing Homes during 2020. Published June 2021. Accessed September 26, 2024. https://oig.hhs.gov/documents/evaluation/2701/OEI-02-20-00490-Complete%20Report.pdf.Google Scholar