Objectives
Elderly in long-term facilities are vulnerable to a pandemic influenza. We aimed to identify characteristics of residential care facilities (RCFs) associated with having a pandemic influenza plan.
Design
Nationally representative, cross-sectional survey.
Setting
RCFs in the United States.
Participants
Participating facilities in the 2010 National Survey of RCFs (n=2,294), representing 31,030 assisted living facilities and personal care homes.
Measurements
Facility-level characteristics associated with a pandemic influenza plan, including general organization descriptors, staffing, resident services, and immunization practices.
Results
Overall, 45% (95%CI, 43–47) had a pandemic plan, 14% (95%CI, 13–16) had a plan in preparation, and 41% (95%CI, 38–43) had no plan. In the multivariable model, organization characteristics, staffing, and immunization practices were independently associated with the presence of a pandemic preparedness plan. The organization characteristics were larger size (extra-large, OR 3.27 [95%CI, 1.96–5.46], large, OR 2.60 [95%CI, 1.81–3.75], or medium, OR 1.66 [95%CI, 1.21–2.27], vs. small), not-for-profit status (OR 1.65 [95%CI, 1.31–2.09] vs. for-profit), and chain-affiliation (OR 1.65 [95%CI, 1.31–2.09] vs. non-affiliated). Staffing characteristics included the amount of RN hours (Less than 15 minutes, OR 1.36 [95%CI, 1.07–1.74] vs. no hours), any LPN hours (OR 1.47 [95%CI,1.08–1.99] vs. no hours), and at least 75 hours of required training for aides (OR 1.34 [95%CI, 1.05–1.71] vs. less than 75 hours). RCFs with high staff influenza vaccination rates (81–100%, OR 2.12 [95%CI, 1.27–3.53] vs. 0% vaccinated) were also more likely to have a pandemic plan.
Conclusion
A majority of RCFs lacked a pandemic influenza plan. These facilities were smaller, for-profit, non-chain-affiliated RCFs and had lower staff vaccination rates. These characteristics may help target facilities that need to develop plans to handle a pandemic, or other disasters.