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J Am Geriatr Soc. 2014 Jul;62(7):1310-6. doi: 10.1111/jgs.12879. Epub 2014 May 22.

Pandemic influenza plans in residential care facilities.

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Division of Geriatric Medicine, School of Medicine, University of Colorado, Aurora, Colorado; Denver Veterans Affairs Medical Center, Denver, Colorado.



To identify characteristics of residential care facilities (RCFs) associated with having a pandemic influenza plan.


Nationally representative, cross-sectional survey.


RCFs in the United States.


Participating facilities in the 2010 National Survey of RCFs (N = 2,294), representing 31,030 assisted living facilities and personal care homes.


Facility-level characteristics associated with a pandemic influenza plan, including general organization descriptors, staffing, resident services, and immunization practices.


Forty-five percent (95% confidence interval (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. 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; 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 nonaffiliated). Staffing characteristics included number of registered nurse hours (<15 minutes, OR = 1.36, 95% CI = 1.07-1.74 vs no hours), any licensed practical nurse 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 <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.


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.


assisted living facility; geriatric; influenza; pandemic; residential facility

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