Pandemic Influenza Plans in Residential Care Facilities

Objectives To identify characteristics of residential care facilities ( RCF s) associated with having a pandemic influenza plan. Design Nationally representative, cross‐sectional survey. Setting RCF s in the United States. Participants Participating facilities in the 2010 National Survey of RCF s (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 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). RCF s 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 RCF s lacked a pandemic influenza plan. These facilities were smaller, for‐profit, non‐chain‐affiliated RCF s and had lower staff vaccination rates. These characteristics may help target facilities that need to develop plans to handle a pandemic, or other disasters.