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MEAWW.COM / NEWS / HEALTH

Over 26,370 US nursing home residents, staff have died from coronavirus but death toll excludes cases before May

Across the nation, nursing home residents have died at the rate of 27.5 per 1,000 while there have been 62 cases per 1,000 residents at these facilities
PUBLISHED JUN 3, 2020
(Getty Images)
(Getty Images)

Nursing homes in the US have been hit hard by the Covid-19 pandemic since the elderly are particularly vulnerable to the virus. And months after the coronavirus started running rampant in US nursing homes, the first nationwide analysis of its impact on these facilities has finally been released by the federal government. It shows that nearly 26,000 residents of nursing homes have died in the Covid-19 pandemic so far. However, the numbers do not give a full picture of the toll on the vulnerable American population as they capture only a part of total coronavirus deaths associated with nursing homes. 

One in four nursing facilities in the US had at least one case of Covid-19, and 1 in five reported at least one death, according to data released by the Centers for Medicare and Medicaid Services (CMS). The analysis shows 25,923 resident deaths due to Covid-19, and 449 deaths among the facilities’ staff (26,372 in all). The survey also found about 94,881 Covid-19 cases at nursing homes across 49 states. This includes 60,439 Covid-19 cases among residents and about a third or 34,442 among the staff.  

Across the nation, nursing home residents have died at the rate of 27.5 per 1,000 while there have been 62 cases per 1,000 residents at these facilities. The District of Columbia reported the highest rate, with 255.4 cases per 1,000 nursing home residents, followed by Massachusetts (244.4 cases per 1,000) and Connecticut (236.1 per 1,000 cases). On the other hand, Hawaii reported no cases among its nursing home residents. The analysis also shows that the highest death rate among residents was reported by New Jersey (145.5 per 1,000 deaths), followed by the District of Columbia (131.2 per 1,000 deaths), and Connecticut (125.0 per 1,000 deaths). 

The state survey includes information from 8,332 or 54.10% of the country's 15,412 nursing homes. According to officials, the numbers will go up as an estimated 20% of the nursing homes have not yet reported the required data to the Centers for Disease Control and Prevention (CDC). The federal data does not include assisted living facilities, which some states count in their coronavirus totals. The CMS also did not ask nursing homes to report deaths and cases that happened before May. 

“As with any new reporting program, some facilities will struggle with their first submissions and therefore, some of the data from their early submissions may be inaccurate. As facilities begin reporting in the early weeks, the increase in certain metrics (for example, the number of cases) is a reflection of an increase in reporting, rather than an increase in the actual number of cases. Facilities may opt to report cumulative data retrospectively back to January 1, 2020. Therefore, some facilities may be reporting higher numbers of cases/ deaths compared to other facilities, due to their retrospective reporting,” says the report. 

“The availability of testing may impact the number of confirmed Covid-19 cases facilities report. Facilities that did not have the ability to test all residents a few weeks ago would not be able to report all residents with confirmed cases. Similarly, access to testing can vary by state, region, or facility. Data may be inconsistent with state data, particularly state death data,” it adds.

According to the CDC, nursing homes, skilled nursing facilities, and assisted living facilities, are collectively known as long-term care facilities in the US. They provide a variety of services, both medical and personal care, to people who are unable to manage independently in the community. Over 4 million Americans are admitted to or reside in nursing homes and skilled nursing facilities each year and nearly one million persons reside in assisted living facilities. 

Across the US, more than 1,831,820 coronavirus cases have been reported as of June 3 and over 106,180 have died in the Covid-19 pandemic. 

The District of Columbia reported the highest rate, with 255.4 cases per 1,000 nursing home residents, followed by Massachusetts (244.4 cases per 1,000 cases). (Getty Images)

Another analysis says that 42% of US Covid-19 deaths have occurred in nursing homes and assisted living facilities in the US. “Hawaii, Michigan, Missouri, New Mexico, North Dakota, South Dakota, and Wyoming do not break out deaths by residential categories. But among the 89,084 US Covid-19 deaths captured by our analysis, 37,214, or 42%, were nursing or residential care home residents,” says the study. The analysis was done by Gregg Girvan, a research fellow at the Foundation for Research on Equal Opportunity (FREOPP).

Based on long-term care usage and demographics in the states that still do not report long-term care fatalities, the study also estimates that, nationally, the share of fatalities from nursing home and residential care facilities is 41% and 52% outside of New York State. “The policy implications of these figures are significant and suggest substantial flaws in the way that we have managed the Covid-19 pandemic. Much more attention must be paid to the risk of SARS-CoV-2 infection in nursing homes, especially through nursing home staff who work at multiple facilities. Nursing homes must use best practices for testing and cleanliness,” says the study. 

A federal watchdog report last month found most nursing homes had a “persistent” pattern of infection control problems even before the coronavirus, while most had infection control deficiencies. Infection control practices are critical in preventing the spread of infectious diseases such as Covid-19, says the report by the Government Accountability Office (GAO). 

In each individual year from 2013 through 2017, the percent of surveyed nursing homes with an infection prevention and control deficiency ranged from 39% to 41%,  In 2018 and 2019, investigation showed that this continued with about 40% of surveyed nursing homes having an infection prevention and control deficiency cited each year. About half — 6,427 of 13,299 (48%) — of the nursing homes with an infection prevention and control deficiency cited in one or more years of the period reviewed had this type of deficiency cited in multiple consecutive years from 2013 through 2017. This is an indicator of persistent problems, said experts. 

“Infection prevention and control deficiencies cited by surveyors can include situations where nursing home staff did not regularly use proper hand hygiene or failed to implement preventive measures during an infectious disease outbreak, such as isolating sick residents and using masks and other personal protective equipment to control the spread of infection. Many of these practices can be critical to preventing the spread of infectious diseases, including Covid-19,” says the report. 

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