For Most States, At Least A Third Of COVID-19 Deaths Are In Long-Term Care Facilities

Coronavirus fatalities in long-term care facilities have surpassed a grim threshold in much of the country, accounting for at least a third of the deaths in 26 states and more than half in 14 of those.

The data, which was published by the Kaiser Family Foundation, reports tallies from a variety of care facilities, including nursing homes, adult care residences, and other skilled nursing care settings. However, it does not break out those categories separately.

The report comes as states prepared to meet a federal reporting deadline Friday.

The striking figures offer only a partial glimpse of the devastating impact of the virus on patients, residents and staff members ahead of the new mandate that requires officials to disclose coronavirus cases and deaths in nursing homes and long-term living residences to the Centers for Disease Control and Prevention.

Priya Chidambaram, a policy analyst with the foundation, was part of the research team compiling information from state dashboards, official statements and other sources. She called the latest statistics "shocking."

"It does really make you think about what the true national numbers will be when we eventually do get data from all 50 states," Chidambaram said.

She expects that skilled nursing facilities will continue to be hot spots for the spread of the virus now that 18 states that have so far declined to publicly report data, hand information over to the CDC.

According to the report, New Hampshire and Pennsylvania reported the highest share of coronavirus deaths — 72% and 70% respectively.

However, the total deaths behind those ratios vary widely from state to state. In the case of New Hampshire, 66 of 114 total deaths occurred in long-term care facilities. Whereas, in Pennsylvania the slightly lower percentage represents a much greater death toll — 2,355 of 3,364 deaths.

"It is not necessarily correlated to the challenges that states might be facing in long-term care facilities," Chidambaram said. One theory is that those residences are simply conducting more thorough testing than is being done among the general public.

New York has the highest number of overall deaths related to COVID-19 in the country. It also has the highest death rate in what Kaiser Family Foundation describes as long-term care facilities.

As of Wednesday, the foundation reported 5,215 people died from the virus in long-term care facilities in New York — 20% of the state's total number of dead. New Jersey had the second-highest rate with 4,556 reported cases in their facilities, 53% of the state's total death toll.

Until now, most states volunteered a patchwork of metrics at their own discretion. But the new rule from the Centers for Medicare and Medicaid Services demands that states report coronavirus-related information to the CDC on a weekly basis. It also requires states to divulge additional data, including Personal Protective Equipment and hand hygiene supplies, resident access to testing, and staffing shortages.

Officials with the American Health Care Association, the trade organization for most nursing homes, has called the outbreak "devastating." The group urged the federal government to prioritize testing to all residents and caregivers of nursing homes and assisted living communities, regardless of symptoms.

"Without expanded testing, it is virtually impossible for us to know who in our facilities, whether they are residents or caregivers, are COVID positive – making it extremely difficult to stop the spread of the virus," officials said in a letter this week.

Increased testing may show where hot spots are, but they still don't address the underlying causes fueling the spread of coronavirus.

"It was certainly expected that nursing homes would be hit but it was not inevitable that they'd be hit this hard," Richard Mollot, of the executive director of New York-based Long Term Care Community Coalition, said. The group advocates for greater oversight of skilled nursing facilities.

"I'm afraid what we're seeing now is the failure to ensure that nursing homes are providing appropriate staffing," Mollot said, "that they are undertaking effective and appropriate measures to control infections and prevent infections in their facilities."

States have been granted a two-week grace period to submit their data. The CDC expects to make the information available sometime before the end of the month. [Copyright 2020 NPR]