New data is emerging on how COVID-19 response policies failed to protect one of the most vulnerable groups to the disease—the 2.1 million residents of American nursing homes.
After COVID-19 struck the Life Care Center in Kirkland, Washington, resulting in at least 30 deaths, nursing homes and residential care facilities became a focal point of the COVID-19 response. Although COVID-19 affects the elderly more severely than younger individuals on average, statistics show that deaths are more concentrated in elderly individuals who live in nursing homes or residential care facilities than those that do not reside in a facility.
The Foundation for Research on Equal Opportunity (FREOPP) has been monitoring infection and death rates among the nursing home population and reports that as of June 2, 2020, approximately 42 percent of all COVID-19 deaths occurred in nursing homes and assisted living facilities.
Death Rates Vary by State
The percentage of COVID-19 deaths in nursing homes and residential care facilities varies widely by state, with Minnesota, New Hampshire, and Rhode Island reporting 81 percent of COVID-19 deaths in these facilities and Nevada and Wyoming reporting under 28 percent of COVID-19 deaths in these facilities. Some states, such as Michigan, Missouri, and South Dakota, have not reported COVID death rates at nursing homes.
New York has been an outlier, says FREOPP. Despite ordering nursing homes to accept COVID-19 patients, the state reports COVID-19 death rates at nursing homes at under 14 percent. It appears the state has not included deaths of residents who eventually die at hospitals. Michigan New Jersey, and Pennsylvania also ordered nursing homes to accept COVID patients.
These orders were a deadly misstep, says Gregg Girvan, Health Care Research Fellow at FREOPP.
“States should never have ordered nursing homes to accept actively infected COVID-19 patients,” Girvan told Health Care News. “While states like New York have since rescinded such orders, others like Michigan have kept them in place, despite the fact that declining COVID-19 hospitalizations mean nursing home residents do not need to be hastily discharged to free up an ICU bed. Therefore, any orders to send patients back to nursing homes before they are no longer infectious should be rescinded immediately.”
According to the Centers for Disease Control and Prevention, COVID-19 impacts nursing homes more greatly due to their congregate nature and resident population served.
“Given emerging evidence that COVID-19 disproportionately affects the elderly with preexisting conditions, long-term care facilities, like hospitals, should have been prioritized for both personal protective equipment and testing for every worker and resident for infection,” Girvan said.
Girvan said states need to focus on this population as they reopen their economies.
“Beyond ensuring adequate PPE and universally testing, we must continue to restrict access by family and friends to nursing homes and to limit long-term care workers to working at just one facility so as to prevent transfer of the virus from one facility to another,” Girvan said. “Finally, all levels of government should work with facilities to accurately report cases and fatalities so that resources can be mobilized to prevent further outbreaks and loss of life.”
Kelsey Hackem, J.D. (khackem@gmail.com) writes from Washington State.