En español | More than 84,000 residents and staff of nursing homes and other long-term care facilities have died from COVID-19, representing 40 percent of all coronavirus fatalities in the U.S., according to Kaiser Family Foundation's most recent analysis released on Oct. 8. Yet federal policymakers have been slow to respond to this crisis, and no state has done a good enough job to stem the loss of life. AARP has called for the enactment of a five-point plan to protect nursing home and long-term care facility residents — and save lives — at the federal and state levels:
- Prioritize regular and ongoing testing and adequate personal protective equipment (PPE) for residents and staff — as well as inspectors and any visitors.
- Improve transparency focused on daily, public reporting of cases and deaths in facilities; communication with families about discharges and transfers; and accountability for state and federal funding that goes to facilities.
- Require access to facilitated virtual visitation, and establish timelines, milestones and accountability for facilities to provide in-person visitation.
- Ensure quality care for residents through adequate staffing, oversight and access to in-person formal advocates, called long-term care ombudsmen.
- Reject immunity for long-term care facilities related to COVID-19.
Policymakers have taken some action, such as requiring nursing homes to self-report COVID-19 cases and deaths at the federal level, ordering testing, and providing limited PPE and other resources to nursing homes. But more must be done. AARP continues to urge elected officials to acknowledge and take action to resolve this national tragedy — and to ensure that public funds provided to nursing homes and other long-term care facilities are used for testing, PPE, staffing, virtual visits and for the health and safety of residents.
COVID-19 cases across the U.S. are again on the rise, and nursing homes remain a hotbed for the virus. AARP will continue to shine a light on what's happening in nursing homes so that families have the information they need to make decisions, and lawmakers can be held accountable. For more information, visit aarp.org/nursinghomes.
AARP fought for public reporting of nursing home COVID-19 cases and deaths. Using this data, the AARP Public Policy Institute, in collaboration with the Scripps Gerontology Center at Miami University in Ohio, created the AARP Nursing Home COVID-19 Dashboard to provide four-week snapshots of the infiltration of the virus into nursing homes and its impact on residents and staff, with the goal of identifying specific areas of concern at the national and state levels in a timely manner.
This first dashboard aggregates and analyzes self-reported data from nursing homes available from the Centers for Medicare & Medicaid Services (CMS), covering the time frame of Aug. 24 to Sept. 20, 2020, and contains five key measures. It is specific to nursing homes:
- Resident deaths per 100 residents
- Resident cases per 100 residents
- Staff cases per 100 residents
- Percentage of nursing homes without a one-week supply of PPE
- Percentage of nursing homes with staffing shortages
This dashboard will be updated every four weeks to track trends over time and will evolve to include more categories to follow other measures of interest.
The AARP Public Policy Institute will analyze data and report on key findings as the dashboard is updated over time. For the first dashboard, these include:
- In every state, nursing homes indicated a shortage of PPE (defined as not having a one-week supply of N95 masks, surgical masks, gowns, gloves and eye protection during the previous four weeks). Nationally, about one quarter (25.5 percent) of nursing homes had a PPE shortage during the Aug. 24 to Sept. 20 reporting period. In the highest performing state, 8 percent of nursing homes had a PPE shortage; in the lowest-performing state, 60 percent did not have a one-week supply.
- While considerable attention has been paid to infections among nursing home residents, it is also critically important to consider direct-care staff. In the four weeks ending Sept. 20, one-quarter (24 percent) of nursing homes had at least one confirmed COVID-19 case among residents, and twice as many (50 percent) had at least one confirmed staff case. Per 100 nursing home residents, there were 2.6 COVID-19 resident cases and 2.5 staff cases, corresponding to a total of about 55,000 cases nationally.
- There is considerable variation across states. COVID-19 deaths in the four weeks ending Sept. 20 averaged 0.5 per 100 residents across the nation (about 1 out of every 200 residents). At the state level, the death rate was as high as 1.2 per 100 residents (about 1 out of 80), and several states reported no resident deaths in the past month.
Since the pandemic started, scant data has been available consistently to help gain a better understanding of the crisis in nursing homes and other long-term care facilities. The country counted mainly on the reporting of news media to glimpse the devastation caused by COVID-19. Organizations such as Kaiser Family Foundation and the COVID Tracking Project also began collecting and publishing important information from the states. It is important to note that each source collects data differently, so similar information may appear at odds due to how the measures are captured. Specific to nursing homes:
- In May, CMS required nursing homes to self-report COVID-19 cases and deaths on at least a weekly basis; however, the required reporting was not retroactive. As a result, there has been a significant undercounting of cases and deaths before June.
- Many states also have required self-reporting by nursing homes and/or other long-term care facilities, but the requirements vary widely. Some states combine data for nursing homes and other long-term care facilities such as assisted living; others combine resident and staff cases and deaths, while others provide limited or no data at all.
- Since June, the data reported by CMS and by individual states appear to be roughly comparable, though exact comparisons are difficult because of the inconsistency in state reporting