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After 10 months and countless promises from government officials to protect the most vulnerable communities, long-term care facilities in the United States surpassed the tragic milestone of 100,000 known COVID-19 deaths among residents and staff last week

The last week of November also saw the largest single-week increase in deaths since June—an especially distressing milestone since these numbers are very likely undercounts, as the Thanksgiving holiday impacted data reporting across the country. Many states that reliably report long-term care data each week published incomplete updates or didn't update at all. This likely explains the slight dip in cases we saw in every region of the US except for the West. Eight states—Alabama, Connecticut, Iowa, Florida, Massachusetts, Nebraska, New Mexico, and Wyoming—reported incomplete data this week due to the holiday. Meanwhile, Florida provided no data about deaths in long-term care facilities for most of November until the very end of the month, when the state reported 524 new deaths. That number arrived too late to be included in last week’s total of 100,240 deaths related to long-term care facilities since the pandemic began.

Midwest leads the nation in deaths and cases

The Midwest has had the highest number of COVID-19 cases and deaths in long-term care facilities every week since mid-November. Ohio and Illinois reported the most cases in the nation, with 4,682 and 3,536 respectively. Long-term care facilities in Minnesota are experiencing such severe staffing shortages that Governor Tim Walz has called in the National Guard and is asking state employees to volunteer. Iowa has updated its guidelines on emergency staffing, allowing staff members who have tested positive for COVID-19 to care for residents with suspected or confirmed COVID-19 (as North Dakota has previously done) and, as a last resort, even for patients who do not have the virus. Deaths reported in Illinois, Ohio, Indiana, and Minnesota topped the nation last week. In November, about one-third of all US states and territories reported their respective highest numbers of new long-term care cases since the start of the pandemic.

Washington, the state that experienced the first long-term care facility outbreak back in February, reported a 75 percent increase in facility outbreaks in November. More than half of the state’s COVID-19 deaths have been associated with long-term care facilities, while they make up only 6 percent of the state’s total cases. California, where cases are surging across the population, reported the highest number of cases in long-term care facilities since The COVID Tracking Project began collecting data; deaths in these facilities are also reaching levels not seen since the summer.

Some good news arrived on Tuesday, when the CDC’s Advisory Committee on Immunization Practices recommended that the vaccine be given first to two groups: healthcare personnel and residents of long-term care facilities. This was the first concrete step by the CDC in deciding how the vaccine distribution will unfold. 

The month ahead

Despite brief blips in reporting by states, new long-term care cases and deaths remain alarmingly high. This coming week’s data may produce a larger than normal jump as state reporting catches back up. With Thanksgiving travel and gatherings behind us, and the winter holiday season approaching, the next few weeks may be very grim.

Thank you to the Long-Term Care COVID Tracker data collection team.

If you have questions or information to share, you can reach the Long-Term Care COVID Tracker team at [email protected].


Artis Curiskis is outreach & reporting co-lead at the COVID Tracking Project and collaboratively runs the CTP special projects Long-Term Care COVID Tracker and City Data.

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Jessica Malaty Rivera has an MS in Emerging Infectious Diseases and is the Science Communication Lead at The COVID Tracking Project.

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Sarah R. McLaughlin is volunteer at the COVID Tracking Project supporting various data visualization initiatives. She has a background in Epidemiology/Biostatistics and is currently working at a Boston-based SaaS company.


Kara Oehler is outreach & reporting co-lead at the COVID Tracking Project and collaboratively runs the CTP special projects Long-Term Care COVID Tracker and City Data.

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Aarushi Sahejpal is a Shift Lead on Long-Term Care and City Data at the COVID Tracking Project. She also studies International Relations & Data Science at American University


Sara Simon works on The COVID Tracking Project’s data quality team and is also a contributing writer. She most recently worked as an investigative data reporter at Spotlight PA and software engineer at The New York Times.


Peter Walker is Head of Marketing & Growth at PublicRelay and Data Viz Co-Lead at The COVID Tracking Project.


Nadia Zonis is a New York City-based writer and editor.


More “Long-Term Care” posts

Vaccines Begin to Arrive as Cases and Deaths Keep Rising: This Week in Long-Term Care COVID-19 Data, Dec 16

Cases are up and known deaths in long-term-care facilities are the highest they’ve been since late May.

What We Know—and What We Don’t Know—About the Impact of the Pandemic on Our Most Vulnerable Community

Residents of nursing homes and other long-term-care facilities suffered an outsized impact from COVID-19. And yet we still don’t know how big of an impact, because so much data is missing or incomplete. What we do know makes plain that we failed to protect this community—and at great cost.

Giving Thanks and Looking Ahead: Our Data Collection Work Is Done

While our work to compile COVID-19 data has concluded, we will continue to share research, analysis, and documentation in the months ahead. We are enormously grateful to the hundreds of volunteers who made this work possible.

By Erin Kissane & Alexis MadrigalMarch 8, 2021