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In the most drastic surge of the last six months, long-term care facilities reported a rise in new COVID-19 cases this week at twice the rate of overall cases in the nation. States reported a 50 percent increase in new long-term care cases—46,153 new COVID-19 cases this week alone. Long-term care facilities recorded about 3,000 new deaths in one week, a marker last passed in early June. Nearly half of these deaths occurred in the Midwest, according to our Long-Term Care COVID Tracker.

The Midwest remains the epicenter of long-term care facility outbreaks, accounting for 39 percent of new cases reported in the US. But the crisis stretches beyond the Midwest, too. As COVID-19 continues to sweep the country, each region reported their largest increase of long-term care cases in the past four months.

Deaths from long-term care facilities still drive all US deaths

There are known limitations to long-term care data: With few federal COVID-19 data standards and no comprehensive reporting process that encompasses all long-term care facilities, the numbers are almost certainly severe undercounts. This reality makes the available data that much more harrowing. So far this month, long-term care residents represent 39 percent of all US COVID-19 deaths. With winter approaching and case numbers higher than ever before, existing safety measures will not adequately protect this vulnerable population.

Illinois’s long-term care crisis tops nation

With the Midwest’s surge ongoing, our attention is on the state that made up nearly one-fifth of the region’s recent long-term care deaths and cases: Illinois. The state recently reported 240 new deaths, or 8 percent of the nation’s long-term care deaths last week. Illinois also reported its highest increase in long-term care cases in the last six months.

New COVID-19 cases and deaths reported in Illinois are reminiscent of the state's deadly surge in early June. On Monday, nearly 700 nursing home workers in the state went on strike,  seeking hazard pay, according to the Chicago Tribune

With death reporting known to lag a few weeks behind rising case numbers, the state’s recent spike likely signals more tragedy for residents of Illinois’s long-term care facilities and their loved ones. A new investigation from WBEZ, Chicago’s NPR news station, found that for-profit facilities recorded much higher COVID-19 death counts than non-profit nursing homes, largely due to insufficient resourcing. 

Three facilities are central to Wyoming’s surge

We’re also monitoring Wyoming, which is reporting its highest case and death numbers since the beginning of the pandemic. This explosion of cases largely derives from three facilities: Casper Mountain Rehabilitation & Care Center, Shepherd of the Valley Rehabilitation & Wellness, and Life Care Center of Cheyenne. These three facilities represent 50 percent of the state’s new long-term care cases since October 29, 2020.

Though Wyoming does not report long-term care data on the state’s COVID-19 dashboard, the Wyoming Department of Health provided The COVID Tracking Project with these totals on November 19, 2020. A timeline published by Life Care Center of Cheyenne, which is reporting the highest number of resident cases of any Wyoming long-term care facility, provides a stark example of how quickly and prolifically COVID-19 can infect people in close proximity.

Surging hospitalization numbers foreshadow more losses 

As cases increase across the nation, we’re entering a period similar to the early months of the pandemic, with hospitals across the country at or nearing capacity. When hospitals are inundated with seriously ill patients, physicians and nurses are left to make excruciating decisions about how to prioritize care, equipment, and medication.

For weeks, experts have sounded urgent alarms about this scenario, warning that the country’s inability to keep case numbers down will further traumatize front-line caregivers at the peak of the holiday season. Now, just days before Americans gather to celebrate Thanksgiving, the inevitability of the country’s upcoming losses are impossible to ignore.

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


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.


Erin Kissane is a co-founder of the COVID Tracking Project, and the project’s managing editor.


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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Joanna Pearlstein is an editorial lead at the Covid Tracking Project and a former editor at WIRED and Protocol.

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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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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.


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