The most complete figures we can assemble are both an estimate and a severe undercount of the true toll on LTC residents. Many states haven’t published data going back to the beginning of the pandemic. Many states report only on recent cases and deaths, rather than a cumulative count. Many fail to separate cases and deaths among staff from those among residents.
Federal data also undercounts cases and deaths in long-term care. The data reported to and published by the federal government is also missing figures from the early months of the pandemic, and includes only reports from nursing homes (“skilled nursing facilities”), omitting counts from assisted living centers and other forms of long-term care. These non-nursing-home facilities are not required to report their COVID-19 cases and deaths to the federal government.
Given those constraints, here is what we know about the impact of the pandemic on long-term-residents, and how we know it.
Based on official federal figures provided by the Centers for Medicaid and Medicare Services, as of March 18, 2021, at least 131,921 people had died in COVID-19 outbreaks in nursing homes alone.
Based on official state figures compiled by our long-term-care tracking team, as of March 4, 2021, at least 174,474 people had died in COVID-19 outbreaks in nursing homes and other long-term-care facilities.
Federal data as of March 23, 2021 indicates that of the 131,921 nursing home workers and residents reported to CMS as having died of COVID-19, 98.8% were residents. Many states don’t separately report staff and resident deaths, so we examined seven representative states that publish total deaths among staff and residents for long-term-care facilities and found that, on average, 98.7% of the people who died of COVID-19 in these facilities were residents. (The states were Arkansas, California, Indiana, Michigan, Nevada, New Jersey, and Oklahoma, and deaths among residents ranged from 97.6% to 99.6%, all figures as of March 23, 2021.) Our estimates use 98% as the calculated proportion of deaths among residents, a more conservative percentage than either the state average or the directly reported federal figure.
Our national figure for LTC resident populations comes from an estimate from the 2016 study conducted by the National Center for Health Statistics. We compared this estimate to a 2017 study from KFF, which posted very similar, but slightly smaller, figures for residents of nursing homes and assisted living facilities. Our estimates use the more generous denominator from the NCHS.
The calculation: If we take 98% as a figure for deaths among residents, we would expect 170,985 of the 174,474 deaths we tracked in these facilities at The COVID Tracking Project to have been among residents. That is 7.9% of the federally estimated total number of residents of long-term-care facilities in 2016 (2,159,100). Using the federal data on deaths in just nursing homes, we see that 130,296 residents have died of COVID-19 out of an estimated 1,347,600 total nursing-home residents, which is 9.6%.
To learn more, read our analysis of what we know—and what we don’t know—about the impact of the pandemic on the long-term-care community.