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How Nursing Home Mortality Rate From COVID-19 Varies in 50 States

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COVID-19 may have caused about two deaths for every 1,000 U.S. nursing home residents in the week ending Nov. 15, and it may have accounted for about 27% of the 8,587 deaths that occurred in nursing homes that week, according to government nursing home data..

The COVID-19 nursing home death rate has increased from 1.3 deaths per 1,000 occupied nursing home beds in the week ending Oct. 18, and from 1 death per 1,000 occupied nursing home beds in the week ending Sept. 20.

The percentage of all nursing home deaths attributed to COVID-19 has increased from 20% in mid-October, and from 16% in mid-September.

The Centers for Medicare and Medicaid Services (CMS) posts the COVID-19 tracking data for nursing homes on its website.

Resources

  • A set of CMS nursing home COVID-19 tracking data for the week ending Nov. 15 is available here.
  • An article about the latest White House Coronavirus Task Force weekly report is available here.

The CMS nursing home COVID-19 data can give professionals involved with life insurance, annuities and long-term care insurance an idea of how the pandemic is affecting people in nursing homes.

Increased nursing home mortality could increase permanent life insurance death claims; reduce reserves for long-term care insurance benefits, group annuity benefits and individual annuity income benefits; and increase individual annuity issuers’ spending on any death benefit provisions built into contracts.

For a look at the six states where COVID-19 caused more than 5 deaths per 1,000 occupied beds — or, in other words, more than 1 death per 200 residents — in the week ending Nov. 15, see the slideshow above.

Data Nuts and Bolts

CMS began collecting the data in the current form May 17. That means the spreadsheets leave out the period from mid-March through early May, when COVID-19 caused a massive wave of deaths in New York, Boston, New Orleans and some other cities in March and April.

Some nursing homes are unwilling or unable to send in data, and CMS has no authority to collect data from long-term care facilities other than nursing homes.

The CMS nursing home tracking spreadsheet for the latest week covers nursing homes with 1.6 million beds, and 1.1 million occupied beds.

Nursing Home Data Analysis Challenges

Regional differences in how people use nursing homes, and how COVID-19 has affected nursing home use, may affect the nursing home COVID-19 impact numbers.

U.S. nursing home residents tend to have serious health problems. From July 1, 2012, through Dec. 31, 2013, they had a mortality rate of about 7 deaths per 1,000 residents per week, according to a 2017 study conducted by researchers affiliated with the University of Texas Medical Branch in Galveston, Texas.

Before the pandemic began, some communities worked harder than others to keep relatively healthy people who needed long-term care in their own homes. Other communities made less use of home care. Regional variations in emphasis on home care mean that the typical health status of a nursing home resident, and the typical nursing home resident’s life expectancy, varied widely from state to state before the COVID-19 pandemic began.

Since the COVID-19 pandemic started, and stories about deadly nursing home outbreaks appeared, many families and communities have pushed to keep people out of nursing homes.

Because of that push, the people still in nursing homes may now have more serious health problems than typical nursing home residents had a year ago.

Medicare assigns each Medicare plan enrollee a heath risk score. Academic researchers and insurance industry analysts will be using the health risk scores to see how much of the current increase in nursing home mortality is due to COVID-19 and how much is due to the nursing home residents’ underlying health problems.

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U.S. Nursing Home COVID-19 Tracking Data (for the week ending Nov. 15)

State Total Weekly Resident Deaths Weekly COVID-19 Deaths Percentage of Deaths Caused by COVID-19 Number of Occupied Beds COVID-19 deaths per 1,000 occupied beds Total Deaths per 1,000 Occupied Beds
Alabama           128           35 27%     19,533 1.8 6.6
Alaska               2              - 0%           646 0.0 3.1
Arizona             47           13 28%     10,005 1.3 4.7
Arkansas           131           66 50%     14,361 4.6 9.1
California           136           26 19%     86,593 0.3 1.6
Colorado           121           51 42%     13,966 3.7 8.7
Connecticut           116           31 27%     17,978 1.7 6.5
Delaware             24             4 17%        3,297 1.2 7.3
District of Columbia               8              - 0%        1,651 0.0 4.8
Florida           273           46 17%     62,275 0.7 4.4
Georgia           198           54 27%     27,333 2.0 7.2
Hawaii             12              - 0%        3,039 0.0 3.9
Idaho             20             5 25%        3,450 1.4 5.8
Illinois           390        180 46%     55,926 3.2 7.0
Indiana           342        159 46%     32,823 4.8 10.4
Iowa           219        114 52%     19,625 5.8 11.2
Kansas           114           46 40%     14,933 3.1 7.6
Kentucky           189           72 38%     19,861 3.6 9.5
Louisiana           100           12 12%     21,846 0.5 4.6
Maine             51             6 12%        5,356 1.1 9.5
Maryland           134           22 16%     20,302 1.1 6.6
Massachusetts           189           20 11%     30,569 0.7 6.2
Michigan           410           83 20%     30,738 2.7 13.3
Minnesota           215           97 45%     20,639 4.7 10.4
Mississippi             89           24 27%     14,013 1.7 6.4
Missouri           292        154 53%     32,854 4.7 8.9
Montana             51           26 51%        3,178 8.2 16.0
Nebraska           107           38 36%        9,635 3.9 11.1
Nevada             19             4 21%        4,874 0.8 3.9
New Hampshire             35             3 9%        5,574 0.5 6.3
New Jersey           156           16 10%     33,979 0.5 4.6
New Mexico             44           24 55%        4,509 5.3 9.8
New York           463           44 10%     89,749 0.5 5.2
North Carolina           311           84 27%     31,289 2.7 9.9
North Dakota             80      38 48%        4,520 8.4 17.7
Ohio           522        227 43%     61,467 3.7 8.5
Oklahoma           136           66 49%     15,784 4.2 8.6
Oregon             28             6 21%        6,536 0.9 4.3
Pennsylvania        1,054        130 12%     63,822 2.0 16.5
Rhode Island             40             9 23%        6,063 1.5 6.6
South Carolina             87           17 20%     15,137 1.1 5.7
South Dakota           109           67 61%        4,882 13.7 22.3
Tennessee           221           74 33%     24,198 3.1 9.1
Texas           450        176 39%     74,932 2.3 6.0
Utah             22           10 45%        5,075 2.0 4.3
Vermont             17              - 0%        2,154 0.0 7.9
Virginia           166           58 35%     23,747 2.4 7.0
Washington           165           21 13%     13,505 1.6 12.2
West Virginia             63           28 44%        8,638 3.2 7.3
Wisconsin           271        138 51%     18,223 7.6 14.9
Wyoming             20           10 50%        2,038 4.9 9.8
UNITED STATES        8,587     2,634 31% 1,117,191 2.4 7.7

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