COVID-19 cases increasing in assisted living residents and staff, linked to ‘hotspot’ states with community spread

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By Kimberly Bonvissuto, McKnight’s Senior Living, September 2 2020

new analysis of COVID-19 data from assisted living communities finds a “significant increase” in cases among residents and staff members, with the rise in staff cases “especially noteworthy.”

Four out of five states with the largest increases in staff cases (California, Florida, Nevada and South Carolina) also are considered “hotspot” states with widespread community transmission, according to the Kaiser Family Foundation. The rise in staff member COVID-19 cases “is most likely to disproportionately affect female, Black and low-wage workers, based on recent analysis,” the authors said.

Only seven states separately report deaths among employees of assisted living communities, according to the analysis. And although some states have been reporting cumulative case and death data since early March, other states don’t specify the start date of their retrospective data reporting. This practice has led to “potential undercounts of cases and deaths that have occurred since the beginning of the pandemic,” the authors said.

A total of 22,080 COVID-19 cases were reported among residents and staff in assisted living communities as of early August, based on the 18 states reporting COVID-19 case data, according to the analysis. Among the 14 states reporting COVID-19 cases in both June and August, the number of cases among residents and staff members increased by 66%, and the number of cases among only residents increased by 63%.

Among the eight states that reported staff case data in June and August, the number of staff cases increased by 156%, from 2,085 to 5,333 cases in early August.

Looking at COVID-19 death data in assisted living communities, a total of 2,651 resident and staff member deaths were reported in the 14 states that report these data. Among the 10 states that reported deaths in both June and August, the total number of deaths among residents and staff increased by 59% from 1,483 to 2,356 (2,257 residents and 99 staff members) deaths in early August.

Looking at just staff death data, among the five states that reported in both June and August, the number of staff deaths increased by 219% from 31 to 99 deaths in early August.

But the authors warn that inconsistent and incomplete state reporting of COVID-19 data in assisted living facilities paints an “incomplete picture of disease incidence and mortality among staff and residents.”

Assisted living communities — home to more than 800,000 older-adult residents nationwide — have been overlooked both in case data and government funding, the authors said, in part because the communities are not federally regulated, leaving states to decide whether to report data or impose restrictions meant to protect residents.

The staff case and death counts are “undoubtedly conservative” because COVID-19 data for assisted living communities are not reported separately from nursing facilities in most states, the KFF analysis said. Also, the authors noted, states that do report assisted living data separately from nursing homes vary significantly in what they report, with some states reporting cases, but not deaths, and some not reporting staff data at all.

Read more about a KFF analysis of long-term care overall in our sister publication, McKnight’s Long-Term Care News, here.