Just after we had wrapped up one of our lead stories in the June issue of The SeniorCare Investor on the nursing home comeback and some COVID myths, NORC at the University of Chicago released its analysis about mortality rates in five states across the senior care spectrum. With funding from NIC, they looked at five states – Colorado, Connecticut, Florida, Georgia and Pennsylvania – and 3,817 seniors housing properties in 113 counties in those states.
Perhaps the key finding, at least for the independent living and CCRC providers (and their residents) was that 67% of the IL communities never experienced a COVID-related death. Better yet, the COVID mortality rate in these IL communities was lower than in the surrounding county for those aged 75 and up in a non-institutional setting, with 5.9 deaths per 1,000 residents compared with 6.7 per 1,000 in the county for the 75 and over group.
The assisted living and memory care communities fared a little worse in these five states, with 64% and 61% of the communities, respectively, having no COVID-related deaths during 2020. But the mortality rate per 1,000 increased sharply, to 19.3 per 1,000 for assisted living residents and 50.4 per 1,000 for memory care. The sharp jump for memory care was a little surprising, except for the fact that memory care residents tend to be frailer than traditional assisted living.
On the nursing home side, 39% of the facilities never had a COVID-related death, which is not what most people would believe after hearing all the media reports last year. Now, the fact that 61% of nursing facilities did have at least one COVID death is not the sort of number one wants to brag about. Still, the 39% number should get out there to the public.
Then, the fact that just 5.96% of nursing home residents actually died (59.6 per 1,000) should imply that once a very frail resident with multiple co-morbidities had COVID, the staff was able to do a pretty good job of caring for them, since the positivity rate was quite high in many nursing facilities and over several outbreaks during the pandemic. Again, what the report has no way of determining is how many of these residents actually died “of” COVID, or died of one of their co-morbidities and just happened to get infected with COVID. This is something we may never know.
There will be a lot of research and statistics coming out over the next few years on what really happened not just in all senior care communities, but for the total population. It is already obvious that the health status (and sometimes the race) of anyone who had COVID was the primary influence on outcome, and not where they lived. Except, of course, where low positivity rates were common, death rates were low, regardless of living environment.
The one issue we have with this study is that the inputs came from many different sources. While not their fault since information is still a bit disorganized, using the New York Times as a source was a little troubling. The Times is well known to have a negative bias against the nursing home industry, and along with other media outlets had been a purveyor of “panic porn” during the pandemic, and especially with regard to nursing homes. At some point in the future, we hope there will be a differentiation between dying “from” COVID and dying “with” COVID. Hope is not a business plan, but it is realistic to assume that a good proportion of people died with COVID as opposed to from it. After all, one-third of nursing home residents die every year when there is not a pandemic. This is the missing piece of the puzzle that needs to be part of any analysis in the future.
