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

Allison Bell

Here are the 6 states where COVID-19 accounted for more than 5 deaths per 1,000 occupied nursing home beds in the week ending Nov. 15, according to CMS nursing home data…

6. New Mexico: 5.3 COVID-19 deaths per 1,000 occupied beds

Total Deaths per 1,000 Occupied Beds: 9.8

Percentage of All Deaths Caused by COVID-19: 55%

(Maps: U.S. Geological Survey)

5. Iowa: 5.8 COVID-19 deaths per 1,000 occupied beds

Total Deaths per 1,000 Occupied Beds: 11.2

Percentage of All Deaths Caused by COVID-19: 52%

4. Wisconsin: 7.6 COVID-19 deaths per 1,000 occupied beds

Total Deaths per 1,000 Occupied Beds: 14.9

Percentage of All Deaths Caused by COVID-19: 51%

3. Montana: 8.2 COVID-19 deaths per 1,000 occupied beds

Total Deaths per 1,000 Occupied Beds: 16.1

Percentage of All Deaths Caused by COVID-19: 51%

2. North Dakota: 8.4 COVID-19 deaths per 1,000 occupied beds

Total Deaths per 1,000 Occupied Beds: 17.7

Percentage of All Deaths Caused by COVID-19: 48%

1. South Dakota: 13.7 COVID-19 deaths per 1,000 occupied beds

Total Deaths per 1,000 Occupied Beds: 22.3

Percentage of All Deaths Caused by COVID-19: 61%

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

.

— Read Club Vita Forms COVID-19 Lifespan Impact Research Panelon ThinkAdvisor.

— Connect with ThinkAdvisor Life/Health on FacebookLinkedIn and Twitter.

Allison Bell


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