A slight majority of communities reported no deaths related to Covid-19 in 2020.
That’s according to a new study released Thursday by NORC at the University of Chicago, which reveals the extent to which Covid-19 impacted senior care settings across different levels of care.
Notably, two-thirds of independent living communities studied reported no deaths from Covid-19 last year, and residents in these communities were as safe as seniors living in non-congregate settings.
And mortality rates increased with care acuity, which took the research team by surprise, Caroline Pearson, senior vice president of health care strategy and lead researcher at NORC, told Senior Housing News.
“It’s very easy to sort of think about long term care as a monolith. In fact, these are very different settings with very different resident needs,” she said.
NORC worked with a grant provided from the National Investment Center for Seniors Housing & Care (NIC). The industry association also wanted to understand how Covid-19 impacted different care settings, and show that senior housing provides safe environments for older people, NIC Chief Economist Beth Burnham Mace told SHN.
“A lot of policymakers and others assume that what was going on in skilled nursing was the same for other types of seniors housing,” she said.
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NORC analyzed data from independent living, assisted living, memory care and skilled nursing facilities in 113 counties across five states — Colorado, Connecticut, Florida, Georgia, and Pennsylvania.
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The organization chose these states because they collected data on Covid-19 deaths with a level of granularity and uniformity, enabling the kind of analysis NORC sought. Additionally, the group wanted variances in geography, states with large senior housing markets, and states that encompassed the width of the political spectrum.
“We knew that the politics was driving the on-the-ground experience in some of these states,” Pearson said.
The analysis was then compared to federal and state public health data to estimate 2020 Covid-19 mortality rates by care type, and compared those rates to those experienced by people age 75 and older living in non-congregate settings in the same counties. The analysis included data from 3,817 market-rate senior housing and skilled nursing facilities.
The analysis revealed 51% of communities studied reported no deaths resulting from Covid-19 in 2020. The mortality rate increased by care type and the complexity of health and caregiving: 67% of independent living communities, 64% of assisted living facilities, and 61% of memory care communities studied reported no Covid-19 deaths last year; while 39% of nursing facilities reported no deaths from the virus.
In fact, the mortality rate in independent living properties in the study was comparable to that of their respective counties, suggesting that residents in these settings were not at higher risk of contracting the virus, despite living in congregate settings.
The adjusted mortality rate for assisted living facilities, meanwhile, was 19.3 deaths per 1,000 people, compared to 59.6 deaths per 1,000 in skilled nursing settings. Mace attributed the variance to the younger and healthier makeup of assisted living residents.
Although the overall percentage of memory care communities with no Covid-19 deaths was comparable to independent living, the mortality rate was similar to skilled nursing, at 50.4 deaths per 1,000 people. This highlights the struggles of memory care providers to implement infection control and social distancing protocols.
A second phase of the study is now underway, Pearson told SHN. It will dive deeper into the risk factors behind residents who died from Covid-19, using health care claims data.
“That enables us to understand the difference between the health needs of residents and the congregate nature of where they’re living, and begin to sort of separate out that impact,” she said.
She anticipates this phase to run more smoothly, because the data being collected is more reliable than public health data. Indeed, one takeaway in the NORC report is that a better system for capturing data is needed.
“We encountered many data challenges in conducting this analysis, including data availability, quality, timeliness, variation in reporting across states, and inconsistencies between state and federal government sources,” the report states. “ … Ongoing improvements in our data infrastructure would enable better understanding of this pandemic and preparation for future health crises.”