Mortality, Admissions, and Patient Census at SNFs in 3 US Cities During the COVID-19 Pandemic

Abstract

Mortality from coronavirus disease 2019 (COVID-19) is disproportionately concentrated in skilled nursing facilities (SNFs). As of June 18, 2020, 50 185 residents died of COVID-19 in the 41 states reporting deaths at SNFs, accounting for 45% of their total COVID-19 deaths statewide. 1 In addition to long-term care, SNFs provide short-term care after elective surgeries and hospitalizations. With the decreases in hospital volume for elective surgeries and other services during the pandemic, SNF admissions may also be declining. 2 Little peer-reviewed evidence on COVID-19 in SNFs exists beyond single centers. 3 Therefore, we examined outcomes at SNFs in 3 metropolitan areas from March to May 2020.

Magnitude, change over time, demographic characteristics and geographic distribution of excess deaths among nursing home residents during the first wave of COVID-19 in France: a nationwide cohort study

“…The steep increase and then decrease in excess deaths during the first wave were similar to those observed in 65 NHs in New York City. 23 In France, however, the decrease in excess deaths began 4 weeks after visits with NH residents were prohibited (week 11) and became much more pronounced 3 weeks after the start of the nationwide period of lockdown (week 12). The mortality rate among NH residents in New York City decreased 5 weeks after visits were prohibited.…”

“…The mortality rate among NH residents in New York City decreased 5 weeks after visits were prohibited. 23…”

“…In line with previous studies, we observed marked spatial heterogeneity in excess deaths among NH residents. 29,23 This heterogeneity might be due to differences in the regional distribution of SARS-CoV-2 infections (notably in north-east France), urban density, and other environmental factors. 23,30,31…”

COVID-19 has hit nursing homes hard

“…In most countries the first wave of COVID-19 mainly killed people in nursing homes. Whereas the nursing home population represents less than 1% of the total population in European countries, nursing home residents accounted for 31–80% of all deaths during the first wave in various countries [ 1 – 5 ]. In fact, the reported COVID-19 deaths may be an underestimate since these deaths have accounted only for two-thirds of excess deaths [ 6 ].…”

Post‐acute care nursing home deaths in the COVID era: Potential for attribution bias

“…This period of widespread COVID-19 activity was consistent with that reported for New York City. 3 This timeframe is compared to the same 3-month periods for 2018 and 2019.…”