COVID-19 Cases and Deaths in Long-Term Care Facilities through June 2021

This analysis is based on data as of the week of June 27th, 2021 from 42 states plus Washington DC, for a total of 43 states. The remaining eight states were excluded because they do not directly report data on cases and deaths in long-term care facilities, their data is sourced from sporadically released media reports, or there were data quality or availability issues in trending data over time.

This analysis relies on state-reported data instead of federal data since federal data may exclude cases and deaths prior to May 8th, 2020. This exclusion may miss peaks in states such as New York, New Jersey, and Massachusetts. Additionally, the federal data does not include non-nursing home settings. COVID-19 has disproportionately impacted all types of long-term care settings, such as assisted living facilities and group homes. Thus, the state-reported data is more likely to capture the full burden of cases and deaths in long-term care facilities.

Within the 43 states included in this analysis, we were able to trend long-term care cases in 39 states plus DC and deaths in 39 states plus DC. We included states for which we could reliably trend at least six months of data, using the earliest reliable period reported in the state as the starting point for that state’s trend.

Louisiana’s trend stops at April 2021 due to reporting changes in May and June that prevent data from being trended. Florida’s trend stops in May 2021 due to the state halting their reporting of cumulative long-term care cases and deaths in June 2021.

States vary in which facilities they include in LTCF reporting and whether they include residents and staff in case and death counts. For all states, we trended the subset of facilities and populations that provide the longest reliable trend line. For example, our data for Delaware excludes staff cases because that data was not reported consistently; in Michigan, this analysis excludes cases and deaths in Adult Foster Care facilities since these cases and deaths were only added for recent weeks. For this reason, this analysis should not be used to identify state-level or national data on total long-term care cases and deaths. See below for details on how each indicator in the Tables and Appendix were calculated.

Average Weekly Long-Term Care Deaths/Cases Per 100,000 State Residents:

These data represent trends in long-term care deaths and cases in states overtime in the context of total state population. Total state population data is from 2019 estimates from the US Census Bureau. The first week of available long-term care data for each state was not included in this analysis since the first week of data does not reflect a single week of deaths and cases, but rather all deaths and cases that have occurred up to that point. New deaths and cases were calculated for each week thereafter, and then averaged for all of the weeks within the month. Weeks where states reported large increases or any decreases due to reporting changes or data reconciliation were not included in the calculations of monthly averages. These average new deaths and cases were converted to represent deaths and cases per 100,000 state residents to allow for easier comparison across states. Totals for each table were calculated by dividing total new deaths and new cases per month by the total state populations for the states represented in each month of data and converting values to represent totals per 100,000 state residents.

Percent Change In LTCF Deaths/Cases Since December 2020:

Percent change is calculated by taking the difference between average weekly deaths in December 2020 and average weekly deaths in June 2021 and dividing that difference by the average weekly deaths in December 2020.