Early Data Reveals 10% Nursing Home Census Drop, But COVID-19 Reporting Remains Incomplete

The first round of federal data on COVID-19 in nursing homes revealed a 10% drop in census related to the pandemic, according to a new analysis by the Wall Street Journal, though the true number may not be known until officials clean up errors in the initial reporting.

The 10% decline was the result of deaths from COVID-19, non-COVID fatalities, and a sharp decline in incoming residents amid the suspension of non-essential surgeries and admission bans at facilities with outbreaks, the WSJ concluded.

The publication compared pre-pandemic numbers from December 31 with the most recent federal information compiled by the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control & Prevention (CDC), which last week revealed nearly 32,000 deaths from the novel coronavirus in the nation’s nursing homes.

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But the WSJ, much like the federal agencies that reported the data, emphasized that there are serious gaps in the information.

Released last Thursday, the data only encompasses 88% of the more than 15,000 nursing facilities in the nation; while operators were required to begin submitting weekly counts of COVID-19 infections and deaths in early May, fines for non-compliance only kicked in for those who missed the most recent deadline this past Sunday.

In addition, early analyses of the public data have revealed anecdotal evidence of reporting errors: One property in New Jersey, for instance, had an “official” death count that was eight times greater than its total number of beds, the Journal found.

CMS administrator Seema Verma acknowledged the issues with the database last week, noting that the case count will likely rise as more facilities come into compliance and mandatory statewide testing programs produce more results.

Verma also emphasized that the initiative was still in its early days.

“As with any new program, some facilities are going to struggle as they come on line, and there’s going to be honest errors in data entry,” Verma said.

Further hobbling the national numbers is a lack of a clear, apples-to-apples timeframe for comparing case trends. The federal government only required operators to report information starting in mid-May, though many facilities provided cumulative data stretching back to the start of the pandemic.

“I feel pretty comfortable that that the nursing homes did report their cases from the beginning, because I don’t think the numbers would have been that high. I mean, there’s no way that we had 26,000 new cases in the week in nursing homes,” Verma said, referring to the official count as of June 1.

The WSJ’s 10% figure joins other early attempts to put a single number on the impact of COVID-19 on nursing home occupancy.

The National Investment Center for Seniors Housing & Care (NIC) in late May reported that census fell to 83.4% in March, a 132-basis-point decline that marks the lowest figure since the organization began tracking nursing home occupancy in 2012.

Genesis HealthCare (NYSE: GEN). the largest publicly traded nursing home chain, saw census fall to 81.9% by the end of April; occupancy had been 88.2% during the first three full months of 2020.

Speaking on the company’s first-quarter earnings call last month, leaders predicted a further occupancy slide to 76% by the end of May.

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