As Community Hotspots Drive Nursing Home Case Spikes, 1 in 3 Report PPE, Staffing Shortages

Almost 3,000 nursing homes across the U.S. reported a shortage of nursing staff, clinical workers, aides, or other staff as of June 28, while almost 2,700 reported a shortage of personal protective equipment (PPE), according to a July 21 issue brief from the Kaiser Family Foundation (KFF).

All told, almost 4,800 nursing homes reported either a staffing shortage or a PPE shortage; the deficits are similar in both COVID-19 hotspots and locations with a lower incidence of the disease, according to the issue brief.

But when it comes to cases of COVID-19 in long-term care, location matters immensely.


“Long-term care cases in ‘hotspot states’ with wider community transmission have risen at four times the rate as long-term care cases in non-hotspot states,” Priya Chidambaram wrote for KFF. “Long-term care facility cases in 23 hotspot states where data are available rose by 18% over a 14 day period (from 123,000 cases to 144,800 cases), while long-term care cases in 12 non-hotspot states rose by 4% over a similar 14-day period (from 125,500 cases to 130,300 cases).”

Source: Kaiser Family Foundation

Multiple studies have found that racial demographics and location play a factor in COVID-19 outbreaks in the nursing home setting, and the data outlined by KFF seems to back up those findings as they relate to location.

The increased outbreaks in long-term care facilities come even as such facilities have implemented strict protocols on visitation, isolating positive residents, and universal testing of residents and staff, to name a few of the steps taken. And the rise in cases in hotspot locations suggest a connection between cases in the long-term care setting and widespread community transmission of COVID-19, Chidambaram wrote.


“The two states with the highest overall increase in cases statewide, Texas and Florida, also report the highest increase in cases in long-term care facilities, with both states reporting an increase of approximately 50% in long-term care cases between June 24th and July 9th and nearly a doubling of cases during this time period,” she wrote.

A similar analysis of outbreaks in the New York City, Detroit, and Cleveland metropolitan areas earlier in the coronavirus crisis reached similar conclusions about the connection between community spread and the impact on nursing facilities.

“From March to May 2020, there was a spike in overall mortality among residents at SNFs in Detroit and New York City, which were two cities with substantial COVID-19 burden, and a lower increase in mortality in Cleveland, which was a city with fewer COVID-19 cases,” that study concluded.