Long-Term Care COVID Deaths Top 100K as Post-Holiday Coronavirus Surge Looms

The nation’s long-term care facilities passed another grim COVID-19 milestone ahead of Thanksgiving, with experts and leaders warning that holiday gatherings over this past weekend could only set off more outbreaks in the weeks to come.

The nursing home death toll passed 100,000 residents and workers as of November 24, according to a data analysis from the Kaiser Family Foundation (KFF).

“Post-Thanksgiving surges in cases are unlikely to spare this community and will likely lead to an even higher death toll in long-term care facilities, raising questions about whether nursing homes and other facilities are able to protect their residents and, if not, what actions can be taken to mitigate the threat posed by the virus,” Kaiser’s Priya Chidambaram, Rachel Garfield, and Tricia Neuman concluded in their analysis.

Source: Kaiser Family Foundation

On a state-by-state level, the numbers become even starker: In New Hampshire, Rhode Island, and Connecticut, nursing home residents represent more than 70% of all coronavirus deaths, while 18 states saw at least half of all COVID-19 deaths in long-term care.

As with all attempts to quantify the exact number of COVID-19 cases and deaths in nursing facilities, the KFF numbers come with some caveats. The number of states with clear reported data has increased from 30 back in April to 49 and the District of Columbia in November, with only Alaska information still unavailable — meaning that the cumulative total almost certainly represents an undercount of the true figures.

In addition, Kaiser cautioned that some states include multiple types of long-term care facilities, such as assisted living campuses, in their totals, while others restrict data exclusively to nursing facilities.


Over the weekend, the New York Times similarly determined that long-term care COVID deaths had crested the 100,000 mark, counting “at least 101,000” fatalities among residents and staff of nursing homes and other care settings; the Times’s total of 27,000 facilities with reported cases far exceeds the approximately 15,300 nursing homes in the United States.

Independent sources of COVID-19’s impact on nursing facilities have routinely outpaced the official federal numbers: The Centers for Medicare & Medicaid Services (CMS) counted 69,872 deaths and 331,904 confirmed cases through November 15. CMS was unable to mandate retroactive reporting of COVID data prior to May, and though many facilities did report retroactive numbers, the federal database is similarly incomplete.

While both CMS and leaders within the nursing home sector preached caution around celebrating Thanksgiving with vulnerable long-term care residents, the coming weeks will reveal whether holiday observances lead to feared surges in the number of overall COVID-19 cases — which, along with staffing levels at individual facilities, serves as a key predictor of nursing home outbreaks.

“This finding comes at a time when public health experts are predicting a surge in cases after holiday gatherings and increased time indoors due to winter weather, which will have ripple effects on hospitals and nursing homes, given the close relationship between community spread and cases in congregate care settings,” Kaiser observed. “As the nation braces for the fallout of the holiday, recent data on deaths in long-term care facilities highlight the ongoing disproportionate impact on this high-risk population.”