Just under 5% of skilled nursing facilities (SNFs) confirmed new COVID-19 cases among their residents in the first week of August, analysis from the National Investment Center for Seniors Housing & Care (NIC) shows.

Among those facilities with new cases, half had a staff vaccination rate below 49%, nearly 12% lower than the national average, which the Centers for Medicare & Medicaid Services (CMS) reports is currently at 60.5%.

“The pandemic is likely not over for the unvaccinated,” Omar Zahraoui, NIC data analyst wrote in a blog post. “Unfortunately, this includes skilled nursing facilities with low vaccination rates among staff and residents.”

Current vaccination rates for residents continue to be higher than that of nursing home staff, as 82.8% of all nursing home residents are now vaccinated, according to CMS.

With delta variant cases emerging across the country, the per-resident rate of new COVID-19 infections within SNFs rose to 0.18%, or 18 residents per 10,000 testing positive, six times the rate reported on June 20 (0.03%). Zahraoui suggests that facilities with low vaccination rates are likely driving the rise in cases.

Differences between states and regions may have also played a role in rising counts.

The highest per-resident rate of new COVID-19 infections was seen in the South, at 0.34%, the highest rate reported in six months, followed by the Midwest (0.11%), and the West (0.1%).

The percent of COVID-19 cases per resident also doubled in the last three weeks for the Midwest and doubled from the prior week for the Northeast, now at 0.06%, showing that the pandemic is not over for any operator, regardless of location.

The West and Northeast appear to be faring best when it comes to staff vaccination rate, while the South continues to lag behind the national average.

Nine of the 11 states with the lowest vaccination rates among nursing home staff reside in the South, according to CMS.

Texas and Florida, in particular, face tough roads ahead with low vaccination rates and case counts rising, the NIC data shows.

In six weeks, weekly cases among the general population in Florida jumped over 1,000%, from nearly 11,000 on June 20 to over 120,000 cases on Aug. 1, continuing to climb through the week ending Aug. 8, according to NIC.

Prior to the outbreak of the delta variant, the high point for Florida was around 110,000 cases for the week ending Jan. 10.

SNFs in the state saw an even greater case spike among residents as the weekly case counts reached 556 on Aug. 1, up from 39 on June 20 for an increase of 1,326%.

The general population in Texas hasn’t fared much better as weekly cases increased by around 640% from over 8,300 on June 20 to nearly 62,000 new cases on Aug. 1, according to NIC, with cases among SNF residents also picking up during that time.

Among Texas SNFs, 15 cases were reported on June 20 and that jumped to 235 SNF cases on Aug. 1, an increase of 1,467%.

While Florida ranks dead last in SNF vaccination rate in the country, at 46.33%, according to CMS, Texas ranks slightly better at 57.38%, though both continue to be below the national average. The vaccination rate among Florida nursing home residents is currently 71.96% and in Texas it’s up to 77.84%.

By the first week of August, the South accounted for about 68% of newly confirmed cases within nursing homes in the U.S.

In the span of six weeks, virus cases among SNF residents in the South went from 97 cases on June 20 to 1,340 cases on Aug. 1, up 1,281%. NIC researchers attribute this, at least in part, to the rise in delta variant cases, up 888% among the general population in the South between June 20 and Aug. 1.