Female doctor in protective suit taking sample for swab test of senior man. Medical professional is examining elderly patient during COVID-19 crisis. They are in hospital.
(Credit: Morsa Images / Getty Images)

Final data on how COVID-19 affected assisted living and similar residential care communities in the nation during the height of the pandemic were released Monday by the Centers for Disease Control and Prevention.

The CDC’s National Center for Health Statistics released the final data figures from the residential care component of the 2020 National Post-Acute and Long-Term Care Study. They reflect the number of coronavirus cases, hospitalizations and deaths among residents and staff members, infection control practices and personal protective equipment shortages.

Data were collected between November 2020 and mid-July 2021 and reflect COVID-19 experiences as reported by directors and administrators from 4,312 communities. A previous report released in August 2021 was based on preliminary data.

COVID-19 infections within communities

During the reporting period, communities reported 143,046 COVID-19 cases, 33,984 hospitalizations (24% of cases) and 25,000 deaths (17.5% of cases).

Large communities (101 or more residents) reported the biggest number of resident cases, at 70,987, with the South reporting the most cases, at 21,664. Medium-sized communities (26 to 100 residents) reported 42,509 cases, with most cases in the South (13,361). Small communities (one to 25 residents) reported 29,540 cases, with cases concentrated in the Midwest (10,692).

Staff cases at large communities numbered 56,525, with the largest case concentration almost a tie between the West (16,893 cases) and the South (16,705 cases). Medium-sized communities reported 34,714 cases, with concentrations in the Midwest (11,436) and South (11,093). Small communities reported 27,589 staff cases, with the largest concentration in the Midwest (12,193). 

Equipment shortages were abundant

Providers reported experiencing shortages of personal protective equipment, particularly N95 respirators (42% of providers), with 40% of providers reporting shortages of eye protection, gloves, face masks or isolation gowns. 

Geographically, the West experienced the biggest shortage of N95 respirators (45%), followed by the Midwest (41%), the South (39%) and the Northeast (35%). Providers in the Midwest (44%) reported the biggest shortages of other equipment, followed by the West (40%), South (39%) and Northeast (32%).

Majority implemented infection control practices

When polled about infection control practices, 89% of respondents reported screening residents daily for fever or respiratory symptoms, 83% reported limiting communal dining and recreation activities in common areas, and 64% reported notifying residents or families of cases within 24 hours of discovery. 

Communities also implemented the use of telemedicine/telehealth (39%) or telephonics/audio-only appointments (34%) to assess, diagnose, monitor or treat COVID-19 infections in residents.

The majority of providers imposed in-person restrictions on visitors, family, volunteers or non-essential personnel during the study period. Ninety percent of respondents reported always or sometimes limiting family members and visitors, 88% limited volunteers and 90% limited non-essential personnel.  

NPALS collects data on assisted living and similar residential care communities every two years from all 50 states and Washington, DC, with a goal of monitoring the diverse long-term care and post-acute sectors.

NPALS also collected COVID-19 data in nursing homes, adult day service centers, home health agencies and hospices. Data also are presented by ownership (nonprofit and for-profit), chain status and metropolitan statistical area.