Newly published research, which the authors tout as the “first ever” empirical study involving the incidence of COVID-19 in U.S. assisted living communities, finds that communities with larger minority populations also have a higher percentage of COVID cases, though not deaths.
The study, “COVID-19 Pandemic in Assisted Living Communities: Results form Seven States,” was published Monday in the Journal of the American Geriatrics Society, one of two studies from University of Rochester Medical Center researchers featured in the issue. The other study is related to nursing homes. The researchers reported that the effect of COVID-19 on assisted living communities “is as critical as that on nursing homes, and is worth equal attention from policymakers.”
The assisted living study combined state-reported COVID-19 data from 4,685 facilities (the ultimate sample size was 3,994 facilities) in seven states — Colorado, Connecticut, Georgia, North Carolina, New York, Ohio and South Carolina — with a 2019 national inventory of assisted living communities and Medicare beneficiary data for residents of those communities.
The researchers reported that assisted living communities with higher proportions of Hispanic and Black residents had more COVID-19 cases, but not more deaths. Also, communities with a higher proportion of residents with dementia, chronic obstructive pulmonary disease and obesity also had more COVID-19 cases, according to study author Helena Temkin-Greener, Ph.D., a professor of public health sciences. Those COVID-19 risk factors are disproportionately present in vulnerable minority populations, the investigators noted.
Assisted living communities are “ill prepared” to deal with a pandemic, the researchers said, because they often are financially challenged, care for increasingly sicker residents, operate under limited federal oversight, experience staff and personal protective equipment shortages, and often use personal care aides to provide daily care, who receive little to no training in the use of PPE, rather than certified nursing assistants or registered nurses.
Temkin-Greener said a lack of previous studies on assisted living exists due to a lack of data. Unlike nursing homes, which are required to collect and report COVID-19 data to CMS, she said, there is no unified system to capture data from assisted living communities.
Echoing cries from the senior living industry, the study authors said that assisted living communities have been “overlooked” by the federal COVID-19 response compared with nursing homes.
“Relying on AL communities to muster a rigorous response to the COVID-19 pandemic largely on their own is clearly unrealistic,” the researchers concluded. “Assisted living communities and their residents urgently need local, state and the federal governments to pay at least the same level of attention as that given to nursing homes.”
After the study period, the Department of Health and Human Services announced that assisted living operators could apply for COVID-19-related aid from the Provider Relief Fund. Assisted living operators also recently were sent COVID-19 antigen tests to use for residents and staff members.
The study was supported with funding from the federal Agency for Healthcare Research and Quality, part of HHS.
Additional reporting by Alicia Lasek.
