coronavirus close-up

A rolling national study is providing insights for the first time into how COVID-19 affected assisted living and similar residential care communities in the United States during the height of the pandemic.

The Centers for Disease Control and Prevention’s National Center for Health Statistics has released preliminary data from the residential care component of the 2020 National Post-acute and Long-term Care Study. Data reflect the number of coronavirus cases, hospitalizations and deaths among residents and staff members; infection control practices; and personal protective equipment shortages.

COVID-19 infections

According to data from 3,295 communities that are weighted to be nationally representative, from January 2020 through March 2021, assisted living communities experienced a total of 168,074 resident COVID-19 cases, 40,100 (23.86%) of which required hospitalization and 29,736 (17.69%) of which resulted in death.

For staff members, the numbers were 147,363 coronavirus cases, 3,753 (2.55%) of which required hospitalization and 591 (0.4%) of which resulted in death.

When broken down by size, among small communities (one to 25 residents), the Midwest experienced the highest number of resident (12,725) and staff member (14,353) cases. Among medium-sized communities (26 to 100 residents), the West experienced the highest number of resident cases (13,979), whereas the Midwest reported the highest number of staff member cases (13,019). Among large communities (101 or more residents), the South had the highest number of resident cases (28,127) and staff member cases (25,234).

In total, small communities reported 33,338 resident and 32,866 staff member COVID-19 cases, medium communities reported 44,863 resident and 38,530 staff member cases, and large communities reported 89,873 resident and 75,967 staff member cases. 

Equipment shortages

The study also looked at the percentage of communities that experienced a shortage of personal protective equipment between January 2020 and March 2021. In total, 40.4% of communities reported shortages of eye protection, gloves, face masks or isolation gowns; 40.9% reported N95 respirator shortages.

Midwest communities reported the highest shortages of eye protection, gloves, face masks or isolation gowns, with 42.6% of communities reporting such shortages, followed by communities in the West (40.7%), South (39.5%) and Northeast (35%). 

N95 respirator shortages were greatest in the West (44.4%), followed by the Midwest (39.9%), South (38.3%) and Northeast (35.8%). 

Infection control

The study also reported findings on infection control practices in the prevention, response or management of COVID-19, including screening, notification and treatment practices.

The data showed that 87% of communities screening residents daily for symptoms; 82.7% limited their hours or temporarily closed communal dining and activity spaces; 66.8% notified residents and families within 24 hours of positive cases; 39.6% used telemedicine or telehealth to diagnose, monitor or treat residents with positive or confirmed coronavirus infections; and 34.4% used telephone or audio-only calls to diagnose, monitor or treat confirmed or positive resident coronavirus cases.

When it came to imposing in-person visitation restrictions, practices differed by visitor category.

The majority of communities (70.2%) reported always limiting volunteers, 57.2% said they always limited total visitors, 54.9% reported always limiting nonessential consultant personnel, and 45.1% said they always limited family and relatives. Among those communities that “never” limited visitation, 2.8% never limited volunteers, 2.3% never limited nonessential consultant personnel, 2% never limited family and relatives, and 1.9% never limited visitors of any kind.

NPALS collects data from assisted living communities every two years for all 50 states and the District of Columbia. The data were collected from November 2020 through March 2021 from directors and administrators at 3,295 communities. The final results will be updated in 2022.

The study also presents data based on ownership (nonprofit and for-profit), chain status and metropolitan statistical area.