Nursing Home COVID-19 Outbreaks Disproportionately Hit Minority Residents: Study

Amid continuing concern about the disparate impact of COVID-19 infections at nursing homes nationwide, with the facilities hardest hit during the pandemic often being those with a long track record of issues, new research indicates facilities with higher minority residency have also seen disproportionate mortality rates from coronavirus.

In findings published earlier this month in the Journal of the American Medical Directors Association (JAMDA), researchers confirmed nursing homes and long term care facilities with a higher proportion of black and Hispanic residents reported more COVID-19 deaths when compared to those serving a higher proportion of white residents.

Researchers with the Center for Health Equality Research reviewed COVID-19 nursing home fatality data recorded by the Centers for Medicare & Medicaid Services (CMS) for 11,718 nursing homes from June 1, 2020, to December 27, 2020, to examine the impact of COVID-19 in high proportion minority resident nursing homes.

According to the findings, within the first weeks of the study period, nursing homes with higher populations of black patients were found to have a statistically higher mortality rate of 6.6 deaths, when compared to those with higher proportions of Hispanics and whites which averaged 3.8 and 3.4 deaths.

However, a shift in COVID-19 nursing home fatalities was identified by mid-July onward, adversely impacting nursing homes with higher Hispanic patients. By the second week of July, Hispanic residents recorded a 3.7 average mortality rate compared to the death rate of 2.9 in facilities with majority white patients, the study found.

Overall, throughout the first 12 weeks of the study period, the data indicates a statistically significant trend in higher mortality rates among nursing homes with higher proportions of racial and ethnic minorities.

With more than 1.3 million residents in over 15,000 Medicare and Medicaid-certified nursing homes throughout the United States, significant attention has been placed on COVID-19’s progress through nursing homes and the vulnerable population residing in the facilities. Many experts have expressed concern that chronic nursing home understaffing, a lack of preparation, and the elderly’s increased vulnerability to the effects of the virus have all contributed to the higher mortality and infection rates at certain facilities.

A supporting study published in the Journal of the American Medical Association on February 10 found nursing homes with higher proportions of minority resident’s experienced COVID-19 mortality rates 3.3 times higher than those of facilities with the highest proportions of White residents.

Study authors suggested “that the inequalities underlying racial disparities in COVID-19 infection and mortality in the general population may also be associated with differences in mortality among nursing home residents with COVID-19 infection.”

The U.S. Centers for Disease Control and Prevention published a study in September 2020, highlighting a link between COVID-19 and nursing home quality of care, indicating facilities which scored better in federal ratings have been less likely to experience severe outbreaks at their facilities.

Federal investigators are exploring the possibility of nursing home neglect playing a role in the COVID-19 outbreak, which was first detected in a nursing home in Washington State that became the epicenter for the U.S. pandemic. Investigators say the nursing home failed to respond to the outbreak adequately, placing residents in jeopardy of illness and death.