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States with the biggest nursing home outbreaks of COVID-19

  • States with the biggest nursing home outbreaks of COVID-19

    More than 40% of all COVID-19 deaths in the U.S. have happened inside nursing homes. As much as 44% of those deaths could have been avoided had “cross traffic” among nursing home employees—those who work at multiple nursing homes—been curbed, according to research released at the end of July.

    To examine nursing home outbreaks in different U.S. states, Stacker consulted a dataset from the COVID Tracking Project at the Atlantic, a volunteer project which compiles COVID-19 data from states’ public health departments. Forty-seven states and Washington D.C. currently report some form of data on outbreaks in nursing homes, assisted living facilities, and other long-term care facilities, according to the COVID Tracking Project’s Long-Term Care COVID Tracker.

    Each state has a different reporting system and terminology for these outbreaks, which the COVID Tracking Project has standardized through consultation with public health experts. We have further standardized the dataset by compiling all nursing home and long-term care (LTC) cases into two figures: resident cases and staff cases. We have similarly compiled resident deaths and staff deaths. The 47 states and D.C. with available data are ranked here according to their total COVID-19 cases in long-term care facilities as of Aug. 20. Our story also includes the total numbers of COVID-19 cases, deaths, and tests conducted in each state as of Aug. 23, via the COVID Tracking Project’s main state dataset.

    It is important to note that these rankings do not capture the full scale of the impact that COVID-19 has had on nursing home residents and staff in many states. State-reported data are often incomplete: while some states report cumulative cases and deaths from long-term care facilities, some only report those in current outbreaks, which are defined differently depending on the state. Also, some states only report total cases, some only report total deaths, and two (Missouri and Arizona) only report the number of outbreaks that have occurred in nursing homes. Montana, South Dakota, and Alaska do not report any data on COVID-19 in long-term care facilities.

    New York state is one notable example of missing data: The state does not report the number of COVID-19 cases that have occurred in its nursing homes, so it is not ranked in this story. However, over 6,600 residents and staff of long-term care facilities have died of COVID-19 in the state—the second-highest LTC death toll of any state. And this number may be an undercount, according to reporting by the Associated Press. 

    Keep reading to see which states have the biggest nursing home outbreaks of COVID-19.

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    Editor's note: Betsy Ladyzhets, a research associate at Stacker who worked on this story, volunteers for the COVID-19 Tracking Project.

  • Arizona (not ranked)

    State nursing home outbreaks as of August 20:
    - Cases and deaths not available
    - 499 outbreaks

    Total state COVID-19 counts as of August 23:
    - 198,103 cases (2,852 per 100,000 people, #3 highest)
    - 4,771 deaths (68.7 per 100k, #9 highest)
    - 1.2 million tests (16,567 per 100k, #12 lowest)

  • Missouri (not ranked)

    State nursing home outbreaks as of August 20:
    - Cases and deaths not available
    - 427 outbreaks

    Total state COVID-19 counts as of August 23:
    - 75,075 cases (1,233 per 100,000 people, #17 lowest)
    - 1,426 deaths (23.4 per 100k, #19 lowest)
    - 914,833 tests (15,022 per 100k, #10 lowest)

  • New York (not ranked)

    State nursing home outbreaks as of August 20:
    - Cases not available
    - 6,624 deaths (26.2% of all state deaths)
    - 459 outbreaks

    Total state COVID-19 counts as of August 23:
    - 429,737 cases (2,190 per 100,000 people, #9 highest)
    - 25,288 deaths (128.9 per 100k, #3 highest)
    - 7.6 million tests (38,847 per 100k, #4 highest)

  • #45. Maine

    State nursing home outbreaks as of August 20:
    - 16 cases (0.4% of all state cases, 378 among residents, 245 among staff)
    - 70 deaths (53.4% of all state deaths)
    - 21 outbreaks

    Total state COVID-19 counts as of August 23:
    - 4,335 cases (325 per 100,000 people, #2 lowest)
    - 131 deaths (9.8 per 100k, #7 lowest)
    - 231,701 tests (17,384 per 100k, #17 lowest)

  • #44. Wyoming

    State nursing home outbreaks as of August 20:
    - 57 cases (1.6% of all state cases, 36 among residents, 21 among staff)
    - 7 deaths (18.9% of all state deaths, 7 among residents)
    - 5 outbreaks

    Total state COVID-19 counts as of August 23:
    - 3,579 cases (615 per 100,000 people, #7 lowest)
    - 37 deaths (6.4 per 100k, #3 lowest)
    - 64,892 tests (11,153 per 100k, #1 lowest)

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  • #43. Hawaii

    State nursing home outbreaks as of August 20:
    - 70 cases (1.1% of all state cases, 34 among residents, 36 among staff)
    - 4 deaths (8.5% of all state deaths)
    - 19 outbreaks

    Total state COVID-19 counts as of August 23:
    - 6,356 cases (447 per 100,000 people, #3 lowest)
    - 47 deaths (3.3 per 100k, #1 lowest)
    - 176,184 tests (12,390 per 100k, #3 lowest)

  • #42. Vermont

    State nursing home outbreaks as of August 20:
    - 176 cases (11.3% of all state cases, 108 among residents, 68 among staff)
    - 32 deaths (55.2% of all state deaths, 32 among residents)
    - 12 outbreaks

    Total state COVID-19 counts as of August 23:
    - 1,557 cases (249 per 100,000 people, #1 lowest)
    - 58 deaths (9.3 per 100k, #5 lowest)
    - 120,043 tests (19,208 per 100k, #25 lowest)

  • #41. West Virginia

    State nursing home outbreaks as of August 20:
    - 806 cases (8.7% of all state cases, 478 among residents, 328 among staff)
    - 71 deaths (39.9% of all state deaths)
    - 123 outbreaks

    Total state COVID-19 counts as of August 23:
    - 9,272 cases (507 per 100,000 people, #4 lowest)
    - 178 deaths (9.7 per 100k, #6 lowest)
    - 396,193 tests (21,661 per 100k, #17 highest)

  • #40. Washington D.C.

    State nursing home outbreaks as of August 20:
    - 1,051 cases (7.7% of all state cases, 707 among residents, 344 among staff)
    - 169 deaths (28.0% of all state deaths, 162 among residents, 7 among staff)
    - 18 outbreaks

    Total state COVID-19 counts as of August 23:
    - 13,590 cases (1,985 per 100,000 people, #14 highest)
    - 604 deaths (88.2 per 100k, #7 highest)
    - 266,046 tests (38,867 per 100k, #3 highest)

  • #39. North Dakota

    State nursing home outbreaks as of August 20:
    - 1,060 cases (10.7% of all state cases, 438 among residents, 622 among staff)
    - 72 deaths (64.3% of all state deaths)
    - 120 outbreaks

    Total state COVID-19 counts as of August 23:
    - 9,876 cases (1,313 per 100,000 people, #23 lowest)
    - 112 deaths (14.9 per 100k, #11 lowest)
    - 190,885 tests (25,377 per 100k, #13 highest)

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