June 30, 2020

Texas Nursing Homes & COVID

Texas Nursing Homes & COVID

Texas publishes some of the most comprehensive data on how COVID has affected nursing homes in the country.  It provides very interesting insight as to how COVID is actually affecting the most vulnerable segment of our population.

There are a little over 1,200 skilled nursing homes1 in Texas caring for about 100,000 residents.  As of June 28, 917 nursing homes reported having at least one case of COVID.  The total cases in all Texas nursing homes was 6,224, indicating an infection rate of about 6%.

On May 11, Governor Abbott ordered all nursing homes to test all residents.  I have not been able to find anything on the results of that testing or if it has been completed.  If so, a 6% infection rate would be remarkably low.

Of those diagnosed with the virus, 4,026 have “resolved”, meaning they have either died or recovered.  I was surprised to see that of those cases that have resolved, 3,109 (77%) recovered and 917 (23%) died.  That leaves about 2,220 patients who are still dealing with the virus.

Overall, fatalities in nursing homes account for about 38% of the state’s total fatalities.  That is a little better than the national averages, which have been running 40-50%.  Some are shocked that nursing homes have contributed about 40-50% of the COVID fatalities, but in normal circumstances about 25-30% of all fatalities occur in nursing homes.2  So, while the toll in nursing homes has been disproportionate, it has not been to the degree a casual reader might assume.

Finally, the nursing homes are not seeing the acceleration in new cases that the state is experiencing generally.  Since the state began reporting nursing home data on May 15, the trend has been almost perfectly flat.3  The same is true with daily fatalities.

So far at least, the surge in new cases has not seeped into nursing homes as many worry it may.  Let’s hope and pray it stays that way.

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1 There are three levels of care for seniors, skilled nursing, assisted living and independent living.  Skilled nursing is for individuals with the most serious health challenges.  Texas also keeps track of COVID cases in assisted living facilities.  Through June 28, there had been about 730 cases in assisted living facilities with 140 fatalities and 304 recoveries.

2 I think the percentage of fatalities in normal circumstances is probably even higher than the reported number because frequently as nursing home residents become critically ill, they are transferred to an acute care hospital and die there.

3 On June 24, the state reported 527 new cases.  The press reported that represented a backlog of tests that had not been previously entered.  For purposes of this chart, I averaged June 23 and June 25 to generate a number for June 24.

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