Report: 51 percent of senior housing properties experienced no COVID-19 deaths in 2020

Caroline Pearson

ANNAPOLIS, Md. and CHICAGO, Ill.—Fifty-one percent of senior housing properties experienced no COVID-19 deaths in 2020, according to an analysis by NORC at the University of Chicago (NORC) with a grant provided by the National Investment Center for Seniors Housing & Care (NIC).

Researchers analyzed data for four facility types in more than 100 counties across five states.

About two-thirds (67%) of independent living properties, 64 percent of assisted living properties, and 61 percent of memory care properties studied experienced no COVID-19-related deaths. Thirty-nine percent (39%) of skilled nursing facilities (also known as nursing homes) experienced no COVID-19-related deaths during the same period.

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“While COVID-19 has been devastating for older adults, a majority of properties avoided any resident deaths,” said Caroline Pearson, senior vice president of health care strategy and lead researcher at NORC. “Death rates in senior housing increased in settings of care that serve the most vulnerable residents, based on age, health status, and caregiving needs. Healthier, more active residents in independent living had comparable mortality to those living in private homes.”

The analysis found COVID-19 deaths across senior housing properties rose in tandem with the acuity, or severity of the illness of the average resident, and the complexity of caregiving needed. The highest mortality by percentage occurred in memory care and skilled nursing facilities. In contrast, the average mortality rate for adults in independent living properties was statistically the same as the mortality rate of the age 75 and over population in corresponding counties, suggesting residents in this type of group setting were not at higher risk of death from COVID-19 than those living in private homes.

“Ultimately every COVID-19 death in any community designed for older adults is tragic, and lessons were learned regarding health and safety protocols and where improvements are most needed,” said Brian Jurutka, NIC’s president and CEO. “The facts include that COVID-19 transmission is more likely with close person-to-person contact and mortality increases with age and co-morbidities. This study shows senior housing isn’t homogeneous, and mortality was higher in property types whose residents, on average, are sicker and require higher levels of care.”

Experts say COVID-19 may have accelerated or replaced other common causes of death in 2020. However, data show that residents in senior housing properties are older and more vulnerable than people who live in private homes. Prior to COVID-19, almost one-third of all skilled nursing residents died annually, with skilled nursing facilities often being the final residence prior to death.

“These findings are critical to informing the public’s understanding of safety within various senior housing options,” said Terry Fulmer, president of The John A. Hartford Foundation. “As older adults consider their living arrangements, this information can empower informed decisions.”

The analysis included data from 3,817 senior housing properties across 113 counties in five states: Colorado, Connecticut, Florida, Georgia, and Pennsylvania. A complete report and data methodology are available here.

Advisors to the NORC study say further research is urgently needed to better understand the role that health, age, and demographic characteristics play in mortality rates by different residential care setting. NIC plans to support a second phase of research building on these findings to be completed later this year.

NIC’s research grant to NORC was supported by an Advisory Committee, including:

  • Terry Fulmer, Ph.D., RN, FAAN, President of The John A. Hartford Foundation;
  • Ardeshir Hashmi, MD, Chair for Geriatric Innovation and Director of the Center for Geriatric Medicine at Cleveland Clinic;
  • Bob Kramer, Co-Founder and Strategic Advisor to NIC, Founder and Fellow of Nexus Insights;
  • David Nash, MD, Founding Dean Emeritus at Jefferson College of Population Health;
  • Arif Nazir, MD, Chief Medical Officer of Signature HealthCARE and immediate past President of AMDA, the Society for Post-Acute and Long-Term Care Medicine;
  • Kevin O’Neil, MD, Chief Medical Officer of ALG Senior; and
  • Anne Tumlinson, Chief Executive Officer of ATI Advisory and Founder of Daughterhood.

The NORC study was directed by Caroline Pearson, senior vice president, health care strategy. Mairin Mancino served as the project manager. David Rein, PhD, program area director of public health analytics, lead the quantitative analysis. Beth Burnham Mace, chief economist, and Ryan Brooks, senior principal, healthcare, oversaw the project for NIC.