SC nursing home COVID-19 death rate tops nation, new AARP study finds

In state-by-state comparisons of COVID-19 deaths per 100 nursing home residents for a recent one-month period, South Carolina ranked highest of all the states, according to a just-released study AARP made with other health groups.

And in the same four-week period, South Carolina was close to highest of all the states in COVID-19 cases per 100 nursing home residents, AARP reported.

From Aug. 22 to Sept. 20, the study found:

▪ South Carolina had 172 nursing home residents die of COVID-19, for a rate of 1.2 nursing home resident deaths per 100 residents. Mississippi (130 deaths) and Alabama (194 deaths) had the next highest state nursing home death rates, each with 1.03 resident deaths per 100. The national average nursing home death rate was .48 per 100 residents.

▪ South Carolina had 823 nursing home resident cases of COVID-19, for a rate of 5.8 nursing home residents stricken with the virus per 100 residents. Only Tennessee (1,416 cases) and Arkansas (872 cases), both with a rate of 5.9 nursing home resident cases per 100, ranked higher than South Carolina. The national state average nursing home resident case rate is 2.6 per 100 residents.

“No state has done a good enough job to stem the loss of life” in nursing homes, AARP said a press release announcing that from now on, it would release a “monthly dashboard” of how nursing homes in all the states were doing in relation to COVID-19-related statistics.

The statistics cover five areas: death rates, case rates, PPE (personal protective equipment, such as mask, gloves, face shield, etc.), nursing home staff infection rates and staffing shortages.

In three other areas for the four-week period — PPE, nursing home staff infection rates and staffing shortages — South Carolina had somewhat higher than average deficiencies than other states, said AARP in its first monthly dashboard.

For example, the study found that 34.1% of South Carolina’s nursing homes only had less than one-week PPE supply on hand. The national nursing home average was 25.5%.

“These statistics are just for one month,” said Teresa Arnold, director of AARP South Carolina.

More meaningful statistics will likely come come from several months worth of the snapshots since longer time periods are more likely to show a trend, Arnold said.

In South Carolina and across the country, nursing homes have had the highest casualties of any group setting.

Nationally, more than 84,000 nursing home residents have died from COVID since January — about 38% of all the U.S.’s approximately 218,000 coronavirus deaths, according to the Kaiser Family Foundation.

In South Carolina, 1,378 nursing home and long-term care facility residents have died from coronavirus infections, according to DHEC.. Those deaths account for about 40% of all of South Carolina’s approximately 3,405 COVID-19 deaths, as of Friday.

In late April, when DHEC began releasing nursing home COVID-related statistics, state nursing home deaths represented only about 25% of the state’s coronavirus deaths.

Arnold speculated that South Carolina’s high nursing home COVID-19 death rate might be due in part to so many residents of the state’s nursing homes having underlying conditions such as diabetes, previous stroke and heart issues that make them particularly vulnerable to dying from coronavirus — conditions that reflect the state as a whole. People in nursing homes also are most often senior citizens, the age group particularly vulnerable to COVID.

According to general, statewide statistics released Thursday by DHEC, “many of those who have died due to COVID-19 also had one or more other conditions: 60.4% also had cardiovascular disease, 34.6% had diabetes, 30.9% had a neurologic or intellectual disability, 22.7% had COPD (chronic obstructive pulmonary disease), 21.2% had kidney disease, 13% had congestive heart failure and 12.3% had a previous stroke.”

Randy Lee, president of the S.C. Health Care Association, the state’s largest nursing home group, could not be reached for comment. His group represents more than 100 long-term care facilities with some 18,000 beds.

Since last spring, Lee’s group has worked with DHEC on testing and other programs to make the state’s nursing homes safer from COVID-19.

A DHEC spokeswoman said Friday her agency’s officials needed more time to study AARP’s statistics before speaking about them.

But, said DHEC’s Laura Renwick, the agency continues “to work closely with the nursing home community to help ensure proper disease prevention practices are in place.”

That includes making sure facilities have testing plans in place, that they have plans for a special COVID unit should a resident test positive and that PPE is being properly used, she said.

DHEC’s regional disease prevention teams also check with facilities that don’t have active cases to make sure they are following the latest Centers for Disease Control and Prevention and Centers for Medicare & Medicaid Services guidelines to prevent exposure, she said.

“When we do learn of a case at a facility, we immediately reach out to the facility to make sure the required actions are taken for preventing further spread,” Renwick said.

In June and July, DHEC visited all 194 licensed nursing homes and performed virus infection control surveys, she said. “We continue to work closely with our state’s nursing homes every day to best protect their at-risk residents as well as the dedicated staff who care for them.”

DHEC’s website says, “DHEC prioritizes the identification of COVID-19 infections in nursing homes and assisted living facilities because the spread of respiratory illnesses like COVID-19 is common in these types of facilities, and the residents who live there are at high risk for developing complications or death from COVID-19 infection.”

Covid-19 is a highly contagious respiratory ailment that has killed more than 1.1 million people worldwide since March, according to Johns Hopkins University, which tracks cases around the nation and world. The United States, with its 218,000-plus dead from COVID-19, has by far the world’s highest death toll. The next-highest toll is in Brazil, with 152,000.

The national AARP, which makes COVID-19 one of the priorities, has some 38 million members and is the nation’s largest group representing people over 50. AARP’s Public Policy Institute is doing the study with the Scripps Gerontology Center at Miami University in Ohio and using federal government figures.

This story was originally published October 18, 2020 at 5:00 AM with the headline "SC nursing home COVID-19 death rate tops nation, new AARP study finds."