Federal Lawmakers Calculate 7,000 Covid-19 Deaths in Assisted Living, Push Bill

More than 7,000 assisted living residents may have died from Covid-19 in the United States, according to a new report based on information that federal lawmakers gleaned from providers.

The report suggests that the numbers may actually be higher, since deaths in assisted living facilities are not reported to the federal government, an issue that a new bill stemming from the survey aims to remedy.

Meanwhile, industry groups are seizing the moment to repeat calls for federal assistance for assisted living communities battling the pandemic, and taking issue with how the report presents some of its findings.

The bill from Massachusetts Senators Elizabeth Warren and Ed Markey, both of them Democrats, along with Rep. Carolyn Maloney, a Democrat from New York, would require assisted living providers to report confirmed Covid-19 cases to federal, state and local public health departments, as well as families of impacted residents. Reporting requirements applying to skilled nursing facilities would also apply to assisted living moving forward.

It also calls for a Government Accountability Office (GAO) report within two years of becoming law, calling for an evaluation of how Covid-19 data on residents in nursing homes during the pandemic was used to prevent or control outbreaks and deaths and how it compares to congregate care facilities without required reporting mandates, and how lessons learned from nursing homes responses to the pandemic can be applied to other care settings for similar outbreaks in the future.

As part of the investigation, Warren, Markey and Maloney sent letters on May 1 to 11 senior housing providers — including many of the largest in the country — requesting responses related to their handling of Covid-19.

The survey revealed that 24% of assisted living facilities operated by respondents had at least one positive Covid-19 case among residents as of May 31, and nearly 8% reported buildings with 10 or more cases.

Assisted living residents have tested positive for Covid-19 at a rate over five times the overall national average: 2.9% of assisted living residents had tested positive for the disease, compared to a national occurrence rate of 0.5%.

Assisted living residents also had higher rates of hospitalization and deaths related to the disease, the survey showed. Overall, approximately 43% of assisted living facility residents who tested positive for Covid-19 were hospitalized, and 31% of residents contracting the disease died — a number nearly six times the national average and comparable to the Covid-19 fatality rate in nursing homes.

The report notes that, if this data is indicative of assisted living facilities across the country, more than 7,000 residents may have died from Covid-19 through the end of May. But the actual number may not be known, as assisted living facilities are not required to report Covid-19 deaths to federal authorities.

“As a result, federal government officials, public health experts, and the public have no comprehensive information on COVID-19 occurrence and fatality rates in assisted living facilities,” the report reads.

The report cited providers for lacking adequate testing and testing protocols for residents and staff, and shortages of personal protective equipment (PPE) stemming from financial and logistical hurdles.

And the report takes providers to task over sick leave policies: Only two of the 11 that participated reported offering two weeks paid sick leave for workers with confirmed positive Covid-19 cases or suspected of catching the virus. The others failed to offer specific sick leave, did not offer enough leave, did not offer it to part-time workers or offered sick leave only if employees tested positive.

“These leave policies make it more likely that workers in assisted living facilities will come to work when ill, putting assisted living residents and coworkers at risk,” the report reads.

Industry response

Industry groups responded to the report with a collective renewed push for federal assistance in fighting the virus. To date, nursing homes have received nearly $5 billion in federal aid and PPE shipments, while assisted living providers have shouldered the costs of their testing and safety equipment.

“Assisted living operators have leveraged innovation and partnerships in procuring and securing critical PPE to protect their residents and staff, saving countless lives. But, in accordance with the report, we believe the federal government needs to take a more active role in providing these essential resources,” Argentum President and CEO James Balda said in a statement sent to Senior Housing News.

Several of the providers who were surveyed by the Congressional lawmakers told SHN that they would defer to Argentum’s response to the report at this time. These providers included ALG Senior (formerly known as Affinity Living Group), Eclipse Senior Living, Enlivant and Five Star Senior Living (Nasdaq: FVE).

Louisville, Kentucky-based Atria Senior Living was also surveyed by Warren, Markey and Maloney.

“We are aware of the report and proposed legislation released today. We responded to Senators Warren and Markey, and Congresswoman Maloney’s letter, and appreciate their interest in this critical issue and the opportunity to share our perspective. At this time we are still reviewing both the report and the proposed legislation,” Atria said in a statement to SHN.

Other providers surveyed were Brookdale Senior Living (NYSE: BKD), Capital Senior Living (NYSE: CSU), Gardant Management Solutions, LCS and Life Care Services, Sunrise Senior Living and Senior Lifestyle Corp.

Other industry organizations also weighed in. The National Center for Assisted Living (NCAL) struck a similar note as Argentum.

“This is an unprecedented threat, and there is no cure all, but if we receive the support we need from all levels of the public health sector, we can better safeguard residents in our care. We hope the report released by Senators Warren and Markey, and Chairwoman Maloney will highlight the fact that we need to rally around assisted living communities so we can win this fight together,” NCAL Executive Director Scott Tittle said in a statement to SHN.

The American Seniors Housing Association (ASHA) also thanked Senators Warren and Markey, and Rep. Maloney, for highlighting the need for assistance. ASHA President David Schless, however, expressed some reservations with the report. He called comparing Covid-19 cases in assisted living to the general population “misleading,” noting that the chronic medical conditions of residents, as well as varying rates of cognitive and functional impairment, creates a higher risk environment for poor Covid-19 outcomes compared to the greater population.

Schless also noted that providers have already been reporting Covid-19 statistics at the state and local levels.

“Assisted living settings across the country are regularly reporting incidents to their state and local health departments. The report fails to mention that policies have almost exclusively been made at the state and local level since the onset of this crisis, and the assisted living industry adheres to these and other reporting requirements,” Schless said in a statement.