Death rates for Hispanic and Black patients were 23% last year, up from 15% in 2019.
The inspector general’s office based its analysis on Medicare billing data, also including patients in Medicare Advantage plans sold by private insurers. Medicare covers the vast majority of nursing home patients, and the report included long-term residents as well as those temporarily at a facility for rehab care.
Health economist Tamara Konetzka of the University of Chicago, who also reviewed the report for AP, said building an estimate from individual death certificates would have faced another set of challenges. Especially in the first wave of the pandemic, many who died would not necessarily have been tested for COVID-19, for example.
“By looking at excess deaths you can get away from some of the measurement issues and say how much worse things were in 2020 than in 2019,” explained Konetzka, who has testified before Congress on the impact of COVID-19 in nursing homes.
The inspector general’s findings about Asians highlight a riddle for researchers, said Konetzka. The reasons for higher cases and deaths among Blacks, Hispanics and Asians may not necessarily be tied to race and ethnicity. Instead, minority patients may be clustered in homes located in communities with more severe outbreaks.
The report also found that low-income nursing home patients covered by Medicare and Medicaid together were much more likely to have gotten COVID-19. The infection rate for that group reached 56%, and 26% died.
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