Excess COVID-19 Mortality Assisted Living

Angie Szumlinski Studies

In a study published in JAMA Network Open, they examined the excess mortality among assisted living residents in the United States during the COVID-19 pandemic. After adjusting for facility fixed effects, assisted living residents experienced 17% higher overall mortality in 2020 compared with the prior year. These results suggest that assisted living residents experienced increased mortality during the COVID-19 pandemic consistent with increases observed among nursing home residents.

The researchers also indicated that it was likely an underestimate of the overall excess mortality during the pandemic given the lag in Vital Status data and the period studied. Additional limitations include their inability to identify the cause of death and the exclusion of Medicare beneficiaries residing in smaller assisted living settings. They were also unable to identify and exclude Medicare beneficiaries who shared a 9-digit residential zip code with a licensed assisted living community but lived elsewhere and residents who relocated after January 1, 2020.

Further state and federal responses to pandemics targeted to long-term care are advised to explicitly identify the experiences of assisted living settings, recognizing that they differ from nursing homes in terms of the overriding model of care (i.e., social vs medical model) and staffing (i.e., lower staffing levels and less nursing care), among other areas. This research calls for specific attention to assisted living in response to pandemics and other emergencies. Stay well, stay informed, and stay tuned!