Nursing home deaths up 32%

WASHINGTON — Deaths among Medicare patients in nursing homes soared by 32% last year, with two devastating spikes eight months apart, a government watchdog reported Tuesday in the most comprehensive look yet at the ravages of COVID-19 among its most vulnerable victims.

The report from the inspector general of the Department of Health and Human Services found that about 4 in 10 Medicare recipients in nursing homes had, or probably had, COVID-19 in 2020, and that deaths overall jumped by 169,291 from the previous year, before the novel coronavirus appeared.

“We knew this was going to be bad, but I don’t think even those of us who work in this area thought it was going to be this bad,” said David Grabowski, a Harvard expert on long-term care who reviewed the report for the Associated Press.

“This was not individuals who were going to die anyway,” Grabowski added. “We are talking about a really big number of excess deaths.”

Investigators used a generally accepted method of estimating “excess” deaths after a calamitous event. They did not examine individual death certificates but compared overall deaths in nursing homes to levels recorded the previous year. The technique was used to estimate deaths in Puerto Rico after Hurricane Maria in 2017 and in New York after the first COVID-19 surge in spring 2020. It does not attribute causes of death but is seen as a barometer of impact.

Death rates were higher every month last year compared with those in 2019. The report documented two spikes in deaths with particular implications for government policy and for protecting the most vulnerable in future outbreaks of lifethreatening illnesses.

In April of last year, a total of 81,484 Medicare patients in nursing homes died. In December, after lockdowns and frantic efforts to expand testing — but before vaccines became widely available — nursing home patients accounted for a staggering 74,299 deaths.

The inspector general’s office based its analysis on Medicare billing data.