Residential Care Communities

Figure 1: Number of COVID-19 cases, hospitalizations, and deaths among residential care community residents and staff since January 2020 through mid-July 2021

This figure shows the number of presumptive positive or confirmed COVID-19 cases, hospitalizations, and deaths reported by RCCs from January 2020 through mid-July 2021, grouped by U.S. Census region and metropolitan statistical areas. Data are presented for both residents and staff separately.

• COVID-19 Cases are reported by directors/administrators and include cases that are either presumptive positive or confirmed by testing.
• Hospitalizations and Deaths due to COVID-19 are reported by directors/administrators.
• Resident includes any resident living in the RCC at any time since January 2020.
• Staff includes direct employees and contractors at the RCC at any time since January 2020.
• US Census Region is based on the U.S. Census definitions:
  • Northeast
  • Midwest
  • South
  • West
• Metropolitan statistical areas are based on geographic entities delineated by the Office of Management and Budget (OMB):
  • Metropolitan: core urban area of 50,000 or more population
  • Nonmetropolitan: areas with less than 50,000 population

Figure 2: Number of COVID-19 cases since January 2020 through mid-July 2021 among residential care community residents and staff, by community characteristics

This figure shows the number of presumptive positive or confirmed COVID-19 cases between January 2020 and mid-July 2021 grouped by U.S. Census region and metropolitan statistical areas, according to five key characteristics of RCCs. Data are presented for both residents and staff separately.

• COVID-19 Cases are reported by directors/administrators and include cases that are either presumptive positive or confirmed by testing.
• Resident includes any resident living in the RCC at any time since January 2020.
• Staff includes direct employees and contractors at the RCC at any time since January 2020.
• US Census Region is based on the U.S. Census definitions:
  • Northeast
  • Midwest
  • South
  • West
• Metropolitan statistical areas are based on geographic entities delineated by the Office of Management and Budget (OMB):
  • Metropolitan: core urban area of 50,000 or more population
  • Nonmetropolitan: areas with less than 50,000 population
• RCC Size: small (1-25 users), medium (26-50 users), and large (51 or more)
• Medicaid certification: whether an RCC is authorized or set up to participate in Medicaid
• Chain affiliation: whether an RCC is owned by a person, group, or organization that owns/manages two or more RCCs, including corporate chains
• Ownership type: whether an RCC is for profit (private or publicly traded/limited liability company) or nonprofit (including government)
• Any PPE shortage: whether an RCC experienced a shortage of eye protection, gloves, face masks, isolation gowns, and N95 respirators at any time since January 2020

Figure 3: Percentage of residential care communities that experienced personal protective equipment shortages since January 2020 through mid-July 2021

This figure shows the percentages of RCCs that experienced a shortage of personal protective equipment at any time since January 2020 and by four time periods (January 2020 through March 2020, April 2020 through June 2020, July 2020 through September 2020, and October 2020 through mid-July 2021), grouped by U.S. Census region and metropolitan statistical areas.

• Personal Protective Equipment Shortages displays “yes” response out of three options (yes, no, don’t know) during each time period included:
  • Eye protection, gloves, face masks, and isolation gowns
  • N95 respirators
• US Census Region is based on the U.S. Census definitions:
  • Northeast
  • Midwest
  • South
  • West
• Metropolitan statistical areas are based on geographic entities delineated by the Office of Management and Budget (OMB):
  • Metropolitan: core urban area of 50,000 or more population
  • Nonmetropolitan: areas with less than 50,000 population

Figure 4: Percentage of residential care communities with selected practices for the prevention, response, or management of COVID-19 infections since January 2020 through mid-July 2021

This figure shows the percentages of RCCs with infection control practices in their prevention, response, or management of COVID-19 infections between January 2020 and mid-July 2021, grouped by U.S. Census region and metropolitan statistical areas.

• Infection control practices:
  • Screening residents daily for fever or respiratory symptoms
  • Notifying all residents or families of cases in the RCC with 24 hours
  • Use of telephone or audio-only calls to assess, diagnose, monitor, or treat residents with presumptive positive or confirmed COVID-19 infection
  • Use of telemedicine or telehealth (ie., audio with video, web videoconference) to assess, diagnose, monitor, or treat residents with presumptive positive or confirmed COVID-19 infection
  • Limiting of communal dining and recreational activities in common areas
• US Census Region is based on the U.S. Census definitions:
  • Northeast
  • Midwest
  • South
  • West
• Metropolitan statistical areas are based on geographic entities delineated by the Office of Management and Budget (OMB):
  • Metropolitan: core urban area of 50,000 or more population
  • Nonmetropolitan: areas with less than 50,000 population

Figure 5: Percentage of residential care communities that imposed in-person restrictions since January 2020 through mid-July 2021

This figure shows the percentages of RCCs with in-person restrictions on individuals from entering the building, grouped by U.S. Census region and metropolitan statistical areas.

• In-person restrictions included five response options for never, sometimes or often, always, and don’t know for the following types of individuals:
  • Family and relatives
  • Visitors
  • Volunteers
  • Non-essential consultant personnel (e.g. barbers, delivery personnel)
• US Census Region is based on the U.S. Census definition:
  • Northeast
  • Midwest
  • South
  • West
• Metropolitan statistical areas are based on geographic entities delineated by the Office of Management and Budget (OMB):
  • Metropolitan: core urban area of 50,000 or more population
  • Nonmetropolitan: areas with less than 50,000 population

Technical Notes

• The final data includes survey submissions through mail, web, or CATI survey mode by July 15, 2021. Previous versions of these figures used preliminary data that included survey submissions through mail and web received by March 25, 2021 and excluded later mail and web submissions and all CATI survey mode respondents, which may have introduced response bias and estimates may have changed using final data.
• Other differences between preliminary and final data may be due to differences in the selection of variables used for weighting the data.
• Data are weighted and are nationally representative.
• Cases with missing data are excluded on a variable-by-variable basis.
• Data represent residential care communities, not individual residents.
• To be eligible to participate in NPALS a RCC had to be licensed, registered, listed, certified, or otherwise regulated by the state; have four or more licensed, registered, or certified beds; provide room and board with at least two meals a day, around-the-clock on-site supervision, help with personal care, such as bathing and dressing or health related services such as medication management, and serve a predominantly adult population. RCCs licensed to exclusively serve the mentally ill or the intellectually disabled/developmentally disabled populations or both are excluded from NPALS.
• All estimates shown meet the NCHS Data Presentation Standards for Proportions and meet NCHS confidentiality standards except three estimates in Figure 5. Percentages for RCCs that “never” restricted visitors, volunteers, and non-essential consultant personnel in non-metropolitan statistical areas do not meet NCHS standards for reliable proportions.

Data Source

National Center for Health Statistics’ 2020 National Post-acute and Long-term Care Study residential care community survey. For more details please visit https://www.cdc.gov/nchs/npals/about_npals.htm.