With their high concentrations of vulnerable residents, Nursing Homes are particularly susceptible to outbreaks of Covid-19.  Countless news stories have documented the ravages of the disease among seniors in these facilities, with the death toll registering over 58,000 by the end of September per CMS data.  The effort to safeguard Nursing Home residents has been swift.  In addition to enhanced Covid-19 reporting requirements, targeted Infection Control Surveys, and the distribution of testing equipment, CMS is also set to further incent Nursing Homes by tying CARES Act funding to performance against local metrics.  In a nutshell, if a facility can keep their case rate and death rate below the average in their county, they can expect additional money.  This pool will be split out and paid based on performance in each of four months from September to December 2020, with an additional payout for performance over the entire quarter.

Our map combines two of CMS’s datasets – one covering the positive test rate for each County, and the other covering information on Covid-19 inside the homes themselves.  We overlaid the two on a map to give an impression of how a given home (or group of homes) is performing relative to their surrounding county. 

By zooming in on an area, you can see the individual facilities, and clicking shows the case rate of a facility and the positivity rate of a county.  This reveals some interesting scenarios.  For example, Essex County, NY is green, with less than 1% of the population testing positive.  But the below facility has had 6 new confirmed cases in the last 14 days for a rate of close to 8% of their population.  This could be an example of the facility’ inability to control spread, staff infecting patients, or just local efforts to cohort Covid patients at one designated facility.  Either way, we now have the information we need to ask the facility some clarifying questions.

On the other side of the coin, Shawano County, WI is showing a 22% community test positivity rate, but the home below appears to be doing a good job of stopping it at the door.

While CMS is yet to publish the final details of the CARES act allocation plan, smart facilities will continue to set themselves up for success by keeping their numbers low.

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