Question: I had read that Florida had done a much better job than New York in protecting nursing home residents. Is that true?

Answer: As of May 22nd, Florida had recorded 1,032 deaths of nursing home and assisted living residents and workers. As of May 24th, New York had recorded 3,282 confirmed deaths and 2,698 presumed deaths for a total of 5,980 deaths among nursing home/assisted living residents and workers. Florida does not include presumed deaths in its totals, so it is perhaps more appropriate to compared confirmed deaths in both states. Either way it’s abundantly clear that New York has experienced far more deaths in nursing and assisted living facilities than Florida. But let’s look a little further.

First, let’s add a denominator to both numbers — number of nursing home residents in each state. According to the Kiaser Family Foundation, Florida has 72,741 nursing facility residents while New York has 101,518 residents. They are respectively the 6th and 1st largest nursing facility resident populations in the country. This would put the COVID-19 mortality rate among nursing facility residents at 1.4% in Florida and 3.2% in New York (or 5.9% if you include presumed deaths). Again, New York is fairing far worse. That said, it’s important to add one more layer of context — how much of a toll the virus has taken on each state. As of May 24th, New York had experienced 23,391 deaths while Florida had experienced 2,316 deaths (data from covidtracking.com). Per the US Census Bureau, New York has a population of 19.45 million and Florida has a population of 21.48 million. So, New York has seen 120 deaths per 100,000 residents while Florida has experienced 11 deaths per 100,000 residents. New York has been hit 10x harder than Florida. But New York’s nursing homes have been hit only 2 to 4 times harder than Florida’s (depending on which NY data you use). Either way you slice it, it’s terrible. But once we add the broader context, I’m not sure that Florida is a shining example of how to get it right. I’m also confident that there’s plenty to criticize when it comes to New York’s response.

Moving forward, there is much to be done to prevent COVID-19 in nursing homes and assisted living facilities. JAMA included a nice commentary on this subject just a few days ago and the American Geriatrics Society issued a brief to policy guide last month. The recommendations are quite straightforward and include having comprehensive testing policies and supplies, making PPE widely available, providing paid sick leave for workers, and more.