The authors of this research study examined COVID-19-related outcomes at skilled nursing facilities (SNFs) in 3 metropolitan areas from March-May 2020.

They derived aggregated data from electronic health records and assessed weekly rates for all-cause mortality, admissions, and patient census at 189 SNFs located in Cleveland, Ohio; Detroit, Michigan; and New York City, New York; along with weekly total COVID-19 death counts for these areas. These SNFs account for 34% of the 559 SNFs in the 3 cities.

In this sample of SNFs, there were 3853 all-cause in-facility deaths from March-May 2020 versus 1765 during March-May 2019, with excess mortality that followed a similar pattern to overall COVID-19 deaths regionally. There was a spike in overall mortality among residents at SNFs in Detroit and New York City, which were 2 cities with substantial COVID-19 burden, and a lower increase in mortality in Cleveland, which was a city with fewer COVID-19 cases.

Their results suggest that SNFs experienced substantial clinical challenges during the COVID-19 pandemic. Mortality increased quickly, raising concerns about the capacity of SNFs to respond to outbreaks.