COVID-19 Had a Devastating Impact on Medicare Beneficiaries in Nursing Homes During 2020

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

The title of this blog is the same as the OIG Report (OEI-02-20-00490) posted on June 22, 2021.


Nursing home residents have been particularly affected by COVID-19, as they are predominately elderly, tend to have underlying conditions, and live in close quarters. However, data on the number of nursing home residents who were diagnosed with COVID-19 or likely COVID-19 have not been readily available, particularly for early in the pandemic. Nursing homes are not required to report cases and deaths that occurred before May 8, 2020.

This data snapshot provides objective, standardized data based on Medicare claims for all Medicare beneficiaries in nursing homes throughout the country. This data snapshot is the first in a three-part series. Subsequent work will address the characteristics of the hardest hit nursing homes and strategies used by nursing homes to confront the challenges of the COVID-19 pandemic.


  • Two in five Medicare beneficiaries in nursing homes were diagnosed with either COVID-19 or likely COVID-19 in 2020.
  • Almost 1,000 more beneficiaries died per day in April 2020 than in April 2019.
  • Overall mortality in nursing homes increased to 22 percent in 2020 from 17 percent in 2019.
  • About half of Black, Hispanic, and Asian beneficiaries in nursing homes had or likely had COVID-19, and 41 percent of White beneficiaries did.
  • Understanding the pandemic’s effects on nursing home residents is necessary if tragedies like this are to be averted.


The toll that the COVID-19 pandemic has taken on Medicare beneficiaries in nursing homes demonstrates the need for increased action to mitigate the effects of the ongoing pandemic and to avert such tragedies from occurring in the future. OIG is committed to understanding and helping to protect nursing home residents from the impacts of COVID-19. We recognize that CMS is also committed to protecting nursing home residents. Additional data analysis, particularly on Medicare claims data, may help CMS in its efforts. Medicare claims data include demographic information about each beneficiary as well as information about the beneficiary’s conditions and care needs. These data are important to understanding the effects of the pandemic and, moving forward, could play an integral part in understanding health disparities within the nursing home population and preparing for and dealing with future public health crises.

The data snapshot is 12 pages in length and well worth the read.  Please share this with your team and colleagues.

Here are some of the graphics included in the OIG report:

Some States were impacted more than others. By the end of June, more than a quarter of the Medicare beneficiaries in nursing homes in each of 11 States had or likely had COVID-19. These States—Connecticut, Delaware, District of Columbia, Georgia, Illinois, Louisiana, Maryland, Massachusetts, New Jersey, New York, and Pennsylvania—were also some of the hardest hit in terms of percentage of their general population that contracted the disease during that time.  By the end of December, more than half the Medicare beneficiaries in nursing homes in each of four States—Connecticut, Illinois, Louisiana, and New Jersey—had or likely had COVID-19.  (Italics added by me.)

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