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States with the most nursing homes unprepared for infection

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Tom Weller/picture alliance via Getty Images

States with the most nursing homes unprepared for infection

The COVID-19 pandemic has ravaged nursing homes across the country. Almost 26,000 deaths related to the disease have been reported in nursing homes and long-term care centers across the country as of June 1, according to a letter from the Centers for Medicare and Medicaid Services and the CDC obtained by The Associated Press. The number of deaths is likely to be higher as it only accounts for 80% of the country's nursing homes.

While the coronavirus crisis may have highlighted the vulnerability of nursing home residents, many of the facilities that are supposed to protect older adults have been putting their patients at risk long before the pandemic. Infection control violations top the list of problems cited during nursing home inspections in the last year, per Medicare.gov. What’s more, one in three Medicare beneficiaries experienced adverse effects or harm in skilled nursing facilities, according to an Office of Inspector General study conducted from 2008–2012. Eldercare advocates are calling for a complete redesign of nursing home layouts to make them safer and healthier for residents.

Nursing home residents’ susceptibility to infection can vary by state. To examine the preparedness level of nursing homes in every state, Stacker used 2019 data from the Center for Medicare Services Nursing Home Compare tool, pulled and cleaned by Erin Petenko of the Vermont Digger, and released publicly via Stanford University’s Big Local News program. All 50 states and the District of Columbia are ranked here, according to the share of nursing homes in the state that have received a failing grade (F) in the inspection category “Provide and implement an infection prevention and control program” during a Medicare inspection in 2019. Supplemental data on each state’s total nursing home population is sourced from the Kaiser Family Foundation and is as of 2017.

Wondering if the nursing homes in your area are prepared for COVID-19 and other infections? Read on to see how facilities in each state stack up.

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#51. North Carolina

- Nursing homes with failing infection control: 28 (0.5%)
- Total nursing homes monitored by Medicare: 5,543
- County with the most unprepared nursing homes: N/A (>2 counties tied)
- Total nursing home population: 35,763

More than 60 nursing homes in North Carolina had at least one resident who tested positive for COVID-19 by May 11, 2020, according to data from the North Carolina Department of Health and Human Services. A collaborative news investigation uncovered a pattern of poor disease control protocols among the nursing homes with the highest volume of cases.

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#50. New Hampshire

- Nursing homes with failing infection control: 14 (1.2%)
- Total nursing homes monitored by Medicare: 1,170
- County with the most unprepared nursing homes: Hillsborough County (4)
- Total nursing home population: 6,442

New Hampshire has had outbreaks of COVID-19 in at least 16 of its long-term care facilities as of May 10, 2020, according to Josie Albertson-Grove of the New Hampshire Union Leader. The state’s commissioner of health and human services is calling for ongoing COVID-19 testing of residents and staff at nursing homes to keep tabs on the spread of the virus.

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#49. Arizona

- Nursing homes with failing infection control: 21 (1.4%)
- Total nursing homes monitored by Medicare: 1,553
- County with the most unprepared nursing homes: Maricopa County (14)
- Total nursing home population: 11,343

Arizona is among a handful of states that have yet to reveal which nursing homes have had outbreaks of the coronavirus. Around 150 nursing homes in the state that receive federal Medicare and Medicaid may soon be required to report data related to COVID-19 at their facilities, according to a memo from the national Department of Health & Human Services from May 6, 2020, but assisted living centers that don’t participate in the federal program would not be required to share that information under the proposed rule.

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#48. Vermont

- Nursing homes with failing infection control: 7 (1.4%)
- Total nursing homes monitored by Medicare: 517
- County with the most unprepared nursing homes: N/A (>2 counties tied)
- Total nursing home population: 2,440

Most of the COVID-19 cases in Burlington, the largest city in Vermont, are connected with two nursing homes, according to an analysis of state data conducted by Derek Brouwer and Andrea Suozzo of Seven Days. By late April, the disease had killed at least 24 nursing home residents in the area.

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#47. Georgia

- Nursing homes with failing infection control: 50 (1.5%)
- Total nursing homes monitored by Medicare: 3,246
- County with the most unprepared nursing homes: Bibb County (3), Chatham County (3)
- Total nursing home population: 33,043

Some nursing homes in Georgia are struggling to find enough workers to provide 24-hour care for residents after more than 1,800 long-term care providers have come down with COVID-19 as of May 7, 2020, according to Carrie Teegardin and Brad Schrade of the Atlanta Journal-Constitution. At least 659 residents of assisted living facilities and nursing homes have died from the disease.

 

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#46. Alaska

- Nursing homes with failing infection control: 5 (1.6%)
- Total nursing homes monitored by Medicare: 318
- County with the most unprepared nursing homes: N/A (>2 counties tied)
- Total nursing home population: 608

The early suspension of visitations to some nursing homes in Alaska gave the facilities a head start at preventing the spread of coronavirus. Some facilities have developed creative ways to help residents stay in touch with loved ones through technology and drive-by parades.

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#45. Rhode Island

- Nursing homes with failing infection control: 13 (1.6%)
- Total nursing homes monitored by Medicare: 814
- County with the most unprepared nursing homes: Kent County (4)
- Total nursing home population: 7,817

The deaths of nursing home residents in Rhode Island from COVID-19 account for 76% of all fatal cases of the disease in the state, according to data from the state’s Department of Health. The state is making an effort to test every patient and worker at nursing homes, according to an announcement from the governor on May 6, 2020.

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#44. Maine

- Nursing homes with failing infection control: 20 (1.7%)
- Total nursing homes monitored by Medicare: 1,191
- County with the most unprepared nursing homes: Cumberland County (4)
- Total nursing home population: 5,947

One in five coronavirus cases in Maine are connected to nursing homes, according to Phil Hirschkorn of WMTW News 8. Nearly 250 nursing home residents and workers in the state have come down with COVID-19 as of May 5, according to data from the Maine Center for Disease Control & Prevention.

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#43. Maryland

- Nursing homes with failing infection control: 56 (1.7%)
- Total nursing homes monitored by Medicare: 3,217
- County with the most unprepared nursing homes: Montgomery County (8)
- Total nursing home population: 24,414

State regulators in Maryland have issued fines to Sagepoint Senior Living, a nursing home with the highest death toll from COVID-19. According to the Washington Post, a letter from the regulators states that the facility neglected to isolate infected patients from the other residents and failed to use the correct personal protective equipment.

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#42. Montana

- Nursing homes with failing infection control: 20 (2.2%)
- Total nursing homes monitored by Medicare: 927
- County with the most unprepared nursing homes: N/A (>2 counties tied)
- Total nursing home population: 4,153

Montana Gov. Steve Bullock said he wants to test all residents of nursing homes in the state for the coronavirus. The logistics of conducting the testing was still being worked out with the facilities as of May 8, 2020.

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#41. North Dakota

- Nursing homes with failing infection control: 25 (2.2%)
- Total nursing homes monitored by Medicare: 1,141
- County with the most unprepared nursing homes: N/A (>2 counties tied)
- Total nursing home population: 5,531

Of the 33 people in North Dakota who had died of the virus as of May 8, 2020, 23 were residents of long-term care facilities like nursing homes, according to a briefing from the governor. Six nursing homes in North Carolina’s Bismarck-Mandan metro area accounted for at least 25 cases of COVID-19 as of May 7, according to Blake Nicholson of the Bismarck Tribune.

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#40. South Carolina

- Nursing homes with failing infection control: 36 (2.3%)
- Total nursing homes monitored by Medicare: 1,583
- County with the most unprepared nursing homes: Anderson County (4)
- Total nursing home population: 16,993

The COVID-19 death toll of staff and residents at nursing homes and long-term care facilities in South Carolina climbed to 107, according to a report from the state’s Department of Health and Environmental Control on May 8. The state was set to begin testing the 40,000 people who live and work in its nearly 200 nursing homes on May 11.

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#39. Oregon

- Nursing homes with failing infection control: 35 (2.3%)
- Total nursing homes monitored by Medicare: 1,510
- County with the most unprepared nursing homes: Multnomah County (9)
- Total nursing home population: 7,317

Oregon’s government has shut down a nursing home in Southeast Portland after it recorded the highest number of coronavirus-related deaths of all care facilities in the state, according to Oregon Public Broadcasting. During an inspection of the facility in mid-April, officials discovered that the nursing home failed to enforce hand-washing and social distancing. The Oregon Department of Human Services reported that at least 117 residents and staff of the nursing home have tested positive for COVID-19.

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#38. Virginia

- Nursing homes with failing infection control: 107 (2.3%)
- Total nursing homes monitored by Medicare: 4,614
- County with the most unprepared nursing homes: Chesterfield County (5)
- Total nursing home population: 27,595

There have been more than 3,700 cases of COVID-19 at long-term care facilities in Virginia, a number that’s four times higher than cases in other congregate settings in the state, according to data from Virginia Department of Health dated May 10, 2020. At least 503 people affiliated with nursing homes in the state have died from the disease.

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#37. Pennsylvania

- Nursing homes with failing infection control: 239 (2.5%)
- Total nursing homes monitored by Medicare: 9,597
- County with the most unprepared nursing homes: Allegheny County (22)
- Total nursing home population: 76,652

Pennsylvania failed to implement a robust plan it had developed in mid-March to protect nursing homes from the coronavirus. The plan would have dispatched health and medical experts to facilities in need of help within six hours of receiving a request. Instead, the state used a more-limited strategy that wasn’t put in place until mid-April.

 

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#36. Kentucky

- Nursing homes with failing infection control: 97 (2.6%)
- Total nursing homes monitored by Medicare: 3,719
- County with the most unprepared nursing homes: Jefferson County (12)
- Total nursing home population: 22,760

Gov. Andy Beshear announced Kentucky is planning to test every resident and worker at nursing homes in the state for the coronavirus. At least 862 residents of long-term care facilities in Kentucky have tested positive for COVID-19, according to Daniel Desrochers of the Lexington Herald Leader.

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#35. Massachusetts

- Nursing homes with failing infection control: 106 (2.8%)
- Total nursing homes monitored by Medicare: 3,819
- County with the most unprepared nursing homes: Middlesex County (21)
- Total nursing home population: 38,673

A coronavirus outbreak at the Courtyard Nursing Care Center, a nursing home in Massachusetts, has proved fatal for at least 54 residents and sickened 117 others, according to Shelley Murphy and Jeremy C. Fox of the Boston Globe. While not every worker at the facility had been tested, there had already been at least 42 confirmed cases of COVID-19 among the staff as of May 5.

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#34. Connecticut

- Nursing homes with failing infection control: 65 (2.8%)
- Total nursing homes monitored by Medicare: 2,285
- County with the most unprepared nursing homes: New Haven County (15)
- Total nursing home population: 22,653

More than 6,000 residents of nursing homes in Connecticut have come down with COVID-19, according to data from the state’s Office of the Chief Medical Examiner. At least 1,228 residents had died from the disease as of May 8, according to the governor.

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#33. New York

- Nursing homes with failing infection control: 171 (2.9%)
- Total nursing homes monitored by Medicare: 5,889
- County with the most unprepared nursing homes: Kings County (10)
- Total nursing home population: 101,518

New York Gov. Andrew Cuomo announced on May 10 that nursing home residents who have recovered from COVID-19 were required to test negative before moving back into their facilities. Nursing homes previously were not required to obtain a negative coronavirus test for readmission of seniors. Critics have said that the earlier rule is to blame for over 5,000 deaths in nursing homes.

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#32. Idaho

- Nursing homes with failing infection control: 30 (2.9%)
- Total nursing homes monitored by Medicare: 1,022
- County with the most unprepared nursing homes: Bingham County (3), Canyon County (3)
- Total nursing home population: 3,319

At least 202 nursing home residents and workers in Idaho have come down with confirmed or suspected cases of COVID-19 as of April 30, according to data from the Idaho Department of Health and Welfare. Nearly nine in every 10 nursing homes in Idaho have received citations for violations of infection control procedures between 2015 and 2020.

 

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#31. Nebraska

- Nursing homes with failing infection control: 61 (3.0%)
- Total nursing homes monitored by Medicare: 2,036
- County with the most unprepared nursing homes: Douglas County (6)
- Total nursing home population: 11,394

AARP Nebraska is calling on the state government to share which nursing homes have had confirmed cases of COVID-19 among workers and residents. Nebraska Gov. Pete Ricketts announced that 455 nursing home patients or staff had received a positive diagnosis of the disease as of May 7.

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#30. Iowa

- Nursing homes with failing infection control: 156 (3.0%)
- Total nursing homes monitored by Medicare: 5,196
- County with the most unprepared nursing homes: Polk County (10)
- Total nursing home population: 23,638

More than half of the coronavirus cases in Iowa have originated in nursing homes and retirement communities, according to Thad Nearmyer of the Iowa View. The state has 440 long-term care facilities, according to the Associated Press.

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#29. Hawaii

- Nursing homes with failing infection control: 17 (3.0%)
- Total nursing homes monitored by Medicare: 565
- County with the most unprepared nursing homes: Honolulu County (6)
- Total nursing home population: 3,474

No-visitor policies at long-term care facilities on Hawaii’s Big Island have helped them stay ahead of the curve of COVID-19. Some nursing homes on the island conduct daily coronavirus screening of their staff.

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#28. Louisiana

- Nursing homes with failing infection control: 91 (3.2%)
- Total nursing homes monitored by Medicare: 2,880
- County with the most unprepared nursing homes: East Baton Rouge Parish (9)
- Total nursing home population: 26,169

Nursing home residents in Louisiana who are feeling better can often be left in limbo if they're still testing positive for the coronavirus after being discharged from the hospital, according to Blake Paterson of The Advocate. More than half the patients at one surge facility—which provides treatment and a place to stay for those who aren’t experiencing acute symptoms—are from nursing homes.

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#27. Utah

- Nursing homes with failing infection control: 32 (3.2%)
- Total nursing homes monitored by Medicare: 990
- County with the most unprepared nursing homes: Utah County (5)
- Total nursing home population: 5,178

AARP Utah is calling on the state to test all staff and residents of nursing homes for the coronavirus. Half of the total COVID-19 deaths in Utah had come from long-term care facilities as of April 23, according to the Kaiser Family Foundation.

 

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#26. Minnesota

- Nursing homes with failing infection control: 159 (3.4%)
- Total nursing homes monitored by Medicare: 4,732
- County with the most unprepared nursing homes: Hennepin County (14)
- Total nursing home population: 24,755

Out of the 508 people who had died after contracting the coronavirus in Minnesota, 407 were residents of long-term care facilities or assisted living communities as of May 7, according to the state Health Commissioner. The COVID-19 infections at nursing homes account for about 15% of all cases in the state.

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#25. Ohio

- Nursing homes with failing infection control: 387 (3.4%)
- Total nursing homes monitored by Medicare: 11,279
- County with the most unprepared nursing homes: Cuyahoga County (26)
- Total nursing home population: 73,826

In the three weeks leading up to May 8, nearly 500 nursing home residents in Ohio have died from COVID-19, according to data from the state. More than 4,300 staff and residents of long-term care facilities in the state have received a positive coronavirus test since mid-April.

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#24. West Virginia

- Nursing homes with failing infection control: 63 (3.5%)
- Total nursing homes monitored by Medicare: 1,800
- County with the most unprepared nursing homes: Cabell County (5)
- Total nursing home population: 9,251

There were confirmed cases of the coronavirus at 25 of the 123 nursing homes in West Virginia as of May 7, according to the Department of Health and Human Services. That state has tested every resident and worker at nursing homes for the virus.

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#23. Florida

- Nursing homes with failing infection control: 321 (3.5%)
- Total nursing homes monitored by Medicare: 9,126
- County with the most unprepared nursing homes: Broward County (18)
- Total nursing home population: 72,741

After at least 703 deaths from COVID-19 among residents and workers at long-term care facilities in Florida, the state’s Agency for Health Care Administration issued new rules on infection control at nursing homes on May 10. Assisted living facilities and nursing homes in Florida are now required to grant entry to officials from the state’s Department of Health to test staff for COVID-19 and provide other disease prevention and control measures.

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#22. Kansas

- Nursing homes with failing infection control: 120 (3.5%)
- Total nursing homes monitored by Medicare: 3,402
- County with the most unprepared nursing homes: Johnson County (11)
- Total nursing home population: 14,657

Less than one in 10 of the confirmed COVID-19 cases in Kansas have originated in the state’s 450-plus long-term care facilities, according to Celia Llopis-Jepsen of the Kansas News Service. However, clusters of infections at certain nursing homes have led to large sources of deaths in the state.

 

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#21. Mississippi

- Nursing homes with failing infection control: 67 (3.5%)
- Total nursing homes monitored by Medicare: 1,890
- County with the most unprepared nursing homes: Covington County (5)
- Total nursing home population: 15,950

There have been at least 1,223 COVID-19 cases and 193 deaths from the disease associated with long-term care facilities in Mississippi as of May 11, according to data from the state’s Department of Health. Lauderdale County, where there have been 120 cases at long-term care facilities, is home to the most “active outbreaks at nursing homes,” according to Sarah Fowler of the Mississippi Clarion Ledger.

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#20. Tennessee

- Nursing homes with failing infection control: 100 (3.6%)
- Total nursing homes monitored by Medicare: 2,786
- County with the most unprepared nursing homes: Shelby County (11)
- Total nursing home population: 26,481

Tennessee has set a goal to test the 70,000 workers and 70,000 residents of its nursing homes and assisted-living facilities, according to the governor. There have been at least 63 cases of COVID-19 at a single nursing home in Athens.

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#19. Wyoming

- Nursing homes with failing infection control: 11 (3.6%)
- Total nursing homes monitored by Medicare: 302
- County with the most unprepared nursing homes: N/A (>2 counties tied)
- Total nursing home population: 2,428

All COVID-19 deaths in Wyoming and Orleans Counties have occurred at nursing homes as of April 24, according to Mallory Diefenbach and Matt Surtel of BataviaNews.com. The state has recommended screening nursing facility staff for possible coronavirus infections and that facilities prohibit visitors, but has not made those rules mandatory, according to data from the Kaiser Family Foundation.

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#18. Delaware

- Nursing homes with failing infection control: 21 (3.8%)
- Total nursing homes monitored by Medicare: 559
- County with the most unprepared nursing homes: New Castle County (8)
- Total nursing home population: 4,181

At least 450 residents of long-term care facilities in Delaware had tested positive for COVID-19 as of May 8, according to the Delaware Division of Public Health. So far, 137 nursing home residents have died from complications related to the disease.

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#17. Alabama

- Nursing homes with failing infection control: 104 (4.0%)
- Total nursing homes monitored by Medicare: 2,614
- County with the most unprepared nursing homes: Jefferson County (16)
- Total nursing home population: 22,482

As of May 8, infections of residents and workers at nursing homes in Alabama account for 17.6% of all COVID-19 cases in the state, according to Brendan Kirby of Fox10 News. They also account for nearly half of all COVID-19-related deaths in Mobile County, Alabama.

 

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#16. New Mexico

- Nursing homes with failing infection control: 42 (4.0%)
- Total nursing homes monitored by Medicare: 1,048
- County with the most unprepared nursing homes: Bernalillo County (7)
- Total nursing home population: 5,693

New Mexico has had at least 166 nursing home residents test positive for the virus, of which around 50 had died as of late April, according to data from the state’s Department of Health. There has been a positive test for COVID-19 or a death related to the disease at around 15 long-term care facilities in the state.

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#15. New Jersey

- Nursing homes with failing infection control: 151 (4.1%)
- Total nursing homes monitored by Medicare: 3,720
- County with the most unprepared nursing homes: Bergen County (15)
- Total nursing home population: 44,033

COVID-19 has killed more than 9,000 people in New Jersey as of May 11, 53% of whom were patients or staff at long-term care facilities in the state, according to Maureen Pao and Ailsa Chang of Wyoming Public Media. The state’s attorney general has begun investigating possible misconduct at the nursing homes where the deaths occurred.

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#14. Wisconsin

- Nursing homes with failing infection control: 130 (4.2%)
- Total nursing homes monitored by Medicare: 3,083
- County with the most unprepared nursing homes: Milwaukee County (11)
- Total nursing home population: 24,239

Around 42% of coronavirus cases in Wisconsin had originated in long-term care centers as of May 11, according to data from the Wisconsin Department of Health Services. At least 169 of the 638 nursing home coronavirus cases have resulted in a death.

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#13. Oklahoma

- Nursing homes with failing infection control: 86 (4.3%)
- Total nursing homes monitored by Medicare: 1,990
- County with the most unprepared nursing homes: Tulsa County (6)
- Total nursing home population: 18,361

Long-term care facilities and nursing homes in Oklahoma have been the source of more than 17% of positive coronavirus cases in the state as of May 8, 2020, according to data from the state’s Department of Health. So far, at least 756 residents or workers at these facilities have tested positive for the virus.

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#12. District of Columbia

- Nursing homes with failing infection control: 6 (4.4%)
- Total nursing homes monitored by Medicare: 137
- County with the most unprepared nursing homes: District of Columbia (6)
- Total nursing home population: 2,380

Washington D.C. has had 72 COVID-19 deaths among residents and workers at its long-term care facilities as of May 4, according to Nick Boykin of WUSA9. That number was a substantial increase from a report from April 22, which found there had been 15 deaths in nursing homes up until that point.

 

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#11. Indiana

- Nursing homes with failing infection control: 227 (4.4%)
- Total nursing homes monitored by Medicare: 5,118
- Counties with the most unprepared nursing homes: Hamilton County (10), Lake County (10), Marion County (10)
- Total nursing home population: 38,682

At least 584 COVID-19 deaths had occurred within nursing homes in Indiana as of May 11, according to data from state health officials. That figure represents 38% of all deaths that have been confirmed or presumed to be related to COVID-19 in the state.

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#10. Nevada

- Nursing homes with failing infection control: 34 (4.5%)
- Total nursing homes monitored by Medicare: 753
- County with the most unprepared nursing homes: Clark County (16)
- Total nursing home population: 5,336

More than 660 people at nursing homes and long-term care facilities in Nevada had tested positive for the coronavirus as of April 30, according to data from the state’s health officials. Positive tests for the virus at nursing homes continued to grow as of May 6.

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#9. Colorado

- Nursing homes with failing infection control: 108 (4.6%)
- Total nursing homes monitored by Medicare: 2,364
- County with the most unprepared nursing homes: Arapahoe County (11)
- Total nursing home population: 16,078

There have been confirmed outbreaks of COVID-19 in at least 148 nursing homes in Colorado, resulting in more than 500 deaths as of May 6, according to Lindsay Fendt of Colorado Public Radio. The figure represents 57% of the total COVID-19 death count in the state.

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#8. South Dakota

- Nursing homes with failing infection control: 57 (4.6%)
- Total nursing homes monitored by Medicare: 1,228
- County with the most unprepared nursing homes: Lincoln County (5)
- Total nursing home population: 5,984

South Dakota had yet to report confirmed cases or deaths from COVID-19 at long-term care facilities as of May 11, according to the Kaiser Family Foundation. One facility that cares for senior citizens in Sioux Falls has been hit hard by the virus, though. At least seven residents had died of the disease at the Evangelical Lutheran Good Samaritan Society's Sioux Falls Village as of May 1, according to Jeremy Fugleberg of the Dickinson Press.

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#7. Washington

- Nursing homes with failing infection control: 115 (4.7%)
- Total nursing homes monitored by Medicare: 2,446
- County with the most unprepared nursing homes: King County (13)
- Total nursing home population: 15,993

Around 20% of all coronavirus cases and two-thirds of COVID-19 deaths in Washington were connected to nursing homes and long-term care facilities as of May 11, according to Kevin Freking and Bernard Condon of the AP. By the week of May 8, nearly 2,900 cases of the coronavirus had occurred among residents, workers, and visitors at 250 facilities in Washington, according to data from the state’s health department.

 

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#6. Texas

- Nursing homes with failing infection control: 552 (5.1%)
- Total nursing homes monitored by Medicare: 10,738
- County with the most unprepared nursing homes: Harris County (29)
- Total nursing home population: 92,250

Texas has had at least 1,100 deaths due to COVID-19 as of May 11, more than 33% of which have been among nursing home residents, according to Asher Price of the Statesman. Texas Gov. Greg Abbott ordered coronavirus testing of all workers and residents at nursing homes in the state on May 11.

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#5. Michigan

- Nursing homes with failing infection control: 261 (5.7%)
- Total nursing homes monitored by Medicare: 4,616
- County with the most unprepared nursing homes: Wayne County (20)
- Total nursing home population: 38,062

Critics say that Michigan has failed to collect and report data on coronavirus cases and deaths at all assisted living facilities in the state, according to Mike Wilkinson of the Bridge. As of April 24, there had been at least 2,108 confirmed cases of the coronavirus at nursing homes in Michigan, according to records from the state.

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#4. California

- Nursing homes with failing infection control: 781 (6.2%)
- Total nursing homes monitored by Medicare: 12,650
- County with the most unprepared nursing homes: Los Angeles County (127)
- Total nursing home population: 101,030

Nearly half of the COVID-19 fatalities in California have been among residents and staff at the state’s senior residential facilities and skilled nursing homes as of May 8, according to data from California officials. Over half of all California nursing homes with confirmed COVID-19 infections were located in Los Angeles County as of April 20, according to state health authorities.

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#3. Missouri

- Nursing homes with failing infection control: 279 (6.2%)
- Total nursing homes monitored by Medicare: 4,504
- County with the most unprepared nursing homes: Jackson County (18)
- Total nursing home population: 37,874

Around 80 assisted care and nursing homes in Missouri have had residents come down with coronavirus infections as of May 1, according to data from the state’s Department of Health and Senior Services. St. Louis County, Missouri, where 46 facilities have had confirmed cases, is home to the highest number of nursing homes with outbreaks.

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#2. Illinois

- Nursing homes with failing infection control: 430 (6.7%)
- Total nursing homes monitored by Medicare: 6,424
- County with the most unprepared nursing homes: Cook County (75)
- Total nursing home population: 66,643

Nearly half of the COVID-19 deaths in Illinois were connected to nursing homes as of May 11, according to Erik Runge of WGN9. More than 24 people from just two nursing homes in the state have died from the disease so far.

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#1. Arkansas

- Nursing homes with failing infection control: 102 (7.4%)
- Total nursing homes monitored by Medicare: 1,380
- County with the most unprepared nursing homes: Pulaski County (10)
- Total nursing home population: 17,439

At least 37 deaths from COVID-19 have occurred in nursing homes in Arkansas as of May 10, according to data from the Arkansas Department of Health. Nearly 300 people at nursing homes in the state have tested positive for the disease so far.

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