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COVID-19 fatalities in nursing homes make up about half of the deaths from the disease that have occurred in Iowa throughout the course of the pandemic, according to new data from the AARP Public Policy Institute.
The policy analysis arm of AARP this week released a dashboard of novel coronavirus cases among residents and staff at nursing homes across the state that uses aggregate self-reported data to federal officials.
The dashboard focused on data in the four week period between Aug. 24 and Sept. 20. In the future, the policy institute plans to release a dashboard with aggregated nursing home data every month.
Since the start of the pandemic in Iowa this year, 643 nursing home residents as of Sept. 25 had died as a result of COVID-19 - or 51 percent of Iowa's total coronavirus deaths, according to the dashboard.
A little more than 40 percent of nursing homes in Iowa reported a confirmed case of the novel coronavirus in at least one resident as of mid-September, including 18 percent reporting a case between Aug. 24 and Sept. 20.
Fifty-six percent of nursing homes in the state reported a confirmed staff case in that four week period, the AARP dashboard shows.
In addition, about 39 percent of the state's nursing homes reported shortages of nurses and other staff between Aug. 24 and Sept. 20.
About 42 of the facilities percent also reported having a shortage of personal protective gear such as N95 masks, gloves and gowns needed to care for residents.
'That in itself is alarming when you're talking about cold weather coming in,” said Anthony Carroll, advocacy director at AARP Iowa. 'How can we possibly have in-person visits? That number should be zero.”
Overall, Iowa hovered above the national average in all categories of the dashboard, but advocates say the data shines a spotlight on long-standing challenges facing the direct care health workforce in the state.
Even before the pandemic, many nursing home staff reported concerns about their ability to address the needs at their facilities, said Di Findley, executive director of the nonprofit Iowa CareGivers organization.
According to the Direct Care Worker Wage and Benefit survey that Iowa CareGivers conducted in 2019, nearly half the respondents said they were 'very concerned” about not having enough staff to provide good care to residents, and 31 percent reported they were 'somewhat concerned.”
'We're very concerned about what 2020 might look like,” Findley said.
But the lack of support for this staff - including adequate PPE supplies and the stress of caring for residents during a pandemic - is likely worsening this issue, according to Carroll.
Officials noted that cases among members of staff can be one of the biggest drivers of infections among residents. That's particularly true for staff like certified nursing assistants who handle personal needs that include bathing and dressing, Findley said.
Nearly 28 percent of respondents in the Wage and Benefit survey reported having an additional job - a factor that could increase their risk for exposure elsewhere, Findley pointed out.
The medium hourly wage for direct care workers was $13.80 in 2019, the survey found.
About 47 percent of the survey's respondents were below $30,000 annual household income. The average household income for a family of four in Iowa is a little more than $46,000.
According to the survey, 80 percent of respondents who left the workforce did so because they wanted better wages.
'We think it's really important that the money the state's receiving to address COVID-19 recovery be used for staffing and supports to bring more stability to this workforce,” Findley said.
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