NIC Notes

Insights in Seniors Housing & Care

By: Omar Zahraoui  |  April 01, 2021

Case Counts Within Skilled Nursing Facilities Continue Dropping, Now a Fraction of U.S. Cases

COVID-19  |  Skilled Nursing  |  Skilled Nursing Tracker


New cases of COVID-19 in skilled nursing facilities account for just a quarter of 1% of U.S. cases overall, down from over 5% of cases in June 2020. NIC’s new interactive data visualization tool shows a divergence as case counts among the general population rise in some parts of the U.S., while those in skilled nursing facilities continue to decline.

U.S. weekly COVID-19 infections are rising again across several states despite ongoing vaccination efforts. Although we are on the road to herd immunity and case count data in skilled nursing facilities (SNFs) suggest that vaccines are indeed effective, the recent uptick in U.S. cases indicates that it is still important to remain vigilant and continue to be cautious regarding enthusiasm about beating the pandemic. It is too early to let our guards down.

This new interactive tool tracks the incidence of COVID-19 and provides a way to compare weekly infections of COVID-19 in skilled nursing facilities and in the U.S. and across regions, sub regions, and states. Data show

  • weekly confirmed cases in SNFs vs. U.S. (sort by region, sub region, or state)
  • per-resident rate of new COVID-19 infections within SNFs (all vs. specific region/state)
  • weekly confirmed cases among skilled nursing residents as a share of U.S. weekly cases.

The data is displayed in an easy-to-use interactive dashboard that allows sorts down to state level, with data updated weekly. Check back each week to see and compare current data. 


Choose specific regions or states from the dropdowns in the tool below to change the graphs. 


Interactive Tool - Weekly COVID-19 Confirmed Cases | Skilled Nursing Facilities vs. U.S.

While skilled nursing residents make up less than 1% of the U.S. population, the analysis shows that newly confirmed cases among skilled nursing residents have shrunk dramatically. Remarkably, weekly confirmed cases within skilled nursing facilities accounted for only 0.26% of U.S. weekly cases on March 14, down 1.86 percentage points from December 20 (2.12%) and the launch of the long-term care vaccination program. This suggests that the incidence of COVID-19 has shifted to the younger adults. Recent data shows that hospitalized COVID-19 patients are getting younger across several states, including New Jersey, Pennsylvania, and Michigan.

New Cases in Skilled Nursing Facilities Fall Below 1,000

Additionally, newly confirmed cases within skilled nursing facilities continued to decline and fell below 1,000 cases for the week ending March 14 (preliminary data). The per-resident rate of new COVID-19 infections continued to decline and reached a new pandemic low of 0.09% - only 9 in 10,000 residents tested positive for COVID for the week ending March 14, 2021 compared to 303 in 10,000 twelve weeks ago on December 20, 2020.

Regional Differences

Regionally, the lowest rate of new infections among skilled nursing residents was seen in the Midwest at 0.06% - a pandemic low, where case counts are down 98% from 8,756 on December 20 to 150 on March 14. This is followed by the West (0.07% - a pandemic low), the South (0.10% - a pandemic low), and the Northeast (0.15%). Case counts within SNFs in the Northeast are down 94% since December 20 while the Northeast overall weekly cases fell only 53% over the same period. Notably, the share of newly confirmed COVID-19 diagnoses within SNFs in the Northeast decelerated from 2.44% to 0.30% for the reporting weeks from Dec 20 through Mar 14 (down 2.13 percentage points).

The positive effects of the vaccines continue to be notable across the four regions of the U.S., the rate of new COVID-19 cases among skilled nursing residents prior to vaccination rollout moved nearly in tandem with the rate of new cases within their respective regions. In recent weeks, following the vaccine rollout, new cases within SNFs have been sharply lower than the weekly cases in their respective region at any previous point.

Furthermore, SNFs weekly confirmed cases in the Middle Atlantic (New York, New Jersey, and Pennsylvania) are down 94% since the week ending December 20 and continued to diverge from the overall weekly cases within the sub region (down 47%).

State Differences

Drilling deeper into state infection rates, New Jersey weekly cases have accelerated since February 21, while weekly cases within skilled nursing facilities in New Jersey continued to decelerate and remained low. In fact, case counts within SNFs in New Jersey are down 91% from December 20 through March 14 while weekly cases among the general population there are down only 30%. Other states that saw an increase in the last few weeks include Maryland, Maine, and Texas – none of these states reported an increase in cases within their skilled nursing facilities as of March 14.


As of March 14, over 40 million people in the U.S. have been fully vaccinated. Of this group, 7.6 million are in long-term care communities. The status of clinics shows that over 90% of skilled nursing facilities participating in the Walgreens and CVS vaccination programs have completed their clinics (data as of March 11). The U.S. is currently administering 2.8 million doses per day (as of March 31), and it is likely that the average vaccination rate will reach 3 million in the coming days. However, it is also important to consider vaccine hesitancy and put more efforts to promote vaccine literacy to more fully immunize those who are hesitant.

In summary, weekly COVID-19 cases within skilled nursing facilities continue to decline or flatten with relatively small increases across few states. Data suggest that vaccines are indeed effective, but it is important to keep track of the incidence of COVID-19 in skilled nursing facilities vs. U.S. since most of skilled nursing patients have been vaccinated.

To gain in-depth insights and track the week-over-week change rate for new resident cases and fatalities of COVID-19 within skilled nursing facilities at the state and county levels, visit You can also access the Skilled Nursing COVID-19 Tracker along with a rich trove of analysis and insight on the NIC COVID-19 Resource Center.

NIC is committed to provide timely data, analyses and insights that increase transparency and understanding of the sector, especially in this difficult time of COVID-19. We strongly support all actions and efforts that prioritize distribution of COVID-19 vaccines, testing, and availability of PPE to protect frontline workers and residents.

About Omar Zahraoui

Omar Zahraoui, Principal at the National Investment Center for Seniors Housing & Care (NIC), is a seniors housing research professional with expertise in providing quantitative analysis and insights on seniors housing & care market data; building new products and reporting capabilities, including dashboards and proformas for clients and internal stakeholders; and implementing new processes and data solutions. Prior to his current role, Zahraoui worked as a data analyst, at Calpine Corporation, supporting the development of new-business strategy initiatives, analyzing sales and financial data, and developing statistical modeling of consumers’ behaviors to drive business performance. Zahraoui holds a Bachelor’s degree in Business Administration with concentrations in Finance and Management, a Master in Corporate Finance from IAE Lyon School of Management at Jean Moulin Lyon III University in France, and a Master of Science in Management Information Systems and Data Analytics from Pace University.

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