140 facilities are currently experiencing outbreaks. This is defined as one case in a resident’s home and two or more cases in staff members over the past two weeks. It has increased from 113 a week earlier, which included 147 additional cases and 22 deaths within a week. Over two-thirds of the state’s nursing homes have experienced outbreaks, compared to 211. According to data from the Centers for Medicare & Medicaid, which regulates nursing homes, Mississippi has had the highest number of cumulative cases per 1,000 people since the pandemic started. This is 407 per capita. Alabama (404), Arkansas (395), and South Carolina (392) are close behind. Mississippi also has the fifth-highest death rate in nursing homes with 83 residents suffering from COVID-19. This is compared to just one thousand other states. New Jersey has 120 deaths per capita, which is the highest. Nearly half of long-term care residents have been infected with the coronavirus. This is 7,131 out of 16,000 total cases. 20% of those who are hospitalized by the virus die in nursing homes. The Mississippi State Department of Health began reporting outbreaks in nursing homes by facility in September and now relies on Medicare data to track them. After a court order, the state’s health department started listing facility names in June. Duplicate reporting was the reason the state switched to Medicare facility data. However, it still monitors active and cumulative outbreaks per county. Some nursing homes haven’t been submitting data to Medicare consistently. Ten Mississippi nursing homes had not submitted any data as of Thursday’s nationwide report. Medicare flagged nine of the 194 nursing homes that submitted data as failing “quality assurance,” which means their data may not be reliable due to inaccurate reporting. Nearly 10% of Mississippi’s COVID-19 nursing home data, even those that don’t submit or do not correctly, is unreliable. This means that the true rate among residents is unknown. The Pine Belt has seen the most nursing home cases. These 60-bed facilities have the highest rates in the state. Both facilities had 39 residents at the end of November, despite having a high death rate. Laurelwood Community Living Center saw the highest number of cases per capita during the pandemic. It had 1,846 cases per 1000 residents or an 185% infection rate according to Medicare data as at Nov. 1. Because more people have died or contracted the virus than there are current residents, the proportion of cases is higher than 100%. Medicare and public health professionals use the per-capita infection rate to assess relative COVID-19 burdens based on state facility sizes for long-term residents and nursing homes. The per capita rate is the same, but it’s calculated for every 100,000 residents. This allows you to determine hot-spots and analyze COVID-19 prevalence in each county. To create an accurate comparison with other facilities, it is calculated by multiplying the number of COVID-19 patients since March by the number of residents of the facility as reported to Medicare. 40% of those who contracted the virus at the Laurel facility died. The virus has been confirmed in 72 people and 17 staff members, with 38 deaths. As of Friday, the facility had 46 residents. Greene County’s Leakesville Rehabilitation and Nursing Center has reported 59 resident cases and 39 staff cases. This equates to 1,512 cases per 1,000 residents and a 29% death rate. Both Greene County and Jones County facilities reported conducting asymptomatic testing for residents and staff to check facility-wide exposure. This could increase numbers as more people are symptomatic. Two Mississippi facilities have a cumulative infection rate greater than 100%. This means that their resident count is higher than the current resident count due to residents dying or leaving. Since November, neither facility reported any new cases to Medicare. Through a spokesperson, the Laurel facility stated that it is “COVID-free” at the moment and added the following statement: “Taking Care of people in their time is what we do. This is what we have done since the inception of COVID and how we are responding to the challenge. We establish controlled checkpoints to ensure that all employees and visitors pass through the area after an COVID “outbreak”. We then create isolation areas for patients and any other cases. Positive team members are sent home to be quarantined and follow the CDC guidelines. Our team has a COVID Plan in which we work closely with our suppliers, state and local agencies to keep sufficient PPE supplies and equipment.” The Leaksville facility didn’t respond to a request for comment. According to data from nursing home inspections, seven of the ten Mississippi facilities that have the highest number of cases per capita are for-profit. Eight of them were cited by Medicare for insufficient Medicare coverage. According to the Mississippi Center for Investigative Reporting, for-profit nursing homes had three times as many COVID-19 deaths and twice the number of COVID-19-related cases than government facilities. While many Mississippi nursing homes have reported resource shortages, they are not able to test their residents. Only five nursing homes were unable to properly test their residents. However, less than 25% of facilities reported that they were able to test all residents and staff after a new patient, despite the Centers for Disease Control and Prevention’s recommendation. Surveillance testing, which is widely considered to be the best way to determine actual case burden and isolate spreading, was used by just 80 facilities. The state health department successfully stopped any spread of disease among nursing homes in May by testing all staff and residents. Many facilities opened again after the outbreaks had stabilized in early summer. As the community spread, nursing home cases also increased. Late July saw the state experience its daily peak in cases. 95% of state facilities were experiencing concurrent outbreaks by that time. Despite increasing cases and the effectiveness of surveillance testing, only two thirds of facilities test asymptomatic employees for surveillance of disease spreading. 25% of nursing homes report a shortage of nurses, while 10% of facilities don’t have enough N-95 masks to last a week. This is the gold standard for medical usage. Both of these shortages are indicative of long-standing resource constraints that limit nursing homes’ ability to combat the virus in their facilities. According to the American Health Care Association, more than half of all nursing homes in the country are losing money. National lobbying group for nursing home has changed their messaging on the topic, shifting from harsh cries for help in the early stages to focusing on safety measures to reopen facilities to visitors during the summer. The group now claims that nursing homes are being infected by a third wave of infection due to widespread community spread, especially in the South and Midwest. After front-line healthcare workers, nursing homes want to be first in line for COVID-19 vaccines. Mississippi has agreed to accommodate them. CVS and Walgreens have announced that they will be partnering with facilities for distribution. However, more details are still to come. Nov. 16 editor’s Note: This story has been updated to reflect Medicare’s most recent reporting date, the methodology behind per capita rates and the updated population of Laurelwood Community Living Center. Correction: This story has been corrected to clarify which facility is responsible for COVID-19 outbreaks. There are 211 nursing home in the state. However, 423 long-term care providers are licensed.