Compared with 1-star–rated (lowest rated) nursing homes, the odds of a COVID-19 outbreak were 87% lower among 2- to 3-star–rated facilities (adjusted odds ratio = 0.13, 95% confidence interval = 0.03–0.54) and 94% lower among 4- to 5-star–rated facilities (aOR = 0.06, 95% CI = 0.006–0.39). Outbreaks, defined as two or more cases within 14 days (with at least one resident case), were identified in 14 (11%) of 123 nursing homes. West Virginia’s census of nursing home outbreaks was used to examine associations between CMS star ratings and COVID-19 outbreaks.
On April 17, 2020, West Virginia became the first state to mandate and conduct COVID-19 testing for all nursing home residents and staff members to identify and reduce transmission of SARS-CoV-2 in these settings ( 4). Since 2008, the Centers for Medicare & Medicaid Services (CMS) has published health inspection results and quality ratings based on their Five-Star Quality Rating System for all CMS-certified nursing homes ( 3) these ratings might be associated with facility-level risk factors for COVID-19 outbreaks.
health departments worked to improve infection prevention and control (IPC) practices in nursing homes to prevent outbreaks and limit the spread of COVID-19 in affected facilities however, limited resources have hampered health departments’ ability to rapidly provide IPC support to all nursing homes within their jurisdictions. Nursing homes are high-risk settings for outbreaks of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) ( 1, 2).
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