These outbreaks were identified through routine COVID-19 surveillance and by universal nursing home testing, which was conducted per the governor’s executive order* during April 21–( 4).

Moreover, such efforts should incorporate activities to improve the overall quality of life and care of nursing home residents and staff members and address the social and health inequities that have been recognized as a prominent feature of the COVID-19 pandemic in the United States ( 5).ĬOVID-19 surveillance data from the West Virginia Department of Health and Human Resources were used to identify all nursing home outbreaks during March 14–June 11, 2020. Efforts to mitigate outbreaks in high-risk nursing homes are necessary to reduce overall COVID-19 mortality and associated disparities.

Health departments could use star ratings to help identify priority nursing homes in their jurisdictions to inform the allocation of IPC resources. 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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