Characteristics of U.S. Nursing Homes with COVID-19 Cases

Hannah R. Abrams, Lacey Loomer, Ashvin Gandhi, David C. Grabowski

Research output: Contribution to journalArticlepeer-review

37 Scopus citations


BACKGROUND/OBJECTIVES: The 2019 coronavirus disease (COVID-19) has been documented in a large share of nursing homes throughout the United States, leading to high rates of mortality for residents. To understand how to prevent and mitigate future outbreaks, it is imperative that we understand which nursing homes are more likely to experience COVID-19 cases. Our aim was to examine the characteristics of nursing homes with documented COVID-19 cases in the 30 states reporting the individual facilities affected. DESIGN: We constructed a database of nursing homes with verified COVID-19 cases as of May 11, 2020, via correspondence with and publicly available reports from state departments of health. We linked this information to nursing home characteristics and used regression analysis to examine the association between these characteristics and the likelihood of having a documented COVID-19 case. SETTING: All nursing homes from 30 states that reported COVID-19 cases at the facility-level. PARTICIPANTS: Nursing home residents in states reporting data. MEASUREMENTS: Whether a nursing home had a reported COVID-19 case (yes/no), and conditional on having a case, the number of cases at a nursing home. RESULTS: Of 9,395 nursing homes in our sample, 2,949 (31.4%) had a documented COVID-19 case. Larger facility size, urban location, greater percentage of African American residents, non-chain status, and state were significantly (P <.05) related to the increased probability of having a COVID-19 case. Five-star rating, prior infection violation, Medicaid dependency, and ownership were not significantly related. CONCLUSION: COVID-19 cases in nursing homes are related to facility location and size and not traditional quality metrics such as star rating and prior infection control citations. J Am Geriatr Soc 68:1653-1656, 2020.

Original languageEnglish (US)
Pages (from-to)1653-1656
Number of pages4
JournalJournal of the American Geriatrics Society
Issue number8
StatePublished - Aug 1 2020
Externally publishedYes

Bibliographical note

Funding Information:
Lacey Loomer reported doing contract work for the American Health Care Association. Ashvin Gandhi reported that he has received funding from the National Institute on Aging (NIA) through Grant No. T32-AG000186 to the National Bureau of Economic Research, the National Institute of Health Care Management, the Harvard Institute for Quantitative Social Science, the Harvard Lab for Economic Applications and Policy, the UCLA Ziman Center for Real Estate, the UCLA Fink Center for Finance & Investment, and the UCLA Morrison Center for Marketing and Data Analytics. David Grabowski reported that he receives research support from grants from the NIA, the Agency for Healthcare Research and Quality, the Arnold Foundation, and the Warren Alpert Foundation. He has served as a paid consultant to Vivacitas; served on the Scientific Advisory Committee for naviHealth; and received fees from the Medicare Payment Advisory Commission, Compass Lexecon, Analysis Group, the Research Triangle Institute, and Abt Associates. The authors have declared no conflicts of interest for this article. All authors made substantial contributions to conception and design, and/or acquisition of data, and/or analysis and interpretation of data; participated in drafting the article or revising it critically for important intellectual content; and gave final approval of the version to be submitted. No sponsor.

Publisher Copyright:
© 2020 The American Geriatrics Society


  • COVID-19
  • long-term care
  • nursing homes

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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