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The Association of Nursing Home Quality Ratings and Spread of COVID-19

Christianna S Williams, Ph.D., Qing Zheng, Ph.D., Alan J. White, Ph.D., and Ariana I. Bengtsson, MPP, Abt Global; Evan T Shulman, M.S., Kurt R Herzer, MD, Ph.D., and Lee A. Fleisher, MD, Centers for Medicare & Medicaid Services


June 2, 2021

As of January 10, 2021, nearly all nursing homes (93.6 percent) had reported at least one case of COVID-19 among their residents, more than three-quarters (76.9 percent) had reported at least one resident death, and the majority (83.5 percent) had experienced at least one week in the top decile of weekly incidence.

In this paper from Abt Global and the Centers for Medicare & Medicaid Services (CMS) for the Journal of the American Geriatrics Society, the authors demonstrate how higher nursing home quality ratings in the Nursing Home Care Compare, a tool Abt created for CMS, are associated with lower COVID-19 incidence and mortality.  The findings indicate that the data and methodology used in Nursing Home Care Compare’s star ratings capture important aspects of quality related to infection control, and that policymakers can use star ratings, along with information on county infection rates and nursing home payor mix, to identify nursing homes more at risk of COVID-19 or potentially other infectious outbreaks.