This study used existing datasets to examine variation across nursing homes in infection rates and deaths among residents and staff with an eye toward how to reduce future outbreaks. It also examined differences in these outcomes between traditional nursing homes and Green House homes.

The analyses presented here indicate that there are several factors that policymakers and nursing homes could employ in the future to reduce threats from infections like COVID-19.   Geographic location was associated with infection and death rates–with nursing homes in the Northeast and South, compared to the West, having higher resident and staff infections and higher resident death rates.  Nursing homes in the Northeast (but not the South) had a larger number of staff deaths.  The West, with Washington state being “ground zero” for COVID-19 infections would be expected to have higher rates, however, infection deficiency data showed before the pandemic, that nursing homes in the Northeast and South had a greater rate of deficiencies, which could explain some of the geographic variation.    In the analyses, the number of people with COVID-19 admitted to nursing homes were a consistent predictor of resident infection rates and deaths and the number of infections and deaths among staff. Preliminary analyses here indicate that residents fared better in Green House homes, compared to traditional nursing homes (but not staff).