Nursing homes are high-risk settings for Covid-19 outbreaks. The Centers for Medicare & Medicaid Services (CMS) publishes star quality ratings of all CMS-certified nursing homes.
During March–June 2020, 14 (11%) of 123 West Virginia nursing homes experienced Covid-19 outbreaks. Compared with 1-star–rated (lowest rating) nursing homes, the odds of a Covid-19 outbreak were 87% lower among 2- to 3-star–rated facilities and 94% lower among 4- to 5-star–rated facilities. CMS star ratings can serve as proxy indicators for Covid-19 outbreak risk; health departments could use them to identify priority nursing homes and inform the allocation of infection prevention and control resources.