[…] In this study, we observed that one third of the included facilities (33.3%) reported at least one AE, with a total of 2,000 events. Most of the events involved only residents. A geographical trend was observed, with higher values in the North-West area compared to the South and Islands. Overall, 29.0% of the NHs reported at least one laboratory-confirmed case of Covid-19 among residents and staff members. When considering also influenza-like symptoms 67.7% of NHs reported at least one case. The NHs that reported AEs also reported a higher frequency of use of psychoactive drugs and physical restraint when compared to those that did not report any AEs. The strong association between these variables is likely a reflection of a critical context in the daily management of residents. An association between AEs and NHs with a higher number of beds and those with a higher number of residents hospitalized due to flu-like symptoms was also reported. All these variables contributed to define a pattern of the facilities who faced critical situations during the pandemic.