Characteristics of nursing homes associated with COVID-19 outbreaks and mortality among residents in Victoria, Australia

Objective To determine nursing home characteristics associated with COVID-19 outbreak, outbreak size and mortality, during the second wave in Victoria, Australia. Method Population-based cross-sectional study of all nursing homes in Victoria between 7 July and 13 November 2020. Results There were one or more resident cases of COVID-19 in 9.7% of nursing homes (74/766). COVID-19 intrusion was more likely in larger metropolitan facilities, privately owned by large chains, with a past history of regulatory non-compliance, located close to high-risk industry. Larger outbreaks were associated with homes in metropolitan areas, accommodating 91 or more residents, with shared rooms, owned by private providers operating many (11 or more) facilities. The highest case-fatality rates were observed in homes owned by not-for-profit providers operating many facilities, located close to high-risk industry. Conclusion Stratifying nursing homes according to characteristics associated with morbidity and mortality can inform risk management, prioritising emergency responses and optimising future nursing home operations.

Automated summary

The study found that COVID-19 outbreaks were more likely to occur in larger metropolitan nursing homes owned by large chains with a history of regulatory non-compliance and located close to high-risk industries. Larger outbreaks were associated with nursing homes in metropolitan areas accommodating 91 or more residents with shared rooms, owned by private providers operating many facilities. The highest case-fatality rates were observed in homes owned by not-for-profit providers operating multiple facilities and located near high-risk industries.