Key Points

Findings In this cross-sectional study of 15 307 US nursing homes, approximately 44% of COVID-19 cases and 40% of COVID-19 deaths that occurred before the start of reporting were not reported in the first NHSN submission in sample states, suggesting there were more than 68 000 unreported cases and 16 000 unreported deaths nationally.

Meaning These findings suggest that federal NHSN data understate total COVID-19 cases and deaths in nursing homes and that using these data without accounting for this issue may result in misleading conclusions about the determinants of nursing home outbreaks.

Abstract

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