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The incidence rate ratios (IRRs) for COVID-19 and its deaths among the nursing facility users were 1.07 (95% confidence interval (CI), 0.82-1.39) and 1.97 (95%CI, 0.92-3.91) compared with the community-dwelling older adults. Four clusters, which had more than 10 COVID-19 cases, accounted for 60% (65/109) of the overall cases by the HCWs and the users. The prevention of COVID-19 clusters is important to reduce the number of COVID-19 cases and deaths among the nursing facility population. The prevention of COVID-19 clusters is important to reduce the