REMPAR EHPAD study addresses environmental and managerial factors associated with an outbreak of COVID 19 in French Long Term Care Institutions in the spring of 2020. The survey used a mixed methodology, combining qualitative and quantitative approaches, with a questionnaire send to all identified institutions (n=501) and qualitative interviews with facility directors (n=21).

1. Declarative retrospective survey :

   A questionnaire was e-mailed to all identified institutions, with 3 reminders in one month. It included 39 questions concerning :

   • morbidity and mortality linked with COVID-19
   • structural features of the facility (location, architecture, residents characteristics)
   • human resources
   • crisis management (visits and circulation restrictions, personal protective equipment) A statistical analysis by logistic regression will be made, to identify explanatory variables for the occurrence of at least one COVID 19 infection among the residents.

2. Qualitative survey :

The investigators conducted semi-directed face-to-face interviews with facility directors. The investigators realized a purposive sample to assure maximal variability of the facilities (location, size, status, severity of the outbreak). The interview guide focused on structural, organizational, and human factors at stake in outbreak management, to identify incentives and obstacles associated with an easier crisis management.

Inclusion Criteria:

• Long Term Care Institution (EHPAD) in Britain, France,

Exclusion Criteria:

-

Long Term Care Institution (EHPAD) director