Long-term care and skilled nursing facilities are particularly vulnerable to COVID-19 infection; this increased risk may present other threats to patient safety. This survey of nursing homes in Italy found that one third of facilities reported at least one adverse event during the early weeks of the COVID-19 pandemic. Adverse events were more likely to occur in nursing homes with higher bed capacities, increased use of psychiatric drugs, and use of physical restraints. These findings can inform nursing homes creating mitigation plans.