Staffing Conditions In US Nursing Homes Before, During, And After The COVID-19 Pandemic

Area of Science:

• Gerontology
• Public Health
• Healthcare Management

Background:

• The COVID-19 pandemic highlighted and worsened pre-existing staffing challenges in US nursing homes.
• Severe staffing shortages were reported by nearly 20% of facilities in early 2020.
• Limited data exists on nursing home staffing trends after the initial pandemic phase.

Purpose of the Study:

• To examine trends in nursing home staffing levels and turnover.
• To analyze changes before, during, and after the COVID-19 pandemic.
• To identify disparities in staffing based on facility ownership.

Main Methods:

• Utilized Payroll-Based Journal daily staffing data from Q2 2018 to Q4 2024.
• Incorporated other administrative data for comprehensive analysis.
• Examined staffing hours per resident day and staff turnover rates.

Main Results:

• Staffing hours per resident day decreased for all nurse types since the pandemic's start.
• This decrease was more pronounced in nursing homes owned by private equity or real estate investment trusts during late and post-pandemic periods.
• Staff turnover saw a slight decrease across all nurse types during and after the pandemic.

Conclusions:

• Nursing home staffing levels, particularly hours per resident day, have declined post-pandemic.
• Investor-owned facilities experienced greater reductions in staffing.
• Policymakers need to implement further measures to ensure adequate nursing home staffing.