Nursing home staffing during the pandemic

More than any other sector in health care, nursing homes have suffered during the pandemic. Nursing home residents and staff account for 34% of all COVID-19 deaths, though they make up less than 1% of the population. As a result of COVID-19-related concerns, the number of Americans living in nursing home has dropped by more than 10%. The result is an unprecedented financial crisis for the industry, with nursing homes closing their doors, some laying off their employees, and others being unable to safely staff their facilities.

Nursing home hallway with an empty wheelchair parked outside an open door.

Working conditions in nursing homes have also worsened during the pandemic—first there was too little equipment to adequately protect staff, then too few tests to routinely test staff, residents, and visitors. Staff have been overburdened, overworked, and burned out during the pandemic. Numerous reports of staffing shortages have emerged in the press, and nursing homes report severe staff shortages in data they submit to the federal government.

However, a new study published in Health Affairs finds that staffing levels in nursing homes did not decrease during the pandemic. Using auditable daily payroll-based staffing data from all U.S. nursing homes, the total number of staff working in nursing homes fell, as did the number of nursing home residents. But when taken together—looking at the number of staff per nursing home resident—staffing levels actually increased, particularly in regions of the country hardest hit by COVID-19.

This story is by Rachel M. Werner and Norma B. Coe. Read more at Penn LDI.