COVID-19 outbreaks pose staffing challenges to nursing homes

Nursing home facilities experience considerable staffing challenges during and after severe COVID-19 outbreaks, according to a study published online July 22 in JAMA Health Forum.

Karen Shen, Ph.D., from the Bloomberg School of Public Health at Johns Hopkins University in Baltimore, and colleagues quantified changes in nursing home facility staffing during and after a severe COVID-19 outbreak using daily staffing payroll data. The analysis included data from 2,967 nursing homes experiencing severe COVID-19 outbreaks from June 14, 2020, to Jan. 1, 2021.

The researchers found that severe outbreaks were associated with a statistically significant drop in nursing staffing levels owing to elevated absences and departures. When average new cases peaked (approximately four weeks after an outbreak's start), staffing hours were 2.6 percent of the mean below preoutbreak levels, despite facilities taking substantial measures to bolster staffing through increased hiring and the use of contract staff and overtime. Staffing declined further in later weeks (16 weeks after an outbreak's start) after temporary measures expired, and staffing hours were 5.5 percent of the mean below preoutbreak levels. Certified nursing assistants experienced the greatest staffing declines.

"These results suggest the need for policy action to ensure facilities' abilities to maintain adequate staffing levels during and after infectious disease outbreaks," the authors write.

Two authors disclosed financial ties to the health care industry.