Study Finds Nursing Home Staffing Hours Held Steady or Rose During Pandemic
Nursing Home Staffing Levels Did Not Change Significantly During COVID-19
Prior research and the popular press have anecdotally reported inadequate nursing home staffing levels during the COVID-19 pandemic. Maintaining adequate staffing levels is critical to ensuring high-quality nursing home care and an effective response to the pandemic. We therefore sought to examine nursing home staffing levels during the first nine months of 2020 (compared with the same period in 2019), using auditable daily payroll-based staffing data from the Centers for Medicare and Medicaid Services.
We found that the total number of hours of direct care nursing declined in nursing homes during the COVID-19 pandemic, as did the average nursing home census. When we accounted for changes in census, the number of nurse staff hours per resident day remained steady or, if anything, increased slightly during the pandemic. The observed increases in staff hours per resident day were small but concentrated in nursing homes operating in counties with high COVID-19 prevalence, in nursing homes with low Medicaid census (which typically have more financial resources), and in not-for-profit nursing homes (which typically invest more in staffing).
These findings raise concerns that although the number of staff hours in nursing homes did not decline, the perception of shortages has been driven by increased stresses and demands on staff time due to the pandemic, which are harder to quantify
Werner, Rachel M., and Norma B. Coe. “Nursing Home Staffing Levels Did Not Change Significantly During COVID-19.” Health Affairs, vol. 40, no. 5, 2021, pp. 795–801. Crossref, www.healthaffairs.org/doi/10.1377/hlthaff.2020.02351.
Nursing Home Staffing Hours Held Steady or Rose During Pandemic
In the May issue of Health Affairs, a new study of government data show nursing home staffing levels during the COVID-19 pandemic held steady or actually increased, dispelling at least in part prior research and coverage in the media that staffing hours declined during the crisis.
In “Nursing Home Staffing Levels Did Not Change Significantly During COVID-19,” report authors said an examination of staffing hours during the first nine months of 2020 (compared with the same period in 2019) used auditable daily payroll-based staffing data from the Centers for Medicare and Medicaid Services (CMS) to show a different story.
Connole, Patrick. “Nursing Home Staffing Hours Held Steady or Rose During Pandemic.” Provider Magazine, 24 May 2021, https://www.providermagazine.com/Articles/Pages/Nursing-Home-Staffing-Hours-Held-Steady-or-Rose-During-Pandemic.aspx
Health Affairs Study Clashes with Previous Reports on Nursing Home Shortages
Public policy journal Health Affairs this month reported a modest decline in nursing home staffing levels for the majority of 2020, rather than a drastic shortage in staff suggested by various news reports over the course of the year.
Taking data from the Centers for Medicare and Medicaid Services Payroll Based Journal (PBJ) system, Health Affairs found that there was no meaningful decline in staffing during the first nine months of the pandemic — in fact, there was a slight increase in staff hours per resident day to make up for the loss of family caregivers during visitor bans and daily activities.
Stulick, Amy. “Health Affairs Study Clashes with Previous Reports on Nursing Home Shortages.” Skilled Nursing News, 27 May 2021, skillednursingnews.com/2021/05/health-affairs-study-clashes-with-previous-reports-on-nursing-home-shortages.
