Researchers recommend that facilities establish emergency staffing plans in advance of future infectious disease events, and policymakers are urged to reconsider whether traditional per-resident staffing measures accurately capture workforce capacity during an outbreak.
Staffing Patterns in US Nursing Homes During COVID-19 Outbreaks
In this cohort study of nursing homes experiencing severe COVID-19 outbreaks, facilities experienced considerable staffing challenges during and after outbreaks. These results suggest the need for policy action to ensure facilities’ abilities to maintain adequate staffing levels during and after infectious disease outbreaks. Staffing reductions were driven by both temporary absences and permanent departures. Facilities were only able to partially offset these losses during outbreaks through increased new hires and the potentially costly use of contract staff and overtime. Because the use of contract hours and overtime declined after the peak outbreak weeks, staffing levels fell further after these weeks and did not recover even 16 weeks after the start of an outbreak, suggesting a lasting effect of severe outbreaks on facility staffing.
Shen, Karen, et al. “Staffing Patterns in US Nursing Homes During COVID-19 Outbreaks.” JAMA Health Forum, 22 July 2022. https://jamanetwork.com/journals/jama-health-forum/fullarticle/2794538
Nursing home staffs shrunk in the weeks and months after severe COVID-19 outbreaks, according to a new study, and federal data shows most facilities lost more than half their nurses and aides in the past year. The study found facilities have struggled to refill openings, particularly among certified nursing assistants, who provide most bedside care – findings that both complicate and underscore the need for President Joe Biden’s push to establish nationwide staffing-level requirements. “Will they come back? Or is this going to be a permanent shock to the caregiving workforce?” asked Karen Shen, the health economist who led the study.
— USA Today, August 04, 2022
Nursing Home Staffing Challenges Worse During COVID-19 Outbreaks
Nursing homes experienced significant staffing challenges during and after severe COVID-19 outbreaks due to temporary absences and permanent departures from workers, according to a study published in JAMA Health Forum. By week 16, the staff count was 5.1 percent below the mean due to the cumulative effect of additional departures relative to new hires. Certified nursing assistants (CNAs) saw the most significant decreases, with staff size down 4.7 percent of the mean staff count and 5.8 percent of mean hours
— RevCycle Intelligence, July 27, 2022
More ‘strike’ teams, policy improvements vital for nursing homes: report
Staffing levels may actually appear higher than normal during COVID outbreaks, but that belies increasingly intense staff-time needs, as well as the fact that worker levels generally do not recover after an outbreak, a veteran academic team of nursing home researchers found. As a result, policy makers should consider steps such as creating centralized ‘strike’ teams to supply temporary staffing assistance, as some states did, and other measures to help lift providers when a crisis hits.
— McKnight’s Long-Term Care, July 25, 2022
“Considerable staffing challenges suggest a potential need for policy action to ensure adequate staffing levels during nursing home outbreaks to protect resident health,” wrote authors Karen Shen, PhD; Brian E. McGarry, PT, PhD; David C. Grabowski, PhD; et al. “Facilities temporarily increased hiring, contract staff, and overtime to bolster staffing during outbreaks, but these measures did not fully replace lost staff, particularly certified nursing assistants,” the researchers wrote. “Finally, policy makers should question whether traditional staffing measures accurately capture the adequacy of staffing levels during a pandemic or if new measures are needed,” they concluded.
— McKnight’s Senior Living, July 25, 2022
Why Minimum Standards Are Not the Best Way to Monitor Staffing During Covid Outbreaks
Staff-to-resident ratios in nursing homes were confirmed to be stable or higher than pre-pandemic levels during Covid outbreaks, as declining resident census outpaced reductions in staffing. Such findings fly in the face of federal efforts to establish a minimum staffing ratio. A JAMA Health Forum study published on Friday found that facility managers were more likely to report staffing shortages during severe outbreaks, suggesting a per-resident staffing measure may not be the best benchmark for really understanding staffing capacity during outbreaks.
— Skilled Nursing News, July 24, 2022
