The drop shows up specifically in PBJ-reported CNA hours in the 43 states that adopted some form of immunity law.
Tort Immunity and Nursing Home Staffing
Results: During the COVID-19 pandemic, approximately 80% of the US states abruptly implemented some form of tort immunity for nursing homes. Of 13 205 nursing homes in the analysis, 11 382 (86.2%) were subject to tort immunity and 1823 (13.8%) were not. Some of the laws included automatic end dates and others were indefinite. Nursing homes immune from tort liability exhibited less staff time per patient per day than nursing homes in states that did not grant tort immunity: a 2.5–percentage point (pp) reduction (95% CI, −4.3 to −0.6 pp) in overall daily staffing hours and a 1.2-pp reduction (95% CI, −2.3 to −0.1 pp) in overall staffing hours per patient per day with significant reduction in certified nursing assistant hours to patient per day (−2.0 pp; 95% CI, −3.5 to −0.5 pp).
Conclusions and Relevance: In this cohort study of US nursing homes, the introduction of immunity was associated with decreased overall nursing home staffing and staff per resident time. Registered nurse and licensed practical nurse to patient time was not statistically different.
— JAMA Health Forum, June 1, 2026
Horwitz, Jill R., et al. “Tort Immunity and Nursing Home Staffing.” JAMA Health Forum, vol. 7, no. 6, 2026, jamanetwork.com/journals/jama-health-forum/fullarticle/2849728.
A study of more than 13,000 US nursing homes concludes that those in states that adopted laws granting them immunity from COVID-related lawsuits operated with 2.5% less daily staff than those in states without those protections, potentially compromising patient care. Facilities immune from tort liability began providing less staff time per patient per day than those in states that didn’t grant such protections: a 2.5–percentage point (pp) reduction in overall daily staff hours and a 1.2-pp reduction in staffing hours per patient per day. The 2.5-pp decrease translated to, on average, nearly eight hours’ less staff time per day for clinical care and other duties.
— CIDRAP, June 2, 2026
When nursing homes lose their fear of getting sued for substandard care quality, they tend to make do with fewer caregivers, a new study reveals. The effect seems largely confined to certified nursing assistants, or CNAs, so it may not generalize to hospitals or provider organizations other than nursing homes.
— Health Exec, June 2, 2026
Nurse Aide Coverage Declined With COVID Immunity Laws
The 43 states that adopted some form of immunity law experienced a 2.5–percentage point drop in overall staffing hours compared to states without such laws, equaling about 5.2 minutes per patient per day, according to a study published in JAMA Health Forum Monday. Certified nurse aide staffing levels saw the only significant effects.
— McKnight’s Long-Term Care News, June 1, 2026
Nursing homes across the country had less staffing in states where legislatures granted the facilities immunity from COVID-19-related lawsuits filed by patients and their families, according to findings from a new UCLA-led study. Researchers examined data from 13,205 skilled nursing facilities; those in states with litigation immunity reduced staffing by 2.5 percent compared to facilities in states that did not pass similar protections for nursing homes. That reduction translated to an average of almost 8 hours per day of staff conducting clinical care and other duties per nursing home.
— UCLA Health, June 1, 2026
Researchers were surprised by the numbers, they said. “These policy changes are not associated with a defined monetary reward or fixed staffing target,” said Dr. David S. Zingmond, corresponding author and professor-in-residence at the UCLA David Geffen School of Medicine’s Division of General Internal Medicine and Health Services Research. “So the robust magnitude of change was surprising.” The study found that Certified Nursing Assistants (CNAs), who provide direct clinical care for patients, made up the primary group that saw reduced staffing. Hours worked by Registered Nurses (RNs), who often serve in administrative roles, stayed consistent in their staffing rates.
— BrightSurf, June 1, 2026
