ArticleJournal of the American Medical Directors Association2020
Shortages of Staff in Nursing Homes During the COVID-19 Pandemic: What are the Driving Factors?
Article in Journal of the American Medical Directors Association, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 105 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
105 citing papers in PubMed, 4 syntheses or guidelines pooled it, 200 citations in OpenAlex.
- Changes in Federal and State Policies on Visitation Restrictions in Nursing Homes During the COVID-19 Pandemic.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025Pooled it
- Safety Outcomes in Same-Day Discharge Anastomotic Metabolic/Bariatric Surgery vs Regular Overnight Discharge Protocol: A Systematic Review and Meta-analysis.Obesity surgery · 2025Pooled it
- Psychological therapies for depression in older adults residing in long-term care settings.The Cochrane database of systematic reviews · 2024Pooled it
- A systematic review of the associations between care home ownership and COVID-19 outbreaks, infections and mortality.Nature aging · 2021Pooled it
- The Wells-Riley Model Revisited II: Parameter Uncertainty and Population Heterogeneity.Risk analysis : an official publication of the Society for Risk Analysis · 2026Article
- Impact of COVID-19 Lockdown on Depressive and Behavioral Symptoms in US Nursing Home Residents.Journal of the American Medical Directors Association · 2026Article
- Concordance Between the Minimum Data Set Kidney Impairment I1500 Item and eGFR Records in Nursing Homes.Journal of the American Medical Directors Association · 2026Article
- State Nursing Home Minimum Staffing Mandates: Increased Staff Levels, Minimal Impact On Finances And Closures, 2010-23.Health affairs (Project Hope) · 2026Article
- Development of Deep Learning Models for AI-Enhanced Telemedicine in Nursing Home Care.Journal of clinical medicine · 2026Article
- Learning from mental health provider perspectives about Veterans Affairs community living center mental health integration and teamwork during the pandemic.Psychological services · 2026Article
- Personnel shortages and the provision of long-term care: an empirical analysis of German nursing homes.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- Nursing home visitor policy and COVID-19 infection rates.American journal of infection control · 2025Article
- The Need to Incorporate Post-Acute Care Entities Into the National Disaster Medical System.Journal of the American College of Emergency Physicians open · 2025Review
- Factors Associated with Intent to Leave and Burnout among Canadian Nurses Amidst the COVID-19 Pandemic: A Quantitative Analysis of the Survey on Health Care Workers' Experiences During the Pandemic.The Canadian journal of nursing research = Revue canadienne de recherche en sciences infirmieres · 2025Article
- Medicaid Payments and Racial and Ethnic Disparities in Alzheimer Disease Special Care Units.JAMA network open · 2025Article
- Lifting Federal Visitation Restriction and COVID-19 Infections in Nursing Homes.Journal of the American Medical Directors Association · 2025Article
- Association of Racial and Ethnic Composition with Staff Levels in Nursing Homes: 2013-2019.Journal of the American Medical Directors Association · 2025Article
- Lessons from the pandemic: Relationship between patient visits and patient length of stay in California's health system.Health research policy and systems · 2025Article
- Nurse workforce change and metropolitan medically underserved areas in the United States.BMC health services research · 2025Article
- Supporting Nursing Staff During Crises: Impact of Organisational Support Measures and Resources in Job Satisfaction in German Nursing Homes.Geriatrics (Basel, Switzerland) · 2024Article
45 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesDuring the Coronavirus Disease 2019 (COVID-19) pandemic, US nursing homes (NHs) have been under pressure to maintain staff levels with limited access to personal protection equipment (PPE). This study examines the prevalence and factors associated with shortages of NH staff during the COVID-19 pandemic.
designWe obtained self-reported information on staff shortages, resident and staff exposure to COVID-19, and PPE availability from a survey conducted by the Centers for Medicare and Medicaid Services in May 2020. Multivariate logistic regressions of staff shortages with state fixed-effects were conducted to examine the effect of COVID-19 factors in NHs. SETTING AND
participants11,920 free-standing NHs. MEASURES: The dependent variables were self-reported shortages of licensed nurse staff, nurse aides, clinical staff, and other ancillary staff. We controlled for NH characteristics from the most recent Nursing Home Compare and Certification and Survey Provider Enhanced Reporting, market characteristics from Area Health Resources File, and state Medicaid reimbursement calculated from Truven data.
resultsOf the 11,920 NHs, 15.9%, 18.4%, 2.5%, and 9.8% reported shortages of licensed nurse staff, nurse aides, clinical staff, and other staff, respectively. Georgia and Minnesota reported the highest rates of shortages in licensed nurse and nurse aides (both >25%). Multivariate regressions suggest that shortages in licensed nurses and nurse aides were more likely in NHs having any resident with COVID-19 (adjusted odds ratio [AOR] = 1.44, 1.60, respectively) and any staff with COVID-19 (AOR = 1.37, 1.34, respectively). Having 1-week supply of PPE was associated with lower probability of staff shortages. NHs with a higher proportion of Medicare residents were less likely to experience shortages. CONCLUSIONS/IMPLICATIONS: Abundant staff shortages were reported by NHs and were mainly driven by COVID-19 factors. In the absence of appropriate staff, NHs may be unable to fulfill the requirement of infection control even under the risk of increased monetary penalties.
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