ArticleHealth affairs (Project Hope)2021
Larger Nursing Home Staff Size Linked To Higher Number Of COVID-19 Cases In 2020.
Article in Health affairs (Project Hope), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis 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.
The trial behind it
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
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of long-term care facility characteristics associated with COVID-19 outcomes.Journal of the American Geriatrics Society · 2021Pooled it
- Nursing home visitor policy and COVID-19 infection rates.American journal of infection control · 2025Article
- Disentangling the force of infection of SARS-CoV-2 in Dutch long-term care facilities.BMC public health · 2025Article
- Lifting Federal Visitation Restriction and COVID-19 Infections in Nursing Homes.Journal of the American Medical Directors Association · 2025Article
- Measures to Prevent and Control COVID-19 in Skilled Nursing Facilities: A Scoping Review.JAMA health forum · 2025Article
- Healthy ageing in long-term care? Lessons learned from the COVID-19 pandemic: a position paper.Primary health care research & development · 2024Article
- Drivers of COVID-19 Outcomes in Long-Term Care Facilities Using Multi-Level Analysis: A Systematic Review.Healthcare (Basel, Switzerland) · 2024Review
- Nursing Homes Increasingly Rely On Staffing Agencies For Direct Care Nursing.Health affairs (Project Hope) · 2024Article
- Association between Timing of Clinical Evaluation by a Physician or Advanced Practitioner and Risk of Rehospitalization in Older Adults Admitted to a Skilled Nursing Facility Following Hospitalization: A Cohort Study.Journal of the American Medical Directors Association · 2023Article
- Impact of the first COVID-19 epidemic wave in a large French network of nursing homes: a cross-sectional study.BMC geriatrics · 2023Observational
- COVID-19 pandemic in long-term care: An international perspective for policy considerations.International journal of nursing sciences · 2023Article
- Covid-19 Surveillance Testing and Resident Outcomes in Nursing Homes.The New England journal of medicine · 2023Article
- Dual impacts of Medicare payment reform and the COVID-19 pandemic on therapy staffing in skilled nursing facilities.Journal of the American Geriatrics Society · 2023Article
- Strategies to Increase Willingness to Receive a COVID-19 Vaccine among Nursing Home Staff.Infectious disease reports · 2022Article
- Excess Mortality Among Assisted Living Residents With Dementia During the COVID-19 Pandemic.Journal of the American Medical Directors Association · 2022Article
- Managing the Impact of COVID-19 in Nursing Homes and Long-Term Care Facilities: An Update.Journal of the American Medical Directors Association · 2022Article
- Perspectives of certified nursing assistants and administrators on staffing the nursing home frontline during the COVID-19 pandemic.Health services research · 2022Article
- Southeastern United States Predictors of COVID-19 in Nursing Homes.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2022Article
- Quantifying Risk for SARS-CoV-2 Infection Among Nursing Home Workers for the 2020-2021 Winter Surge of the COVID-19 Pandemic in Georgia, USA.Journal of the American Medical Directors Association · 2022Article
- Incidence, Mortality, and Risk Factors of COVID-19 in Nursing Homes.Epidemiologia (Basel, Switzerland) · 2022Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
Staff in skilled nursing facilities (SNFs) are essential health care workers, yet they can also be a source of COVID-19 transmission. We used detailed staffing data to examine the relationship between a novel measure of staff size (that is, the number of unique employees working daily), conventional measures of staffing quality, and COVID-19 outcomes among SNFs in the United States without confirmed COVID-19 cases by June 2020. By the end of September 2020, sample SNFs in the lowest quartile of staff size had 6.2 resident cases and 0.9 deaths per 100 beds, compared with 11.9 resident cases and 2.1 deaths per 100 beds among facilities in the highest quartile. Staff size, including staff members not involved in resident care, was strongly associated with SNFs' COVID-19 outcomes, even after facility size was accounted for. Conventional staffing quality measures, including direct care staff-to-resident ratios and skill mix, were not significant predictors of COVID-19 cases or deaths. Reducing the number of unique staff members without decreasing direct care hours, such as by relying on full-time rather than part-time staff, could help prevent outbreaks.
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Registered trials
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