Predicting COVID-19 Cases in Nursing Homes of California and Ohio: Does the Work Environment Matter?

Objective The cross-sectional study evaluates if the prepandemic work environments in nursing homes predict coronavirus disease 2019 (COVID-19) cases among residents and staff, accounting for other factors. Method Leveraging data from a survey of California and Ohio nursing homes (n = 340), we examined if Workplace Integrated Safety and Health domains — Leadership, Participation, and Comprehensive and Collaborative Strategies predicted cumulative COVID-19 cases among nursing home residents and staff. Results In Ohio, a 1-unit increase in Leadership score was associated with 2 fewer staff cases and 4 fewer resident cases. A 1-unit increase in Comprehensive and Collaborative Strategies score in California showed an average marginal effect of approximately 1 less staff case and 2 fewer resident cases. Conclusions These findings suggest that leadership commitment and interdepartment collaboration to prioritize worker safety may have protected against COVID-19 cases in nursing homes.