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August 20, 2020Health Affairs277 citationsOpen Access

Severe Staffing And Personal Protective Equipment Shortages Faced By Nursing Homes During The COVID-19 Pandemic

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BMBrian E. McGarryDGDavid C. GrabowskiMBMichael L. Barnett

Key Points

  • To evaluate national prevalence and predictors of severe personal protective equipment (PPE) and direct care staffing shortages in US nursing homes during the COVID-19 pandemic.
  • Analyzed national registry data covering 98% of all US nursing homes from May to July 2020.
  • Assessed associations between shortage reports and facility-level characteristics, including resident and staff COVID-19 cases, proportion of Medicaid recipients, and quality ratings.
  • More than 20% (> 1 in 5) of US nursing homes reported a severe shortage of PPE and shortages of staff.
  • Deficits in staff and PPE did not show meaningful improvement between May and July 2020.
  • Shortages occurred at significantly higher rates in facilities with active COVID-19 cases, higher Medicaid census, and lower baseline quality scores.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic continues to devastate US nursing homes. Adequate personal protective equipment (PPE) and staffing levels are critical to protect nursing home residents and staff. Despite the importance of these basic measures, few national data are available concerning the state of nursing homes with respect to these resources. This article presents results from a new national database containing data from 98 percent of US nursing homes. We find that more than one in five nursing homes reports a severe shortage of PPE and any shortage of staff. Rates of both staff and PPE shortages did not meaningfully improve from May to July 2020. Facilities with COVID-19 cases among residents and staff, as well as those serving more Medicaid recipients and those with lower quality scores, were more likely to report shortages. Policies aimed at providing resources to obtain additional direct care staff and PPE for these vulnerable nursing homes, particularly in areas with rising community COVID-19 case rates, are needed to reduce the national COVID-19 death toll.

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Cite This Study

McGarry et al. (2020) studied this question.

synapsesocial.com/papers/69dbdbb1f7e0c66ced8368fehttps://doi.org/10.1377/hlthaff.2020.01269
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