Staffing Conditions In US Nursing Homes Before, During, And After The COVID-19 Pandemic

The COVID-19 pandemic exacerbated long-standing challenges in US nursing homes around staffing conditions, with nearly one in five nursing homes reporting severe staffing shortages during the early months of the pandemic in 2020. However, less is known about how nursing home staffing has evolved since the early part of the pandemic. This study used Payroll-Based Journal daily staffing data from the second quarter of 2018 through the fourth quarter of 2024 and other administrative data to examine trends in nursing home staffing levels and turnover before, during, and after the COVID-19 pandemic. Since the start of the pandemic, staffing hours per resident day decreased for all nurse types, especially in nursing homes associated with private equity funds or real estate investment trusts, during the late pandemic and postpandemic periods. Staff turnover decreased slightly during the pandemic and postpandemic periods for all nurse types. Policy makers should consider additional measures to ensure appropriate nursing home staffing levels going forward.