Nursing Home Administrator Perspectives on the Role of State Guidance and Assistance in COVID-19 Response: A Rhode Island Case Study.

OBJECTIVE: The COVID-19 pandemic significantly impacted nursing homes in the United States. The Departments of Health within each state played a substantial role in providing guidance, issuing regulations, and supplying resources to help organizations respond to this health emergency. This research characterizes nursing home administrator perspectives on the role of Rhode Island's state agencies during the COVID-19 pandemic. DESIGN AND METHODS: This qualitative case study includes data from 19 repeated interviews with administrators of six nursing homes, conducted from July 2020-December 2021. In-depth, semi-structured interviews focused on their COVID-19 response, including infection control, vaccination, and interactions with state agencies, among other topics. Interview transcripts were qualitatively analyzed to determine overarching themes. RESULTS: Three themes emerged from analysis of interview transcripts: 1. Nursing home administrators described the regulatory guidance and communications from Rhode Island's Department of Health, which shaped their COVID-19 response. 2. Administrators discussed the tangible resources and support, such as personal protective equipment and staffing support, they received from the state. 3. Administrators identified the strengths and challenges in collaborating with state agencies and noted areas for improvement. CONCLUSIONS: Study findings have implications for how states help nursing homes respond during emergencies. While the vaccine has reduced the impact of COVID-19 on nursing home residents and staff, insights provided by administrators in this case study suggest best practices for improving future health emergency communications around guidance and regulations, and suggestions for necessary resources.