Nursing Home Understaffing Worsens over Covid-19 Pandemic

Plummeting staffing levels have devastated the nursing home industry, according to an Associated Press analysis which found that one-third of US facilities have “fewer nurses and aides than before the Covid-19 pandemic.” One expert described the stark decline in staffing levels as “appalling.”

Federal data suggests that lower staffing ratios are correlated with poorer resident care, according to the AP. When a facility has fewer staffers, residents have less “contact with staff,” which in turn results in “scarcer help at mealtime, fewer showers and less repositioning to prevent painful bedsores.” The AP found in its analysis of nursing home data that a whopping “32 percent of nursing homes had worse staffing levels in June” than in March 2020, when the pandemic began.

A trade group representing long-term care facilities corroborated the federal data, telling the AP that its own data suggested 99% of nursing homes self-reported staffing shortages last month. It also found in June that “84% of nursing homes were losing revenue due to fewer patients coming from hospitals,” resulting in budget cuts. The group, known as the American Health Care Association, suggested that nursing homes may have to close down due to the labor shortages, calling for federal funding and other policy changes to help with hiring.

As the AP notes, the nursing home aides who care for residents are “overwhelming female and disproportionately members of minority groups,” and suffer high rates of churn and low pay rates. Over the course of the pandemic, aides reportedly left their jobs for roles in other industries—where the pay is better and the conditions more favorable—or otherwise lost their jobs. According to the report, critics of the industry, which includes many for-profit facilities and chains, have suggested that nursing home operators could address labor shortages by increasing their employees’ pay.

One victim of staffing shortages described by the AP was Teresa Dalton, a 74-year-old resident of a nursing home in Greensboro, California, As the pandemic started, her daughter would stop by Dalton’s window to see her. Over time she noticed “fewer and fewer aides,” with Dalton occasionally “left in a soiled diaper for hours,” her hair and nails uncared for and “a bedsore the size of a fist fester[ing] on her backside.” Her daughter told the AP that Dalton “would call out for help and no one would come.” She died in early 2021.

The AP’s analysis of nursing home staffing shortages over the Covid-19 pandemic is available here.