Changes in nursing home staffing instability throughout the COVID-19 pandemic

Nursing homes play a crucial role in providing 24-hour long-term care to approximately 1.4 million Americans. Despite their importance, maintaining adequate staffing in nursing homes has been a persistent challenge, which was significantly exacerbated by the COVID-19 pandemic. High nursing home staffing instability (i.e. daily variation) is associated with poor resident outcomes.

While it is known that nursing homes had difficulty maintaining adequate average staffing during the COVID-19 pandemic, it is not known how staffing instability was impacted by the pandemic, and if it was impacted, if rates of instability have returned to pre-pandemic levels once the pandemic abated. By examining trends in staffing instability in the years before  the pandemic through the post-pandemic period (2017 – 2023), this study examines changes in nursing home staffing instability during the COVID-19 pandemic and investigates whether instability patterns differed by nursing home characteristics.