Effect of Shortages of Personal Protective Equipment and Staff on COVID-19 Infection in Nursing Homes: The Moderating Role of Quality

During the COVID-19 pandemic, more than twenty percent of the total COVID-19 fatalities in the United States originated in nursing homes. While previous studies underline the shortages of personal protective equipment and staff as potential causes that led to the COVID-19 infection, the generalizability of their findings is limited because they focus on certain states or cross- sectional data. This study empirically investigates these effects using nationwide data spanning 29 weeks. Using longitudinal nursing home-level data and panel regression analyses with fixed effects, this study shows that both shortages led to rise in cases in nursing home residents and staff in the United States. In addition, nursing home quality intensifies the unfavorable effect of staff shortage on staff infection. The results imply that there is a trade-off between improving nursing home quality and preventing staff infection in nursing homes. This study contributes to the literature on the healthcare industry and provides practical implications for stakeholders on how they can mitigate the spread of COVID-19 in nursing homes. First, it suggests nursing home administrators develop contingency plans for personal protective equipment. Second, the study proposes amending the laws on nursing homes’ minimum staffing levels.