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Nursing Homes and COVID-19: A Crisis on Top of a Crisis

Author

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  • Brian E. McGarry
  • David C. Grabowski

Abstract

The COVID-19 pandemic has caused a staggering number of deaths and a great deal of suffering in U.S. nursing homes. The spread of the virus across the country introduced a new emergency to a long-term care sector that had already been in a state of crisis for multiple decades. Nursing homes have been underfunded and understaffed for years, often delivering inadequate care to their vulnerable residents, and they are financed and regulated separately from the rest of the U.S. health care system. During the pandemic, policy responses at both the federal and state levels were often slow and inadequate, partly due to a frayed infrastructure that is the result of years of inattention from policy-makers. We review the state of nursing home care in the United States and the impacts of the pandemic, and we argue that a package of broader policy and delivery reforms should be implemented to improve the care of older adults that could help to prevent future tragedy.

Suggested Citation

  • Brian E. McGarry & David C. Grabowski, 2021. "Nursing Homes and COVID-19: A Crisis on Top of a Crisis," The ANNALS of the American Academy of Political and Social Science, , vol. 698(1), pages 137-162, November.
  • Handle: RePEc:sae:anname:v:698:y:2021:i:1:p:137-162
    DOI: 10.1177/00027162211061509
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    References listed on IDEAS

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    1. Elizabeth J. Williamson & Alex J. Walker & Krishnan Bhaskaran & Seb Bacon & Chris Bates & Caroline E. Morton & Helen J. Curtis & Amir Mehrkar & David Evans & Peter Inglesby & Jonathan Cockburn & Helen, 2020. "Factors associated with COVID-19-related death using OpenSAFELY," Nature, Nature, vol. 584(7821), pages 430-436, August.
    2. Min M. Chen & David C. Grabowski, 2015. "Intended and Unintended Consequences of Minimum Staffing Standards for Nursing Homes," Health Economics, John Wiley & Sons, Ltd., vol. 24(7), pages 822-839, July.
    3. David C. Grabowski, 2004. "A Longitudinal Study of Medicaid Payment, Private-Pay Price and Nursing Home Quality," International Journal of Health Economics and Management, Springer, vol. 4(1), pages 5-26, March.
    4. Jeffrey R. Brown & Amy Finkelstein, 2011. "Insuring Long-Term Care in the United States," Journal of Economic Perspectives, American Economic Association, vol. 25(4), pages 119-142, Fall.
    5. Foster, Andrew D. & Lee, Yong Suk, 2015. "Staffing subsidies and the quality of care in nursing homes," Journal of Health Economics, Elsevier, vol. 41(C), pages 133-147.
    6. Jing Guo & R. Tamara Konetzka & Elizabeth Magett & William Dale, 2015. "Quantifying Long-Term Care Preferences," Medical Decision Making, , vol. 35(1), pages 106-113, January.
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