Mama used to say the only good thing about being sick is that you’ll feel better later — if you live.

Long-term care operators might be forgiven for giving a similarly mixed review to the disease caused by SARS-CoV-2.

Fortunately, the most damaging wrecking ball to ever hit this sector appears to be moving on. And the facilities that survived the carnage are starting to feel a bit better.

But lest we forget how bad COVID-19 was, some clear if obvious documentation appears in a recent issue of JAMA Network Open. While the findings will probably not surprise anyone, they do point to how dire staffing challenges were during the storm.

For the mixed-methods study, investigators conducted 156 interviews with 40 nursing home administrators in eight markets. To determine staffing practices, they used Centers for Medicare & Medicaid Services Long-term Care Facility Staffing Payroll Based Journal (PBJ) data.

And what did they find? Facility coping tactics during COVID-19 included additional overtime payments, greater reliance on staffing agencies and reductions in resident admissions.

The major takeaway: Higher staffing costs and fewer customers can lead to financial difficulties. Imagine that.

Still, it’s useful to have some documentation of the damage. After all, future generations may simply not believe how bad facilities had it during COVID-19.

In fact, by the looks of things, many observers don’t believe nursing homes are suffering much these days. Or at least, not enough.


·      Currently, CMS is putting the finishing touches on a first-ever requirement: mandatory staffing levels.

·      In recent weeks, we have also seen lawmakers send correspondence to CMS demanding the agency keep a closer eye on nursing home practices.

·      We’ve also seen a proposal from two Senators to set up a national advisory commission for long-term care. One slight problem: long-term care providers need not apply. Perhaps it should more accurately be called a national advisory commission for long-term care oversight?

Talk about trading one bag of guano for another.

Which reminds me of something else Mama used to say. People who think they can’t fall off the floor never lived through an earthquake.

John O’Connor is editorial director for McKnight’s.

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.