Many state governments installed new regulations to govern nursing homes during the COVID-19 pandemic, but those state-level policies weren’t clearly linked to reduced transmission, according to new analysis published in JAMA Network Open.

Long-term care providers often complained of struggles keeping up with complicated and frequently changing state regulations during the peak of the pandemic — some of which were later criticized as ineffective or even dangerous by providers and policymakers alike.

The researchers focused on 1,500 healthcare policies implemented across the country between March 2020 and July 202. A majority applied to all healthcare settings, but 486 were specific to nursing homes. 

The policies examined were focused on policy goals such as reducing COVID transmission, expanding facilities’ capacity, temporarily relaxing administrative requirements and changing admissions and discharge practices.

The number of policies varied widely by state and had inconsistent results, the authors found.

“Higher numbers of policies at the state and territory levels were not consistently associated with reductions in community- or [nursing home]-level COVID-19 burden,” they wrote, “suggesting policy effectiveness may depend on implementation and compliance.”

New York had the highest number of healthcare policies implemented throughout the pandemic and also simultaneously had a high level of transmission. States as dissimilar as Pennsylvania and Montana had COVID case and death burdens similar to New York but far fewer state-level policies. 

“This information can be useful to show policymakers… how their actions and outcomes compared to other states,” lead author Patricia Stone, PhD, professor of health policy at Columbia University told McKnight’s

Stone emphasized Monday that followup research is needed to dig into the efficacy of specific policies. 

“We need to identify the policies that were most protective and reduced spread. We need to learn from this crisis so as to be better prepared for the next,” she said.

Retroactive analysis of how federal and state governments handled COVID regulations continues to roll in, with many provider complaints seemingly vindicated. A 900-page independent analysis of New Jersey’s early-pandemic policies noted that, while well-meaning, they were often ineffective and confused providers

The researchers were also concerned that only 43 of the nearly 1,400 total state policies were focused on home health. 

“We also found limited attention to HHAs compared with NHs, despite both settings serving vulnerable older populations,” they said. “This suggests a gap in public health planning, raising questions about resource allocation and prioritization among healthcare settings during pandemics.”