Anna Amirkhanyan, American University – State COVID-19 Restrictions Helped Contain the Virus in Nursing Homes

Nursing homes were greatly affected by the COVID-19 pandemic, so what did we learn from the pandemic?

Anna Amirkhanyan, professor of public administration and policy at the School of Public Affairs at American University, digs into the data.

Anna Amirkhanyan is a professor of public administration and policy at American University. Her research focuses on public and nonprofit management, organizational performance, public-private differences, and citizen participation. Her articles have been published in various peer-reviewed outlets such as the Journal of Public Administration Research and Theory (J-PART), Public Administration Review, the Journal of Policy Analysis and Management, the Nonprofit and Voluntary Sector Quarterly, and others.

State COVID-19 Restrictions Helped Contain the Virus in Nursing Homes

After the termination of the national public health emergency in 2023, government agencies began returning to normalcy and reflecting on the lessons learned from the COVID-19 experience. My recent article published in the International Public Management Journal and coauthored with Ken Meier, William Prince, and Miyeon Song shows that state regulations were strongly linked to COVID-19 outcomes in U.S. nursing homes. 

Nursing homes were the ground zero of the recent pandemic, accounting for a significant share of the loss of human life. To study this, we combined five large datasets measuring COVID cases and deaths in all U.S. nursing homes hoping to identify the factors that explained these outcomes. 

States implemented a range of restrictions related to travel, stay-at-home orders, gathering size, school, workplace, or transit closings. We discovered that, in 2020, the severity of these restrictions was closely linked to COVID-19 cases in nursing homes.   

Tighter state regulations put pressure on individuals and organizations, helping minimize the exposure of nursing home leadership, staff, and residents and ensuring more reliable levels of staffing and resources dedicated to core functions.

We also found that governmental and nonprofit nursing homes performed, on average, significantly better in terms of COVID-19 cases and deaths than for-profit homes.  These findings suggest that a stronger orientation toward quality (as opposed to profit) may have resulted in investments in resources and policies that improved the resilience of organizations during crises.