Date of Conferral

8-11-2026

Date of Award

August 2026

Degree

Doctor of Healthcare Administration (D.H.A.)

School

Health Sciences

Advisor

Harold Griffin

Abstract

The COVID-19 pandemic intensified existing staffing challenges in U.S. nursing homes. Although previous studies have examined the effects of COVID-19 in nursing homes, limited research has examined the association between staff COVID-19 infection counts, staffing shortages, and resident COVID-19 deaths in New York State nursing homes. The purpose of this quantitative correlational study was to examine whether staff COVID-19 infection counts were associated with staffing shortages and resident COVID-19 deaths in New York State nursing homes. The study was guided by the Donabedian structure-process-outcome model. Analyses of the four research questions examined whether staff COVID-19 infection counts were associated with nursing, clinical, aide, and other staff shortages and resident COVID-19 deaths. Secondary data from the 2021 Centers for Medicare & Medicaid Services COVID-19 Nursing Home Dataset were analyzed using descriptive statistics, logistic regression, and Spearman's rank-order correlation. The findings showed that higher staff COVID-19 infection counts were significantly associated with staffing shortages across all staff categories (p < .05) and with resident COVID-19 deaths. These findings suggest that higher staff COVID-19 infection counts were associated with workforce disruption and poorer resident outcomes in New York State nursing homes. The findings support strengthening workforce planning, infection prevention, and emergency preparedness. By informing healthcare leaders and policymakers, this study supports positive social change by promoting safer care environments and strengthening protections for vulnerable nursing home residents and the frontline workforce.

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