Unjust Enrichment

According to an NIA-funded study published in JAMA Network Open, nursing homes that received a Paycheck Protection Program (PPP) loan during COVID-19 had a slight increase in staffing hours compared to facilities that did not receive loans. Most of the money went directly into corporate pockets. 

The COVID-19 pandemic highlights many problems within the nursing home sector in the United States, including staffing shortages that threaten the quality of life for residents. In May 2020, more than one in five U.S. nursing homes reported staffing shortages, often as a result of insufficient working hours for nurse aides, licensed nurses, and other clinical staff. In response, state and federal agencies, such as the National Academies of Sciences, Engineering, and Medicine, advocated for a funding program to provide a specific percentage of funds for staffing. 

The PPP is a forgivable loan program that requires recipients to allocate 60%-75% of their loan toward staffing to qualify for forgiveness, which was enacted by the U.S. Congress during the pandemic. Based on metrics from Nursing Home Care Compare, nursing homes that received the PPP loan were more likely to have a higher percentage of Medicaid-funded residents and lower quality of care levels. 

Researchers also analyzed the differences in staffing hours between facilities that received PPP loans and those that did not. Results showed that nursing homes who received PPP loans had an increase of staffing hours for CNAs and Lps, but not RNs. The study authors believe that nursing homes increase the hours of CNAs and LPs because they are less expensive than RNs. This ultimately increased hours while having limited funding as well.

All in all, the study results suggest that the PPP loan is related to an increase in staffing hours for CNAs and LPs. However, PPP loans were only temporary, and nursing home staffing shortages existed long before the pandemic. There needs to be an increase in support from federal and state entities to create incentives for nursing homes to invest in the frontline staff.