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COVID-19 in Nursing Homes: Who is leaving the Job?

Project status
Verena Cimarolli
Institution web page
Host institution
LeadingAge LTSS Center @UMass Boston
Team members
Natasha Bryant, Robyn Stone
Funding information (if funded)
Aging in America
Project Summary

The LTSS Center @UMass Boston formed a partnership with WeCare ConnectTM to study the impact of COVID-19 on the long-term services and supports workforce. WeCare ConnectTM is a program/service used by aging services providers at more than 1,000 locations to collect ongoing feedback from new and existing employees, and employees who resign. Managers use this information to develop real-time solutions that help reduce turnover and improve retention. WeCare ConnectTM administered Covid-19-related questions designed by the LTSS Center as part of its interview battery during May 2020. The questions were designed to assess internal and external stresses experienced by employees, as well as employees’ perceptions of the quality of employer COVID-19-related communication and of their preparedness to care for older adults during the pandemic.

Using data from the sub-sample of resigned and currently employed nursing home workers (n=1,730), the first aim of our study was to describe COVID-19-related stressors and to explore whether COVID-19-related stressors differed by resignation status (resigned vs. still employed). The second aim of the study was to investigate whether high-quality employer communication regarding COVID-19 (an organizational support) can mediate the impact of COVID-19-related stressors on nursing home workers’ decision to resign by optimizing workers’ preparedness to care for residents with COVID-19.

Results show that among both resigned and current employees, increased risk of COVID-19 transmission, increased workload demands, and understaffing were the most frequently mentioned stressful work challenges. Furthermore, in both groups, separation from family members, managing personal needs and family demands, and experiencing financial hardship emerged as the top three stressful non-work-specific challenges faced by employees. Chi-square analyses examining each of the stressful work-related and non-work-specific challenges based on resignation status yielded only one statistically significant result: unexpectedly, employees who resigned after May 2020 were less likely to have reported lack of childcare as a challenge in May 2020.

Regarding aim two, results from path analyses indicate that higher quality of communication and more optimal preparedness mediated the relationship between COVID-19-related stressors and likelihood of resignation. Specifically, higher levels of COVID-19-related stressors were indirectly associated with reduced likelihood of resigning through the paths of more optimal communication and preparedness. That is better quality communication was significantly associated with higher preparedness, and higher levels of preparedness were subsequently significantly associated with a reduced likelihood of resignation. Findings underscore the importance of effective employer communication during emergencies in nursing homes in reducing staff turnover.


Cimarolli, V. R., Bryant, N. S., Falzarano, F., & Stone, R. (2021). Job Resignation in Nursing Homes During the COVID-19 Pandemic: The Role of Quality of Employer Communication. Journal of Applied Gerontology41(1), 12-21.

Cimarolli, V. R., & Bryant, N. S. (2021). COVID-19: Experiences of Direct Care Workers in Aging Services. Research Brief. LeadingAge. Washington: DC.

Outputs / Expected Outputs

The research brief ‘COVID-19: Experiences of Direct Care Workers in Aging Services’ was published in February 2021.

The paper ‘Job Resignation in Nursing Homes During the COVID-19 Pandemic: The Role of Quality of Employer Communication’ was published in the Journal of Applied Gerontology in August 2021.

Please see the Publications & Other Outputs section below for both papers.


COVID-19: Experiences of Direct Care Workers in Aging Services - Research Brief
Job Resignation in Nursing Homes During the COVID-19 Pandemic The Role of Quality of Employer Communication


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COVID-19 in Nursing Homes: Who is leaving the Job?