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The Paycheck Protection Program and its Effects on Staffing Patterns and the Outcomes of Residents Living with Dementia

Award Number: R01AG083173
ORGANIZATION: NATIONAL INSTITUTE ON AGING
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/15/2023
PERIOD OF PERFORMANCE END DATE: 04/30/2028

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The Paycheck Protection Program and its Effects on Staffing Patterns and the Outcomes of Residents Living with Dementia - Nursing home staff shortages are well known to be an important factor impacting both the quality of care that nursing home residents receive, their health outcomes, and healthcare worker outcomes. Staffing shortages are compounded by limited financial resources in nursing homes during public health emergencies, especially for smaller nursing homes. These staffing shortages disproportionately impact nursing home residents living with Alzheimer’s disease and related dementias (ADRD) as they require more time from staff compared to care for residents who do not have ADRD. As the number of Americans living with ADRD increases, the need for fully staffed nursing homes that can provide quality care for older adults living with ADRD is now more important than ever. During public health emergencies, direct funding to nursing homes has been proposed as an expedient way to prevent staffing losses and maintain safety standards for residents. One federal policy mechanism utilized by nursing homes in 2020 and 2021 was the Paycheck Protection Program (PPP). The PPP loan program offers a unique natural experiment by which to evaluate the effectiveness and efficacy of a program that directly funds small businesses and in the case of this project, nursing homes, to maintain safe staffing levels during public health emergencies. While PPP loans were effective overall at keeping workers on the payroll across all US small businesses, it is unclear if the effects of the program worked as well for nursing homes in socioeconomically deprived neighborhoods which prior work from our team showed have lower staffing rates. Using robust econometric methods and an exploratory sequential mixed methods approach, the proposed project will assess the effectiveness and equity of PPP funding by 1) examining changes in staffing patterns and resident outcomes among nursing homes that received the PPP loans compared to nursing homes that did not and evaluating whether changes in staffing patterns and outcomes were equitable for those with ADRD living in the most socioeconomically deprived facilities; 2) qualitatively exploring facility strategies, tools, and social contexts that promoted resilience to declines in staffing and ADRD resident outcomes after receipt of PPP, and 3) quantitatively assessing the extent to which resilience strategies, cultures, and behaviors identified in Aim 2 are reflected in administrative actions about staffing and care for residents with ADRD, and how actions differed by neighborhood context. The overall goal is to develop a framework by which to guide future nursing home responses to public health emergencies that will improve staff patterns and subsequent ADRD outcomes in the most socioeconomically deprived/lowest-resourced neighborhoods.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $740,689 )
2025	2025	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	000	3	7/30/2025	NON-COMPETING CONTINUATION	$740,689
														Subtotal = $740,689

Issue Date FY: 2024 ( Subtotal = $766,503 )
2024	2024	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	000	2	6/12/2024	NON-COMPETING CONTINUATION	$766,503
														Subtotal = $766,503

Issue Date FY: 2023 ( Subtotal = $740,150 )
2023	2023	NEW YORK UNIVERSITY	70 WASHINGTON SQ S	NEW YORK	NY	10012	NEW YORK	USA	Aging Research	000	1	8/2/2023	NEW	$740,150
														Subtotal = $740,150

Grand Total All Awards = $2,247,342

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The Paycheck Protection Program and its Effects on Staffing Patterns and the Outcomes of Residents Living with Dementia

Award Number: R01AG083173

ORGANIZATION: NATIONAL INSTITUTE ON AGING

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/15/2023

PERIOD OF PERFORMANCE END DATE: 04/30/2028

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