Steering, Rowing, and Bailing Water: The Role of Government Regulation and Ownership in COVID-19 Outcomes in Nursing Homes

Abstract

Studies of organizations with limited capacity operating in uncertain environments and hit by major crises can contribute important insights into public administration and management. Based on a large-N quantitative analysis of U.S. nursing homes, which became ground zero of the COVID-19 pandemic, this article examines the effect of government regulation, ownership, and several distinct management strategies on organizational capacity to curb the threats posed by the pandemic. Using hybrid datasets including nursing home facility data, administrator surveys, COVID-19 outcome data, a COVID-19 regulatory stringency index, and U.S. Census Bureau data, our analyses show that restrictive COVID-19 state government policies and public/nonprofit ownership help minimize environmental threats and reduce COVID-19 impacts. Yet the management strategies we examine – external management, innovation management, distributive leadership, and regulation management – have only modest effects on COVID-19 outcomes. These findings inform an understanding of how organizations operate at the margins and the impact of management on outcomes during a crisis.

Note:

Funding Information: No funding was received in support of this work.

Conflict of Interests: The authors report there are no competing interests to declare.

Keywords: Crisis Management, Public-Private Comparison, Health Regulation, COVID-19