The impact of COVID-19 on long-term care facilities and their staff in Israel: Results from a mixed methods study

Aim: We examined the impact of COVID-19 regarding organizational and management issues at Israeli long-term care facilities. Background: Residents in facilities were very vulnerable to significant disease and mortality during COVID-19. Methods: A survey of 52 facilities in Israel was conducted in 2020, consisting of closed- and open-ended questions. Mixed methods were used to analyze data both quantitatively and qualitatively. Results: Three main effects emerged: worsened financial status of long-term-care facilities resulting from high expenditures for preventive measures and reduced revenue due to deaths and fewer resident admissions, increased workload due to decreased workforce and additional duties, and negative mental health effects on staff because of increased workload and the conflict between maintaining good clinical practice and following COVID-19 regulations. Conclusion: The development of government directives needs to take into account potential conflicts between the directives and quality care principles and to provide a balanced approach that assures humane care. Facilities and their staff lacked adequate pandemic-related guidance and support. Implications for Nursing Management: The results highlight the need to address staff shortages and training, to provide more support and clearer guidance to facilities and their staff, and to devise a framework and strategies for future health crises.