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 crises can contribute important insights into public administration. Based on a large-N quantitative analysis of US 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 data, administrator surveys, COVID-19 outcome data, a COVID-19 regulatory stringency index, and US Census Bureau data, our analysis shows that restrictive COVID-19 state government policies and public/nonprofit ownership help minimize environmental threats and reduce COVID-19 impacts. Yet management strategies—external management, innovation management, distributive leadership, and regulation management—have only modest effects on COVID-19 outcomes. These findings inform our understanding of how organizations operate at the margins and the impact of management on outcomes during a crisis.