Working paper 01 — Draft complete
Schools Reopening and Nursing Home Staff Labor Supply
When schools closed during the pandemic, did childcare obligations pull certified nursing assistants out of nursing homes — and did reopening bring them back?
Austin Tucker · Harvard University · 2026
204,455
workers observed
1,658
facilities
21
states
01 — Why it matters
Nursing home staffing collapsed during COVID-19, with deadly consequences for residents. But it was hard to tell how much of the collapse came from infection risk, burnout, or wages — versus a quieter channel: the workers, overwhelmingly women, who suddenly had children at home all day. Isolating the childcare channel matters because it points to a very different set of policy fixes.
02 — How I answer it
I link the CMS Payroll-Based Journal — daily, worker-level staffing records — to district-by-district variation in school reopening modality (in-person, hybrid, remote). Because neighboring districts reopened differently for reasons unrelated to nursing home conditions, this variation lets me isolate the childcare channel from everything else happening in the pandemic labor market.
03 — What I find
A 10 percentage-point increase in in-person schooling raises CNA hours by 0.27 hours per worker-month, concentrated on the intensive margin — existing staff working more, rather than new staff returning.
04 — What it means for policy
Childcare access is long-term care workforce policy. When schools function as childcare infrastructure, closing them quietly drains the caregiving workforce that the most vulnerable populations depend on.