{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T08:04:38Z","timestamp":1779782678919,"version":"3.53.1"},"reference-count":51,"publisher":"Elsevier BV","issue":"11","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","jamda.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of the American Medical Directors Association"],"published-print":{"date-parts":[[2025,11]]},"DOI":"10.1016\/j.jamda.2025.105749","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T19:00:15Z","timestamp":1758135615000},"page":"105749","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Subcontracting, Employment Characteristics, and COVID-19 Infections Among Staff and Residents of Nursing Homes in Canada"],"prefix":"10.1016","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0743-8561","authenticated-orcid":false,"given":"Valentina","family":"Antonipillai","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rochelle","family":"Garner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Ng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Crea-Arsenio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Baumann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.jamda.2025.105749_bib1","first-page":"66","article-title":"What is old is new again: global issues influencing workers and their work in long-term care","volume":"17","author":"Berta","year":"2022","journal-title":"Healthc Policy"},{"key":"10.1016\/j.jamda.2025.105749_bib2","series-title":"Associations of Job Strain and Health: Differences Among Nurses and Personal Support Workers in Residential Care Homes During the COVID-19 Pandemic. (Under Review)","author":"Antonipillai","year":"2025"},{"key":"10.1016\/j.jamda.2025.105749_bib3","series-title":"Impacts of the COVID-19 Pandemic in Nursing and Residential Care Facilities in Canada","author":"Clarke","year":"2021"},{"key":"10.1016\/j.jamda.2025.105749_bib4","author":"Comas-Herrera"},{"key":"10.1016\/j.jamda.2025.105749_bib5","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.15957","article-title":"Risk factors associated with mortality among residents with coronavirus disease 2019 (COVID-19) in long-term care facilities in Ontario, Canada","volume":"3","author":"Fisman","year":"2020","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.jamda.2025.105749_bib6","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1177\/07334648221146252","article-title":"Experiences of healthcare workers in long-term care during COVID-19: a scoping review","volume":"42","author":"Boamah","year":"2023","journal-title":"J Appl Gerontol"},{"key":"10.1016\/j.jamda.2025.105749_bib7","series-title":"Women\u2019s mental health: Resistance and resilience in community and society","first-page":"19","article-title":"The mental health of health care workers: A Woman\u2019s issue?","author":"Armstrong","year":"2015"},{"key":"10.1016\/j.jamda.2025.105749_bib8","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.socscimed.2011.10.037","article-title":"Structural violence in long-term, residential care for older people: comparing Canada and Scandinavia","volume":"74","author":"Banerjee","year":"2012","journal-title":"Social Sci Med"},{"key":"10.1016\/j.jamda.2025.105749_bib9","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1007\/s12126-017-9288-4","article-title":"We\u2019re told, \u2018suck it up\u2019: long-term care workers\u2019 psychological health and safety","volume":"43","author":"Braedley","year":"2018","journal-title":"Ageing Int"},{"key":"10.1016\/j.jamda.2025.105749_bib10","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1017\/S071498081100016X","article-title":"Lifting the \u2018violence veil\u2019: examining working conditions in long-term care facilities using iterative mixed methods","volume":"30","author":"Daly","year":"2011","journal-title":"Can J Aging"},{"key":"10.1016\/j.jamda.2025.105749_bib11","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1177\/1048291118824872","article-title":"Breaking point: violence against long-term care staff","volume":"29","author":"Brophy","year":"2019","journal-title":"New Solut"},{"key":"10.1016\/j.jamda.2025.105749_bib12","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1097\/00001786-200007000-00009","article-title":"The relationship between staffing and quality in long-term care facilities: exploring the views of nurse aides","volume":"14","author":"Bowers","year":"2000","journal-title":"J Nurs Care Qual"},{"key":"10.1016\/j.jamda.2025.105749_bib13","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1093\/geront\/gnt167","article-title":"Influence of nurse aide absenteeism on NH quality","volume":"55","author":"Castle","year":"2015","journal-title":"Gerontologist"},{"key":"10.1016\/j.jamda.2025.105749_bib14","first-page":"3","article-title":"Work precarity, employment characteristics and health among Canada's long-term care and seniors' home workers during the COVID-19 pandemic","volume":"35","author":"Antonipillai","year":"2024","journal-title":"Health Rep"},{"key":"10.1016\/j.jamda.2025.105749_bib15","first-page":"971","article-title":"Comparing care regimes: worker characteristics and wage penalties in the global care chain","volume":"28","author":"Lightman","year":"2021","journal-title":"Social Polit Int Stud Gend State Soc"},{"key":"10.1016\/j.jamda.2025.105749_bib16","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1177\/0020731417730011","article-title":"\u201cIt\u2019s totally destroyed our life\u201d exploring the pathways and mechanisms between precarious employment and health and well-being among immigrant men and women in Toronto","volume":"48","author":"Premji","year":"2018","journal-title":"Int J Health Serv"},{"key":"10.1016\/j.jamda.2025.105749_bib17","doi-asserted-by":"crossref","first-page":"E527","DOI":"10.9778\/cmajo.20210338","article-title":"Precarious work among personal support workers in the greater Toronto area: a respondent-driven sampling study","volume":"10","author":"Pinto","year":"2022","journal-title":"CMAJ Open"},{"key":"10.1016\/j.jamda.2025.105749_bib18","doi-asserted-by":"crossref","first-page":"1657","DOI":"10.1111\/jgs.16509","article-title":"Essential long-term care workers commonly hold second jobs and double-or triple-duty caregiving roles","volume":"68","author":"Van Houtven","year":"2020","journal-title":"J Am Geriatr Soc"},{"key":"10.1016\/j.jamda.2025.105749_bib19","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1377\/hlthaff.2023.01101","article-title":"NHs increasingly rely on staffing agencies for direct care nursing: study examines NH staffing","volume":"43","author":"Bowblis","year":"2024","journal-title":"Health Aff"},{"key":"10.1016\/j.jamda.2025.105749_bib20","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2023.25993","article-title":"Examination of staffing shortages at US NHs during the COVID-19 pandemic","volume":"6","author":"Brazier","year":"2023","journal-title":"JAMA Netw Open"},{"key":"10.1016\/j.jamda.2025.105749_bib21","series-title":"Opening the black box: unpacking the use of nursing agencies in Canada","author":"Almost","year":"2024"},{"key":"10.1016\/j.jamda.2025.105749_bib22","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1139\/facets-2020-0056","article-title":"Restoring trust: COVID-19 and the future of long-term care in Canada","volume":"5","author":"Estabrooks","year":"2020","journal-title":"Facets"},{"key":"10.1016\/j.jamda.2025.105749_bib23","author":"Ireton"},{"key":"10.1016\/j.jamda.2025.105749_bib24","series-title":"Non-Profit LTC Homes are Being Gouged By Some Temporary Staffing Agencies. Retrieved From: Non-Profit ltc Homes are Being Gouged By Some Temporary Staffing Agencies- (advantageontario.ca)","year":"2023"},{"key":"10.1016\/j.jamda.2025.105749_bib25","series-title":"B.C Care Homes Propped up by for-Profit Staffing Agencies \u2018Near Breaking Point\u2019. CTV News. Retrieved From: B.C. Care Home Group Laments Reliance on for-Profit Nurses | CTV News","author":"Daflos","year":"2023"},{"key":"10.1016\/j.jamda.2025.105749_bib26","series-title":"\u2018It\u2019s corrosive. They\u2019re Price Gouging:\u2019 Agency Staffing Is Costing Hospitals, LTC Homes, Critics Say. Ottawa Citizen. Retrieved from: Agency Staffing Is Costing Hospitals and LTC Homes, Critics Say | Ottawa Citizen","author":"Laucius","year":"2022"},{"key":"10.1016\/j.jamda.2025.105749_bib27","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1016\/j.jamda.2023.08.008","article-title":"NHs\u2019 use of contract direct care staff before and during the COVID-19 pandemic","volume":"24","author":"Zhang","year":"2023","journal-title":"J Am Med Dir Assoc"},{"key":"10.1016\/j.jamda.2025.105749_bib28","first-page":"3","article-title":"Staffing levels and expenses in Canadian long-term care facilities by ownership status before and during the COVID-19 pandemic","volume":"36","author":"Antonipillai","year":"2025","journal-title":"Health Rep"},{"key":"10.1016\/j.jamda.2025.105749_bib29","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1177\/15271544241240489","article-title":"The trajectory of agency-employed nurses in Ontario, Canada: a longitudinal analysis (2011\u20132021)","volume":"25","author":"Drost","year":"2024","journal-title":"Policy Polit Nurs Pract"},{"key":"10.1016\/j.jamda.2025.105749_bib30","doi-asserted-by":"crossref","DOI":"10.1177\/23337214221090803","article-title":"Who\u2019s in the house? Staffing in long-term care homes before and during COVID-19 pandemic","volume":"8","author":"Vellani","year":"2022","journal-title":"Gerontol Geriatr Med"},{"key":"10.1016\/j.jamda.2025.105749_bib31","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1017\/S071498082100012X","article-title":"Long-term care facility workers\u2019 perceptions of the impact of subcontracting on their conditions of work and the quality of care: a qualitative study in British Columbia, Canada","volume":"41","author":"Banerjee","year":"2022","journal-title":"Can J Aging"},{"key":"10.1016\/j.jamda.2025.105749_bib32","doi-asserted-by":"crossref","first-page":"192","DOI":"10.3928\/19404921-20090428-01","article-title":"Use of agency staff in NHs","volume":"2","author":"Castle","year":"2009","journal-title":"Res Gerontological Nurs"},{"key":"10.1016\/j.jamda.2025.105749_bib33","doi-asserted-by":"crossref","first-page":"870","DOI":"10.1086\/368197","article-title":"Infectious disease outbreaks in NHs: an unappreciated hazard for frail elderly persons","volume":"36","author":"Strausbaugh","year":"2003","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.jamda.2025.105749_bib34","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1377\/hlthaff.2020.00957","article-title":"High nursing staff turnover in NHs offers important quality information: study examines high turnover of nursing staff at US NHs","volume":"40","author":"Gandhi","year":"2021","journal-title":"Health Aff"},{"key":"10.1016\/j.jamda.2025.105749_bib35","series-title":"CFNU Member Survey Report. Retrieved 65f2170954d430c73820ef18_2024 CFNU Members Surv - Web.pdf (website-files.com)","year":"2024"},{"key":"10.1016\/j.jamda.2025.105749_bib36","series-title":"Poll Finds More Than 60% Of Registered Practical Nurses Are Being Driven Out Of Healthcare. Retrieved from: Poll Finds More Than 60% Of Registered Practical Nurses Are Being Driven Out Of Healthcare - SEIU Healthcare","year":"2023"},{"key":"10.1016\/j.jamda.2025.105749_bib37","series-title":"Nursing and Residential Care Facility Survey (NRCFS). Retrieved from: Surveys And Statistical Programs - Nursing And Residential Care Facility Survey (NRCFS) (statcan.gc.ca)","year":"2022"},{"key":"10.1016\/j.jamda.2025.105749_bib38","doi-asserted-by":"crossref","first-page":"379","DOI":"10.3390\/healthcare13040379","article-title":"Agency nursing staff utilization and turnover in nursing homes: a longitudinal analysis","volume":"13","author":"Pradhan","year":"2025","journal-title":"Healthcare (Basel)"},{"key":"10.1016\/j.jamda.2025.105749_bib39","doi-asserted-by":"crossref","first-page":"E946","DOI":"10.1503\/cmaj.201197","article-title":"For-profit long-term care homes and the risk of COVID-19 outbreaks and resident deaths","volume":"192","author":"Stall","year":"2020","journal-title":"CMAJ"},{"key":"10.1016\/j.jamda.2025.105749_bib40","doi-asserted-by":"crossref","first-page":"e129","DOI":"10.1016\/S2666-7568(20)30065-9","article-title":"Factors associated with SARS-CoV-2 infection and outbreaks in long-term care facilities in England: a national cross-sectional survey","volume":"2","author":"Shallcross","year":"2021","journal-title":"Lancet Healthy Longev"},{"key":"10.1016\/j.jamda.2025.105749_bib41","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1016\/j.jamda.2020.06.016","article-title":"Is there a link between NH reported quality and COVID-19 cases? Evidence from California skilled nursing facilities","volume":"21","author":"He","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"10.1016\/j.jamda.2025.105749_bib42","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1177\/1527154420938707","article-title":"Nurse staffing and coronavirus infections in California NHs","volume":"21","author":"Harrington","year":"2020","journal-title":"Policy Polit Nurs Pract"},{"key":"10.1016\/j.jamda.2025.105749_bib43","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1016\/j.jamda.2021.02.004","article-title":"Characteristics of NHs by COVID-19 cases among staff: March to August 2020","volume":"22","author":"Ryskina","year":"2021","journal-title":"J Am Med Directors Assoc"},{"key":"10.1016\/j.jamda.2025.105749_bib44","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1177\/1077558720931652","article-title":"Two decades of NH compare: what have we learned?","volume":"78","author":"Tamara Konetzka","year":"2021","journal-title":"Med Care Res Rev"},{"key":"10.1016\/j.jamda.2025.105749_bib45","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1377\/hlthaff.2021.00323","article-title":"Larger NH staff size linked to higher number of COVID-19 cases in 2020: study examines the relationship between staff size and COVID-19 cases in NHs and skilled nursing facilities","volume":"40","author":"McGarry","year":"2021","journal-title":"Health Aff"},{"key":"10.1016\/j.jamda.2025.105749_bib46","series-title":"How do Canada\u2019s Provinces Compare on Restricting Movement of Care Workers During COVID-19? Retrieved from: How Do Canada\u2019s Provinces Compare on Restricting Movement Of Care Workers During COVID-19? - BC Care Providers Association","year":"2020"},{"key":"10.1016\/j.jamda.2025.105749_bib47","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.jamda.2021.01.068","article-title":"Impact of a public policy restricting staff mobility between NHs in Ontario, Canada during the COVID-19 pandemic","volume":"22","author":"Jones","year":"2021","journal-title":"J Am Med Dir Assoc"},{"key":"10.1016\/j.jamda.2025.105749_bib48","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/j.jinf.2020.07.027","article-title":"Increased risk of SARS-CoV-2 infection in staff working across different care homes: enhanced CoVID-19 outbreak investigations in London care homes","volume":"81","author":"Ladhani","year":"2020","journal-title":"J Infect"},{"key":"10.1016\/j.jamda.2025.105749_bib49","doi-asserted-by":"crossref","first-page":"10625","DOI":"10.1073\/pnas.0712014105","article-title":"Protecting residential care facilities from pandemic influenza","volume":"105","author":"Nu\u00f1o","year":"2008","journal-title":"Proc Natl Acad Sci"},{"key":"10.1016\/j.jamda.2025.105749_bib50","series-title":"1st Reading October 31, 2023. 43rd Legislature, 1st Session. Legislative Assembly of Ontario. Retrieved from: b144_e.pdf (ola.org)","year":"2023"},{"key":"10.1016\/j.jamda.2025.105749_bib51","author":"Watts"}],"container-title":["Journal of the American Medical Directors Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S152586102500266X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S152586102500266X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T07:34:06Z","timestamp":1779780846000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S152586102500266X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":51,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["S152586102500266X"],"URL":"https:\/\/doi.org\/10.1016\/j.jamda.2025.105749","relation":{},"ISSN":["1525-8610"],"issn-type":[{"value":"1525-8610","type":"print"}],"subject":[],"published":{"date-parts":[[2025,11]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Subcontracting, Employment Characteristics, and COVID-19 Infections Among Staff and Residents of Nursing Homes in Canada","name":"articletitle","label":"Article Title"},{"value":"Journal of the American Medical Directors Association","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jamda.2025.105749","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"Crown Copyright \u00a9 2025 Published by Elsevier Inc. on behalf of Post-Acute and Long-Term Care Medical Association.","name":"copyright","label":"Copyright"}],"article-number":"105749"}}