Over the past 25 years, research has consistently shown that nurse staffing levels and skill mix are critical to patient outcomes. Yet hospitals often underinvest in nurse staffing because nurse labor is treated as a cost rather than a source of revenue under the current payment system. To address this, the newly established Commission for Nurse Reimbursement (2025) is exploring whether reimbursing nursing services could change hospitals’ financial incentives and ultimately improve staffing levels.

This article explores whether higher hospital resource levels were associated with higher nurse staffing before (2019) and then during (2020–2022) the COVID-19 pandemic, a period of increased funding to most US hospitals.