About

Dr. Elizabeth (Betsy) White, APRN, PhD, is an Assistant Professor of Health Services, Policy, and Practice at the Brown University School of Public Health within the Center for Gerontology and Health Care Research. Her research focuses on care quality and outcomes in long-term care, with a primary interest in understanding how factors affecting the nursing and primary care workforces impact care delivery and health outcomes for older adults, particularly those with dementia and residents of nursing homes. She has contributed to the development of large-scale infrastructure projects supported by the National Institute on Aging (NIA), such as the Long-Term Care Data Cooperative and the National Dementia Workforce Study, which provide new data sources to support research on care and outcomes in nursing homes and for people with dementia. During the COVID-19 pandemic, Dr. White led multiple study teams examining COVID-19 treatment and outcomes in nursing homes. She completed an AHRQ T32 postdoctoral fellowship at Brown and an NINR T32 predoctoral fellowship at the University of Pennsylvania School of Nursing. In addition to her research, she is an adult geriatric primary care nurse practitioner with extensive clinical experience working in long-term care and primary care, currently practicing in the Brown Medicine Division of Geriatrics and Palliative Medicine.

Research topics

• Medicine
• Nursing
• Internal medicine
• Emergency medicine
• Gerontology
• Environmental health
• Virology
• Political Science
• Demography
• Pediatrics
• Immunology
• Psychiatry
• Engineering
• Architectural engineering
• Public relations
• Applied psychology
• Marketing
• Business
• Psychology

Selected publications

• Nursing Home Administrator Experiences Navigating the Changing Regulatory Environment During the COVID-19 Pandemic

  Journal of Aging & Social Policy · 2026-01-13 · 1 citations

  article

  = 156) with administrators of 40 nursing homes across the U.S. between July 2020 and December 2021 to better understand their experiences with governmental agencies amid shifting regulatory standards, frequent inspections, and possible enforcement actions. Administrators highlighted confusion due to the evolving and sometimes conflicting guidance between state and federal agencies, although some states offered valuable COVID-19-specific assistance. They also described challenges in understanding and implementing new, frequently changing requirements, resulting in potential inspection deficiencies. Although enforcement actions, including financial penalties, are intended to deter noncompliance, administrators expressed concerns about added resource strain. Recommendations included increasing collaboration and data collection between regulatory agencies; reducing administrative burden during outbreaks and incorporating feedback from centers during regulatory changes; and increasing reimbursement to support compliance. Continued changes to oversight, including increased penalization and risk-based survey prioritization, should be evaluated to determine differential impacts on nursing home operations and resident care.

  PublisherDOI

• Staffing Conditions In US Nursing Homes Before, During, And After The COVID-19 Pandemic

  Health Affairs · 2026-02-01

  article

  The COVID-19 pandemic exacerbated long-standing challenges in US nursing homes around staffing conditions, with nearly one in five nursing homes reporting severe staffing shortages during the early months of the pandemic in 2020. However, less is known about how nursing home staffing has evolved since the early part of the pandemic. This study used Payroll-Based Journal daily staffing data from the second quarter of 2018 through the fourth quarter of 2024 and other administrative data to examine trends in nursing home staffing levels and turnover before, during, and after the COVID-19 pandemic. Since the start of the pandemic, staffing hours per resident day decreased for all nurse types, especially in nursing homes associated with private equity funds or real estate investment trusts, during the late pandemic and postpandemic periods. Staff turnover decreased slightly during the pandemic and postpandemic periods for all nurse types. Policy makers should consider additional measures to ensure appropriate nursing home staffing levels going forward.

  PublisherDOI

• Assessing the feasibility of linking Section G and Section GG measures of function in skilled nursing facilities

  The Gerontologist · 2026-05-20

  article

  BACKGROUND AND OBJECTIVES: In skilled nursing facilities (SNFs), Section GG replaced Section G as the instrument for measuring function in 2023. To inform how previously validated scales and scores derived from Section G items might be re-produced from Section GG items, we examined key measurement assumptions in both instruments. RESEARCH DESIGN AND METHODS: We identified 1,131,694 Minimum Data Set 3.0 assessments of unique persons with complete Sections GG and G between October 2018 and September 2023 across 2,200 SNFs in the Long-Term Care Data Cooperative. We examined: (i) assessment instructions, (ii) item-level Spearman's correlations, (iii) measures of fit and factor structure in confirmatory and exploratory factor analyses (CFA and EFA), and (iv) graded response item response theory (IRT) parameters. RESULTS: Several Section GG items were conceptually similar and highly correlated (ρ ≥ 0.7). After removing redundant items, a combined scale of both instruments was not unidimensional in CFA (Comparative Fit Index = 0.753, Tucker-Lewis Index = 0.724, root-mean-square error of approximation = 0.153) and items from each instrument generally loaded onto separate but correlated factors (inter-factor correlation 0.735) in EFA. In IRT analyses, Section GG items better captured independence while Section G items better captured dependence. DISCUSSION AND IMPLICATIONS: Sections GG and G measure related yet distinct constructs, emphasizing the need for caution when interpreting a sum of Section GG items as a reflection of underlying health in SNF patients. Scales and scores derived from Section G items cannot be presumed to be equivalent when derived from Section GG items, and further work is needed examining interchangeability.

  PublisherDOI

• Approaches to Identify Nursing Home Specialists Using Medicare Claims Data

  Medical Care · 2025-04-28 · 1 citations

  article

  BACKGROUND: Physicians and advanced practice clinicians who practice in nursing homes (NHs) are becoming increasingly specialized. Studies have identified clinicians as NH specialists using multiple data sources; yet, researchers' access to several sources may be limited due to required data purchases. OBJECTIVE: Examine the concordance of 2 approaches to measure NH specialization versus a standard approach using clinician-level Medicare Data on Provider Practice and Specialty (MD-PPAS). These alternative approaches leveraged: (1) publicly available clinician-level Medicare Part B data; and (2) patient-level Medicare Part D Event claims linked to publicly available clinician-level Medicare Part D prescribers data. RESEARCH DESIGN: Yearly cross-sections from 2016 to 2020. SUBJECTS: Physicians and advanced practice clinicians with at least one Medicare-paid service to NH residents and at least 100 total services in a given year. MEASURES: Nursing home specialists were classified as clinicians with ≥90% of annual services provided to NH residents. RESULTS: Between 2016 and 2020, NH specialists comprised 49,542 of 321,267 eligible clinician-years (15.4%) in MD-PPAS data; 35,983 of 189,992 eligible clinician-years (18.9%) in Part B data; and 31,148 of 1,101,484 eligible clinician-years (2.8%) in Part D data. Compared with the MD-PPAS approach, the concordance was greater for the Part B approach (sensitivity 71.8%, specificity 99.7%) than the Part D approach (39.4%, 97.6%). CONCLUSIONS: There were large differences in the numbers of eligible clinicians and NH specialists identified by 3 approaches. The Part B approach was reasonably concordant with the MD-PPAS approach and could be considered by researchers without the financial resources required to purchase MD-PPAS data.

  PublisherDOI

• A Matched Cohort Analysis of Kidney Transplant Recipients Treated with Depleting and Non-Depleting Antibody Induction and Early Corticosteroid Cessation

  American Journal of Transplantation · 2025-08-01

  article
  PublisherDOI

• The National Dementia Workforce Study: Development of Questionnaires for Home Care, Assisted Living, and Nursing Home Settings

  Journal of the American Geriatrics Society · 2025-09-02 · 3 citations

  articleOpen access

  The growing aging population and rising prevalence of dementia are driving increased demand for long-term care services and supports in the United States. People with dementia require substantial support and care, often from direct care workers in private homes, assisted living communities, and nursing homes. Despite their crucial role, these workers receive highly variable training, particularly in dementia care, and face significant work-related challenges including stress, injury, and burnout. The National Dementia Workforce Study (NDWS), sponsored by the National Institute on Aging, was designed to include large-scale, nationally representative annual surveys of staff and administrators providing care to individuals with dementia in home care, assisted living, and nursing homes, and of community clinicians practicing across settings. NDWS will capture workforce demographics, training adequacy, job satisfaction, and their impact on dementia care quality. This report describes NDWS's rigorous process for questionnaire design for the initial wave of home care, assisted living, and nursing home surveys. Our survey development methods integrated literature reviews, validated questionnaire items, expert consultations, and cognitive interviews to ensure instrument reliability and validity. Resulting survey data will be available to researchers seeking to examine workforce conditions, training, and worker knowledge, and their impact on care for people with dementia. NDWS infrastructure will also allow researchers to link survey responses with administrative and medical claims data to examine how workforce dynamics and organizational factors are associated with outcomes for people with dementia over time, enabling insights into policies to improve dementia care training, workforce retention, and care delivery.

  PublisherOA PDFDOI

• Differences in Skilled Nursing Facilities Admitting Medicare Patients With and Without COVID-19 After Hospitalization

  Journal of General Internal Medicine · 2025-07-08

  letterOpen access
  PublisherOA PDFDOI

• The National Dementia Workforce Study: Methods for Surveying Community Clinicians Who Provide Care to People With Dementia

  Journal of the American Geriatrics Society · 2025-08-08 · 3 citations

  articleOpen access1st authorCorresponding

  People with dementia have complex medical, functional, and social needs and experience highly variable care quality and outcomes across the U.S. health care system. Community-based physicians, nurse practitioners, and physician assistants serve critical roles in diagnosing and managing dementia, yet little is known about this workforce and factors contributing to variability in care. The National Dementia Workforce Study (NDWS), sponsored by the National Institute on Aging, is conducting large nationally representative surveys of health care workers who provide care to people with dementia in nursing homes, assisted living communities, home care, and community medical practices. In this report, we summarize the methods for one of those surveys, the NDWS Community Clinician Survey, which surveys community-based physicians and advanced practice providers specializing in primary care, psychiatry, and neurology who provide clinical care to people with dementia. This survey captures comprehensive data on these clinicians, including demographics, training, and licensure; where and how they practice; their patient panels; processes of care for dementia diagnosis and management; and job factors influencing retention and turnover. These survey data can be linked with Medicare claims and other administrative data sources to allow for expansive research on this workforce and the care they provide. In turn, this will generate insights into modifiable factors that can be targeted to prepare, expand, and strengthen the clinical workforce to optimize care and meet demand for the growing population of people with dementia.

  PublisherOA PDFDOI

• Reply to: “Comment on: Differences in Setting of Initial Dementia Diagnosis Among Fee‐for‐Service Medicare Beneficiaries”

  Journal of the American Geriatrics Society · 2025-01-07

  letterOpen access1st authorCorresponding

  See the related comment by Wu et al . in this issue.

  PublisherOA PDFDOI

• Disenrollment From Special Needs and Other Medicare Advantage Plans Among Nursing Home Residents

  JAMA Network Open · 2025-07-31 · 1 citations

  articleOpen access

  This cohort study analyzes variations in Medicare plan disenrollment among long-stay nursing home residents from 2010 to 2022.

  PublisherOA PDFDOI

Frequent coauthors

• Stefan Gravenstein

  Brown University

  101 shared

• Vincent Mor

  Providence College

  81 shared

• Momotazur Rahman

  Brown University

  63 shared

• David H. Canaday

  54 shared

• Christopher M. Santostefano

  Providence College

  53 shared

• Cyrus M. Kosar

  Brown University

  47 shared

• Kevin W. McConeghy

  Brown University

  43 shared

• Richard A. Feifer

  39 shared

Education

• Ph.D.

  University of Pennsylvania

  2018

• Other

  Brown University School of Public Health, Center for Gerontology and Healthcare Research

  2018

Awards & honors

• AHRQ T32 postdoctoral fellowship at Brown
• NINR T32 predoctoral fellowship in the Center for Health Out…