EXHIBIT 4.

Nurse staff hours per resident day in nursing homes with various characteristics in the first 39 weeks of 2020

SOURCE Authors’ analysis of data from the Centers for Medicare and Medicaid Payroll-Based Journal system and from LTCfocus.org. NOTES Staff hours include hours for registered nurses, licensed practical nurses, and certified nursing assistants. “High Medicaid” refers to facilities with more than 75 percent Medicaid residents, and “low Medicaid” to facilities with less than 45 percent.