Significant Staffing Challenges Continue for Nursing Homes

Nursing homes are experiencing the most significant staffing challenges of any healthcare sector and have lost 210,000 jobs during the COVID-19 pandemic, according to a report from the American Health Care Association and National Center for Assisted Living (AHCA/NCAL).

The analysis reflects year-end data from the Bureau of Labor Statistics (BLS).

Between February 2020 and December 2022, the number of nursing home employees dropped from over 1.5 million to 1.3 million, indicating a loss of 210,000 jobs. The sector has not seen workforce levels like this since 1994, the report noted.  

The low staffing levels are perhaps due to slower job growth in 2022 than was previously projected. Nursing homes added an average of 3,700 jobs per month over the last nine months. At this pace, nursing homes would not return to pre-pandemic staffing levels until 2027.

“The data doesn’t lie. This is not just an exaggerated call for help, and this labor crisis will not go away on its own or through government enforcement,” Mark Parkinson, president and chief executive officer of AHCA/NCAL, said in the press release.  

“Our nursing homes are struggling to recruit caregivers, and if we do not get meaningful assistance soon, then the consequence will be hundreds of thousands of seniors displaced. We need immediate support, but we also need long-term investments and programs from policymakers to attract individuals to serve our nation’s seniors.” 

According to a separate survey from AHCA/NCAL, recruitment is the biggest challenge when it comes to alleviating staffing shortages. For example, 96 percent of nursing homes said they are struggling with hiring new staff. Almost half of nursing home providers reported that their workforce situation has worsened since May 2022.

All healthcare sectors have faced staffing shortages during the pandemic. However, while most industries have rebounded to pre-pandemic job levels, long-term care facilities continue to struggle.

Long-term care facilities lost a total of 307,000 jobs between February 2020 and December 2022. Meanwhile, physicians’ offices gained 157,700 jobs, outpatient care gained 42,100 jobs, and home health added 55,300 jobs. Hospitals saw slightly lower growth, adding 43,700 jobs.

Staffing shortages have caused long-term care facilities to limit resident admissions. As a result, hospitals are facing significant backlogs while patients ready for discharge wait for available nursing home beds. Some nursing homes have had to permanently close due to staffing shortages, AHCA/NCAL said.

Unsurprisingly, past research found that nursing home staffing challenges increased during severe COVID-19 outbreaks, resulting from temporary absences and permanent departures from workers.

A lack of financial support has also exacerbated labor challenges for nursing homes. Medicaid reimbursement rates for nursing homes are typically lower than the actual costs of care, according to the report.

The Biden Administration is considering implementing a federal staffing minimum for nursing homes to help address these issues. However, a federal mandate without substantial and consistent resources could worsen the situation.

An AHCA/NCAL report from July 2022 found that nursing homes would have to spend up to $10 billion per year and hire almost 188,000 nurses to comply with increased minimum staffing requirements.