Growing the Nursing Home Workforce Requires Investing in Caregivers to Create Good-Paying Jobs

Workforce; Advocacy
​The Biden Administration plans to establish a federal staffing mandate for nursing homes this year. Yet, the current proposal offers no resources or workforce development programs to help nursing homes implement the mandate. Experts have estimated that the mandate could require hiring nearly 200,000 more caregivers at an annual cost of $11.3 billion for their wages and benefits. 
Despite significant increases to nurses’ wages in recent years, nursing homes are still facing a historic labor crisis and are struggling to compete against hospitals, other health care providers, and private industries for workers. The industry is primarily funded by Medicaid and Medicare and with fixed government reimbursement rates, nursing homes are limited in making additional investments in their staff. Moreover, the entire health care system is grappling with a nationwide shortage of nurses—even if nursing homes had the resources, there aren’t enough trained caregivers to serve a growing elderly population. 
In recent years, the Biden Administration and Congress have invested trillions in private industries—including energy, manufacturing, and construction—as well as government sectors to help create jobs:  
  • ​ The American Rescue Plan of 2021 distributed more than $360 billion in emergency funding for state, local, territorial, and Tribal governments to “ensure that they are in a position to keep front line public workers on the job and paid,” among other support. The bill also provides emergency grants, lending, and investment to small businesses so they can rehire and retain workers. The American Rescue Plan is credited with accelerating job growth by one to four million additional jobs. 
  • The Bipartisan Infrastructure Law of 2021 invests $1.2 trillion in roads and bridges, electric vehicle charging, clean energy infrastructure, and environmental remediation. Throughout its guidebook, the White House says these investments will help “create good-paying jobs,” and the U.S. Department of Transportation says the law will support more than 700,000 new jobs in manufacturing, construction, and transportation a year. 
  • The Inflation Reduction Act of 2022 invests $370 billion in clean energy to help “create good-paying jobs and new economic opportunities for workers.” The BlueGreen Alliance estimates the legislation will create more than 9 million jobs over the next decade. 
  • Earlier this month, the White House released the President’s Budget for Fiscal Year 2024, which proposes $150 billion over 10 years to improve and expand Medicaid home and community-based services as well as “recruit the next 1.3 million additional home care workers that we will need,” commented Health and Human Services Secretary Xavier Becerra. For nursing homes, the budget only offers $494 million for survey and certification activities. 
Time and time again, Washington has supported key industries to help spur job growth and develop career opportunities for workers. Many of these investments were made to private industries, unlike nursing homes that are primarily funded by government health care programs. Federal policymakers should follow a similar approach to help address the labor crisis in nursing homes and support the entire long term care continuum.
The American Health Care Association (AHCA) has outlined several workforce policies that could help rebuild and strengthen the nursing home workforce. The Care For Our Seniors Act suggests assistance programs to recruit care professionals, like loan forgiveness, tax credits, affordable housing, and childcare support. It also builds a pipeline of caregivers by investing in nursing education programs and passing common-sense immigration reform. Lastly, it calls on federal and state policymakers to properly fund Medicaid, so that long term care providers can compete for workers and offer good-paying jobs. 
Nursing homes need resources—not requirements—to increase its workforce. Investing in long term care, like Washington has done for countless other industries, will help ensure our nation’s growing elderly population has the caregivers they need.