New Report Finds Access To Nursing Home Care A Growing Crisis

Nearly 450,000 Residents At Risk Of Displacement Under Federal Staffing Mandate

Research and Data; Workforce
​​​WASHINGTON, D.C. — The American Health Care Association and National Center for Assisted Living (AHCA/NCAL), representing more than 14,000 nursing homes and other long term care facilities across the country that provide care to approximately five million people each year, released a data-backed report today that illustrates the growing access to care crisis within the nursing home sector. 
Nationwide labor shortages, coupled with inflation and chronic government underfunding, have forced nursing homes to limit admissions, downsize or even close entirely – leaving tens of thousands of vulnerable residents displaced, and countless prospective residents and families in desperate search of care.
The report reveals that during the pandemic, an overall decline in the number of nursing homes accelerated by nearly four times. Specifically, from 2020 to present:

  • 579 nursing homes closed.
  • More than 21,000 residents have been displaced by closures.
  • 30 more U.S. counties became nursing home deserts.
  • Two out of five closures had four- or five-star ratings.
  • Only three new nursing homes have opened in 2023, compared to an average of 64 each year between 2020 and 2022.

Additionally, the report highlights a survey of nursing home providers from June 2023, which found that due to ongoing labor shortages:

  • Fifty-five percent of nursing homes are turning away prospective residents and patients.
  • Forty-eight percent of nursing homes have waitlists spanning at least a few days.
  • Twenty-one percent of nursing homes are downsizing beds or units, and 24 percent have closed a wing, unit or floor because of labor shortages.

During the pandemic, nursing homes lost more of their workforce than any other health care sector—approximately 15 percent or 250,000 workers. While most other health care sectors have largely rebounded, nursing homes are not projected to return to pre-pandemic workforce levels until 2026.
“Too many of our nation’s seniors are having to look farther and wait longer for the long term and post-acute care they need. These are sobering numbers and should serve as a wake-up call to policymakers to help nursing homes rebuild,” said Mark Parkinson, president and CEO of AHCA/NCAL.
As nursing homes struggle to overcome labor shortages and stay afloat, the Biden Administration is expected to propose a federal staffing mandate, currently without corresponding funding or workforce development programs. The report notes a December 2022 analysis by CLA, which found that nearly 450,000 nursing home residents are at risk of displacement if facilities cannot increase their workforce and must reduce their census to comply with an arbitrary staffing ratio. 
“With a growing elderly population, federal policymakers are at a crossroads in terms of how we address this access to care crisis,” continued Parkinson. “If they proceed with unfunded staffing mandates, this situation will only get worse. Instead, we need comprehensive policies and meaningful investments that will address the caregiver shortage and protect access to high-quality nursing home care.”
AHCA has long advocated for common-sense solutions and laid out several in its Care for Our Seniors Act. Among them are proper Medicaid funding, as well as numerous programs that will attract and retain caregivers and build a strong workforce.
View the full Access to Care Report HERE.