Survey: Nursing Home Providers Say Workforce and Economic Challenges Persist

More than Half of Nursing Homes Are Limiting New Patients Due To Staffing Shortages


WASHINGTON, D.C. – The American Health Care Association (AHCA), representing more than 14,000 nursing homes and other long term care facilities across the country, released a survey of more than 500 nursing home providers from across the U.S. highlighting how nearly three years into the COVID-19 pandemic, the industry continues to face a serious labor and economic crisis. The survey findings also demonstrate how the crises are impacting access to care for vulnerable seniors and would make it impossible for the industry to meet increasing government staffing requirements without corresponding support. 
Key findings include:
  • Nearly half (45 percent) of nursing home providers said their workforce situation has worsened since May 2022.
  • 84 percent are currently facing moderate to high levels of staffing shortages.
  • 96 percent find difficulty in hiring staff.
  • 97 percent said the lack of interested or qualified candidates is a major obstacle to hiring new staff.
  • More than nine out of 10 nursing home providers have increased wages and offered bonuses to try to recruit and retain staff.
  • To adjust for staffing shortages, 78 percent have hired temporary agency staff.

The labor shortage is impacting access to care for the nation’s seniors and individuals with disabilities. More than half (54 percent) of nursing home providers say they are having to turn away prospective residents. More than two-thirds (67 percent) are concerned their facility may have to close due to persistent workforce challenges.
The workforce crisis is contributing to the financial instability for the chronically underfunded sector, as more than half (55 percent) of nursing home providers say they are operating at a loss and may not be able to continue operating for more than a year at the current pace (52 percent).  
“It’s been nearly three years since the first COVID case in the U.S., and nursing homes are still far from recovery,” said Mark Parkinson, president and CEO of AHCA. “Nursing homes have done everything they can on a fixed government budget—they cannot solve this crisis on their own. We need policymakers to invest in long term care, so we can compete for health care workers, transform America’s nursing homes, and prepare for a growing elderly population.” 
Nursing home providers were also asked about a potential federal minimum staffing mandate, which is expected to be proposed by the Biden Administration later this year. The survey found that providers’ biggest concern with a potential mandate is finding staff to meet the requirement, followed by having to rely on more costly agency staff to fill shifts. A proposal that has been floated in the past would require that each resident receive 4.1 hours of care per day (HPRD) from nursing staff. Nearly all respondents (95 percent) were concerned about being able to meet a 4.1 HPRD staffing minimum, including 79 percent who were “very concerned.” 
“This survey shows that nursing homes are making every effort to address this ongoing labor crisis, but continue to struggle with finding caregivers,” said Holly Harmon, RN, AHCA’s senior vice president of quality, regulatory and clinical services. “Government staffing mandates will not solve the core issue here. We need a concerted, collective effort with proper resources and incentives to help recruit more individuals to work in long term care.” 
The AHCA/NCAL survey ran December 7-16, 2022 and included 524 responses from individuals who identified as nursing home providers. Nearly two-thirds of respondents represented a single nursing home, of which 62 percent said their facility was located in a rural community.
View the nursing home provider survey results HERE.