10 Things LTC Leaders Should Know About Nursing Home Staffing Shortages

staffing shortages in nursing homes

Despite struggling with post-COVID symptoms, Director of Nursing, Sylvia Abbeyquaye was called back to work. Eventually, she turned in her letter of resignation without a new job lined up. Her story paints a picture of the grim reality of staffing shortages in nursing homes. Almost three years have passed since the start of the pandemic and things don’t seem to be turning around; a survey by the American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) published in September 2021 revealed that essentially every nursing home (99%) and assisted living community (96%) in the United States is dealing with a staffing shortage. 

As you address the impact of staffing shortages in your nursing homes, this overview of critical statistics can be helpful in finding a way forward and taking advantage of emerging opportunities. 

10 Essential Insights into Post-Acute Staffing Shortages

1. The current stats are some of the worst of the pandemic.

Nursing homes across the country have reported their worst shortages since the federal government began tracking in 2020. 40% of facilities have reported a shortage of direct care workers, amounting to a drop of 25% from previous highs. (AARP)

2. Things don’t appear to be getting better. 

The workforce situation also doesn’t appear to be improving. According to the AHCA and NCAL survey, 86% of nursing homes and 77% of assisted living providers reported that their workforce situation had gotten worse in the three months prior to their responses to the September 2021 survey. 

3. Residents are paying the price. 

Inadequate staffing has always had a negative impact on residents, but the effects have become even more severe during the COVID-19 pandemic. In addition to the 150,000 nursing home residents and staff that have died from the disease, many others are left dealing with isolation and neglect. 

The Associated Press estimates that the period between March and November 2020 saw 40,000 excess deaths among nursing home residents from non-COVID-19 related causes compared to the prior year. The National Consumer Voice for Quality Long-Term Care found that over 80% of family members reported severe declines in their loved ones, in relation to physical and mental well-being. 

4. Facilities are closing and turning away residents. 

More than a third of members of LeadingAge, a nation-wide association that represents nonprofit senior care providers, reported that staffing challenges meant they couldn’t bring in new residents or work with new clients. 

But even existing residents are at risk. Up to 40% of residents in nursing homes are currently in facilities that are at financial risk of closure this year. (Clifton Larson Allen, wealth adviser in long-term care)

5. Hiring has become a significant challenge. 

Facility leaders trying to respond to staffing shortages are finding themselves in a difficult position. 

According to the AHCA/NCAL survey, almost every nursing home and assisted living provider reports having a difficult time hiring new staff and seven out of 10 report having a “very difficult” time. 

6. Staffing shortages in nursing homes are worse in certain areas.

Shortages have long been worse in long-term care than in the acute sector, but the post-acute sector in rural areas and small cities has taken a disproportionate hit in staffing shortages. 

Missouri, for example, saw 13.9% fewer jobs in nursing and residential care facilities as of January 2022 compared to the same month in 2020—amounting to a net loss of 10,500 jobs in just two years. 

7. Nursing professionals are leaving for new kinds of work.

Nursing professionals are leaving work in post-acute care and finding employment in other areas. This includes hospitals, private homes, and travel nursing positions. Others have taken early retirement or returned to their home countries. Opportunities at large employers like Amazon and McDonald’s have also been attractive. 

8. Post-acute challenges are unique. 

While staffing shortages in nursing homes have reflected broader pandemic trends, they have been more severe than the acute side which saw a much less severe drop in 2020 and has since seen a more significant recovery. 

According to data from the U.S. Bureau of Labor Statistics, the nursing home industry lost about 235,000 jobs since March 2020—about 15% of the nursing home workforce, significantly outpacing other healthcare sectors. 

9. Nursing professionals have clear reasons for leaving. 

At least 50-60% of nursing and allied health professionals have expressed that they want to change career paths. Over one out of four are considering leaving the profession completely. Retention has long been shaky because of nursing home staffing shortages, but COVID sent everything into overdrive. Nursing home workers report that they’re leaving because of issues including

  • Limited opportunities for advancement
  • Dangerous working conditions
  • Poor pay and benefits
  • Burnout
  • A deficit of respect for their work

10. But there is opportunity in a new perspective. 

These issues have left post-acute leadership to overcome challenges, including a lack of qualified candidates. If you’re looking for a new approach that keeps up with today’s staffing shortages in nursing homes, we invite you to get started today


Megan is a business writer with over 15 years’ experience in healthcare enterprise technology. She holds an MBA and B.S. in Healthcare Administration. She now keeps an ongoing eye on the latest developments and successes in healthcare admin technology and the people who use it to build a better world for providers, patients, and their care communities.


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