Nursing Home Staffing Shortages: 5 Key Trends

Nursing professional helping a resident amidst nursing home staffing shortages

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. Unfortunately, her story paints a picture of the grim reality of staffing shortages in nursing homes.

Several years have passed since the start of the pandemic and things don’t seem to be turning around. The American Health Care Association (AHCA) and National Center for Assisted Living (NCAL) conducted a survey of nursing homes and assisted living facilities in the U.S. and found that over 95% are dealing with a staffing shortage. This is the definition of a crisis and its ripple effects continue to shape the healthcare field.

As you consider your approach to the crisis of nursing home staffing shortages, it’s important to dig a little deeper into the data to really understand the problem. Here are 5 key trends to keep an eye on as well as certain opportunities that are emerging.

1. Shortages Have Worsened Since the Height of the Pandemic

In 2022, nursing homes across the country reported their worst shortages since the federal government began tracking in 2020. According to the AARP, 40% of facilities have reported a shortage of direct care workers, amounting to a drop of 25% from previous highs.

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 worsened in the three months leading up to the survey.

What does this mean for you? When it comes to the nursing home staff shortage, 2022 is not looking like an outlier year but part of a deeper trend. Don’t expect things to return to the pre-pandemic norms. In fact, it may be helpful to interpret nursing home staffing shortages as another indicator of structural changes taking place in the nursing home industry.

Now is the time to re-think old models of staffing in favor of one that specifically plans — and budgets — for in-house and float pool staff for the foreseeable future.

2. 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.

Coupled with this is an ever-increasing shortage of nursing homes. Over 1,000 nursing homes closed between 2015 and 2021, leading to the displacement of nearly 45,000 residents. In 2022 alone, projections show that an estimated 400 nursing homes will close, with a similar result for nursing home residents.

The impact of the nursing home caregiver shortage on residents can’t be understated. This is the human toll of the crisis and one more reason why bold action is needed to protect facilities and the critical care that they provide. But there’s good news. If facilities like yours can get ahead of these trends by utilizing a more flexible staffing strategy for the long-term, you will be better positioned to meet the ever-increasing demand for post-acute care.

3. Post-Acute Challenges Are Unique, Especially in Certain Locations

While staffing shortages in nursing homes have reflected broader pandemic trends, they have been more severe compared to acute facilities which saw a much less severe drop in 2020 and has since seen a more significant recovery. The nursing home industry, on the other hand, lost about 235,000 jobs since March 2020. This was about 15% of the nursing home workforce and it significantly outpaced other healthcare sectors.

The post-acute sector has also taken a disproportionate hit in rural areas and small cities. 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 — a net loss of 10,500 jobs in just two years.

Nursing home staffing shortages will continue to be a problem requiring a paradigm shift when it comes to staffing strategies. While the dramatic loss of nursing professionals in post-acute facilities has taken its toll, it also means that there’s a large pool of qualified professionals who may be willing to return to post-acute care under the right conditions.

If your facility is located in more impacted rural areas, incorporating a trusted staffing partner in your staffing strategy can help you tap into a larger pool of nursing professionals in your region.

4. Hiring Has Become a Significant Challenge

According to the AHCA/NCAL survey, almost every nursing home and assisted living provider reports difficulty with hiring new staff, with seven out of ten saying they’re having a “very difficult” time. This is putting facility leaders in a difficult position as they try to respond to nursing home staffing shortages, especially with the prospect of lost revenue.

However, while hiring is a growing challenge, it doesn’t have to be a growing problem. In fact, with the right staffing partner in place, you can minimize the overhead spent on the hiring process while also boosting the pool of nursing professionals available to staff your shifts. With more time spent on finding the right staffing and less time spent on hiring, you can take the steps needed to get your facility — and your residents — set up for success in the long-term.

5. 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 have also been attractive.

Why are these nurses choosing other professions? Put in better terms, what is it that nurses are looking for that they’re not getting? According to one study, nursing professionals want their leadership to take bold new steps to improve their staffing policies. This means changing the way things have been done in the past and finding ways to bring more balance for everyone going forward. A hybrid staffing model offers you that win-win opportunity, while also giving your facility the flexibility to adjust its staffing levels as needed.

Ready For a Solution to Your Nursing Home Staffing Shortages?

If you’re struggling to fill shifts with qualified nursing professionals, we have both short and long-term staffing solutions to help you buck the trend. Learn more about how our cost-effective nurse staffing options can support your staffing strategy 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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