Nursing Leaders’ Guide to the Future of Long-Term Care

The future of long-term care

The pace of change in post-acute care is picking up—and the next several years will likely result in a future of long-term care that looks very different from the past. So, how can forward-thinking leaders adapt and adjust? 

Take some time to look at the past, present, and future predictions and you’ll be better equipped to create the strategies that align with your goals and support smart staff planning from here on out. 

Past Predictions Have Come True

Back in 2009, researchers tried to predict the next half century of long-term care. We’re still less than 15 years in, but it’s worth noting that many of the predictions were in line with what we’ve seen. These include: 

  • Graying of the Baby Boomers
  • Lower fertility rates
  • Increased population diversity
  • The continued pressures of chronic illness
  • The increase of patient consumerization
  • The growth of home- and community-based care

What wasn’t accounted for, though, is the impact of the COVID-19 pandemic.  

Today is the Foundation of the Future of Long-Term Care

As the present plays out, we’re seeing trends in nursing and long-term care that will continue to unfold for years, shaping the future of long-term care. 

Staffing remains a challenge

Turnover in healthcare has always been high, but rates in senior living in particular stand out. Leaders in senior living are tasked with maintaining quality and a positive provider experience with turnover rates hovering between 22% and 52% according to the Oliver Wyman and IntelyCare Research Report.

There has also been an overall decline in jobs, with the negative impact strongest among continuing care retirement communities (CCRCs) where jobs were lost at a rate of 2.5% compared to a decline of only 0.8% in assisted living in the first eight months of 2020. 

Technology is necessary for addressing staffing challenges

As turnover persists and care needs are complicated by a pandemic, an aging population, and the continued rise of chronic illness, the potential of technology in addressing staffing problems now and in the future is only growing. 

Successful tech strategies will need to align with long-standing issues, including broken and outdated staffing models, an increasing demand for home health, and a widening skills gap as experienced nurse professionals age out of their careers. 

Regulatory compliance is on the rise

Nursing home leaders saw a relaxation in training requirements during the pandemic, but this didn’t last long. The Centers for Medicare and Medicaid Services (CMS) reinstated staffing requirements later in 2020. Now in 2022, CMS is instituting even stricter staffing guidelines.

Leaders invested in the future of long-term care have been keeping an eye on both national and state-level regulations as the country adjusts to ongoing and emerging pandemics. This includes grass roots movements like a push for minimum, mandated, nurse-to-patient staffing ratios to protect patients and improve the experience of clinicians.

The Future of Long-Term Care Will Remain in Flux

No one can say for certain where the future of long-term care is headed, but a few hints and glimpses are emerging. 

A COVID reset will be necessary

COVID “changed everything”, leaving huge numbers of nursing homes reeling from staff reductions after the most severe outbreaks. Today, many are still struggling to refill vacant positions, with a lack of certified nursing assistants (CNAs) standing out as the most glaring issue. But this talent drain has helped shine a light on the difficulties that nursing home workers face, including low pay and failures to meet nurse-staffing minimums. 

In 2022, McKnight’s reported workforce vacancies around 30% in Wisconsin which resulted in limited occupancy rate between 65% and 75%. This report also stressed recommendations, including certification flexibility, funding sustainability, and having compassion for professional caregivers. To move forward in a world reshaped by a pandemic, they also highlight the importance of reducing administrative burdens, and investing in technology and education.

Keep an eye out for the technology that can help you achieve these goals—including solutions that take the frustration and administrative demand out of staffing, freeing your nursing professionals from covering every open shift.  

Skilled nursing will take additional blows

Skilled nursing was strained by the COVID-19 pandemic. According to Skilled Nursing News, it can expect to see continued pressures through 2023. For example, government support and funding is drying up. There are some signs that individual states might provide financial assistance, but support from the federal government has mostly ended. 

SNFs can find their footing by staying nimble and keeping their eye on thriving even as they’re pressured to not do much more than survive. 

Closures will persist

Nursing home closures have been one of the darkest features of the COVID-19 pandemic, and they aren’t over. 

The American Health Care Association predicts that another 400 nursing homes could go out of business before 2022 is over. Closures have been dominated by smaller facilities with under 100 beds, usually in urban areas where residents are Medicaid recipients. CMS has also announced that it plans to decrease reimbursement for SNFs by $320 million in 2023, so closures likely will be a feature of the near future of long-term care. 

Home care will dominate the long-term care discussion

Part of the pull away from nursing home support has been fueled by a new focus on home care

Though it didn’t pass, President Joe Biden’s Build Back Better plan set aside $150 billion for in-home care, with the goals of improving low wages for workers and reducing waiting lists for in-home services. Additionally, the Choose Home Care Act of 2021 set up an add-on payment to establish Medicare home health benefits for patients 30 days after discharge from a hospital..  As the demand for home care increases, long-term care will need to pivot. Monitor this shift, especially its impact on your census numbers and volatility in staffing needs.

If the future of long-term care is going to be anything, it will be different from the past, and for many leaders, different from what they expected. But there is one thing you can count on—by prioritizing the well-being of your nursing professionals, you’ll be investing in a powerful asset that will carry you through a future of change for years to come. 


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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