Gulf Between Nursing Shortage, Surplus to Expand by 2030

In two years, California is projected to be short almost 45,000 registered nurses (RNs), while Florida will have a surplus of almost 54,000. By 2030, the numbers get even starker; the number of RNs needed in the U.S. will be 3.6 million, according to data from RegisteredNursing.org, but pain will still depend on where you look.

When the size of a state’s available workforce is taken into account, the rankings shift somewhat. Based on the percentage of the RN workforce that’s projected to be vacant, Alaska ranks the worst for deficits. In 2030, 22.7% of the needed 23,800 RNs in the Last Frontier are projected to go vacant.

California’s issues stem in part from the fact that the state is so populous, Bryce Hall, the owner of RegisteredNursing.org — which provides resources for RNs — told Skilled Nursing News: With about 39 million residents, more than any other state, the ratio of nursing to people is simply imbalanced.

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The other issue is cost of living.

“It’s the most expensive area, so even though nurses get paid well in California, they don’t get paid enough to live and survive in California,” he said.

Rural areas like Alaska, on the other hand, have trouble filling shortages because people don’t want to live in such remote locations. As a result, states in this situation tend to see a lot of contract nurses, Hall said.

On the other side of the coin, Wyoming is projected to have an RN surplus of 50.9%, or 8,300 RNs filling 5,500 positions. New Mexico is expected to have 31,300 RNs to cover 21,600 needed jobs. Other states projected to have a surplus of more than 30% include Ohio, Vermont, Kansas, and Nevada.

For some states, the problem is only going to get worse.  By 2030, the U.S. is expected to add 795,700 new RN positions, with California expected to add 110,500 positions by this year. Texas and Florida followed, with each state expected to add 88,800 and 69,400 new positions, respectively. But both California and Texas will still face a shortfall, while Florida is projected to add more RN positions than it actually needs.

In terms of how growth in new positions compares to the existing RN pool, South Carolina is expected to see the most expansion, adding 26,600 new jobs to an existing RN workforce of 36,900 for a boost of 69.4%. Hawaii came in second with 51.4% growth projected by 2030.

New York and Ohio, which have growth rates of 12.1% and 8.1% respectively, are among states with slow growth rates that will likely see large overages as RN supply outpaces demand.

Staffing is a long-standing headache in the skilled nursing sector, and insufficient RN numbers is a particular issue. One analysis found in March that nursing homes report RN staffing levels at half an hour per day or less. More recently, data analyzed by Kaiser Health News for The New York Times found that most nursing homes experience staffing fluctuations and have been overreporting nursing and caretaking staff levels. That led to the Centers for Medicare & Medicaid Services (CMS) hitting 1,387 facilities with one-star ratings for staffing coverage.

For nursing homes, part of the problem is that RNs are so costly, Hall said.

“You have to go and find people that are interested in pursuing senior care, so you’re diluting the pool you’re pulling from,” he told SNN. “And they’re already too expensive [for nursing homes].”

Written by Maggie Flynn

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