94% of Nursing Homes Face Staffing Shortages

Of 616 nursing homes surveyed by the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), 94% said they are experiencing a staffing shortage.

Nearly three-fourths of respondents indicated that their workforce situation has worsened compared to 2020, largely due to higher turnover associated with the COVID-19 pandemic. Facilities are actively trying to hire across the board, including registered nurses, licensed practical nurses (LPNs), certified nursing assistants (CNAs), dietary staff and housekeeping.

While operators could make headway on these shortages if they offered better pay and benefits as incentives, 81% said that higher reimbursement from payers is necessary to support those actions.


“The survey results clearly indicate that the long term care workforce is facing serious challenges,” Mark Parkinson, president and chief executive of AHCA/NCAL, said in a statement. “Lawmakers across the country must prioritize long term care to ensure the profession has the necessary resources to maintain a strong workforce. This begins with addressing chronic underfunding of Medicaid for nursing homes, which currently only covers 70 to 80% of the cost of care.”

Parkinson pointed to the Care For Our Seniors Act as a first step, a policy proposal from AHCA/NCAL and senior care advocacy group LeadingAge, calling for clinical improvements, oversight reforms, strengthening and supporting the workforce, and adding structural modernizations.

Specific to workforce changes, the proposal suggests a “multi-phase tiered approach” to recruit and retain talent through partnerships with federal, state and academic institutions. If enacted, loan forgiveness, tax credits, housing and childcare programs would help incentivize potential staff to work in long-term care, AHCA/NCAL said.


Increased subsidies for graduates working in nursing homes for at least five years were also mentioned in the proposal.

“We look forward to working with federal and state governments to ensure every facility has the ability to recruit and retain the necessary staff to ensure our residents receive the level of care they need and deserve,” added Parkinson in the survey statement. “We need to make sure they are being adequately supported so they can provide the highest quality care to our elderly population.”

The Washington, D.C.-based organization represents more than 14,000 nursing homes and long-term care facilities in the United States; more than 15,000 skilled nursing facilities operate in the country, according to the Centers for Disease Control & Prevention (CDC).

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