SNFs See Largest Health Care Wage Increases Yet Employment Levels Lag Behind

Despite seeing the largest wage increase over the course of the first two years of the COVID-19 pandemic, skilled nursing employment levels continued to fall at a faster rate than other health care sectors.

That’s according to a study analyzing the U.S. Bureau of Labor Statistics employee and wage data released in the JAMA Health Forum on Friday.

The group of researchers, headed by Thuy Nguyen, PhD, research assistant professor, health management and policy, at the University of Michigan’s School of Public Health, also found that employment declines among SNFs were most severe in counties with high COVID-19 burden.


Adjusted 2020 employment levels compared to 2019 showed that counties with fewer COVID-19 cases had better employment numbers, according to the research.

The study conducted two analyses to quantify changes in employment and average employee wages across six health care organizations: physician offices, dentist offices, home health, hospitals, skilled nursing facilities and combined other facilities.

While the employment level of most health care sectors rebounded to the pre-COVID levels by Q2 2021, declines in employment were greatest for SNFs (a 13.6% decline compared to 2019), according to the study.


The research also found that SNFs saw the second largest employment decline in Q2 2020 (8.4%), behind dentists (10%).

Employees in skilled nursing facilities, however, saw the largest wage increase in 2020 (9.5%) and 2021 (6.3%), compared to 2019.

Skilled nursing’s average weekly wage increase peaked in the fourth quarter of 2020, at around 115% of its 2019 average, the study showed.

Trends of Quarterly Employment Level of the Health Care Sector During 2019-2021 | JAMA

Still, a recent analysis of BLS data by the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) shows that long-term care facilities have lost more than 400,000 caregivers since the beginning of the pandemic, more than any other health care sector.

Average wages within the health care sector increased at a lower rate – 5% in 2020 and 1.5% by Q2 2021 – relative to other industries – 6.7% in 2020 and 6.9% by Q2 2021, according to JAMA.

However, a statistically significant and positive association was still seen between COVID-19 case counts and changes in employment levels among SNFs.

“Our results imply that intensified early efforts are needed to protect the health care workforce in future pandemics,” the researchers concluded.

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