Nursing Homes Add 1,600 Jobs in February as Occupancy Recovery Crawls

Nursing homes gained 1,600 jobs in February, a modest increase compared to home health and physician offices at 20,000 and 15,000, respectively, according to data compiled by the U.S. Bureau of Labor Statistics (BLS).

The sector added 3,800 hires from December 2021 to January 2022, BLS data found. To put this data in perspective, nursing home hires decreased every month in 2021 except in October and December.

It’s a start considering the sector has lost 238,000 caregivers since the start of the pandemic, but long-term care still needs “immediate assistance” as well as a long term solution to recruiting and retaining efforts, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) said in an email to Skilled Nursing News.


“We’ve been calling for help, but little assistance has been provided,” AHCA/NCAL added. “We need policymakers to prioritize long-term care and work with us to develop a comprehensive strategy to address this crisis.”

Overall, health care employment last month rose 64,000, BLS data found. Employment in the sector is still down by 306,000 hires, or 1.9%, compared to pre-pandemic levels.

The overall unemployment rate decreased to 3.8%, or 6.3 million unemployed persons; in February 2020, the unemployment rate was 3.5%, or 5.7 million people, according to the BLS data.


Broken down by industry, the number of unemployed people in education and health services decreased from February 2021 to February 2022 – 899,000 to 754,000. That’s a 0.7% drop in unemployment rates, BLS data found.

Prior to job gains in January and February, skilled nursing experienced a 24-basis-point increase in occupancy to rest at 76% in December, according to NIC MAP Data, released by NIC MAP Vision.

December marks the highest occupancy level since May 2020, NIC MAP Vision authors noted, after the statistic remained unchanged from October to November. Recovery continued to be slowed first by the delta variant, and then omicron during winter months.

“The fact that occupancy has held steady through the delta variant and the early stage of omicron suggests that the demand for skilled nursing properties remains, but a significant challenge for many skilled nursing operators around the country has been the staffing shortages that limit the ability to admit new residents,” NIC authors said.

Skilled nursing’s “already difficult” labor situation worsened when staff became infected with the more contagious omicron variant toward the end of the year, NIC authors wrote.

The National Association of Health Care Assistants (NAHCA), the professional association for certified nursing assistants (CNAs), found poor wages and benefits were cited as primary reasons why CNAs left, or are considering leaving the profession.

Nearly 84% of about 650 respondents told the association as much in a survey released on Friday. Burnout and lack of respect from leadership were the second- and third-largest challenges for CNAs and contributors to the staffing crisis.

“The comments from CNAs illustrate that the largest contingent of the [long-term] care sector’s workforce has reached a breaking point of extreme exhaustion and burnout,” said NAHCA Board Chair Sherry Perry. “It is a tragedy that we are losing so many caring professionals to a crisis that could have been avoided.”

Managed Medicare revenue mix increased 20 basis points from November to December to land at 9.9% – a reversal of the decline that happened from October to November, but remaining well below its February 2020 high of 10.8%.

NIC authors attribute the turnaround to elective surgery referrals. Managed Medicare revenue per patient day (RPPD) declined slightly to end December at $451 – the statistic has dropped $107, or 19.2% since January 2012; this was when the NIC MAP data series began to be reported.

While Medicare RPPD increased to $580 in December compared to November, the statistic declined 1% since June 2020 when severe cases of Covid were increasing early on in the pandemic.

“The federal government implemented many initiatives to aid properties for cases of Covid-19, including increases in Medicare fee-for-service reimbursements,” NIC authors stated.

Medicare revenue mix increased along with RPPD by 57 basis points to end December at 20.7%, but NIC authors were quick to point out the statistic has been falling from 24.5% in January 2021.

Medicaid RPPD remained flat at $248 from November to December – taking a look at most of 2021, RPPD for Medicaid decreased 1.1% from February to September before increasing 1.6% the last four months of the year. NIC authors tie these changes to some states adjusting Medicaid budgets, increasing reimbursements for the 2022-2023 fiscal year.

“Medicaid reimbursement has increased more than usual as many states embraced measures to increase reimbursement related to the number of Covid-19 cases to support skilled nursing properties,” the authors stated.

Since December 2020, Medicaid RPPD increased 0.9% and 5% compared to $236 in February 2020.

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