The people make the place. Nowhere is that more true than in skilled nursing, where care staff and administrators work every day to deliver the best quality care and experiences for residents.
Yet despite their shared mission, new research from Viventium shows a striking divergence in how each group views the biggest workforce challenges, especially when it comes to retention, motivation and trust.
In The 2025 Healthcare Workforce Management Report, Viventium surveyed nearly 650 health care professionals — including 505 administrators and 141 care staff — from across organizations of all sizes, some with fewer than 200 employees to others with more than 5,000.
The findings expose a critical reality: staffing shortages and burnout are accelerating. Nationally, nursing facilities report turnover rates as high as 128%. Rising care demand, shrinking labor pipelines and wage pressure are compounding the strain.
To help address these gaps, the report explores the big challenges impacting workforce management and the areas of greatest disconnect, and ultimately lays out the innovative ways in which leading organizations are restoring trust and fostering resilient teams to reimagine care delivery from the inside out. Read on for a sneak peek of some of the most interesting takeaways.
To download and read The 2025 Healthcare Workforce Management Report, click here or scroll to the end of this article.
Challenges Fueling the Skilled Nursing Staffing Crisis
Workforce shortages remain the defining pressure point for skilled nursing. In fact, the American Health Care Association notes that nursing homes have experienced the worst job loss of any health care sector, with 9 in 10 saying they cannot hire enough staff to meet demand. Competition from retail and other service industries, along with a dwindling pipeline of new care staff, leaves many providers unable to keep pace with the growing needs of an aging population.
These shortages intensify burnout. Heavier caseloads, longer shifts and unpredictable schedules erode well-being and push experienced care staff toward the exits. Financial headwinds compound the strain: wage inflation, rising supply costs and tighter reimbursement — especially as Medicare Advantage reshapes payment models — squeeze margins and limit flexibility.
Technology fragmentation adds another layer, as disconnected payroll, scheduling and HR systems force staff to bridge gaps manually, slowing workflows and increasing the risk of costly errors.
Within this challenging landscape, the research highlights perhaps the sharpest insight: care staff and administrators diverge on what would help most. Nearly 70% of care staff live paycheck to paycheck, and 82% are their household’s primary earner. Yet administrators most often cite professional development — not compensation — as the key retention lever.
Additionally, fewer than 40% plan to raise wages soon. This disconnect undermines trust, accelerates turnover and perpetuates the very staffing crises organizations are struggling to solve.
What drives retention: The unrealized importance of pay
For many care staff, compensation is not just one important reason why they stay with their employer — it’s their primary reason. An overwhelming majority of care staff in the survey selected “higher pay” as the top motivating factor for retention.
Administrators often see it differently, ranking professional development as the key lever. According to survey results, less than one in five are currently increasing pay, and only about a third plan to do so soon. This disconnect helps explain why retention remains so fragile.
Further fueling this issue is a surprising lack of confidence in payroll accuracy. While even minor payroll errors can irreparably erode employee trust and confidence, 81% of administrators report feeling very or extremely confident that their payroll is calculated correctly.
Yet, the research revealed that administrators are more error-prone than their optimism indicates: 80% of administrators make at least one payroll error each month. And they are more forgiving of these errors than their employees are. While 80% of care staff would lose trust in their employer after three errors, 10% of admins think it would take six or more errors per year before their team lost trust.
Left unchecked, this will continue to fuel cycles of turnover and attrition. Nearly one in four care staff do not believe their pay is calculated correctly today — and more than half say they would consider seeking another job if they experienced recurrent errors. This is a hint for administrators looking for an easy morale booster: improve your payroll processes and improve your loyalty and retention.
Toward a new day for workforce management
Time and again, hidden disconnects between the way care staff and administrators view their jobs, the industry and the best way to operate create misunderstandings. These gaps impact burnout, job satisfaction and workplace morale — but they are avoidable.
While these forces may feel overwhelming, the data reveals a hopeful truth: the future of health care is already taking shape. This transformation is happening from the inside-out, driven by people who are committed to solving avoidable challenges so they can refocus on what matters most: delivering exceptional care.
And while care staff and administrators may often view the industry’s challenges through different lenses, new solutions offer a way to bridge these gaps and nurture their workplace culture. From reflection to insight and action, the report offers a sustainable — and actionable — framework for people and process.
By investing in a people-first strategy, the industry can move forward with intention, helping to align perspectives, empower administrators to lead with clarity and empower care staff to deliver with confidence.
This Views article is sponsored by Viventium, who are working toward a new day in health care, with resilient, robust and empowered care teams that can get them there. To download “The 2025 Healthcare Workforce Management Report” in full, click here.
