A new survey points to a growing gap between job satisfaction and workplace challenges among nurses working in skilled nursing facilities, with certain types of documentation topping the list of burdens and workplace culture and relationships – especially with supervisors – as possible solutions.

Based on responses from nearly 500 nurses in skilled nursing facilities (SNFs) in November 2025, the survey from the American Association of Post-Acute Care Nursing (AAPACN) in collaboration LTC 100, found generally strong job satisfaction among nursing home staff, with 65% of nurses and CNAs reporting they are “very happy” or “somewhat happy” in their roles.

Satisfaction was higher among experienced registered nurses (RNs), with 58% of those with seven or more years in the field reporting they are “very happy,” compared with 48% of RNs with less than three years of experience.

The results showed that retention is largely driven by purpose and relationships. Nurses cited meaningful connections with residents (31%), a strong sense of purpose (28%) and positive team culture (15%) as the top reasons they stayed at their existing roles.

However, in response to what made their jobs harder, about 22% of the nurses said it was due to not having enough staff, while 16% said it was due to workload being harder. Meanwhile, in response to other stressors contributing to burnout, the nurses cited rising regulatory burdens (16%), staffing shortages (12.5%) and leadership gaps (7%).

Released at the LTC 100 Leadership Conference Tuesday, the data suggests that providers need to address workforce challenges as demand for higher-acuity care grows.

The findings emphasize that workplace culture – particularly relationships with frontline supervisors – plays a critical role in retention.

Hiring well, recognizing staff and improving supervisor relationships can make or break employee satisfaction, said Amy Stewart, chief nursing officer at AAPACN who spoke to Skilled Nursing News at the conference. 

“Work culture is really low hanging fruit. It doesn’t cost a lot to invest in your culture, hiring the right people, investing in some kind of program where we’re honoring people,” Stewart said.

At the same time, the survey pointed to clear areas for improvement. Increasing documentation and compliance demands are straining staff, she said, highlighting the need for better tools, resources and training.

What surprised Stewart wasn’t the nurse’s sentiment on general documentation, but the burdens from overlapping requirements across payment systems. Nurses noted duplicating documentation tied to Medicaid, PDPM and managed care – beyond standard regulatory requirements – in order to ensure coverage and reimbursement.

“I expected burdens from documentation and regulatory stuff related to the survey process [to top the list],” she said.

The nationwide survey gathered responses from 489 RNs, licensed practical nurses (LPNs) and CNAs working in skilled nursing facilities. The 16-question survey examined job satisfaction, key drivers of retention, workplace challenges and attitudes toward AI.

In terms of what made the nurses most content, almost 34% listed flexibility of hours as their top choice, followed by about 22% who selected pay as their source of satisfaction.

Stewart noted AI tools as a solution to streamline documentation, freeing nurses to focus on patient care and purpose. While paperwork won’t disappear, she said, simplifying it with technology is key to reducing burden, staying competitive and attracting younger nurses.

AAPACN plans to use these insights to guide education and resources aimed at improving retention and care quality across the sector, Stewart said. Short of that, she warns, the sector is looking at a shortage of nurses in the near future.

“What are we going to do when the plethora of these nurses who responded to our survey retire?” Stewart asked. “So we’re going to need that pool of nurses sooner rather than later. We don’t have four or five years to wait. We have to think about how we’re going to get that pipeline going now.”

(Amy Stulick contributed to the reporting of this article.)