Nursing home industry projects workforce won’t rebound until 2026

Nursing homes were struggling to attract and keep workers before the arrival of COVID-19, so it’s no surprise the pandemic made matters much worse.

Now, a new report suggests the nursing home industry remains years away from rebuilding its workforce, unless there is more government assistance.

It could take at least four years to get nursing home staffing back to pre-pandemic levels, according to the report released Aug. 8 by the American Health Care Association and National Center for Assisted Living.

The number of nursing home employees nationwide remains 14% lower than in February 2020, the month before COVID-19 led to shutdowns and radically upended American life.

Nursing homes are starting to have some more success in finding employees. From April through July, the nursing home workforce added an average of 4,600 workers each month, climbing to 1.36 million in July.

But that’s well below the pre-pandemic nursing home workforce of 1.58 million, a difference of about 220,000. The nursing home workforce is at about the lowest point since 1994.

Mark Parkinson, president and CEO of AHCA/NCAL, said it’s time for the federal government to step up.

“Our caregivers, who are working themselves ragged, and our growing elderly population can’t afford to wait another four years,” Parkinson said in a statement. “The long term care workforce needs a boost now. We urge federal and state policymakers to put their support behind policies that attract and retain caregivers for our nation’s seniors.”

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Hospital leaders have said they are affected by the staffing challenges of nursing homes as well. In recent months, healthcare system executives have said they have been keeping some patients because local nursing homes weren’t able to take those patients, due to staffing shortages.

Six in 10 nursing homes and assisted living centers are limiting admissions due to staffing issues, the ACHA said.

Staffing among all long-term care facilities, which includes both nursing homes and residential care facilities, has dropped to a 14-year low, according to the report. There are about 3 million workers at all of the nation’s long-term care facilities, a drop of more than 362,000 since the pandemic began.

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The National Academies released an exhaustive report calling for changing the funding of the nursing home industry. The report concluded “the way in which the United States finances, delivers, and regulates care in nursing home settings is ineffective, inefficient, fragmented, and unsustainable.”

President Biden has called for minimum nursing standards at nursing homes. The Biden administration has also proposed more funding for inspections and tougher penalties for nursing homes that have consistently fallen short in protecting patients.

Advocates for nursing homes have said they don’t need additional regulations, but could sorely use additional federal funding to hire workers and improve facilities.

“Rebuilding the long term care workforce will not happen by decree. Nursing homes cannot solve this labor crisis on their own. We need policymakers and stakeholders to work together to address the root causes of the staffing challenges in nursing homes and employ a comprehensive set of solutions​,” Parkinson concluded.

Some lawmakers and advocates for patients have criticized the industry for not doing enough to protect patients and to improve struggling facilities. The criticisms have escalated during the COVID-19 pandemic. About 200,000 of America’s COVID-19 deaths have occurred in nursing homes and long-term care facilities, and critics have faulted the industry for not taking appropriate steps to keep patients safe.

The nursing home industry’s defenders have said insufficient funding at the federal and state levels have hampered efforts to care for patients.