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June 22, 2023

Workforce Challenges Persist: State of the Nursing Home Industry Survey

Max Pinch
Healthcare Industry


Adequate healthcare staffing is critical in delivering quality care and maintaining operational efficiency. A recent survey released by the American Health Care Association and the National Center for Assisted Living (AHCA/NCAL) revealed some concerning findings about the healthcare workforce in the long-term care sector.  

Let’s explore the survey's key findings here and examine what solutions are available to combat these trends. 

Survey Findings:

1. The staffing shortage in healthcare is worsening due to the lack of effective recruiting strategies and limited access to labor. 

  • 90% of providers are increasing wages, and 85% are offering bonuses.
  • 95% of providers say it is somewhat or very difficult to recruit new staff.

According to the survey, the biggest obstacles for providers in recruiting new staff are the need for more interested or qualified candidates and a poor financial situation. 

Recruiting has been incredibly challenging for the long-term care sector. One of the biggest concerns is that almost all providers have increased wages and offer bonuses, but applicant  numbers remain low. Other recruitment practices must be administered and executed, or the problem will worsen. 

2. As the population of people needing long-term care services increases, healthcare providers are being forced to downsize or turn away prospective residents or patients, further compounding the problem. 

  • More than ¼ of nursing homes had to close a wing, unit, or an entire facility due to the shortages.
  • 55% of facilities have to turn away prospective residents or patients.
  • 48% of nursing homes have a waiting list for prospective residents/patients of at least a few days.
  • 21% of facilities are downsizing the number of beds/units they can offer because of staffing shortages.

This industry-wide staffing problem is steadily worsening, and the risks are high. The presence of waiting lists and downsizing of available beds further exacerbates the challenges providers and patients face. Urgent measures and proactive solutions are needed to address this growing crisis and ensure that adequate care is accessible to all who require it.

3. The Biden Administrations’ Iinevitable staffing mandate will require a robust workforce.

  • 96% of facilities are somewhat or very concerned about meeting the federal staffing mandate.
  • 63% of facilities' largest concern with the mandate is finding enough staff to meet it.
  • 45% say they cannot sustain operations for more than a year at the current pace.

No matter what, recruitment and staffing strategies are a high priority. This may involve seeking investments from the government, implementing new programs, or exploring comprehensive solutions such as leveraging technology and optimizing staffing processes. By adopting a proactive approach and focusing on these areas, healthcare providers can strive towards building the workforce they need. 

The Key Takeaway:

This survey from AHCA/NCAL seemingly played out an avalanche of compounding problems ready to engulf the long-term care industry whole. 

Multiple factors contribute to the staffing crisis, including increased patient demand and decreased available staff. The inability of healthcare providers to recruit effectively, despite offering competitive wages, exacerbates the issue. Providers are already incurring financial losses to secure staff, and without adequate resources, they risk losing their beds or even their entire facilities. Staffing mandates, while well-meaning, can create an even bigger disparity between labor supply and facility needs, highlighting the urgency for better resources and funding.

Utilizing technology to streamline operations is one way organizations can adapt to this changing landscape. Technology can enhance recruitment efficiency, improve scheduling and resource allocation, reduce administrative burdens, and provide valuable insights through data analytics. 

What Does the Solution Look Like?

To maintain high-quality patient care and financial operability, a technology-driven solution should provide the following:

  1. Flexibility and Improved Recruitment: The solution should provide healthcare facilities with increased flexibility by allowing internal staff members to easily pick up open shifts. This reduces reliance on external labor pools and promotes a sense of ownership and engagement among the staff. Additionally, a centralized platform for scheduling makes it simple to fill gaps and maintain appropriate staffing levels, ensuring seamless operations.

  1. Gig Workforce Integration: To address staffing shortages, the solution should enable healthcare facilities to tap into the gig workforce. By bringing in external workers and expanding labor pools, facilities can access a broader talent pool while reducing costs associated with temporary staffing solutions. This approach offers both flexibility and cost-effectiveness.

  1. Sustainability and Streamlined Operations: A robust solution promotes sustainability by providing long-term workforce planning and scalability. It optimizes resource allocation and minimizes administrative burdens, empowering healthcare providers to focus on patient care and operational improvements. This results in improved outcomes for both staff and patients.

By embracing these key elements, healthcare facilities can find a solution that enhances staffing flexibility, reduces costs, and promotes sustainable growth. This ensures a continued focus on delivering exceptional patient care while maintaining financial stability in the ever-evolving healthcare landscape.


The survey findings highlight the urgent need for innovative solutions to address the staffing challenges in healthcare. A solution that paves a way forward by providing flexibility, cost-effectiveness, and long-term sustainability. By embracing technology-driven solutions healthcare providers can overcome the staffing crisis and deliver quality care while ensuring the success and viability of their facilities in the face of growing demands.

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