Hope you had a nice Labor Day. For most of the country, it comes around once a year. But if you are leading a long-term care organization, it’s pretty much an everyday event.

Here’s why:

Labor is your most expensive cost of doing business. Depending on how things are run at your place, it is probably eating at least half of your operating budget, more than likely about two-thirds. Possibly even more.

And yet for all the time and energy you put into managing labor and its attendant challenges, it is probably still your go-to topic for a semi sleepless night.

It’s probably reasonable to ask why labor remains so problematic in this field, given how much funding is already allocated toward it, as well as the inordinate amount of time most managers spend dealing with it. You’d think by now the problem would have been hashed out, right?

But things are not generally getting better, are they? In fact, there are many good reasons to believe they might soon become far worse.

For one, the overall job market remains heavily tilted in favor of those perusing the classifieds. Unemployment is basically non-existent at the moment. And many of your competitors (especially big box stores and fast-food restaurants) are stepping up their game, both in terms of pay and other sweeteners. Walmart, for example, has a program that allows workers to get online college degrees in business for about $75 a semester, all in.

Moreover, many long-time employees are nearing retirement. If you’re like most facilities, your director of nursing has probably been at it for the better part of 30 years. How much longer do you think she’s going to stick around? The short answer: probably not too many more years.

To be sure, there are some helpful signs on the labor front as well. Recent studies show that opening our borders to more foreign workers could help offset projected shortages. Of course, that remedy does not exactly appear to be the flavor of the day in Washington right now.

Perhaps robots can help as well.

Then there are other technology-related breakthroughs that will allow staffers to get more work done in less time. These and other improvements can help.

But no matter how you look at the labor situation in long-term care, facilities remain in an uphill battle. And that reality is not likely to change any day soon.

John O’Connor is McKnight’s Editorial Director.