Image of female nurse using telephone in office

A new skilled nursing workforce poll reveals deep and persistent hiring challenges at the nation’s nursing homes ahead of a minimum staffing rule expected to be announced by federal regulators next month.

Among nearly 900 respondents in an informal LeadingAge survey, two-thirds said they had not seen an improvement in labor issues since June 2022, when a similar poll was conducted. Among nursing homes, 92% were still reporting significant or severe workforce shortage in the new poll, taken Feb. 21 through March 13.

Leaders with the national association of nonprofit providers said the latest findings reveal ‘scary’ realities about the impact of staffing shortages.

“As much of the country is moving beyond the pandemic, aging services providers are still struggling to staff up enough to serve older individuals and their families in need of care,”  Ruth Katz, senior vice president of public policy and advocacy, wrote in a blog published late Tuesday. “Many providers aren’t able to support those coming out of hospitalization because nursing homes and home health providers don’t have the staff to serve them.”

Katz noted that there are 1.7 jobs open for every person looking for a job in the US, making it especially hard to compete for entry-level workers.

“It is indeed really scary right now for long-term care,” she added.

Katz called on policymakers to “step up to the plate” and strengthen domestic training programs through new internship, apprenticeship and loan forgiveness programs. She also noted that despite lip service given to some immigration initiatives over the last year-plus, providers are growing increasingly frustrated with a lack of action.

One LeadingAge member responding to the poll said “there seems to be no urgency among government agencies involved in [helping foreign workers come to the US].”

Just 12% of responding organizations have successfully recruited foreign workers from the Philippines, Puerto Rico, Canada or other countries through work-based visas, with 5%  having hired workers on refugee status.

More than 200 other respondents specifically commented that they want better policy solutions to seek immigrants to fill empty positions.

“It will take courage and political will to frame and fund these solutions, but it must be done,” Katz wrote.

Of the 891 respondents to the poll, 71% said they offered nursing home care.

Across sectors, respondents said the top three most difficult positions to recruit for were: registered nurses (86%), licensed practical nurses (85%), and certified nursing assistants (85%).

Respondents also reported that staff are still leaving positions for better pay (78%), better work schedules (53%), and due to burnout/professional fatigue (73%).

Most respondents are offering additional incentives to hire and retain staff, with 92% of those offering increased hourly wages, 69% offering sign-on bonuses, and 61% offering “creative” scheduling.

“We’d hoped the workforce shortages – especially for critical nursing positions (registered nurses, licensed practical nurses, and certified nurse aides) – would ease at the end of the pandemic, but we’ve seen little change,” Katz wrote.

“Older people who need care and services expect, and we should, provide the high-quality care that comes from having a full and fairly compensated staff. LeadingAge members always look to hire and retain mission-focused professional caregivers who are motivated and committed to service. But they have to be reimbursed adequately to pay their workforce a living wage.”