The need for nursing assistants in long-term care facilities continues to grow, even as demand for nursing home care overall is on the decline, according to new research.

PHI released a study Tuesday on the state of the frontline healthcare workforce that projected open positions for nursing assistants in nursing homes would grow to 769,300 by 2031. That comprises 442,400 job openings due to workers moving to other occupations and 311,100 openings due to people leaving the labor force entirely. 

Those figures were likely calculated in advance of a proposed federal staffing mandate that is likely to drive demand for certified nurse aide hours higher.

PHI, which advocates for frontline healthcare workers, actually expects the nursing assistant workforce to lose 17,200 jobs by 2031 due to a decreased demand for nursing home care because of both consumer preference and public policies.  But turnover will mean a constant cycle of hiring and rehiring.

“While demand for nursing home care has declined in recent years, nursing homes continue to play a critical role in supporting individuals with complex needs,” PHI said in the report. Nursing assistants provide 24-hour care to 1.2 million facility residents, it noted.

“Low wages, heavy workloads, and long work hours — driven by chronic understaffing and greatly exacerbated by the ongoing COVID-19 pandemic — contribute to high rates of stress, injury and burnout among nursing assistants in nursing homes,” the organization added.

The median turnover rate in this specialized workforce is “nearly” 100%, PHI noted, advocating for interventions to improve job quality such as higher wages and better support from employers. 

There are currently 447,940 nursing assistants in the US, and although their wages have risen slightly since 2012, the median hourly wage, when adjusted for inflation, increased to $17.06 in 2022 from $14.51. 

“This overall trend means that nursing assistants’ wages have only increased slightly faster than the costs of goods and services over the past decade,” the report noted. “Although overall demand for nursing homes is declining, there is still a pressing need to recruit and retain enough nursing assistants to support individuals with complex needs in this care setting.”

The report also found that nursing assistants are nearly eight times as likely than the typical US laborer to sustain workplace injuries, including illnesses that are contracted in professional settings. Due to COVID-19, the rate of workplace injuries for nursing assistants increased by more than 300% from 2019 to 2020, the latest year for which occupation-specific data is available, the report noted.