Caregiver holding a resident's hand
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Fifteen months after the start of the COVID-19 pandemic, nursing home employment remained 13.2% lower than it was in February 2020, just before the public health crisis was declared. 

This sagging statistic exists while other healthcare sectors have seen steady improvements during the same period, according to a new study published in the January edition of Health Affairs

Findings showed that as of June 2021, employment levels were 2.2% lower in hospitals, 0.7% lower in physician offices and 2.6% higher at outpatient centers — as opposed to the continued decline seen in nursing homes. 

The double-digit drop in nursing home employment came after the sector saw a 3% decline as of April 2020. 

Health Affairs Chart (January 2021)

“Although overall employment has fallen much more in nursing homes than in other non-hospital sectors, the trends in unemployment for RNs, LPNs, and NAs were similar across these settings,” noted study author Peter I. Buerhaus, of Montana State University,and his fellow researchers. “For example, unemployment of NAs increased 1.8 percentage points between 2019 and the second quarter of 2021 in nursing homes while rising 1.7 percentage points in all other non-hospital sectors.” 

There weren’t significant unemployment changes for registered nurses, licensed practical nurses and nursing assistants during the first 15 months of the pandemic, according to additional study fundings. 

Full-time employment among LPNs and NAs has remained relatively flat between 2011 and 2021, while RN employment has steadily increased from around 2.4 million in 2011 to slightly less than 3 million in 2020. RN employment leveled off, however, once the pandemic began, while LPN and NA employment decreased. 

Researchers specifically found that total employment decreased 20% for LPNs and 10% for NAs — when comparing the five quarters before the pandemic (Oct. 2018 – Dec. 2019) to the five-quarter period from April 2020 to June 2021. Employment among RNs decreased just 1% when comparing the same periods. 

Based on the findings, researchers said the important question now is whether the employment trends will continue long-term. 

“Regarding entry, it is unclear whether the pandemic will lead to increased or decreased interest in nursing. One indicator is the number of applicants to four-year nursing programs, which grew just 1.5% in 2020 compared with increases of 4.5% and 8.5% in the prior two years. As a consequence, these exit and entry questions bear careful watching,” they concluded.