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The number of workers in skilled nursing facilities declined in May, according to federal data published Friday. That stops a months-long positive trend for the sector.

Healthcare in general added 68,000 jobs in May in line with average monthly gains of about 64,000 monthly for the last year, the US Bureau Labor of Statistics reported. Together, nursing and residential care facilities added more than 11,000 jobs. 

But the good news stopped at skilled nursing care facilities, for which the data reflected a loss of about 0.1% nationwide last month. While the one-month decline may not appear significant, it comes at a time when providers are trying to hold onto every worker they can and even ramp up with new federal staffing requirements to begin in 2026.

“It is discouraging to see a decline in nursing home employment this month when we have seen a slow but steady increase since March 2022,” said Holly Harmon, senior vice president of quality, regulatory and clinical services at the American Health Care Association/National Center for Assisted Living.

“The nursing home workforce recovery from the pandemic has been extremely slow — four years later, and the sector still has not recovered its workforce to pre-pandemic levels,” she told McKnight’s Long-Term Care News Friday. “While all other healthcare settings that have more resources have fully recovered, nursing homes are struggling to find qualified candidates and compete for workers.” 

Following major pandemic-era losses, a 2022 study found it would take nursing homes at least until 2026 to recover the initial workers. That was with facilities adding an average of 4,600 jobs per month. It also didn’t take into account the additional 102,000 workers that would be required to meet the mandate’s registered nurse and nurse aides rules.

As providers seek a way around the staffing mandate, they’re often being met by consumer and congressional rhetoric that discounts the data produced by government officials, with many insisting publicly that there is no worker shortage.

On Wednesday, two lawmakers made such claims in a widely covered press conference outside the Capitol.

And a new blog from a think tank that often backs higher wages and union causes last week criticized the nursing home sector’s continued insistence that more direct care staff is not readily available.

Monique Morrissey, senior economist for The Economic Policy Institute said her organizations were pushing back “against unfounded industry claims of a worker shortage that would prevent nursing homes from meeting the new standard.”

“The nursing home industry has attempted to equate a staffing decline with a worker shortage,” she wrote. “But this decline mirrored a decline in occupancy, and, if anything, suggests that there’s a pool of sidelined workers who could be lured back if pay and working conditions improved. This is true in both urban and rural areas. …

“While there’s no evidence of a widespread worker shortage, there is a pay shortage. EPI found that nursing homes pay registered nurses and aides less than other healthcare providers,” she added, failing to note that nursing homes have few private-pay patients to help drive the reimbursement the sector says it needed to afford higher wages.

“Nursing homes are doing everything they can to attract workers, including making unprecedented investments. So, it is not for lack of trying — the candidates simply do not exist,” Harmon added. “On top of this labor shortage, chronic Medicaid underfunding has left long-term care providers struggling to compete for workers. Now, this unfunded staffing mandate does nothing to help us offer higher-paying, competitive jobs. Nursing homes are eager to rebuild their workforce, but we need the support of policymakers to invest in more meaningful ways to boost our workforce.” 

Morrisey also argued that many nurse aides earn “poverty-level wages despite difficult working conditions” and claimed that “staffing standards would help nursing homes attract and retain nurses by improving working conditions.”

But a major annual report published by the Hospital & Healthcare Compensation Service last August showed skilled nursing facility pay increases for direct care and clinical staff continued to far outpace historic averages in 2023. Raises averaged 7% for RNs; 8.9% for LPNs and 9.7% for CNAs. That brought national hourly pay rates to $37.86 for RNs, $29.66 for LPNs and $18.68 for CNAs.

A separate Petersen-KFF Health Tracker report found nursing homes have increased wages by 27% since February 2020, among the highest of all healthcare sectors. 

According to an AHCA report from March, 90% of nursing homes had increased their wages in the past six months, and 78% had offered bonuses, including sign-on payments.