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Assisted living communities, continuing care retirement communities and skilled nursing facilities are experiencing slower workforce recoveries compared with other healthcare sectors, according to a new report from the National Investment Center for Seniors Housing & Care.

In a market trends blog, NIC Senior Data Analyst Omar Zahraoui compared employment patterns, including workforce contraction and recovery and wage increases, since March 2020 in the long-term care sectors with other adjacent healthcare industry areas.

Pointing to Bureau of Labor Statistics data, Zahraoui said that the number of assisted living and continuing care retirement community workers dropped significantly during the height of the pandemic — a 7.5% for assisted living from March 2020 to November 2021 and a 13.9% drop for CCRCs from March 2020 to January 2022. Skilled nursing saw a 15.1% drop in its workforce from March 2020 to March 2022.

Recovery faster in assisted living

On a positive note, the assisted living and CCRC sectors saw total employment inch up by 1.8% and 0.8%, respectively, in recent months from pandemic-related lows. But employment figures remain well below pre-pandemic March 2020 levels, at –5.8% for assisted living and –13.2% for CCRCs. The skilled nursing sector remains at 14.7% below pre-pandemic employment levels.

“These stats show that assisted living is experiencing a relatively fast workforce recovery compared with CCRC and skilled nursing,” Zahraoui said, adding that NIC MAP Vision data shows that occupancy and demand for assisted living also are recovering faster than they are for skilled nursing and CCRCs.

Adjacent healthcare industries — including home healthcare services, general medical and surgical hospitals, individual and family services, and physician offices — dropped in the early months of the pandemic but began to recover quickly, Zahraoui said. Home health and individual and family services took two years to return to pre-pandemic levels, whereas the assisted living, CCRC and skilled nursing labor forces only just recently began recovering.

BLS data from May showed that total employment in some of those sectors surpassed pre-pandemic March 2020 levels, at 1% for home health, 1.5% for individual and family services and 4.4% for physician offices.

Other sectors see success in recruitment, retention

“The relatively fast recovery across these healthcare industries suggests that these sectors have been successful in attracting and retaining workers during the pandemic — some of whom may have been part of the senior housing and skilled nursing workforce prior to the pandemic — and demand has been relatively strong compared with skilled nursing and senior housing,” Zahraoui said. 

Among the factors influencing workforce recovery for assisted living, CCRC and skilled nursing providers, he said, are macroeconomic market conditions, the continuing COVID-19 pandemic, size and growth of the labor force, demand patterns and competition.

“The relationship between labor and demand for the senior housing and skilled nursing sectors has never been strong and will remain critical,” he said. “The pandemic has shown that both residents and staff are part of the success equation for a smooth recovery.”

Wages higher in skilled nursing

The senior housing and skilled nursing sectors reacted to the workforce crisis by implementing the largest wage increase across health industries, but a quicker recovery across home health and individual and family services revealed that factors driving workforce recovery go beyond competitive wages, Zahraoui said.

Average hourly earnings in assisted living and CCRCs increased by 17.1% and 16%, respectively, from March 2020 to April 2022, whereas skilled nursing saw an 18.2% jump in wages. 

Skilled nursing workers now earn 17% more than assisted living workers and 8.7% more than CCRC workers. Skilled nursing workers also earn 4.3% higher wages than home healthcare services and 19.7% more than workers in individual and family services.