Beth Burnham Mace headshot
Beth Burnham Mace

Staffing shortages have become “pervasive” nationwide since the pandemic began, and the acute shortage of nursing staff and aides in skilled nursing facilities likely has not hit rock bottom yet, National Investment Center for Seniors Housing & Carer Principal Bill Kauffman and analyst Omar Zahraoui wrote Friday in a blog post.

“It’s a fundamental problem in the U.S. economy right now, affecting all industry sectors, and the senior housing and skilled nursing sectors are included in that,” Beth Burnham Mace, chief economist at NIC, told the McKnight’s Business Daily. “The labor shortage is here, and it’s going to be here for the foreseeable future.”

The shortages of staff members reported by SNFs have been highest among nursing staff and aides, which represent the largest share of all SNF staff, and SNFs find themselves competing with other industries while trying to recruit and retain workers to provide care, according to the blog authors.

“Further, the industry is challenged with maintaining operating margins due to very low occupancy rates, elevated operating expenses, and the often-inadequate Medicaid payment rates in many states,” Kauffman and Zahraoui wrote.

“We have a number of workers that have not come back into the market since the pandemic for some reason. They have childcare [issues], or they might have elder care responsibilities. A lot of these workers are women,” Mace said. 

“There have been some people that have said, ‘Well, it’s because there were generous unemployment insurance benefits,’ but so far, the data doesn’t support that. We haven’t seen that pop in the most recent data from [the Bureau of Labor Statistics],” she added.

Some concern exists that, as the population ages and more people need skilled nursing care, there will not be enough younger workers to replace people who retire. 

“The number of baby-boomer retirees increased by over a million in 2020, and the national birth rate hit a 35-year low in 2019. These demographic trends suggest a tightening labor market ahead, and that a large and growing labor pool of essential workers are needed today and in the foreseeable future,” Kauffman and Zahraoui wrote.

Almost all of the nursing homes that responded to a recent survey by the American Health Care Association said they are asking staff members to work overtime or extra shifts. More than half of the respondents said they are limiting new admissions due to staffing shortages.

Mace said she found those numbers to be “pretty stunning” and added that the industry needs to collectively find ways to entice staff back into the workforce such as through flexible scheduling and bonuses. In one NIC survey recently, she said, 67% of respondents suggested higher wages.

“For our industry in particular, it’s challenging, since a lot of our workers are intimately involved with people. It’s a human industry, person helping person,” Mace said. “You can’t really substitute that with a machine. There are still shortages that are being cited, and there are shortages that are bleeding over to the ability to do business and to expand business.”