Closeup of a pair of glasses sitting on an employment application

(Credit: Geri Lavrov / Getty Images)

Although employment at hospitals and physicians offices has returned to almost pre-pandemic levels, assisted living communities, life plan / continuing care retirement communities and nursing homes continue to see relatively high unemployment, according to an analysis of Bureau of Labor Statistics data by the Peterson Center on Healthcare and the Kaiser Family Foundation.

“Relatively recession-proof” in past recessions, healthcare employment fell dramatically in early 2020, according to the report. The COVID-19 recession saw health sector jobs fall sharply, although not as steeply as jobs in other sectors — healthcare employment fell by 9.3% in April 2020 from the previous month, whereas non-healthcare employment fell by more than 14%.

“While health employment in many facilities has nearly returned to pre-pandemic levels, the effects of the pandemic linger,” the authors wrote.

According to the data, however, community care facilities — including assisted living communities and CCRCs — as well as nursing homes, show continued decreases in employment, whereas other health sectors had nearly recovered to pre-pandemic employment levels by summer 2020. 

By November 2021, outpatient care centers and physician’s offices employed more people than in February 2020, and hospitals and home healthcare organizations were within 2% of their pre-pandemic employment numbers.  

Assisted living communities and CCRCs, however, saw an 11.1% decrease in employees from February 2020 (976,100 employees) to November 2021 (867,700). And the number of employees has continued to drop each month since, according to the report.

Nursing homes saw a 15% drop in employment during the same timeframe, going from 1.59 million employees to 1.35 million. That sector also is seeing decreasing employment almost every month, according to the report. 

Health sector employment overall remains below expectations, the authors said. As of November, the number of employees in the overall sector remained 2.7% lower than in February 2020; that level compared with 2.5% in non-healthcare jobs. For assisted living communities and CCRCs, employment rates were 14.6% lower than expected, followed by nursing homes (13.4%) and home health services (6.9%).


During the pandemic, however, employees of nursing homes, assisted living communities and CCRCs, and home health services all have seen higher wage increases than have employees who work in hospitals, outpatient care centers and physician offices, according to the research.

From February 2020 to October 2021, the cumulative change in average weekly earnings (seasonally adjusted) was 14.7% for nursing homes, 13.9% for assisted living communities and CCRCs, and 13.8% for home health services. That compares with 11.5% for hospitals, 7.3% for outpatient care centers and 5.5% for physician offices.

Job openings versus quit rates

Job openings in the overall health sector are higher than pre-pandemic levels. According to Job Opportunity & Labor Turnover Survey data, the combined number of health and social assistance job openings has been increasing since April 2020 and now is 51.9% higher than before the pandemic.

But since the beginning of this year, workers have been leaving their jobs at higher rates than before the pandemic. By October, healthcare and social assistance job quit rates increased to 35% higher than before the pandemic, compared with a quit rate of 29% among all workers. 

“The long-term effects on the health sector labor market from the pandemic are unknown, but changes in the delivery of healthcare — such as the growth of telehealth — may lead to lasting shifts in the health industry,” the authors wrote. 

More research is necessary to understand employee motivations and how the pandemic has shifted the supply of and demand for healthcare workers in the long term, they said.