The senior living industry employed more personal care aides than skilled nursing in 2021 and paid competitive wages that came close to the national hourly average, according to a new analysis of jobs and wages for nursing staff and aides.
Omar Zahraoui, a senior data analyst at the National Investment Center for Seniors Housing & Care, used 2021 Occupational Employment and Wage Statistics data from the Bureau of Labor Statistics to discuss the state of the nursing labor market in senior living in a Friday blog post.
Four occupations — registered nurses, licensed practical and licensed vocational nurses, nursing assistants, and home health and personal care aides — accounted for 52% of all employees within the senior living sector (defined as assisted living and CCRCs) in 2021, compared with approximately 60% in the skilled nursing sector, he said.
Personal care aides (27.6%) and nursing assistants (15.8%) accounted for the largest share of all employees within senior living, followed by LPNs and LVNS (5.1%) and RNs (3.6%). Compared with skilled nursing, senior living employed fewer nursing staff but more aides in 2021.
Wages somewhat competitive
Other than for RNs, senior living and skilled nursing wage rates were somewhat competitive compared with the U.S. average wages and other healthcare industries. Zahraoui said that this fact suggests that workforce attraction and retention are more about a mix of factors in addition to workers’ pay.
Senior living and skilled nursing proved to be the lowest-paying healthcare industries for RNs in 2021, however. RNs were paid hourly wages of $32.59 (18.1% below the U.S. average hourly wage) in senior living and $34.74 (12.7%) below the national average in skilled nursing.
LPNs and LVNs in senior living, on the other hand, earned 1.2% above the national hourly average at $25.22 compared with $25.80 per hour in skilled nursing. The hourly wage paid in senior living was almost the same or better than in all other healthcare settings, including general medical and surgical hospitals, where LPNs and LVNs earned $23.10 per hour.
Salaries for nursing assistants in senior living ($15.15) and skilled nursing ($15.43) also were competitive, according to Zahraoui, although they were slightly lower than the $15.99 national hourly average for the position. Nursing assistants in senior living and skilled nursing earned below the rates paid in general medical and surgical hospitals ($16.92) but above those in home healthcare services ($14.39) and individual and family services ($13.84).
Average hourly rates for personal care aides in senior living ($14.06) and skilled nursing ($14.49) also were competitive compared with the $14.07 national average for other industries and healthcare settings. Aides in individual and family services earned $14.20 per hour, and aides in home health care services — which employed the largest number of aides across all healthcare industries — earned $13.52.
Labor participation down
Workforce shortages continue to be a major challenge for the senior living and skilled nursing sectors, where labor participation rates remained well below pre-pandemic levels at 62.2% as of June — 1.2 percentage points below the pre-pandemic level of 63.4%, Zahraoui wrote. Fewer jobs exist today in senior living and skilled nursing than in March 2020, he said.
When looking at employment ratios, the data showed that in 2021, there were 5.2 LPNs and LVNs for every 100 80-year-olds, whereas the nursing assistant ratio was 10.7 for every 100 older adults. In comparison, there are more RNs (24.8) and aides (27.4) for each older adult than LPNs, LVNs or nursing assistants.
When it comes to RNs, overall, 18 states had labor concentrations higher than the national average of 24.8 per 100 older adults. Those states included Colorado (30.2), Indiana (27.8), Massachusetts (32), Ohio (27.9) and Texas (27.6). The lowest labor concentration ratios of RNS were in New Jersey (21.1), New Mexico (20.6) and Florida (16.8).
Sixteen states, overall, had labor concentrations of LPNs and LVNs above the 5.2 national average. The largest labor concentration ratios of these job categories were in Louisiana (11.4), Oklahoma (8.6) and Texas (8.2). Some of the lowest labor concentration ratios for LPNs and LVNs were seen in New Mexico (2.2), Oregon (2.2) and Utah (1.5).
For nursing assistants, 27 states had labor concentrations higher than the 10.7 national average, with the highest labor concentrations in Kansas (19.3), Nebraska (19.1) and Wisconsin (13.2). California (7) — which employed the largest number of nursing assistants in 2021 at 94,450— Nevada (8.2) and Florida (7.4) had the lowest concentration ratios of nursing assistants. Zahraoui noted that California’s relatively high number of older adults 80 and older (1.35 million in 2021) resulted in its lower labor concentration ratio.
Ten states had labor concentrations of home health and personal care aides higher than the 27.4 national average, with the highest concentration ratios in New York (57.5), Washington, DC (53.6) and California (53). Illinois (21.5), Alabama (10.6) and New Jersey (19.8) were among the states with the lowest labor concentration ratios for those employment categories.
Zahraoui’s Friday post was a followup to a previous report that assisted living communities, continuing care retirement communities and skilled nursing facilities were experiencing slower workforce recoveries compared with other healthcare sectors.
NIC also recently reported that employment in residential care facilities and nursing homes increased by 8,000 jobs in June, the fifth consecutive monthly gain. But jobs remained 11.3% below a July 2019 high point.
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