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Skilled Nursing Facilities (SNFs) are facing a number of persistent recruitment challenges, some of which are compounded by lingering impacts of the COVID-19 pandemic.
In AHCA / NCAL’s “State of the Sector” report more than 99 percent of nursing homes are currently advertising open jobs, including 89 percent who are trying to hire registered nurse (RN), certified nursing assistant (CNA), or licensed practitioner nurses (LPN) positions. In the same report which surveyed more than 441 providers, nearly three quarters (72%) of facilities have reported workforce numbers below pre-pandemic levels.
More than two-thirds of facilities are reporting a lack of qualified candidates, or receiving low interest levels in open jobs. To combat this, organizations are increasing wages to attract candidates into these vacancies, as well as introducing bonuses which includes acts such as a sign-on bonus – in order to make up an estimated shortfall of c.130,000 workers needed to match pre-COVID levels. Survey respondents cited that positions in nursing homes are often seen as less desirable compared to other healthcare settings, owing to the perception of higher stress and workload levels.
These challenging working conditions have seen high levels of turnover, and reported burnout within SNFs, despite facilities increasing pay and training. A staffing rule implemented in early 2024 to raise the minimum staffing levels and improve the overall work environment for nursing home staff was seen as a positive step in theory, the reality is that getting clinical staff into SNFs would be very hard to deliver. It is estimated that the changes would require more than 100,000 clinicians, at a cost of $6.5bn annually – at a time when most SNFs are absorbing more and more costs.
This is leading to a high reliance on temporary staffing (or agency staff) which can lead to inconsistent care, and increased costs. The financial strain, alongside a limited labor market, is adding further pressure on overstretched facilities – which can lead to compliance issues impacting resident admissions, risking the closure of SNFs.
