U.S. nursing homes face severe staffing shortages: Vivian Health report
CALIFORNIA, UNITED STATES — Nursing homes across the United States are grappling with severe staffing shortages, a challenge that has persisted even as hospital staffing levels have rebounded post-pandemic.
A quarter of all U.S. nursing homes report “critical” staff shortages driven by an increasing demand for long-term care from an aging population.
This issue is particularly acute in certain states, where registered nurses (RNs) in long-term care (LTC) facilities are working exceptionally long hours.
Critical shortages plague long-term care facilities
The decline in workforce capacity within nursing homes, exacerbated by the COVID-19 pandemic, has been highlighted in the 2023 National Healthcare Quality and Disparities Report by the Agency for Healthcare Research and Quality (AHRQ).
The report noted that 8.4% fewer nursing and residential care workers were employed in January 2023 than in January 2020. This decline is not solely due to the pandemic; factors such as burnout, occupational hazards, and low salaries contribute significantly to the staffing shortages.
Burnout among nursing home care workers is a critical issue, with many nurses opting for less stressful healthcare settings. This shift exacerbates shortages and increases the workload for those who remain, creating a vicious cycle. Nearly half of new nurses report working overtime, and more than 10% hold a second job, often working undesirable hours like night shifts.
U.S. states most affected by long nursing shifts
According to data from the Centers for Medicare & Medicaid Services (CMS) and compiled by Vivian Health, nurses in Alaska, Utah, Nevada, Montana, and Kentucky are working the longest shifts in the nation.
In Alaska, nurses average 11.9-hour shifts, with the state experiencing over 1,500 registered nurse vacancies—a number expected to grow significantly by 2030. A new law enacted in July 2024 aims to address these shortages by expediting nursing licensure processes.
In Utah, where nurses work an average of 11.77 hours per shift, the shortage is compounded by an aging nursing workforce, with nearly 20% nearing retirement. States with large rural areas, like Nevada, Montana, and Kentucky, face additional challenges due to the uneven distribution of healthcare workers.
Impact on patient care and new regulations
Long shifts and staffing shortages not only contribute to nurse burnout but also affect patient care quality. Fatigued nurses are more prone to errors, which can compromise patient safety.
In response, new staffing requirements were introduced in April 2024 to alleviate worker schedules and shortages. However, the American Health Care Association (AHCA) reports that 80% of nursing homes cannot meet the 24/7 staffing requirement, and only 6% of facilities can currently comply with all new standards.
The potential for nursing home closures looms large, with 66% of LTC facilities expressing concern over their ability to remain operational if workforce challenges persist.
This scenario poses a significant threat to residents, families, and staff, highlighting the urgent need for effective solutions to this ongoing crisis.
Outsourcing as a solution to the crisis
Outsourcing certain functions can be a strategic response to the staffing crisis in nursing homes. According to a recent study by AMN Healthcare, more than half of nurse leaders found utilizing recruitment process outsourcing (RPO) helpful in addressing workforce shortages.
Outsourcing administrative tasks, such as billing and insurance claims, also helps nursing homes alleviate the burden on their existing staff and allows them to focus more on patient care. This approach not only reduces the administrative workload but also offers cost savings by minimizing overtime expenses and recruitment costs.
Furthermore, outsourcing nursing services can provide access to a wider pool of skilled professionals, offering flexibility and scalability to meet varying demands. This strategy can help maintain high levels of patient care, even amid staffing shortages, by ensuring that qualified nurses are available when needed.
Implementing outsourcing solutions can also improve operational efficiency and accuracy, which are crucial for maintaining nursing homes’ financial health. As the healthcare landscape continues to evolve, exploring innovative solutions like outsourcing could be key to overcoming the current staffing challenges.
