ICYMI: New Report from ASPE Confirms Disproportionate Workforce Shortage Among Long Term Care Facilities

In case you missed it last week, the Assistant Secretary for Planning and Evaluation (ASPE), part of the U.S. Department of Health and Human Services (HHS), released a new report that provided additional evidence that long term care facilities have been impacted by the workforce shortage to a larger degree than other sectors within the health care industry. The report found that between December 2020 and December 2021, hospital employment declined by just 32,900 employees, while nursing and residential care facilities lost upwards of 145,000 workers.

The COVID-19 pandemic has fueled historic workforce shortages within the long term care industry. According to data from the Bureau of Labor Statistics (BLS), the sector has lost more than 400,000 employees since February 2020. The report from the ASPE touched on the growing crisis of caregiver exhaustion and mental health struggles amongst the entire healthcare industry, stating:

“A survey conducted by the HHS Office of the Inspector General (OIG) in February 2021 found

that increased work hours, in combination with the stress of the pandemic, had resulted in high levels of staff

exhaustion as well as some reports of trauma and PTSD.”

These conditions, coupled with the inability of long term care providers to offer competitive wages and benefits due to chronic government underfunding, have led to far too many dedicated caregivers seeking work elsewhere. This has forced many facilities to limit admissions or in a growing number of cases, close their doors for good. Facilities need more investments from lawmakers and public health officials in order to recruit and retain a sufficient workforce to fill these growing labor gaps.

As reported in Skilled Nursing News, the latest BLS report showed the health care industry added approximately 34,300 jobs in April, but only 900 of those were among the skilled nursing sector. In an article in Skilled Nursing News, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) said:

“Providers are doing everything they can to recruit and retain staff, but we need government support to go further faster. It’s time for policymakers to invest in our frontline heroes and develop policies that will help recruit and retain hundreds of thousands of long term caregivers.”

The ASPE report also cited a 2016 study that estimated a national shortage of registered nurses (RN) by more half a million by 2030. While the skilled nursing industry supports reforms that would require having a RN on-staff 24 hours a day, increasing nursing home staffing requirements must be coupled with funding and policies that support tackling these national caregiver shortages. Facilities can’t hire more nurses if the nurses aren’t there.

AHCA/NCAL has offered solutions to the ongoing workforce crisis in the Care For Our Seniors Act. The proposal includes a multi-phase strategy to address staff recruitment and retention challenges, including loan forgiveness for recent graduates pursuing careers in long term care, tax credits for licensed long term care professionals, programs for affordable housing and childcare assistance, and increased subsidies to schools that have graduates working in nursing homes for five years or more. These proposals, along with funding, will provide meaningful change that will allow long term care facilities to invest in a strong labor force for years to come.

With the help of state and federal governments, incentives to build back the long term care workforce can put this devastating labor crisis behind us and prepare for a growing elderly population. Long term caregivers work every day to provide quality care to America’s most vulnerable population, and we need to prioritize investing in that workforce so seniors can access the care that they need.


The American Health Care Association and National Center for Assisted Living (AHCA/NCAL) represents more than 14,000 non-profit and proprietary skilled nursing centers, assisted living communities, sub-acute centers and homes for individuals with intellectual and development disabilities. By delivering solutions for quality care, AHCA/NCAL aims to improve the lives of the millions of frail, elderly and individuals with disabilities who receive long term or post-acute care in our member facilities each day. For more information, please visit www.ahcancal.org or www.ncal.org.