Nearly a third of the nation’s 15,000 nursing homes recently reported a shortage of nurses or aides, according to a new AARP analysis of government data, raising concerns about resident care at a time when many facilities are still battling COVID-19. The numbers represent the worst staffing shortages since the government began collecting COVID-19 data from nursing homes in May 2020.
Thirty percent of U.S. nursing homes reported staff shortages during a four-week period ending in mid-October, the analysis found. It also showed that there were more than 2,000 resident deaths from COVID-19 for a second month in a row.
In more welcome news, the national rate of COVID-19 infections in nursing homes declined after rising for a few months. And the rate of fully vaccinated nursing home staff climbed significantly more than it has over the past few months, following the adoption of more vaccine mandates. “There’s some good and some not so good news in this month’s data,” says AARP's Ari Houser, a senior methods adviser and coauthor of the analysis.
Check the vaccination rates of your nursing home
You can now find vaccination rates of both residents and staff at any Medicare-certified nursing home and compare it with state and national averages on Medicare.gov’s Care Compare website.
- Find a nursing home’s profile via the home page’s search function
- Visit the “Details” section of its profile
- Click the “View COVID-19 Vaccination Rates” button
Low staffing levels in nursing homes, particularly among registered nurses, are associated with worse outcomes for residents, including more COVID-19 cases, deaths and a higher likelihood of an outbreak.
“Even on [a nursing home’s] best day, if you’re fully staffed, things can still go wrong,” says Lori Porter, cofounder and CEO of the National Association of Health Care Assistants. “But things will definitely go wrong if you’re staffed at a third of what you need.”
Staffing shortages are hitting some states particularly hard. In Alaska, 81 percent of nursing homes reported shortages, the analysis found, the highest rate of any state. In Maine, Washington and Minnesota more than 60 percent of facilities reported staff shortages, while in Wyoming, Kansas, North Dakota, Oregon and Wisconsin, more than 50 percent did.
Worker shortages at their worst
When the coronavirus was crushing nursing homes last winter — infecting more than 200,000 residents and staff and killing 20,000 in just one month — the number of facilities nationwide reporting staffing shortages sat just below 30 percent.
In the latest four-week reporting period for AARP’s ongoing monthly analysis of federal nursing home data, which ran from mid-September to mid-October, the share of facilities reporting such shortages topped 30 percent for the first time. At the same time, COVID-19 nursing home infections were less than a sixth of what they were last winter.
AARP’s analysis of data from the Centers for Medicare & Medicaid Services (CMS) doesn’t say what’s causing the staffing shortages. But likely factors include the recent rise of COVID-19 cases in nursing homes due to the delta variant and increased worker burnout.
Trade organizations representing nursing homes, including the American Health Care Association/National Center for Assisted Living (AHCA/NCAL) and LeadingAge, say that vaccine mandates, including a new federal mandate that gives nursing homes until Jan. 4 to have all their employees fully vaccinated, are also contributing to staff departures.