Like most organizations, a post-acute long-term care practice is only as strong as the staff it employs. Whether it’s the job of a medical director or the daily grind of a nurse practitioner, every role is crucial for the success of a practice. But, like a house of cards, when even just one section is left open, the entire structure can come crashing down. This is why practices everywhere are growing concerned over staffing shortages inflicted by the Covid-19 pandemic. Staffing shortages have always been a mainstay in the PALTC communities, but with the abruptness of COVID, staffing requirements have changed drastically as NH’s continued to fight and sadly fell ill to COVID. The PHE has been waived, but the issue of staffing pre-existed the global pandemic. In fact, according to a recent report from the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), over 210,000 jobs in the nursing home healthcare sector have been lost due to the pandemic. But where are we now and how do we move forward? 

So what hopes do we have to mediate a broken system, when the world was broken for 3 years? 

In this guide, we’ll take a look at the background of these shortages, how they affect post-acute long-term care practices, and the actions to take moving forward.  


      According to the AHCA/NCAL’s report, the number of nursing home employees dropped drastically from 1.5 million to 1.3 million between February 2020 and December 2022, resulting in the 210,000 eliminated positions we mentioned above. The report also pointed out that the sector has not seen workforce levels this low since 1994, which has caused great concern among practitioners over when these numbers will return to normal. According to the AHCA/NCAL, job growth in 2022 was slower than previously projected, with only 3,700 jobs accumulated each month over the last nine months. At this rate, experts predict that post-acute long-term care practices will not return to pre-pandemic staffing levels until 2027, roughly four years from now.  

      With such abysmal numbers, practices are struggling to keep up with the growing demands of the industry now that the Covid-19 Public Health Emergency has ended. In a separate survey from the AHCA/NCAL, recruitment was the biggest challenge facing post-acute long-term care practices when relieving the shortages. The piece went on to show that 96% of all nursing homes struggle to maintain their staff, while half of them claim their workforce has worsened since May of last year.  

      But at the end of the day, these are just numbers and statistics. What truly matters is how these staffing shortages impact the day-to-day operations of post-acute long-term care practices as well as the impact on patient care. This brings us to… 

      Post-Acute Long-Term Care Staffing Shortages Impact

      It’s no secret that the pandemic has had a significant impact on every healthcare sector. Still, while certain industries have rebounded from the virus, post-acute long-term care practices continue to struggle. For example, PALTC practices experienced a loss of 307,000 jobs between February 2020 and December 2022, while other sectors like outpatient care and home health actually saw an increase in staffing.  

      These shortages have resulted in multiple challenges for practices nationwide, such as limited resident admissions that can disrupt a practice’s revenue stream. As a result, practices are facing monumental backlogs that are affecting their overall efficiency. In fact, some facilities have been permanently closed since the pandemic due to staffing shortages, according to the AHCA/NCA. As the unemployment numbers continue to rise, most practitioners are preparing for some rough upcoming years, with some already taking the necessary steps forward.  

      Actions To Take  

      As the pandemic spread, staffing challenges arose. Severe Covid-19 outbreaks resulted in temporary absences or permanent departures from staff employees. But now that we retreat to the status quo, there are still lessons to be learned. So, with these lessons, where do we go from here?  

      One of the most significant staffing challenges facing practices today is recruitment. While recruiting can be difficult in any industry, it’s especially challenging for healthcare providers as the bar is set higher for medical professionals. Most agree that these issues stem from a lack of financial support, as Medicaid reimbursement rates are often lower than the actual costs of care provided in post-acute long-term practices.  

      There is, however, a silver lining.  

      The administration has considered crafting and implementing a federal staffing minimum for these practices, granting them the extra help and resources required to run a successful facility. While this plan could benefit practices nationwide, most professionals are concerned about the consistency of this proposal, as most federal mandates without substantial and consistent resources often make the situation worse. In addition, the AHCA/NCAL predicts that post-acute long-term care practices will have to spend up to 10 billion each year to comply with increased staffing measures,  

      While this might not seem like the optimal situation for the industry, many are optimistic about what the future will hold as practices shift their focus to recruitment.  

      Post-Acute Long-Term Care Staffing Shortages Wrapped-Up  

      As the pandemic fades, practices everywhere are forced to pick up the pieces in the aftermath of this historical event. Even as the industry experiences record lows in staffing, there’s hope for a better tomorrow as we return to a new normal.  

      Saisystems Health is a dedicated provider of high-tech solutions designed to enhance post-acute long-term care practices with expertise in revenue management, electronic health records, and payor enrollment. As we wait for staffing levels to return to normal, let us carry the burden. Fill out the form below for an in-depth look at our solutions and offerings.  

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