Staffing shortages in senior living communities create challenges

Senior Living communities are facing ongoing challenges as staffing shortages reach critical levels.

While employment across health services in the United States has rebounded post-pandemic — particularly in physicians’ offices, outpatient care centers, home health services and hospitals — the number of workers employed at skilled nursing care and other communities continues to remain below pre-pandemic levels.¹ Approximately, 99% of nursing homes currently have job openings, including 89% actively hiring registered nurse (RN) positions.²

These shortages are driven by significant obstacles in hiring qualified candidates and exacerbated by an aging workforce nearing retirement. At the same time, demand for care is accelerating. According to new projections, the United States will face a shortage of up to 86,000 physicians by 2036.³

Causes contributing to staffing challenges in healthcare

Staffing shortages in senior living communities stem from a combination of structural, cultural, and economic factors. Key contributors include:

• Lack of qualified and credentialed applicants, especially for roles such as RNs, LPNs and CNAs
• Low pay and limited benefits
• Minimal upward mobility and career advancement opportunities
• High stress, emotional fatigue and physical strain tied to the work
• Stronger competition from other healthcare sectors that offer higher wages, better hours and stronger reputations
• Increased compliance demands
• Lack of effective onboarding and ongoing training, which contributes to low job satisfaction and early departure

Problems that staffing shortages create for senior living communities

Staffing shortages give rise to challenges that affect both the staff and the residents. These include:

• Decreased individualized attention and supervision: Reduced staffing levels mean residents receive less one-on-one care, increasing the risk of missed needs, emotional isolation and delayed health interventions.
• Disruption in care continuity: High staff turnover and reliance on temporary agency personnel undermine the consistency of care, making it harder to build trust and spot early changes in residents’ health conditions.
• Increased risk of accidents and adverse events: When facilities are understaffed, response times to falls, emergencies or behavioral issues can be delayed, contributing to preventable harm and potential liability exposure.
• Reduced admissions and revenue loss: Without adequate staffing, facilities may cap admissions or leave beds unfilled, limiting their ability to generate revenue and serve the growing senior population.
• Employee burnout and turnover: Overextended staff face higher stress, job dissatisfaction and emotional fatigue. On average, nursing home care workers rate their burnout at a 3.5 out of 5.⁴ This cycle fuels more resignations and deepens the workforce shortage.
• Increased legal and reputational risks: Short staffing can lead to compromised care, which increases the risk of resident/family complaints, regulatory citations and lawsuits — particularly in cases involving neglect, injury or wrongful death.
• Difficulty meeting evolving regulatory requirements: Post-pandemic mandates related to infection control, minimum staffing levels and quality reporting place additional strain on facilities that are already struggling to meet basic coverage.

How management can combat staff shortages

To address staffing shortages in senior living organizations and reduce the risks associated with this issue, here are 10 strategies that can help retain employees and attract new staff — and support them in the process.

1. Recognize and appreciate employees: Celebrate the hard work and dedication of staff regularly to strengthen retention and motivation. Build a supportive workplace culture through mentorship, team recognition programs and visible, empathetic leadership. A positive culture has become one of the strongest predictors of retention in today’s workforce.
2. Offer competitive compensation: Increase base pay, provide shift differentials for nights and weekends and consider sign-on and retention bonuses. Competitive compensation can be essential in a tightening labor market.
3. Invest in your employees: Support staff with access to mental health services, wellness programs, childcare assistance, tuition reimbursement and flexible spending accounts. These benefits help reduce stress and signal a long-term commitment to employee success.
4. Provide flexible scheduling: Develop flexible scheduling options that cater to employees’ individual needs, allowing them to work hours that align with their preferences and help promote work-life balance.
5. Offer training and support: Ensure all staff receive robust, practical training that builds confidence and skill. Involve managers in onboarding and use real-world scenarios to create a culture of continuous learning and leadership development.
6. Design benefits that actually matter: Focus on benefits that meet essential needs — such as free or subsidized meals, housing stipends, transportation support and paid time off. These have greater impact than superficial perks and promote long-term job satisfaction.
7. Engage with the local community: Improve your facility’s reputation by participating in career fairs, open houses and volunteer events. Build awareness and trust among potential job seekers and referral networks.
8. Collaborate with training partners and workforce programs: Partner with local hospitals, nursing schools, vocational tech programs and state-funded apprenticeship or workforce development boards. Leverage training grants or incentive programs when available.
9. Prioritize resident safety and staffing compliance: Regularly evaluate staffing ratios and align workforce plans with the new Nursing Home Minimum Staffing Rule to avoid citations, reimbursement issues, or care-related claims. Staff shortages should never compromise care quality.
10. Continuously improve: Stay informed about what’s working in other senior living communities by benchmarking your recruitment and retention strategies against peers. Just as importantly, seek regular feedback from your own staff — through surveys, suggestion boxes or one-on-one check-ins — and use that input to guide improvements. When employees feel heard and see their ideas put into action, it strengthens engagement, loyalty and workplace culture.

By implementing these strategies, senior living organizations can work to mitigate staffing shortages, enhance the work environment and ultimately provide better care and support to their residents while fostering a culture of appreciation and commitment among their employees.

It can be more difficult to develop those relationships when organizations use an agency, but it’s still very possible to curate the best workers and cultivate a successful community. Lastly, consider sharing real-life claims with your clients so they understand what the trends are and what’s really at stake with staffing challenges.

Creative solutions for staffing shortages are needed

Nationwide’s Risk Management and Client Solutions team has professionals with direct industry experience who have developed resources that can help communities reduce risks to their staff, operations and residents.

Below are some of these resources that can be shared with customers:

• Senior Living industry library
• Setting realistic expectations in senior living communities
• Measures to reduce the risk of elopement
• Preventing abuse, neglect and exploitation
• Security cameras: What you need to know
• Mastering the art of documentation in senior living

As the country grapples with the challenges of an aging population, senior living operators will need to find ways to navigate staffing shortages and reduce risks associated with this issue.