Focusing on Employees Can Help Address Short-Staffed Nursing Homes’ Poor Health Outcomes

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medical doctor holding senior patient's hands and comforting her

As a medical analyst, I’ve been closely following and researching the healthcare worker shortage throughout the pandemic, and I hate to break it to you, but there’s no clear end in sight. Despite salary increases, improved benefits and added perks, healthcare providers are still struggling to attract and retain workers.

This is especially true for nursing homes. In Software Advice’s 2022 Nursing Home Staffing Survey, we found that there has been a startling decline of care for the elderly—and facilities are even turning away patients in some cases. 

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Current state of nursing home worker shortage

According to the U.S. Bureau of Labor Statistics, only about 46,000 nursing and residential care workers have been replaced for the more than 400,000 roles lost since the start of the pandemic in March 2020. And who’s suffering the most from this catastrophic shortage? Elderly patients. 

Our study found that 65% of nursing homes reported poor health outcomes due to staffing shortages.

Nursing and residential care facilities jobs data by the numbers

Source: U.S. Bureau of Labor & Statistics

Software Advice surveyed over 200 U.S.-based nursing home workers to get a pulse on everything from quality of care to effective recruitment methods. We included nurses, physicians, owners, and administrators currently working in nursing homes, geriatric practices, palliative care providers, and assisted living facilities. 

The findings paint a dark picture for the current state of elderly care in the U.S., but there are a few things providers can do to improve internal processes, recruitment and retention. 

Quality of care for the elderly has plummeted and response time has skyrocketed

Elderly care specialists are treating patients at a frightening and difficult time in their lives, which makes the impact of staff shortages even more alarming for patients and their families. To paint the picture, half of respondents said they lost between one and 10 employees in the past year, and a fifth of respondents have had between 11 and 20 employees quit in the past year. 

Nursing home workers are fed up with the conditions, created in part by staffing shortages, and cite these top three reasons for turnover:

  • Workload is too high (87%)
  • Pay is not adequate (78%)
  • Support from management is lacking (54%)

Unfortunately, 65% of employees at elderly care facilities have witnessed a negative health consequence for a patient caused by staffing shortages  in the past two years, and 52% of them saw this happen on more than one occasion. What’s more, 72% of respondents say that the time it takes to respond to patient calls has increased (on average, it takes most nursing home staff between 11 and 20 minutes to respond, with 14% of providers saying they usually take over half an hour.). Delays in response time can have serious consequences for patient health.

The past few years have been challenging,  and medical professionals must find solutions to improve patient care. Fortunately, there are a few routes you can take to help improve recruiting, retention, and internal processes affecting response times. 

Leveraging internal recruiting methods is most effective for reducing turnover

Public job-posting websites like ZipRecruiter and Indeed aren’t the most effective for recruiting, yet 42% of nursing homes say they’re relying on these platforms. In the survey, nursing homes using internal recruiting methods report a significantly lower rate of turnover, compared to other recruiting methods. 

Practices that use internal recruiters and referral programs are more likely to hire skilled workers who are well equipped to provide elderly care. 

Hiring an internal recruiter and developing a referral program is the most cost-effective and reliable route you can go. In fact, the American Hospital Association recently said that staffing agencies are even exploiting the staffing shortages by charging uniformly high prices in a coordinated way. 

Adopting new technologies for automation can improve functions and reduce turnover

Beyond recruiting, it’s important to take a look at internal processes that could be holding your practice back. Supporting staff with new technologies to help remove tedious work and speed up response times is paramount in this current environment. 

In addition to automating work, software can help improve the employee experience by providing tools for employee feedback, benefits access and management, payroll preferences, employee scheduling, performance management, and more. 

We found that less than half of nursing home facilities are actively using HR software, and opting to focus on software related to patient care (EHR and billing software). Nursing home managers should consider adopting technology that equips employees with the necessary tools for professional success and optimal care for patients.

Elderly care is a specialty that demands compassion, so the people that choose this career path deserve careful consideration and attention. Supporting them in every way they require is the best path forward and out of the current staffing crisis. 

By offering elderly care staff better working conditions and processes, existing patients will experience enhanced care while the door opens for new patients on lengthy waitlists.

Lisa Hedges
Associate Principal Medical Analyst at

Lisa Hedges is an associate principal medical analyst at Software Advice, a company that simplifies software buying. Through 1-on-1 conversation and trusted insights, industry-specific advisors guide buyers to top software options in as little as 15 minutes (and it’s 100% free).