Labor Shortages

Skilled Nursing News had an interesting article about labor shortages causing facility closures. According to the July 2025 Ziegler CFO Hotline survey, staffing shortages have caused providers, particularly in Skilled Nursing units, to limit admissions, which affects 25% of single-sites and 18% of multi-site  communities.

The survey gives insight into staffing trends in long-term care communities across the U.S., including vacancy and turnover rates, reliance on agency staff, and workforce stabilization strategies. “Amid an evolving labor landscape, rising costs, and growing care demands, the senior living sector continues to face considerable obstacles in attracting, retaining, and supporting its staff,” the survey notes.

Vacancy and turnover remain the top concerns for CFOs. CNAs, LPNs, and RNs are identified as the most challenging roles to recruit and retain, with a CNA turnover rate reaching 44.2% on average. Vacancy rates are highest in rural areas, particularly among CNAs and LPNs, while multi-site sub-metropolitan organizations reported particular difficulty in filling RN roles.

Over 60% of respondents reported using agency staff in the past year, with multi-site organizations relying more heavily on temporary workers. Some providers have had to limit admissions due to the staffing shortages.

Nearly all organizations, approximately 96%, experienced an increase in staffing costs over the past year, with one-third of the providers experiencing a “significant” increase in labor costs. Compensation now averages 56.1% or more of the budgets of more than half of providers. One in six organizations reported that staffing challenges had “severe” impacts on their operating margin.

Providers have adopted various approaches to attract and retain staff, with top strategies including promoting a positive workplace culture among 78% of respondents, and 77% are planning to increase wages and offer bonuses. However, only about 6% have reported success in international recruitment, as they face struggles with legal and visa hurdles.

The participating CFOs represented a wide range of providers, primarily single-site communities, with most offering independent living and skilled nursing services. This is followed by a significant number who also offered assisted living, and nearly half provided home and community-based services (HCBS).
Thirty-three states were represented in this survey, with the most significant number of respondents coming from Pennsylvania, Florida, Virginia, North Carolina, and Ohio.