$11.3 Billion Needed for Nursing Homes Staffing 

Due to increasing labor costs and pervasive workforce shortages nationwide, more than 191,000 nurses and nurse’s aides are needed at the annual cost of $11.3 billion for nursing homes to meet a staffing minimum of 4.1 hours per resident day (HPRD), according to a new estimate. This figure is up from July 2022, when the estimate foresaw the need for an additional 187,000 caregivers and an annual cost of $10 billion.  

The estimate comes from the American Health Care Association (AHCA), representing more than 14,000 nursing homes and other long-term care facilities across the country, which released an updated report from accounting and consulting firm CliftonLarsonAllen (CLA) regarding a potential federal staffing mandate for America’s nursing homes. The report also found: 

• 94 percent of nursing homes would be unable to comply with a potential 4.1 HPRD staffing minimum. 
• More than one-third of residents might be at risk of displacement if facilities are unable to increase their workforce and must reduce their census in order to comply with a 4.1 HPRD staffing minimum. 

“This report once again highlights how our nation’s policymakers should be investing in our long term caregivers, not mandating quotas,” said Mark Parkinson, president and CEO of AHCA. “Nursing homes have been doing everything they can to recruit and retain staff, including increasing wages, but it has not been enough to stem the tide.” 

The CLA report models three different minimum staffing requirement scenarios to estimate the additional staff necessary as well as the costs associated due to hourly wages. The 4.1 HPRD model is frequently referenced by industry stakeholders due to a 2001 study evaluating staffing levels in nursing homes.