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LeadingAge Poll Shows Stagnant Workforce Issues, Foreign Workers as Potential Solution

Analysis  |  By Jasmyne Ray  
   March 17, 2023

A small percentage of the aging services providers the nonprofit association represents has found success hiring foreign workers through work-based visas.

In a recent poll, 64% of aging services providers stated their workforce situation hasn't improved since June 2022.

The poll, conducted by LeadingAge, a nonprofit association representing aging services providers across the country, shows that providers continue to struggle with hiring and retention, worsening financial burdens, and frustration with policymakers’ lack of action.

"The hours are insane for the pay people get. It is not uncommon to have staff routinely working 60+ [hours] per week because they do not want to let their residents go without," a LeadingAge member stated. "I have been doing this for 32+ years and this is the most dire time I have ever seen."

LeadingAge last surveyed its members in 2022 on similar issues to gain insight on their struggles.

Staffing struggles

Results of the poll showed that the three most difficult positions to hire for are registered nurses (86%), licensed practical nurses (85%), and certified nursing assistants (85%). Many have found that current staff are leaving their positions for better-paying roles (78%) and better hours (53%).

Another 73% are leaving due to burnout.

Member comments included with poll results note that some providers turn to agencies for staffing, which can be costly. As a result, nursing homes and home health agencies are limiting the number of patients they serve to ensure they can provide quality care with the staff they have.

Getting creative

70% of respondents said they've implemented different strategies to help with recruitment efforts, including offering sign-on bonuses (69%), flexible scheduling (61%), and emphasizing career advancement opportunities (56%).

92% of providers have offered increased hourly wages to employees in hopes of retaining them.

"We have closed units or delayed filling apartments … due to insufficient staff to provide quality care in SNF and memory care assisted living;" one provider commented. "Staffing continues to get worse, so [we] anticipate additional measures may need to be taken if it doesn't turn around."

Other options

Some organizations have found success in recruiting foreign workers to work in the United States through work-based visas (12%) or on refugee status (5%). The interest in foreign recruitment overall is high, according to almost 200 member comments from the poll. To make this process easier, they will need help from policymakers.

"We are in the process of starting a foreign workers program, but our approval for prevailing wages has been pending for 6+ months," one provider said. "There seems to be no urgency among the government agencies involved in this process."

“The hours are insane for the pay people get. It is not uncommon to have staff routinely working 60+ [hours] per week because they do not want to let their residents go without.”


Poll results show that there hasn't been a positive change regarding workforce struggles for over half of aging services providers.

With some staff leaving their positions for better pay elsewhere, nursing homes and home health agencies are having to limit the number of patients they care for.

Some organization's have seen success in recruiting foreign workers, but policymakers will need to take action to make the process easier.

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