The Nursing Shortage Crisis
The U.S. is facing an unprecedented nursing shortage that is pushing the healthcare system to its limits. Wage inflation is soaring for direct-care staff, and many skilled nursing homes (SNHs) are struggling to keep their doors open. With hospitals offering significantly higher wages, SNHs are left with a difficult choice: raise wages to compete or continue operating with fewer nurses – a no win situation that negatively affects both nurse mental health and patient safety. Without immediate intervention, this unsustainable situation will only deteriorate further.
Causes of the Nursing Shortage
Nurses across the United States are struggling with burnout. A 2023 study from the National Council of State Boards of Nursing reported that over 100,000 nurses have left the workforce in the last 2 years, and over 600,000 more nurses are expected to leave by 2027. Concurrently, wages are skyrocketing, with the average wage for nurses expected to rise by 13% over the next 9 years. In response to this growing nurse crisis hospitals are offering significantly higher wages, which is having a direct adverse impact on skilled nursing homes (SNHs) already struggling to keep their doors open. Raising wages will only increase strain on the tight operating margins of nursing homes, which has already caused SNHs across the country to shut their doors. On the flip side, continuing operations with fewer nurses leads to burnout and a growing perception that nursing home work is simply too strenuous for the compensation offered.
The Nursing Shortage and Patient Safety & Care
Skilled nursing homes across the country are facing issues that have been causing closures at an increasing rate over the last several years. “Nursing home deserts” are expanding, and that’s having the biggest impact on rural America. In smaller cities and towns, patients are already facing difficult choices: relocating, waiting longer for care, paying for home health services, or receiving less care than they need.
When SNHs are operating with skeleton staff, it has a direct negative impact on patient outcomes. Before the COVID-19 pandemic, the average nurse to patient ratio was 1:4. In 2024, that ratio jumped to an average between 1:8 and 1:40, depending on the facility type and state. The impact of the growing nursing shortage is higher patient mortality rates – an outcome that’s bad for everyone. Despite their best efforts, SNHs cannot compete with hospitals who can afford to pay higher wages.
Solutions to the Nursing Shortage
While the Centers for Medicare & Medicaid Services (CMS) have made commendable efforts to increase the number of U.S.-trained nurses, these initiatives will take months or even years to yield nurses. Plus – the demand for nurses in SNFs and hospitals is likely to far exceed the available supply, leaving SNFs particularly vulnerable. While some policymakers believe that setting staffing minimums will improve care quality and attract nurses back to the profession, this approach will only work if there are enough available nurses to meet these requirements. Many of those who left the field have retired and are unlikely to return.
What we need now is an immediate solution: bring in qualified nurses from outside the United States. The fastest and most effective way to fix the nursing shortage is for Congress to approve more Visas and/or add a special visa category under the H-1 (Working Visa) program. These nurses will meet all U.S. educational requirements.
The current process for foreign nurses to enter the U.S. through the Immigrant Visa (EB-3) system involves a nearly three-year waiting period due to the backlog of available visas. In contrast, the H-1 program offers a much quicker pathway, typically taking four to nine months after the nurse is approved.
We urge Congress to take immediate action by adding more available visas and/or reinstating the H-1A or a similar visa program to address this critical shortage. The future of skilled nursing facilities, the well-being of patients, and the stability of our healthcare system all depend on immediate changes.
By acting swiftly to alleviate the nursing shortage, Congress can ensure that our communities have the nurses they need to provide quality care and support. The power to prevent a further healthcare crisis lies in their hands.
FACING A STAFFING SHORTAGE?
UMHR can help. Get in touch with our staffing experts who will match you with qualified healthcare professionals. Let us solve your nursing shortage!
