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Rural Areas Most Impacted by Nursing Home Staffing Shortages in 2023

The onset of the coronavirus pandemic in March 2020 exacerbated staffing shortages in nursing homes and long-term care facilities. Staff burnout seemed to hit an all-time high, and many caregivers left the industry entirely, causing nurse-to-patient ratios to skyrocket.

More than 400,000 long-term care workers left the industry at the height of the pandemic. Since then, only a quarter of those jobs have bounced back.

As of March 2023, nursing home staffing shortages are continuing at concerning rates. With so few nursing homes properly staffed, residents are at even greater risks of nursing home abuse, neglect, and wrongful death. Additionally, thousands of those needing long-term care are stuck on waiting lists or unable to find an open facility, especially in rural communities.

Nursing Home Staffing Shortage Statistics

In rural Iowa, a Good Samaritan Society nursing home left 38 residents to find a new facility when it shuttered its doors late last year. The organization joined 13 other rural Iowa homes forced to close for lack of staffing.

Montana also saw 11 facilities close, which amounted to about 16% of care for the state. In Pennsylvania, an estimated 2,000 residents are on waiting lists to access the long-term care they need.

An early estimate from the Centers for Medicare & Medicaid Services (CMS) reported that 129 nursing homes throughout the U.S. had closed in 2022. Many of these closures were due to staffing shortages requiring the homes to cut down on resident numbers and thus be unable to afford operational costs.

We may see even more closures and rates of abuse increase soon. Nearly 30% of 14,000 nursing homes surveyed in March 2022 by the Centers for Disease Control and Prevention (CDC) reported a staffing shortage.

In an interview with Local 21 CBS News, Pennsylvania Health Care Association President and CEO Zach Shamberg explained that, “Providers are still limiting admissions due to lack of staff. We can’t be in a position where our population is aging, but, at the same time, long-term care providers are being forced to shutter their doors.”

As staffing shortages rise, the demand for long-term care continues to grow. A report from the Boston Indicators details that the retiree population in the Boston area will increase by more than 50% in the next 20 years.

The same report estimates that the population of 85-year-olds in the U.S. will triple by 2060.

Why Nursing Home Staffing Shortages Are Concerning

While nursing home abuse and nursing home neglect can have several causes, one of the most concerning links is the lack of appropriate staffing to adequately care for long-term care residents.

Without an adequate staff-to-patient ratio, nurses and other staff members must work long hours and rush through providing care, increasing the chances of injury and medication errors.

Additionally, staff might forget to move or bathe residents who are unable to perform these necessary tasks themselves. This can lead to stage 4 bedsores and infections that, if left untreated, may result in wrongful death.

Abuse is already far too common in nursing homes. The National Center on Elder Abuse (NCEA) reports roughly 95% of nursing home residents have been neglected or have witnessed nursing home neglect. As staffing shortages continue to rise, residents may be even more in danger of preventable illness and injury.

Ways to Keep Loved Ones Safe From Nursing Home Abuse

To protect this vulnerable population, it is critical that we all work together to advocate for changes in the long-term care industry.

Larger societal and regulatory changes should be made. Facility managers, who have too often put profits over residents, must quickly address working conditions, wages, and benefits for nursing home staff. Lawmakers should push for more funding and regulations to aid and support facilities in providing the best care possible.

However, everyday people can also significantly impact the health and safety of nursing home residents.

Too many nursing homes are able to keep poor conditions hidden because of a lack of friends and loved ones visiting residents. By scheduling regular visits, you can develop relationships with residents and be more aware of current conditions.

Additionally, visitors must be mindful of the warning signs of abuse and neglect and report concerns to the authorities.

If someone you love has experienced nursing home abuse, you can also hold the facility accountable for its negligence by filing a nursing home abuse lawsuit.

Our team of advocates at Nursing Home Abuse Center is here to help protect you and your family. Contact us today at (855) 264-6310 to get started.

Nursing Home Abuse Support Team

The Nursing Home Abuse Center (NHAC) was founded to bring justice to those affected by nursing home and elder abuse. Our mission is to educate and empower victims of abuse and their families to take a stand against this unlawful mistreatment. We work to return dignity back to those who have been broken down by nursing home abuse and neglect.

  1. Boston Indicators. “Care Work in Massachusetts: A Call for Racial and Economic Justice for a Neglected Sector.” Retrieved March 16, 2023, from
  2. Kaiser Family Foundation. (2022). “Nursing Facility Staffing Shortages During the COVID-19 Pandemic.” Retrieved March 16, 2023, from:
  3. Local 21 News. (2023). “Nursing home providers urge lawmakers to address care crisis with increased funds.” Retrieved March 15, 2023, from:
  4. NBC News. (2023). “Small-town nursing homes closing amid staffing crunch.” Retrieved March 15, 2023, from: