The number of licensed skilled nursing facility (SNF – nursing home) beds declined by 2.5% from 2019 to 2024, while operating capacity declined by 5.0% over the same time period. A recently published study found that the estimated operating capacity based on maximum census counts declined 5% by 2024, with many counties experiencing declines of 15% or more, and that areas with larger declines in SNF capacity had more frequent reports of facility staffing shortages and larger increases in hospital length of stay – 1-in-4 counties experienced operating capacity declines of 15.1% or more, with the largest declines being more common among rural counties.
SNF capacity declines were larger in counties with more frequent reports of SNF staffing shortages—a 1–percentage point decline in county SNF capacity was associated with a 0.20–percentage point increase in the frequency of reported staffing shortages. And hospitals that experienced larger declines in nearby SNF capacity experienced greater increases in mean length of stay, percentage of stays lasting 28 or more days, and median distance traveled to admitting SNFs.
The study concluded: “Results of this study suggest that SNF operating capacity declined following the pandemic and these declines were larger than the observed declines in licensed SNF bed counts, potentially because of staffing shortages. Greater loss of SNF capacity was associated with longer hospital stays and increased travel distances to SNFs, suggesting that declines in operating capacity may be impairing access to care.”
The number of nursing facilities certified by CMS decreased by 6% between July 2015 and July 2025. Since 2021, the number of nursing facility residents has gradually increased from 1.10 million to 1.24 million. However, between 2015 and 2025, the number of residents living in nursing facilities decreased by 9%, with most of that coming from a steep decline between 2020 and 2021, reflecting the effects of the COVID-19 pandemic. Prior to the pandemic, the number of residents was relatively steady, although it declined from 1.37 million in 2015 to 1.32 million in 2020. COVID-19 exacerbated the decrease in nursing facility residents, in part because nursing facility residents and staff incurred so many deaths during the pandemic.
The total hours of nursing care per resident decreased between 2015 and 2025, but rose briefly in 2021. The relatively higher staffing hours per resident in 2021 reflected the fact that the number of residents declined more quickly than the number of total nursing staff hours did between 2020 and 2021. In 2021, the number of staffing hours was 12% lower than in 2020. These lower staffing levels in the last several years align with data as of March 2024 showing that the number of workers employed at long-term care facilities continues to remain below pre-pandemic levels.
If you or a loved one may have been injured (or worse) in a nursing home in the United States due to nursing home understaffing, nursing home staff shortage, nursing home infection, nursing home pressure ulcer (nursing home bedsore), nursing home fall, nursing home aspiration, nursing home neglect, nursing home negligence, nursing home abuse, or the nursing home failing to properly care for a vulnerable adult, you should promptly find a nursing home malpractice lawyer in your state who may investigate your nursing home injury claim for you and represent you or your loved one in a nursing home case, if appropriate.
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