Home Health Nursing Shortage Produces Trickle-Down Effect

• A Wisconsin family shared with a local media outlet how the home health nursing shortage has affected their daily lives. 
• Their story reflects the larger industry concern regarding staffing, as supported by at least two workforce reports. 
• Federal projections show that the home health and personal care aide workforce will increase 21% by 2033. 

For one Wisconsin family, the trickle-down effect of the home health nursing shortage has become dire. 

The Piaseckis, who have five children (four who have special needs), have been largely going it alone even though they’ve been approved for both private-duty nursing and respite care. NBC26 reported that the family has been working with a nurse placement agency but has had little luck. 

“When we don’t have that nurse, I sleep in Levi’s room so that I can get up and suction him, so basically, I’m awake 24 hours a day,” Mindi Piasecki said, referring to her son who has Goldenhar syndrome and needs constant care. 

Meanwhile, the family’s 4 year old has been waiting for a kidney transplant due to kidney failure. 

The National Association for Home Care and Hospice (NAHCH) has said the lack of home health workers has reached “crisis proportions.” 

“Despite the best efforts of industry leadership and management, the gap between the numbers of patients and families seeking assistance and the availability of workers to provide that care is accelerating at an unsustainable pace,” NAHCH stated in a 2023 industry report. 

Home Health Nursing Shortage Effects 

Staffing is still the leading challenge for home health, according to Home Health Care News’ Home-Based Care Outlook 2025, despite a 4% decrease among survey respondents. The second highest concern was changing payment dynamics at 34%, compared to staffing concerns at 55%. 

A separate report, produced by AxisCare, also pointed to workforce shortages as a concern in 2025. It found that the three biggest “pain points” to growing home care businesses are caregiver shortages, recruitment, and retention.  

At the same time, job growth for home health and personal care aides is expected to increase 21% by 2033, according to the U.S. Bureau of Labor Statistics. 

RELATED COURSE: Home Health Legislation and Billing Overview

When home health nurses aren’t available to help families like the Piaseckis, the caretaking responsibilities fall solely on parents or guardians, sometimes requiring them to take a leave of absence from work or reduce their hours. While Mindi stays with their son at a hospital roughly 100 miles from home, Mark Piasecki cares for their four other children.  

“Family caregivers are already stretched beyond the limit, leading them to take unpaid leave, lose wages, and suffer from care burnout,” NAHC President William A. Dombi said in a 2023 statement. “This also leads people to seek care from costlier settings, such as hospitals and nursing homes. The home care workforce crisis has implications far beyond the care at home community.” 

Further Implications of Home Health Nursing Shortage

In addition to the mental and physical toll caregiving can have on families, there’s also a financial burden. Some organizations, like the Family Social Services Administration in Indiana, have introduced changes that affect not only how families with “medically complex” children receive funding but also how those children are cared for. 

WTHR 13, an NBC affiliate, reported that the changes — in some cases moving from an hourly pay rate to daily — were implemented due to an expected $1 billion shortfall. One family tried to remain under the hourly rate program because it gave their 6-year-old daughter to have two additional caregivers. Despite going to the courts with their request, the family said a clerical error resulted in “pausing payment” for their daughter’s care.

The Bottom Line

Families that rely on home health nurses to help care for children with special or “medically complex” needs are feeling the effects of the home health nursing shortage. Hiring, retention, and recruitment of nurses for these in-home roles, whether caring for children or adults, remains a top concern, according to industry outlook reports and surveys. At the same time, federal labor statistics show the industry will see a 21% increase in jobs by 2033. 

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