Skilled Nursing Workforce ‘in Crisis,’ Report Says

• The 2025 Skilled Nursing Workforce Report found that there’s an average turnover rate of 82% in the industry.
• The high turnover rate coincides with the federal ruling from the current White House administration regarding minimum staffing requirements for skilled nursing facilities.
• However, the report notes that as workforces stabilize, complaints filed against facilities will decrease, along with “incidences of abuse.”

The skilled nursing workforce is fractured due to a “broken organizational culture,” according to a new report.

“The conversation across skilled nursing today is no longer just about wages or benefits — it’s about creating a culture where staff feel valued, engaged, and supported,” Brandi Kurtyka, MissionCare Collective CEO, wrote in the 2025 Skilled Nursing Workforce Report. “When culture is neglected, low wages, inadequate benefits, overwhelming workloads, and leadership instability only intensify the problem. High-stress environments drive away both frontline workers and leaders, further exacerbating turnover.”

Kurtyka said that facilities with leadership that “nurture a positive workplace culture” will see a decrease in turnover, improved ratings, and fewer regulatory issues, among other improvements.

Skilled Nursing Workforce and Leadership Turnover 

The skilled nursing workforce currently sits at 1.7 million employees, with more than 536,000 in healthcare support roles and nearly 360,000 in healthcare practitioner and technical roles. It also sees an average turnover rate of 82%, according to the report. 

“A common issue raised by residents in facilities with high turnover is the need to repeatedly explain their care preferences to new staff,” the report stated. “When caregivers are unfamiliar with residents’ needs, it can negatively impact both the quality of care and quality of life.” 

Reasons for turnover include both demanding workload (a one to 13 CNA to resident ratio), low wages, and lack of benefits. 

But turnover isn’t just a staff problem. The annual turnover rate for administrators is 43%, with burnout as the main reason cited for leaving. Other reasons cited were high staff turnover and transitioning to a new industry. 

Staffing Mandates 

Along with concerns about retention and quality of care, skilled nursing facilities have been in a state of flux due to the current White House administration’s staffing mandate that was issued in earlier this year. The ruling requires facilities that receive federal funding through Medicare and Medicaid to implement specific staffing ratios, which include having a registered nurse onsite at all times.

Shortly after the announcement, lawsuits were filed on behalf of both healthcare organizations and state attorneys general. The suits argue that the mandate violates the Major Questions Doctrine and the Administrative Procedures Act.

Since the presidential election in November, the nursing home industry has urged the incoming White House administration to rescind the mandate, according to KFF Health News. 

“The [incoming] administration has proven itself really eager to reverse overreaching regulations,” Linda Couch, senior vice president for policy and advocacy at LeadingAge, which represents nonprofit elder care providers, told the media outlet. “We think it’s got a pretty good chance of being repealed, and hope so.” 

However, Sam Brooks, director for public policy at the National Consumer Voice for Quality Long-Term Care, told KFF Health News they would be “devastated” to see the ruling reversed. 

“We’re hoping the president-elect will come in and take a look at the science and data behind it and see this really is a modest reform,” Brooks said. 

A McKnights Long-Term Care News reported highlighted interest from consumer in having Congress repeal the ruling.  

Addressing the Skilled Nursing Facility Workforce Problem

The industry issues, according to Kurtyka, go beyond the workforce itself and are reflective of the business of skilled nursing as a whole. And stabilizing the workforce is where leaders should start. 

As staffing turnover declines, so do complaints filed against facilities and “incidences of abuse,” the workforce report found.  

A 2021 study on nursing home turnover suggested that policymakers “consider mandating benefits” like health insurance and sick leave. 

“Such policies could substantially improve conditions for lower-wage staff, such as CNAs, and might aid in reducing their turnover,” the authors stated. “In addition, policymakers could provide financial support for CNAs and LPNs seeking upward-mobility within a facility through further education and training.” 

The Bottom Line

The skilled nursing workforce has a high turnover rate that has a trickle-down effect on employee morale, quality of care for residents, and the tenure of organizational leadership. A workforce report found that the industry’s turnover rate is 82% among staff and 43% for nursing home administrators. In order to build up interest in and renewed dedication to the industry, one study suggests increasing benefits like sick leave and financially supported education and training. 

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