​Across long term care, one reality continues to unite providers: a strong workforce is essential for delivering quality care. The dedication of caregivers shapes every resident experience and defines the strength of communities across the country.

To care for the 4 million seniors who rely on nursing homes and skilled nursing facilities for care each year, nursing homes employ 1.5 million individuals. More than 500,000 individuals work in the nation’s assisted living communities, and nearly 120,000 work in intermediate care facilities for individuals with developmental disabilities. As the competition for workers increases, providers continue to seek new ways to maintain and build the long term care workforce.

According to an analysis from the American Health Care Association and National Center for Assisted Living (AHCA/NCAL), providers are making measurable gains in rebuilding their workforce. In 2025 alone, nursing homes added more than 40,000 jobs, and nearly two-thirds of providers reported improved workforce conditions. Turnover has steadily declined since 2022, and reliance on agency staffing has dropped by more than 40 percent since 2023. These improvements reflect the commitment of providers to strengthen recruitment, retention, and training efforts, even amid ongoing financial pressures.

At the same time, workforce challenges remain. Staffing shortages continue to affect access to care in many communities, and demographic trends will place additional demands on the system in the years ahead. The progress achieved so far is meaningful, but it must be sustained.

Building on Progress with Smart Policy

Sustaining workforce gains requires more than operational changes. It depends on a policy environment that supports providers and recognizes the realities of delivering long term care.

Engagement with policymakers plays a critical role. Clear communication about workforce challenges and practical solutions helps ensure that policies align with the needs of providers and the individuals they serve.

The Ensuring Seniors’ Access to Quality Care Act offers an example of a targeted, thoughtful policy solution. AHCA/NCAL has endorsed this bipartisan legislation because it addresses one of the most pressing workforce challenges: strengthening the pipeline of certified nurse aides. The bill would help providers resume and expand nurse aide training programs by reducing unnecessary stoppages tied to civil monetary penalties that are unrelated to quality of care or resident safety. In addition, the legislation would give Medicare and Medicaid providers (e.g., skilled nursing facilities) access to the National Practitioner Data Bank, which would help strengthen background screening and support more informed hiring decisions.

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​AHCA/NCAL continually hosts long term care webinars on a variety of workforce-­related topics. You can learn more on this series at https://educate.ahcancal.org. If you are interested in learning more about AHCA/NCAL’s Workforce Committee, policy, and initiatives, please contact AHCA’s Associate Vice President of Workforce & Constituency Services, Dana Ritchie, at dritchie@ahca.org.

Together, these provisions would make it easier for providers to train, recruit, and retain qualified caregivers. This type of practical, targeted policy approach helps remove barriers and supports the long-term stability of the workforce.

Policy leadership also extends beyond individual legislation. The Caregivers for Tomorrow initiative represents a nationwide effort to drive policy change and strengthen the long term care workforce through innovative, sustainable solutions. These efforts focus on attracting new caregivers, supporting current staff, and ensuring that older adults and individuals with disabilities have access to high-quality care for years to come.

This is a critical moment for policymakers, regulatory agencies, and stakeholders at every level to come together and advance meaningful, supportive solutions that address workforce challenges in a lasting way.

These priorities are further reinforced through AHCA’s The Better Way agenda, which outlines a comprehensive approach to strengthening the profession. By focusing on sustainable funding, regulatory alignment, and workforce investment, the framework provides a roadmap for long-term stability and success.

Taken together, these policy efforts reflect a unified strategy: remove barriers, expand opportunity, and ensure providers have the tools needed to build and sustain a strong workforce.

Strengthening the Workforce Pipeline

While policy solutions are essential, long-term success also depends on continuing to build awareness and interest in caregiving careers.

For example, efforts like like AHCA’s Careers in Caring campaign help raise awareness about opportunities in long term care. By sharing the stories of caregivers and highlighting the purpose behind the work, the campaign encourages more individuals to explore careers in the field.

These efforts are especially important as the demand for long term care services continues to grow. Building and sustaining a workforce requires both attracting new talent and supporting those already in the field.

A Broader Approach to Workforce Support

Workforce development does not happen in isolation. Instead, it is closely tied to broader issues, such as reimbursement, regulation, and access to resources.

The Better Way outlines a comprehensive approach for addressing these interconnected challenges. By focusing on sustainable funding, regulatory alignment, and workforce investment, the framework provides a roadmap for long-term stability.

Providers understand that meaningful workforce investments require adequate resources. At the same time, reducing unnecessary administrative burden allows for more focus on staff support and resident care. Aligning these priorities is key to maintaining progress.

Advocacy in Action

Advocacy remains one of the most effective tools for advancing workforce solutions. Providers bring valuable insight to policy discussions through their direct experience managing teams and delivering care.
Practical steps can help strengthen advocacy efforts, such as:

• Sharing real-world examples that illustrate workforce challenges and successes.
• Engaging with elected officials through meetings and facility visits.
• Utilizing data and resources to support policy recommendations.
• Collaborating with peers to amplify a unified message.
• Encouraging staff participation in advocacy efforts.

These actions help ensure that policymakers have a clear understanding of the issues and the solutions that can make a difference.

Looking Ahead

The long term care sector continues to demonstrate resilience and commitment. The progress reflected in recent workforce data is a testament to the efforts of providers and caregivers across the country.

Maintaining that momentum will require continued collaboration and focus. Policy solutions must support the realities of care delivery. Workforce initiatives must continue to expand opportunities and strengthen the pipeline. Advocacy must remain a priority at every level.

There is no single solution to the workforce challenges facing long term care, but there is a clear path forward. By building on recent progress, advancing thoughtful policies, and continuing to invest in caregivers, the sector can move toward a more stable and sustainable future.

The demand for care is growing, and meeting that demand depends on a workforce that is supported, valued, and empowered to succeed. With continued effort and engagement, we can reach this goal. 

Claire Krawsczyn is senior director of media relations at the American Health Care Association/National Center for Assisted Living.