Report: Nursing homes cope with huge staff shortages

Media Contacts

Understaffing has led to COVID-19 outbreaks, staff stress, decline in patient care

US PIRG Education Fund

WASHINGTON — More than 3,000 U.S. nursing homes last month had a shortage of nurses, aides or doctors, the nadir for a crippling problem that started last May. At any given time throughout most of 2020, more than 200,000 Americans resided in nursing homes that admit they were suffering through staff shortages.

As the COVID-19 pandemic tore through the United States’ 15,000 nursing homes and our country as a whole last year, the number of understaffed homes increased from May to December, according to “Nursing home safety during COVID: Staff shortages,” an analysis of government data by U.S. PIRG Education Fund and Frontier Group. Our report also shows that:

  • By early December, 23 percent of homes reported a shortage in at least one staff category: nurses, aides or clinical staff.

  • Shortages of aides were the most widespread problem, affecting 20.6 percent of nursing homes in December, up from 17.4 percent in May.

  • Shortages of nurses were almost as bad, affecting about 18.5 percent of homes in December, up from 15 percent in May.

  • The number of homes with a shortage in at least one staff category increased to 3,136 in December, up from 2,790 in May.

“This is a circular nightmare,” said Teresa Murray, U.S. PIRG Education Fund Consumer Watchdog. “Staff shortages existed before the pandemic and they just got worse as COVID-19 spread. That caused staff to stress out and quit in some cases. And staff who contracted the coronavirus had to miss work. That led to more staff shortages, fewer people to protect nursing home residents from contracting COVID-19 and ultimately, overall patient care has suffered.”

Our research also shows that nursing homes are still trying to overcome shortages of personal protective equipment (PPE). After these shortages improved during the autumn versus the August numbers mentioned in our first report on nursing homes, they got worse in December. 

In the new report, U.S. PIRG Education Fund is calling for several policy actions to improve the situation in nursing homes. That would require approving money in a new federal COVID relief bill to buy more PPE and tests; hire more staff; and pay hazard pay, higher wages or bonuses to ensure optimal staffing levels through the end of the pandemic. 

The staffing and PPE shortages are just two of the problems that U.S. PIRG Education Fund found by mining Medicare and Medicaid data on nursing homes. We will explore more of these issues in a series of reports in the months ahead.

Click HERE for our guide: “20 questions to ask your nursing home during COVID.”


U.S. PIRG (Public Interest Research Group) Education Fund is an independent, non-partisan group that works for consumers and the public interest. Through research, public education and outreach, we serve as counterweights to the influence of powerful interests that threaten our health, safety and wellbeing.