Survey of Pa. hospitals and nursing homes finds provider shortages limit, delay care

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A new survey of Pennsylvania‘s hospitals and nursing homes revealed that persistent, health care workforce shortages strain patients’ access to care. 

Conducted November 2024 through January 2025 by The Hospital and Healthsystem Association of Pennsylvania (HAP), LeadingAge PA, and Pennsylvania Health Care Association (PHCA), the survey demonstrates the ways patients and residents feel the effects of workforce shortages throughout the continuum of care. 

“Despite the remarkable progress that Pennsylvania’s hospitals and health systems have made reducing turnover, growing their teams, and transforming care delivery, the commonwealth continues to face a persistent shortage of health care professionals,” HAP president and CEO Nicole Stallings said in a statement. “These shortages are already affecting communities’ access to hospital and nursing home care and, without proactive action, challenges will only worsen as the commonwealth ages.

“It’s imperative that state and national leaders focus on policies that grow the number of health care professionals and ensure providers have the flexibility to innovate and meet their communities’ needs,” added Stallings.

Per the report, nursing homes have to limit admissions as they comply with new state staffing mandates while working to fill staff vacancies, leading to hospital discharge delays. Hospitals are forced to navigate provider shortages, resulting in longer emergency department waits and delays in care. Hospitals and nursing homes in some instances have been forced to close beds and eliminate or scale back services.  

“This report highlights how interconnected Pennsylvania’s healthcare ecosystem is, especially when it comes to our ability to care for older adults,” said Garry Pezzano, president and CEO of LeadingAge PA. “The data is clear: there are simply not enough direct caregivers in the workforce to care for our state’s growing senior population.

“As a result, mission-driven nursing homes are being stretched to their limits and forced to deny admissions, rely on unsustainable temporary staffing agencies, and permanently reduce capacity. Now, this access-to-care crisis is impacting our hospital partners upstream. Pennsylvanians deserve better,” added Pezzano.

Important findings from the survey include the following: 

• Due to workforce shortages, 70% of hospitals report having to increase emergency department wait times and 68% report having to delay appointments and procedures. 

• Among responding nursing homes, 53% have had to limit admissions or cap their census and 42% report having to limit or deny admissions as a direct result of state staffing ratio mandates. 

• Hospitals report statewide average vacancy rates of 12%–30% for direct care positions, including 19 percent for registered nurses. Rural hospitals report higher vacancy rates for some key positions. 

• More than half of nursing homes (53%) have more than 10 open positions. 

• Hospitals reduced care team turnover by 19 percent in 2024 through strategies such as pay increases, professional development, tuition support, bonuses, flexible schedules, and providing childcare. 

• 57% of nursing homes have had to increase their use of contracted temporary agency staff because of increased state staffing requirements. 

 “Our 2025 Workforce Survey illustrates and emphasizes the key challenges facing Pennsylvania’s acute and post-acute care settings,” said Zach Shamberg, president and CEO of PHCA. “In nursing facilities, the findings are staggering – with a shortage of nearly 2,600 care providers to meet state staffing ratio requirements, and an additional shortage of over 20,000 per year through 2032, it’s no wonder we’re facing an access to care crisis throughout the commonwealth. 

“Nursing facilities are trying to manage these challenges but are inevitably forced to limit admissions, close units and increase their use of costly contract agency staff. This survey should serve as a clear ‘wakeup call’ to state leaders, and the time is now to address the sustainability of nursing facilities to care for our older adults,” added Shamberg.