Why Higher Wages Alone Won’t Solve Senior Living Industry’s Staffing Woes

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If the senior living industry is serious about growing to meet its current “golden age” of demand ahead, it must also get serious about staffing support.

Senior living operators already spend a large amount of their budgets on staff wages. In fact, some operators report that increases in staffing expenses have eclipsed gains in revenue this year as they’ve prioritized competing for workers with higher pay.

But recent data shows that senior living workers are still leaving their jobs because of low pay, burnout and other pressures. I’ve heard countless times how important it is for operators to “close the back door” on staffing, and a popular way to do that is through pay bumps that recognize performance and training. While that is important, I think the solution lies in pay increases – and importantly beyond. 

I think operators should focus on making the jobs of frontline staff less difficult and emotionally draining while also paying them the wages they need to make a basic living. Although doing both may sound simple, it’s something I think operators are still struggling with in 2025. But it is important given that care aides, nursing assistants, LPNs and LVNs and RNs make up half of the overall senior living workforce, according to NIC data.

While operators have made improvements from the dark years of 2020 and 2021 when average senior living turnover reached as high as 85%, churn rates still impact the industry. Assisted living turnover has declined since 2023, with resident assistant rates falling from 47% in 2023 to 44% in 2024, while certified nursing assistant (CNA) turnover decreased from 41% to 40% over the time period, according to annual reports from the Hospital and Healthcare Compensation Service (HCS).

I recently spoke with Ascension Living CEO Erin Shadboldt, who told me a story of a frontline staffer who came to her concerned that they would need to find another job outside of the community to make ends meet at home.

In response, Shadbolt rethought staff support, partly by creating a real-time, electronic tracking system for employees to submit similar concerns when they arise.

“It’s hard for them to pay their bills and they’re having to get other jobs, and as a CEO, that’s really hard and it’s gut-wrenching for me,” Shadbolt told me. “We’re a business and we have a budget we have to follow but it’s important that we have these conversations and I can’t respond to it unless people share their stories with me.”

While Shadbolt’s anecdote is but a drop of water in an ocean of other senior living operators’ challenges and experiences, I think it illustrates the tough spot operators can find themselves in 2025, and the organization’s journey could be instructive for how others move forward. In this week’s exclusive, members-only SHN+ Update, I analyze recent data on staffing and offer the following takeaways:

– Why wages are one important piece of the staffing puzzle

– Operators are finding new ways to support staff

– How higher resident acuity will complicate staffing

Wages and the senior living staffing puzzle

While many senior living operators have made staffing the focus of their efforts in recent years, the data shows senior living licensed care workers are still leaving their positions due to low pay, burnout and lack of career advancement.

Approximately 29% of the more than 3,000 senior housing and care workers who responded to a recent study from digital workforce company Kare said they planned to leave their respective jobs in the future due to low pay. Another 16% of licensed caregivers responded to the survey that burnout was pushing them to leave the industry.

To improve retention, Shadbolt told me of how Ascension Living focused on reducing turnover through “relationship management” with leaders at the community level, implementing required meetings between community leaders and new staff at least once a quarter to check-in and hear feedback. The company also overhauled its orientation process, she told me.

“I think if we can really get them that feeling in the first few weeks through that first 90 days, we know a lot of people will stay,” Shadbolt added.

Looking across the industry, I also don’t think Ascension Living is an outlier. NIC data from earlier this year showed more than half of care aides, nursing assistants, LPNs, LVNs and RNs are mothers with children under 18, “highlighting the central role of family dynamics in staffing stability,” NIC Senior Principal Omar Zahraoui wrote.

I think Ascension Living’s experiences in staffing call back to 2021, a time in which crises gripped the industry during the height of the pandemic. In an article published at the time, senior living providers polled in an SHN Pulse Survey reported using a variety of tactics, including raising wage rates (67%) and offering more flexible schedules (47%).

“In addition to higher pay and built-in raises, they need to really emphasize paid sick time and paid vacations,” a senior living employee told SHN in response to the story.

I think these comments still ring true and show that the industry must get creative in supporting employees if they cannot make double-digit wage increases a reality.

In my mind, the senior living must reposition what are considered entry-level positions as vital future careers in health care, given their important role in the larger health care continuum. Higher pay would help reflect the importance of that role.

According to data from the U.S. Bureau of Labor Statistics, as of May 2023, home health and personal care aides earned a median hourly wage of about $16.78, nursing assistants earned an average wage of roughly $19.04 per hour, and hand laborers and material movers received a median wage of approximately $18.12 per hour. Home health aide wages are in line with retail salespersons at $16.62 per hour.

I get that senior living operators have little wiggle room to raise wages given where margins are, but that doesn’t change the fact that caregivers aren’t making much more than people working in food service or in industrial warehouses. Although it’s said that senior living caregivers join the industry due to their passion to make a difference, passion alone doesn’t solve that fact.

Still, Zahraoui told me that low pay is “just one piece” of the puzzle in solving senior living staffing issues.

“When jobs feel both undervalued and unsustainable, retention suffers,” he added. “The broader challenge is designing roles people can see themselves staying in the long-term.”

For furniture and home goods retailer Ikea, part of the answer to its turnover problem was to give employees more flexibility and pay higher wages. The company also helped part-timers make ends meet by giving them extra hours working remotely and answering customer calls.

No doubt, retail is just a different business entirely from senior living. But with regard to staffing, I think there are things senior living operators can take away from Ikea and other industries they technically compete with.

Creating places of purpose for workers

Operators are wrestling with “fluidity in staffing needs” based on geographic location, desired or open roles and community size. This makes staffing challenges a property-by-property problem that is unique in a multitude of ways, as each community can vary in resident dynamics and staff culture, according to 12 Oaks Senior Living Chief People Officer Melissa Labor.

At the same time, workers are “craving work environments” where they are able to find purpose and can “clearly see their connection to making a difference,” she said.

To improve the entry point for new workers in the industry, 12 Oaks has centralized its recruiting team by specific regions to learn the “nuances of each community” and its staffing needs, while simultaneously finding mission-driven workers that “see their future” in senior living.

Another aspect operators must focus on is building pipelines for potential workers, as operators build partnerships with higher education to find new talent or expanding recruiting efforts to focus on each community’s hiring needs.

To that end, 12 Oaks is piloting a program for onboarding new staff over the course of their first six months of employment, including a live, virtual onboarding session with an “onboarding specialist” with new community employees focusing on “culture and connection versus policies.”

This gets to the “broader challenge” in designing roles for workers in which they can realistically picture career longevity, Zahraoui told me, to make “these roles attractive and sustainable.”

To create a more clear pathway for workers to advance into higher paying roles, Houston, Texas-based The Aspenwood Company created its “Aspenwood Pathways” program with opportunities for caregivers, CNAs and nurses to advance their careers to grow from entry-level roles into leadership or speciality care positions, according to The Aspenwood Co. President Heather Tussing.

While Tussing called Aspenwood’s wage rates “competitive pay” for licensed nurses, memory care caregivers and frontline supervisors, she said it was important to go “beyond wages” and provide “total support” for workers. That means things like mental health resources, tuition reimbursement, wellness stipends and professional development.

“Pay alone isn’t enough—well-being, career growth and belonging are essential to retaining a thriving workforce,” Tussing said.

The efforts of 12 Oaks and Aspenwood shows that creating specific career advancement ladders can counteract burnout and reduce turnover. When it matters most, operators can move quickly when a crisis strikes, but lasting workforce improvements will require changes that move beyond higher wages.

The industry also has an opportunity to attract a wide swath of workers.

“Compared to institutional healthcare, senior housing has more flexibility to pilot new scheduling models, part-time pathways, or hybrid roles, appealing to caregivers, mothers, men, and older workers,” Zahraoui wrote. “The opportunity ahead is not just to compete for talent, but to redefine what it means to build and belong to a senior housing and care workforce, invest in fast-track training pipelines, and create the kinds of jobs people want to stay in.”

Acuity trends make staffing challenge harder

Some senior living providers have embraced assisted living and memory care services to meet demand for high-acuity services ahead. But that might only exacerbate their staffing challenges if they’re not careful.

The “biggest challenge” facing the senior living industry in 2026 will be its ability to scale the workforce quickly to meet the growing demand for senior living, Zahraoui told me. To succeed, operators need to compete against hospital systems and other health care providers. NIC data shows that senior living operators have remained competitive with service providers in other healthcare sectors, which has tightened margins, especially for high acuity settings.

This will be made “even harder” for senior living providers to do as traditional ways of getting new workers quickly, like through direct care workers via immigration work visas have been stymied by deportations and other anti-immigration actions from the Trump administration.

Turnover and worker shortages continue to negatively impact operators in their pursuit of new growth, “especially in higher acuity settings” due to varying state regulations regarding assisted living staffing requirements, Zahraoui told me.

I’ve heard from operators that they’re already seeing the baby boomer generation enter independent living settings in some instances, and this push to bring more workers into the fold must happen more quickly.

Simply put, if the industry can make double-digit pay increases in the span of the last five years, operators must now find innovative ways to compensate their employees through new bonus structures, performance-based incentives and outcome-based rewards.

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