Washington, D.C. — Nursing home operators say workforce challenges remain the sector’s most persistent problem, but artificial intelligence adoption is emerging as the most immediate operational priority, according to a new survey conducted ahead of this month’s RETHINK conference.
The survey, fielded by industry reports in late August, found that 36.8% of respondents named recruiting and retaining clinical staff as their greatest challenge today. Financial pressure from low reimbursement rates ranked second at 21.1%.
Yet when asked about the next 12 months, 42.1% of providers identified AI adoption and automation as the issue with the greatest potential impact on care quality. Rising acuity and complexity of resident care placed second at 36.8%.
The results suggest a dual timeline for transformation. About 55.6% of respondents named workforce evolution as the biggest transformational force over the next decade. But 50% identified the expansion of value-based care and alternative payment models alongside AI integration as equally transformational.
“Providers view technology as a lever to address staffing pressures rather than a replacement for clinical staff,” the survey analysis noted. When asked about specific technology opportunities, operators ranked remote patient monitoring first, followed by workforce management and smart scheduling platforms.
On the workforce front, the outlook remains mixed. More than half of providers expect recruitment and retention conditions to remain unchanged over the next six months. About 26.3% expect conditions to worsen, while 15.8% anticipate improvement.
Flexible scheduling and career development training programs led retention efforts over the past year, according to respondents. Higher wages and better benefits showed moderate effectiveness. International recruitment received the least attention, with only 11.1% reporting positive effects.
The survey also revealed strategic priorities for growth. Expanding partnerships with hospitals, accountable care organizations, and health systems emerged as a top priority for 33.3% of respondents. Facilities said demonstrating reduced hospital readmissions and strong clinical outcomes would deliver the most negotiating power in such relationships.
For clinical priorities, 31.6% of operators named improving quality measures and outcomes as their top initiative. About 21.1% prioritized building and retaining clinical leaders.
When asked about launching new service lines in 2026, 57.9% of operators said they were unsure or still considering options. Just over 10% expressed interest in outpatient therapy and dialysis services.
The findings come as the Bureau of Labor Statistics projects home health and personal care aide positions will add more than 847,000 jobs between 2025 and 2035 — more than any other occupation in the United States.
For operators, the data points to a bifurcated strategic timeline requiring simultaneous investment in workforce development and technology adoption. Facilities prioritizing flexible scheduling, career pathways, and AI-driven operational tools are positioning themselves to address both immediate staffing gaps and long-term transformation pressures.
The partnership emphasis suggests a clear admissions growth path: facilities that can demonstrate reduced hospital readmissions and strong clinical outcomes gain access to hospital and ACO referral networks, which represent higher-acuity, higher-revenue census opportunities.
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