Denver, Colorado — Long-term care nurses are committed to their residents. But they’re burning out under a weight of paperwork, staffing shortages, and leadership gaps — and a new survey says the line between staying and leaving often comes down to one person: their supervisor.
The findings come from a nationwide survey of nearly 500 nurses and certified nurse aides, conducted last November by the American Association of Post-Acute Care Nursing in collaboration with Long Term Care 100. The results were unveiled this week at the LTC 100 Leadership Conference in Denver.
The numbers tell a complicated story. A solid majority — 65.2% — say they’re happy in their current position. But 73.8% also report that their job has gotten meaningfully harder over the past 18 months. Both things are true at once.
Purpose keeps nurses in the building
When asked what matters most to staying in long-term care, the top answer wasn’t pay. It was relationships. Nearly a third of respondents (31%) cited meaningful connections with residents as the most important factor in their decision to remain. A strong sense of purpose came in second at 28%, followed by team and workplace culture at 15%.
“Nurses are deeply committed to their residents and the care they provide,” said Amy Stewart, Chief Nursing Officer at AAPACN. “But they are also navigating increasing complexity in their roles. Organizations that recognize and address these challenges will be better positioned to retain and support their workforce.”
Regulation and short staffing are driving people out
On the other side of the ledger, the biggest source of dissatisfaction isn’t low wages — it’s the growing burden of compliance. Increasing regulatory requirements topped the list of complaints at 16%, followed by staffing shortages at 12.5% and leadership gaps at 7%.
The survey also zeroed in on something facilities can actually control: the relationship between a nurse and her direct supervisor. Nurses who have strong frontline leadership tend to stay. Those who don’t, leave.
That finding echoes what some of the industry’s most successful operators have already figured out — including the retention strategies shared by nursing home executives who have kept their teams intact through years of sector-wide turbulence.
What operators can do
AAPACN says the data points to clear levers: invest in work culture, build stronger middle management, and reduce the administrative load that’s grinding nurses down. Facilities that ignore the leadership gap do so at their own risk.
With long-term care demand rising and the pipeline of new nurses under pressure from federal cuts to nursing education, retention isn’t a soft issue anymore. It’s a survival strategy.
