When the federal nursing home staffing mandate was repealed late last year, some took it as a sign that the workforce pressure was off. Tracey Moorhead, president and CEO of the American Association of Post-Acute Care Nursing (AAPACN), sees it differently.
“Just because the staffing mandate has been eliminated, the problem of adequate staffing for our sector has not gone away,” Moorhead said. “We still need staff — and more specifically, we need registered nurses and certified nurse aides in the care delivery sector.”
Speaking with industry sources, Moorhead laid out AAPACN’s agenda for 2026: a three-part push to address workforce shortages, financial instability, and what she described as a growing compliance burden that’s wearing nursing staff thin.
The Culture Question
Workforce recruitment isn’t just a numbers problem, according to Moorhead. It’s a perception problem — and in some cases, a culture problem that the industry hasn’t fully owned up to.
“Many owners believe the sector doesn’t have a culture problem, but the reality is that their staff, including their leadership, will tell you a different story,” she said.
To bridge that gap, AAPACN is partnering with LTC100 on a workforce culture survey set to be released at the LTC100 conference this April. The data will give operators a clearer picture of what drives staff satisfaction — and where things need to change. A separate communications initiative, pushed by AAPACN’s board of directors, will make the case for long-term care as a genuine career destination, targeting both healthcare workers and the families who rely on the sector.
The Money Problem
Moorhead’s second concern comes down to what’s in the budget. Medicaid and managed care reimbursement rates often fall short of what it costs to care for high-acuity residents, she said. The situation has gotten harder to predict, not easier.
“The One Big Beautiful Bill Act has created the real possibility that states will have to make decisions about how funds are distributed across all providers,” she said. “Who gets paid less, but still is expected to provide quality care? The pie is simply going to get smaller.”
On top of that, she cited increasing managed care reviews and financial clawbacks as a source of ongoing instability for operators trying to plan ahead.
Surviving the Survey Process
The third issue is regulatory. Changes to quality measures, new requirements around antipsychotic medication data, and the pressure of state surveys have become a consistent source of stress for nursing staff and directors.
“Survey is one of their biggest pain points,” Moorhead said of AAPACN members.
The association has rolled out survey-readiness tools, resident safety guides, and its Quality Assurance and Performance Improvement programming — including the QCP certification program, which marks its 10th anniversary this year.
Staff training, Moorhead emphasized, is the real key: workers need to know how to monitor systems, conduct audits, and document accurately — especially for newer admissions or residents whose condition is changing.
