On the surface, commercial real estate is defined by the dynamic between owner and tenant, with clear lines separating each party’s obligations. In most sectors, like offices or retail, a landlord’s job typically ends at providing the space—never is a landlord expected to operate a forklift in a warehouse or ring up customers at the register. But for senior housing and skilled nursing, the relationship upends this norm. Owners and operators must deliver a continual supply of skilled staff to care for residents, much like a hospital or clinic cannot function without its nurses and aides. Space alone, according to research from the National Investment Center for Seniors Housing & Care (NIC), simply isn’t enough to attract tenants.
Workforce and staffing, NIC recently underscored, have become some of the most urgent challenges facing senior housing and skilled nursing providers. The aging population is not only expanding, but the speed at which the workforce must grow is outpacing general population growth due to demographic shifts. By 2033, while the overall U.S. population is projected to increase by just 4%, the age cohort 75 and older—and by extension, the senior care resident base—is expected to surge by 50%. According to NIC, this will require an estimated 664,000 additional workers to meet demand, assuming current staff numbers hold steady. Specifically, the breakdown includes 159,000 more care aides, 80,000 registered nurses, 109,000 licensed practical or vocational nurses and 316,000 nursing assistants. This figure doesn’t even account for roles in operations, maintenance, sales, and other vital services.
The composition of this workforce is also unique: more than 98% of direct care roles are held by women, and over half of them have children under 18, according to NIC data. Meanwhile, the employment landscape for senior care is evolving. For the first time, assisted living has overtaken continuing care retirement communities (CCRCs) in the total number of production and nonsupervisory staff, and home health services now employ more workers than skilled nursing. Yet, neither CCRCs nor skilled nursing facilities have managed to return to their pre-pandemic workforce levels, even as assisted living and home health continue to expand.
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Senior housing and care providers now find themselves in fierce competition for talent, not just with each other but with adjacent sectors like home health, hospitals and family services. Attracting and maintaining sufficient staff will likely require pay increases—measures that, while necessary, could further tighten already thin margins, particularly in high-acuity settings.
Solving the workforce puzzle will require innovation, according to NIC. The industry must begin automating tasks and leveraging artificial intelligence and technology to boost efficiency and reduce burnout. Redesigning job roles, building a more resilient labor model and implementing fast-track training pipelines may be critical steps toward creating rewarding careers that can attract—and retain—the workforce the sector desperately needs for the decade ahead.
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