As 2022 concluded, senior healthcare saw several notable developments that shaped the year. COVID-19 and related outbreaks remained central, but workforce challenges, evolving care expectations, and policy debates also defined the landscape. The American Health Care Association (AHCA) and the National Center for Assisted Living (NCAL) highlighted a number of widely read topics in Provider Magazine, reflecting these shifts:
- Rising CNA wages. Across the country wages for certified nursing assistants increased, with California leading an organized push to ensure CNAs earn a living wage. The state’s Drive to 25 campaign aims to have all CNAs earning a livable wage by 2025, reshaping recruitment and retention strategies.
- Community spread driving outbreaks. Research showed that local community COVID-19 case rates became the primary predictor of outbreaks in nursing homes, surpassing facility size as the most influential factor. This finding emphasized the importance of broader community mitigation efforts to protect residents and staff.
- Persistent staffing shortages. The majority of long-term and post-acute care providers reported staffing shortfalls through 2022. These shortages prompted greater reliance on staffing agencies, enhanced recruitment incentives, and new employee benefits to maintain care levels.
- New precautions for unvaccinated staff. Facilities implemented stricter protocols for unvaccinated personnel, including assigning roles away from face-to-face resident contact, increasing testing frequency, and reinforcing physical distancing and other infection control measures.
- Higher expectations beyond five-star ratings. While five-star ratings remain important, the bar for success shifted. Facilities must be more adaptive and comprehensive—meeting higher-acuity needs, offering person-centered services, motivating staff, and pursuing diverse revenue sources—to attract residents and retain employees.
- Advocacy on federal policy. The AHCA requested meetings with the U.S. Department of Health and Human Services, the White House, and CMS to address inaccuracies and concerns related to the presidential nursing home reform agenda. Discussions focused on quality of care, COVID-related challenges, and chronic underfunding.
These topics highlighted ongoing industry challenges: occupancy levels stayed depressed, roughly 87% of facilities reported being understaffed, COVID precautions and outbreak management remained central operational priorities, and industry leaders continued to advocate for increased government support. The changes of 2022 set the stage for continued transformation in 2023, with opportunities to strengthen workforce stability, improve infection prevention, and adapt services to evolving resident needs.
For further context, Provider Magazine reviewed its most-read coverage of the year, which includes deep dives into the wage initiatives, outbreak research, staffing agency trends, guidance on precautions for unvaccinated staff, the evolving standards of quality, and advocacy efforts by nursing home leaders.