There’s plenty of good news to go around in the largest skilled nursing salary report of the year.
For workers, the average pay rate continues to clip upward at a decent, above-historical rate in many roles, especially for frontline nurses. Taken along with an expected interest rate cut that could help push inflation lower, that would be doubly good news for those who need their paychecks to stretch farther.
For providers, there’s relief that those increases are finally starting to moderate a bit, after record gains for employees several years in a row during the pandemic. Those raises may have been initially funded by federal or state relief but now demand an annual investment far above the old normal for wages.
But the 47th Annual Nursing Home Salary & Benefits report covered this week by my colleague Jim Berklan also confirms there’s still plenty of bad news out there, if you know where to look.
Most of you will find it on the scheduling chart, when there’s a big empty spot where a weekend CNA or RN should be, or in housekeeping, or most likely, on the therapy floor.
HCS, which this year surveyed nearly 1,000 operators nationwide, started including vacancy data in its survey last year. And despite some anecdotal gains in various markets, the 2024-2025 version found vacancies across facilities still averaged 17% over the year.
That average was led by therapy jobs, which respondents said were vacant 27.6% of the year.
For a sector that not too long ago was reliant on its therapy billing for its lifeblood — and for whom quality therapy outcomes remain critical to patients and referral partners — that is terrible news indeed.
But it’s not just providers at fault for this alarming absence. Federal tinkering in the last few years has reduced how and how much some therapists can bill for services in nursing homes.
In the latest move last month, the Centers for Medicare & Medicaid Services proposed what basically amounts to another 3% rate cut for therapists working in nursing homes under the Part B fee schedule.
As with other wage concerns in the sector, all the administration talk about creating quality jobs hasn’t really amounted to much in terms of actual action or investment in nursing or therapy jobs. Congress, once eager to fix these Medicare physician fiascos, has grown slow to address them in the last two years, creating financial and billing nightmares.
Payment policies that undercut efforts to attract and fairly pay workers across the board, and especially on the clinical and therapy side, are incredibly short-sighted.
Decisions that make hands-on patient roles supporting seniors and those with disabilities even less attractive to young workers and those so desperately needed amid a demographic shift … Well, that makes it seem something besides those nursing home jobs are “vacant.”
Empty ideas will continue to leave providers with empty jobs.
