Home Health & Hospice Workforce Data

The data and information located here is in addition to our Workforce Crisis White Paper Series.

Occupations in Home Health

Home health care and hospice have a lot of competition with other sectors of health care.  The largest employers of RNs continue to be hospitals (state, local and private) (61%), followed by Ambulatory Health Care Services (AHCS) (18%).  The AHCS sector includes industries such as hospitals, physicians’ offices, home health care, nursing facilities, and outpatient care centers.  Home Care ranks third representing 13.23 percent of employment in the AHCS sector.

RN Industries

Home Health Services ranks fifth as the industry with the highest concentration of employment in RNs, and accounted for 5.1 percent of all jobs for RNs in 2002 (114,950 jobs).  By 2010, RN employment in home health care increased to 5.5 percent and to 6.1 percent in 2016, and is projected to grow the fastest from 2016 to 2026, with an annual increase of 4.4 percent.

Demand for RNs

Employment of RNs is expected to increase by 106,880 from 2016 to 2018, with a projection of 116,030 average annual openings.  (Openings include annual new jobs and replacements that are needed due to workers who will change occupations, retire, or permanently leave the occupation.)  In this two year period, Colorado is expected to have the highest percent change in employment, followed by Nevada and Louisiana.  Rhode Island and Puerto Rico will have the least amount of change.  Looking at a ten year projection from 2014 to 2024, Kentucky ranks as the state with highest percent change in employment.  While Connecticut remains in the bottom five with the least amount of employment change, four states are replaced in the bottom ranking.  See projections at right

Click here for our whitepaper on demand for HHAs, PCAs, and LPNs-LVNs.

The Supply Side … to 2030

According to the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services, the growth in supply of RNs is expected to exceed the growth in demand at the national level.  This will result in a projected excess in 2030 of just over 290,000 RN FTEs.  However, projections in supply and demand across the states vary significantly.

By 2030, seven states are projected to have a shortage on RNs.  States with a substantial RN FTE shortage include California (with a shortage of 44,500 FTEs), Texas, New Jersey, and South Carolina.  Shortages are also forecasted for South Dakota, Georgia, and Alaska.  See map at right

Florida, Ohio, Virginia, and New York are projected to have a large excess supply versus demand.  Florida alone is expected to have an excess supply of 53,700 FTEs.

LPN/LVNs also have a supply and demand that varies by state. Although, unlike the projection for RNs, thirty-three states are expected to have a workforce shortage.  Texas and Pennsylvania are two of the states with large deficits in supply; 33,500 FTEs in Texas, and 18,700 FTEs in Pennsylvania.  Seventeen states have a projected excess in LPN/LVN supply in 2030, with the greatest excess in Ohio (4,100 FTEs).  While California is expected to have a shortage of RNs, the state is expected to have an excess in LPN/LVN supply (3,600 FTEs) in 2030.

For HRSA’s model, the supply methodology includes labor-market factors, traits of the existing workforce, entrants, and workforce decisions such as retirement and hours worked.  The demand methodology includes population, health care use patterns, and the demand for services.  The model also assumes that health care delivery will not extensively change from the base year and health care use will be stable with the current rates (along with graduation rates and workforce participation).

An article in The American Academy of Nursing by Auerbach, Buerhaus, and Staiger predicts nursing supply to grow with demand at a national level to 2030.  The authors also agree on significant differences in supply and demand for U.S. regions, with a few area variances from HRSA.  Auerbach, et al. used the nine U.S. Census Divisions for region projections.  Their methodology for workforce projection used data on RN ages, employment, hours worked, and population (age and size).

Auerbach, et al. projections show RN growth at zero for New England and Pacific regions, and up to 39 percent growth in the East South Central and West South Central regions.  The analysis showed that New England has an older current workforce with slower recent entry compared to exit in the workforce, and the population is projected to age the fastest which may increase demand with a slow growth in supply.  See table at right

“The New England region has the oldest RNs, with 45% older than 50 years, 32% younger than 40 years, and an average age of 46 years.  That region also saw the lowest rate of growth in RN supply from 2009 to 2014 among the regions and is projected to grow the slowest from 2015 to 2030.  At the other extreme, the West South Central region is essentially the inverse, with 42% of RNs younger than 40 years and 32% of RNs older than 50 years, an average age of just under 43 years, and has the fastest growing regional growth in RN supply between 2009 and 2014 and is expected to increase the fastest between 2015 and 2030.”

Interestingly, the Mountain region has the third-oldest RN population but is projected to be one of the fastest growing regions.  This is due to “a relatively large and growing group of younger RNs aging into their most productive years spent in the workforce – ages 40s and 50s” in the past decade.

Looking at a New Generation

The Millennials, also known as Generation Y, are the largest generation in U.S. history and currently make up about half of the U.S. workforce.  Millennials number 92 million compared to 77 million Baby Boomers.

A recent study shows that Millennials are nearly twice as likely to be RNs than Baby Boomers were.  “Those born in the late 1980s were 65 percent more likely to become an RN, compared to those born in 1955.  Overall, an average Millennial has thus far been nearly twice as likely (186 percent) to become an RN as an average baby boomer.”

Although the Millennial rate of entry into nursing has appeared to level, the number is still expected to grow moderately and will not erase the growth rate, but will lessen the workforce effect of Baby Boomers retiring.   Millennials are also more likely than Gen X’ers to become RNs.  Experiencing the Great Recession, Millennials looked to nursing as a profession offering “stable earnings and low unemployment”.  Millennials are also “looking for more meaningful work and work that they care about”.

And what follows Millennials?  iGen; those born between 1995 and 2012.  According to Dr. Jean Twenge, who named the generation, “iGen is more practical in their work attitudes than millennials were at the same age. They are more willing to work overtime to do a good job and less likely to have unrealistically high expectations.”

 State Projection Tables

RN 2019 Short Term Projections
RN 2018 Short Term Projections
RN Long Term Projections
LPN 2019 Short Term Projections
LPN 2018 Short Term Projections
LPN Long Term Projections
PT 2019 Short Term Projections
PT 2018 Short Term Projections
PT Long Term Projections
HHA 2019 Short Term Projections
HHA 2018 Short Term Projections
HHA Long Term Projections
PCA 2019 Short Term Projections
PCA Long Term Projections

Supply and Demand

RN Supply and Demand
LPN Supply and Demand

Projections are from the Bureau of Labor Statistics of the U.S. Department of Labor (Projections Central) and display the projected employment by state and estimated average annual job openings. A Job opening requires that: 1) a specific position exists and there is work available for that position, 2) work could start in 30 days whether or not the employer found a suitable candidate, and 3) the employer is actively recruiting from outside the establishment to fill the position.

Projections to 2030 by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services are for supply and demand of Registered Nurses and Licensed Practical Nurses by state.

home health nurse workforcce

The projection of supply and demand for U.S. regions in the table below is from a study by Auerbach, Buerhaus, and Staiger printed in The American Academy of Nursing.

 Entry, Exit, and Projected RN FTE Growth by Region
Region
2001-2014
2015-2030
Average
Annual
Entry
Average
Annual
Exit
Growth in RNs (%)
Growth in RNs per Capita (%)
New England
 4,554
 1,798
 6.1
 0.0
Middle Atlantic
 16,000
 6,608
 9.5
 8.3
East North Central
 13,548
 6,234
 21.7
 17.7
West North Central
 7,751
 3,197
 19.9
 16.4
South Atlantic
 20,068
 5,964
 26.3
 2.9
East South Central
 6,309
 2,553
 44.7
 39.2
West South Central
 13,975
 2,185
 55.2
 39.2
Mountain
 7,358
 1,436
 45.6
 18.5
Pacific
 15,685
 5,603
 19.2
 0.7
Source: Auerbach, David I., Buerhaus, Peter I., and Staiger, Douglas O. How fast will the registered nurse workforce grow though 2030? Projections in nine regions of the country. American Academy of Nursing. Nursing Outlook, Vol. 65, Issue 1, p116–122. Published online: July 12, 2016

 

census regions

home health RN workforce

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