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Press Release | Home Health, Hospice, Policy

New Report on Nurse and Home Care Aide Shortage Offers Practical Solutions to Solve the Crisis

March 27, 2023
Media Contact:
Thomas Threlkeld
Director of Communications, NAHC


Rachel Edwards
Director of Marketing & Communications

New Report on Nurse and Home Care Aide Shortage Offers Practical Solutions to Solve the Crisis


Washington, D.C. – The United States is facing an unprecedented crisis in developing an adequate workforce of home care aides and nurses to care for the country’s burgeoning elderly and disabled population. It is estimated that between 2020 and 2030, the number of U.S. citizens 85 years of age or older will double, from the current 2.4 million. Such growth in the U.S. aged population exacerbates the current shortage of caregivers that over 12 million Americans of all ages rely on today. With an annual turnover rate of 64 percent and Medicaid reimbursement that has not kept pace with wage inflation, the result is that patients must wait for badly-needed care as agencies are forced to delay accepting new cases due to a lack of qualified workers.

The National Association for Home Care & Hospice (NAHC) and the Home Care Association of America (HCAOA) have brought together some of the smartest and most experienced industry leaders to create The Home Care Workforce Crisis: An Industry Report and Call to Action. This groundbreaking initiative not only addresses the needs of the nursing and home care aide workforce, but also the supply and demand issues for home based care. This report, told from the perspective of the people on the front lines of this crisis, offers policy recommendations and operational best practices to address the workforce shortage in home-based care.

Leaders from across the home care spectrum came together over the last year to conduct a deep dive assessment of the challenges and possible solutions to the current home care workforce crisis. The charge was to create a solutions-focused document that:

  • Reflects the home care industry’s response to the workforce shortage.
  • Presents recommendations to multiple audiences, including policy makers, elected officials, educators, and members of national trade associations.
  • Quantifies and validates the workforce shortage and commits to making the welfare of DCWs and nurses a top priority of home care employers.
  • Commits to promoting tangible and concrete steps to mitigate the workforce shortage so that all Americans have access to the most preferred health care delivery — in one’s own home.
  • Understands and is responsive to the needs of health and long-term care delivery systems in terms of avoidance of costly hospital and nursing home stays and respect for individual choice of care setting.

“The supply of nurses and home care aides is not sufficient to meet the demand for their services, which means America’s most vulnerable population suffers,” said NAHC President William A. Dombi. “Family caregivers are already stretched beyond the limit, leading them to take unpaid leave, lose wages, and suffer from care burnout. This also leads people to seek care from costlier settings, such as hospitals and nursing homes. The home care workforce crisis has implications far beyond the care at home community.”

“This report is just the first step to addressing the home care workforce shortage, but it is a significant one,” said Vicki Hoak, CEO of the Home Care Association of America. “It encapsulates the industry’s commitment to elevating the profession of caregiving and urges other stakeholders and policymakers to join us in solving this problem. This week home care providers from both of our associations will be on Capitol Hill meeting with lawmakers to tell their personal stories of the impact this shortage has on families. As the preferred choice of care for older Americans, home care is a lifeline for millions of families with elderly loved ones. But today they are struggling to find the care and support they need. We must continue to stress the urgency of addressing this shortage to meet the massive demand for home-based care from America’s growing aging population by creating a stronger safety net and enabling all Americans to age at home with dignity and respect.”

“Everyone involved in bringing this Call to Action to fruition is thrilled at the result,” says Private Duty Care at NAHC Executive Director Kristen Wheeler. “This report contains actionable steps we as an industry can take, starting now, to effect real change and combat the workforce crisis. The Home Care Workforce Action Alliance, truly a collaboration, shows firsthand that we can no longer work in silos but, together, we can make a difference. It takes a village, and we can succeed!”

The Home Care Workforce Crisis: An Industry Report and Call to Action represents a new and comprehensive look at the direct care workforce crisis and how to solve it. It is the hope of everyone involved that it will help guide the discussion moving forward and provide a framework for all stakeholders to solve the problem and enable America’s elderly and disabled to live independently in the place that they love the most, their own homes.


About NAHC

The National Association for Home Care & Hospice (NAHC) is the voice of home care and hospice. NAHC represents the nation’s 33,000 home care and hospice providers, along with the more than two million nurses, therapists, and aides they employ. These caregivers provide vital services to Americans who are aged, disabled, and ill. Some 12 million patients depend on home care and hospice providers, who depend on NAHC for the best in advocacy, education, and information. NAHC is a nonprofit organization that helps its members maintain the highest standards of care. To learn more, visit


As the industry’s leading trade organization representing home care agencies and their suppliers across the country, the Home Care Association of America (HCAOA) strives to provide member agencies with practical resources to enhance operations, margins, and improve training and quality within our industry. Our association advocates to help ensure caregivers have safe and secure environments in which to work and the industry continues to innovate care in our communities. Finally, our association brings together innovators and suppliers to help sustain families as they age, helping build independence and choice.