The senior care staffing shortage is not a new story, but 2026 has made it harder to ignore. Roughly 95 percent of home and community-based care providers report moderate or severe staffing shortages, and a large share say they have had to turn away new referrals because they simply do not have enough staff to take them on.
For families comparing care options right now, it is worth understanding how this shortage is actually playing out differently depending on the size and structure of the community you are considering, since the same national statistic can mean very different things depending on a facility's staffing model. You can see all of our locations on our home page.
The same national statistic can mean very different things depending on a facility's staffing model.
The Scope of the Caregiver Shortage in 2026
The certified nursing assistant shortfall alone is projected to reach roughly 73,000 unfilled positions by 2028, and senior living operators nationwide are competing directly with hospitals and other health systems that can often offer higher pay for the same clinical roles. In-home care agencies report the same problem from a different angle, with families now waiting weeks rather than days to get a caregiver placed, and in some markets, months.
Why Larger Communities Feel the Shortage More Acutely
Assisted living communities that serve dozens or hundreds of residents typically run on shift-based staffing models, which means a single vacancy has to be filled by someone, often an agency or temporary worker who does not know the residents, just to keep the shift covered. Higher resident counts also mean higher turnover exposure generally, since more employees means more people who might leave in a given month.
How Smaller, Home-Based Care Models Are Different
A board and care home built around a caregiver-to-resident ratio of roughly 1 to 3 has a fundamentally different staffing structure from the start. Fewer staff are needed to maintain that ratio, and the same small group of caregivers tends to work with the same small group of residents consistently, which reduces the day-to-day reliance on rotating agency staff that larger communities lean on more heavily during a shortage.
Worth noting: occasional use of agency staff to cover gaps is common industry-wide and not automatically a red flag. Heavy, ongoing reliance on agency staff for day-to-day core coverage is more worth asking follow-up questions about.
How the Shortage Is Affecting the Cost of Care
Staffing is one of the largest operating expenses in senior care, so a national shortage does not just create scheduling headaches, it puts upward pressure on pricing across the industry. As agencies and communities raise wages to compete for a shrinking pool of qualified caregivers, those costs tend to get passed along to families, whether through higher base rates or new add-on fees as care needs increase.
This is one more reason it is worth asking directly about a community's staffing model and pricing structure together, rather than treating them as two separate conversations. A lower advertised rate that depends heavily on agency staff to actually deliver care may not hold up as reliably as a rate built around a stable, in-house team, and it may not reflect what the rate looks like a year or two down the road once the shortage continues to put pressure on wages.
What This Means for a Family Choosing Care Right Now
Staffing shortages are not evenly distributed across every type of care setting, and asking direct questions about staffing during a tour will tell you more than any general industry statistic. A community that relies heavily on agency staff or has high turnover is more likely to feel the effects of the broader shortage than one with a smaller, more stable team. We've laid out the key questions to ask further down this page.
How the Industry Is Responding, and What It Means Long Term
Larger senior living operators have started investing in internal training pipelines, offering their own certified nursing assistant programs and career-advancement tracks to build a more reliable staffing base rather than depending entirely on the existing labor market. Some of these programs report meaningfully better staff retention than industry averages, which suggests the shortage is pushing real innovation in how operators recruit and keep caregivers.
That said, these kinds of large training investments tend to be more accessible to bigger operators with the scale to fund them. Smaller, home-based providers generally address the same underlying problem differently, by keeping the staffing model itself simpler and less dependent on filling a large number of shift-based positions in the first place. Neither approach eliminates the shortage, but understanding which strategy a specific community is relying on helps explain what to expect if staffing gets tighter. You can read more about our approach on our Why Us page.
Common Questions Families Ask
How bad is the senior care staffing shortage right now?
Nearly 95 percent of home and community-based care providers report moderate or severe staffing shortages as of 2026, and the CNA shortfall alone is projected to reach roughly 73,000 unfilled positions by 2028.
Quick Takeaway
The senior care staffing shortage is real and widespread in 2026, but its effects are not evenly felt across every type of care setting. Asking direct staffing questions during a tour reveals more than any national statistic.
Are smaller board and care homes affected by the staffing shortage too?
They are not immune, but the structure of a smaller home built around a low caregiver-to-resident ratio generally requires fewer staff overall and relies less on rotating agency workers to fill shifts.
What is the most useful question to ask about staffing during a tour?
Ask how much of the staffing relies on agency or temporary workers versus a stable core team. That single answer tells you a lot about how a community is handling the current shortage.
Is the staffing shortage affecting how much care costs?
Yes, generally. Rising wages to compete for a shrinking caregiver pool tend to get reflected in pricing across the industry, which is part of why it is worth understanding a community's staffing model alongside its rates.
Should I be worried if a facility relies partly on agency staff?
Occasional use of agency staff to cover gaps is common industry-wide and not automatically a red flag. Heavy, ongoing reliance on agency staff for day-to-day core coverage is more worth asking follow-up questions about.
If you would like to know more about our staffing model and caregiver ratios, reach out through our Contact Us page or call (951) 900-4326. Our team is available Monday through Sunday, 8:00 AM to 8:00 PM, and happy to answer specific staffing questions directly.
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Quick takeaway: the senior care staffing shortage is real and widespread in 2026, but its effects are not evenly felt across every type of care setting.
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