How U.S. Healthcare Employers Can Address Staffing Gaps

U.S. healthcare employers, especially in long-term care, are facing unprecedented staffing challenges. Nursing homes and care facilities struggle with high turnover and difficulty finding qualified staff to fill critical caregiver roles. The average nursing home sees over 50% of its nursing staff turn over each year – a rate that impacts continuity of care and financial stability. This section provides resources and strategies for employers to recruit and retain talent effectively, including tapping into international healthcare workers through programs like AfroHealth.

Staff shortages in long-term care don’t just mean unfilled shifts – they affect patient care quality and burden your existing employees with overtime and burnout. Consider these facts:

• High Turnover Costs: When a caregiver quits, the facility incurs costs to advertise, hire, and train a replacement. Research shows that each frontline healthcare employee turnover can cost around $1,900–$2,100 in direct expenses for nursing homes. Indirect costs include overtime pay for others covering shifts, or expensive agency temp workers, and even potential admissions freezes if staffing falls below regulatory minimums. Frequent turnover also disrupts care continuity, which can hurt patient satisfaction and outcomes.
  
  

• Shrinking Candidate Pool: The demand for nurses and aides is rising as the population ages, but fewer local candidates are available. Facilities often compete with hospitals or other employers for the same small pool of licensed CNAs, LPNs, etc. This leads to chronic vacancies. By 2025, the U.S. could face a shortage of hundreds of thousands of healthcare workers, particularly in roles like nursing assistants. Employers must think outside the box to meet staffing needs.
  
  

• Compliance and Quality Pressure: Understaffing can lead to compliance issues (e.g., not meeting required care hours per resident) and lower quality ratings. Regulators and families pay close attention to staffing levels. Thus, achieving stable staffing is not just a HR headache but core to your facility’s reputation and success.
  
  

1. Partner with International Training Programs: One effective approach is to recruit internationally. Programs like AfroHealth train healthcare workers in Africa and prepare them for U.S. jobs, helping to bridge the workforce gap. By partnering with such programs, you gain access to a pipeline of pre-vetted, certified candidates eager to work. These professionals are often extremely motivated and loyal, as getting a U.S. job is a big opportunity for them. AfroHealth candidates, for example, commit to a minimum 3-year contract at your facility. This ensures lower turnover – imagine having staff who you know will be with you for at least three years. It’s a stark contrast to the revolving door many facilities face. Additionally, these recruits arrive fully trained to U.S. standards and certified, so they can hit the ground running with minimal additional orientation. Employers who have hired through AfroHealth have managed to stabilize their workforce and reduce their reliance on costly temp agencies.
   
   

2. Embrace Tailored Talent Matching: When hiring, it’s important to find the right fit – someone whose skills and values align with your facility. AfroHealth and similar agencies often use tailored matching processes to pair candidates with employers. This means looking at your specific needs (for example, do you need aides comfortable with dementia care? Or someone who speaks a certain language?) and matching those with candidate profiles. By getting a good fit, you improve employee satisfaction and retention. Take advantage of any recruitment partner services that let you interview candidates via video, review their training performance, and assess language proficiency. A well-matched hire is more likely to succeed and stay long-term.
   
   

3. Provide Strong Onboarding and Support: How you integrate new staff – especially those from abroad – makes a huge difference in retention. Ensure a comprehensive onboarding that covers not only job tasks but also cultural orientation. Assigning a mentor or buddy to each new hire (perhaps a senior aide or charge nurse) can help them feel welcome. AfroHealth, for instance, provides ongoing support to its placed employees throughout their tenure, but as an employer you should also cultivate that support system internally. Small things like helping an international employee get settled in the community (finding housing, understanding public transport, etc.) and checking in regularly on their adjustment can foster loyalty. When employees feel cared for, they are more likely to commit to your facility beyond any initial contract.
   
   

4. Focus on Retention Strategies: Retaining staff you’ve trained or recruited saves money and maintains quality. Along with competitive pay, consider non-monetary incentives that matter to healthcare workers. This could include flexible scheduling options to prevent burnout, opportunities for professional development (like tuition assistance for further nursing education), and recognition programs (Employee of the Month, etc.) to make staff feel valued. Creating a positive work culture where employees feel heard and respected is key. For example, regular meetings where frontline workers can voice concerns and suggest ideas for care improvement can empower staff. Also, address burnout proactively – ensure adequate staffing levels (ironic as it may sound, hiring enough people reduces burnout-driven turnover), encourage vacation time, and possibly provide resources like counseling or wellness programs. A workplace that prioritizes employee well-being will retain people, and your reputation as a good employer will in turn attract new candidates.
   
   

5. Leverage Technology for Scheduling: An often overlooked aspect is using tools to optimize staffing schedules. Consider adopting staff scheduling software or apps that use AI to forecast patient census and staffing needs. By optimizing schedules, you avoid overworking staff or being caught short-handed unexpectedly. Some advanced systems even allow employees to swap shifts easily or request coverage, providing flexibility that today’s workers appreciate. Happier staff who can balance work with life are more likely to stay. And with better scheduling, you’ll rely less on last-minute agency hires.
   
   

Many U.S. facilities have started recruiting internationally to great success. For instance, a long-term care center in Texas partnered with AfroHealth and brought in five CNAs from Kenya and Ghana in 2024. These aides integrated well, had strong work ethics, and significantly reduced the facility’s staffing shortages. Because each of them had a 3-year commitment, the director of nursing could plan staffing rosters far in advance without fear of sudden resignations. Over those years, the facility saved on recruitment costs and improved their state inspection outcomes (as consistent staffing led to more consistent care). This case illustrates how global recruitment, when done thoughtfully, can solve local staffing issues.

U.S. healthcare employers don’t have to face the staffing crisis alone. By utilizing resources like international training programs, focusing on retention, and improving hiring practices, you can build a dependable workforce even in these challenging times. The key is to be proactive and open-minded: amazing caregivers might be oceans away, but with modern technology and partnerships, they can become the backbone of your facility. Reducing turnover from 53% to even 20% will have profound effects on your financial health and, most importantly, on your residents’ quality of care. Invest in your staff – whether local or international – and they will invest their time and talents in your organization. Together, we can solve the long-term care staffing puzzle and ensure our elders and patients receive the steady, compassionate care they deserve.