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Temporary Staffing in Long-term Care Facilities in Tennessee

Temporary Staffing in Long-term Care Facilities in Tennessee

December 2022

Authors: Kim Potts and Lance Iverson

Executive Summary
Full Report

Staff shortages have existed for decades in long-term care facilities, but the effects of the pandemic significantly worsened shortages beginning in 2020. To alleviate the shortages, many nursing facilities and some assisted care living facilities across the country and in Tennessee contracted with healthcare staffing agencies to hire temporary nursing staff (licensed nurses and nurse aides) at reportedly high costs.

To determine the potential effects on state costs, the Tennessee General Assembly passed Senate Bill 2463/HB 2347 in 2022 requiring the Comptroller’s Office to examine long-term care facilities’ use of temporary staffing agencies. The Comptroller’s Office of Research and Education Accountability (OREA) completed the study on behalf of the Comptroller. For purposes of the study, the facilities considered are nursing home facilities and assisted care living facilities.

The study focuses on the costs that these long-term care facilities incurred for temporary staffing during the pandemic and how this may affect the TennCare program. The report contains information gathered through surveys of the state’s nursing facilities and assisted care living facilities as well as policy considerations for the General Assembly.