Four Moves Senior Care Providers Can Make Now on the LPN Shortage

Home / News / Blog / Heart of the Matter Post
September 23, 2026

Guest Blog: Contribution by LeadingAge PA Business Partner and sponsor of the LeadingAge PA Career Center, Brandon Tappan, Chief Revenue Officer, ShiftKey

September is National Workforce Development Month, which makes it a useful moment to look at the LPN shortage and what you can do about it. If you operate a skilled nursing community, you've already felt the LPN squeeze. The harder question is what the next decade and beyond looks like, and the data does not look good.

The Numbers to Know

The U.S. Health Resources and Services Administration (HRSA) projects a 30% LPN shortfall by 2038, equivalent to about 246,000 full-time equivalent positions the country won't be able to fill at the current trajectory. That figure comes from HRSA's December 2025 nursing workforce projections. HRSA's broader workforce report shows the LPN supply contracted 6% between 2020 and 2024, meaning we're not just failing to grow the pipeline; we're losing ground.

Significantly, the post-acute and senior care sectors are feeling the brunt of this impact, as roughly four in 10 LPNs nationwide work in skilled nursing or residential care settings. That concentration is the part that matters for providers in our space. When the pool shrinks, our communities feel the hit first.

Geography Matters

While the 30% figure is a national projection, the shortage is uneven across regions: it's concentrated in specific states and falling hardest on non-metropolitan markets.

HRSA identifies Oklahoma, South Carolina, Louisiana, and Virginia as the states with the largest projected RN shortages by 2038. Notably, rural areas are projected to face an 11% RN shortage by 2038, compared to just 2% in metropolitan areas. The same dynamics apply to the LPN workforce.

What this means in practice: a multi-site provider running communities across a mix of urban, suburban and rural markets is looking at different workforce dynamics in each environment. Any strategic conversation about workforce sustainability needs to start with where your communities sit on the regional curve, not what the national headlines say.

Recruiting Harder Won't Solve It

We've seen providers responding to workforce pressures by doubling down on traditional recruiting, with bigger sign-on bonuses, expanded recruiter teams, and aggressive outreach. These efforts assume the underlying problem is execution, and it isn't.

This is a supply problem. The pipeline feeding LPN roles, such as nursing school graduates, NCLEX-PN test takers, and new license holders, is under structural pressure across the country.

Wage competition between providers just redistributes a shrinking pool; it doesn't grow the pool. Winning bidding wars isn't a sustainable strategy, especially for non-profit providers operating on tight margins. Providers who recognize this key distinction will make different decisions than providers who don't.

Strategies You Can Act on Now

The good news is that some forward-thinking leaders are paying attention and aren't waiting. A few patterns are emerging from those who are planning ahead.

1. Hold on to the people you already have. LPNs who walk out the door make the situation worse for your community – and maybe for the entire sector if they leave the profession. Retention is one of the highest-leverage moves providers can make, but it's often deprioritized by the urgency of filling open shifts. There's real goodwill to build on here: in the ShiftKey 2025 Workforce 360 report, 89% of employees and 96% of independent professionals said they keep coming back because of the people they serve. Stay interviews, schedule predictability, real career pathways, and manager training are not new ideas, but they are even more valuable in a structurally constrained market. Providers who treat retention as a workforce strategy, not just an HR program, will be the ones whose problems don't worsen year after year.

2. Build the pipeline from within through CNA-to-LPN laddering. Instead of waiting for external supply to recover, a growing number of senior care providers are creating earn-and-learn pathways for their existing CNAs. Kane Community Living Centers, a Western Pennsylvania provider, partnered with a licensed practical nurse program to educate CNAs and other team members at no cost, building a clear ladder from CNA to LPN to RN. Similar earn-and-learn models are running in Hawaii, Wisconsin, Indiana, and Arizona, with providers reporting that the pipeline effect is real, including stronger CNA recruitment as candidates pursue organizations that offer a real path forward. For mission-driven providers, this is a strategy that sits alongside the values embedded in the work: investing in the people who chose this field.

3. Revisit the RN mix in certain roles. Some providers are taking a hard look at their care model and asking whether shifting certain responsibilities toward RNs in specific units can offset projected LPN shortfalls. This isn't right for every community, and the bottom-line math needs to work, but it's a planning conversation worth having before the gap widens further.

4. Maintain flexible access to independent licensed professionals. Internal pipeline programs can take years to develop to maturity. CNA-to-LPN laddering programs typically run 10 to 16 months per cohort, and benefits increase gradually. In the interim, providers need reliable access to credentialed independent professionals to keep schedules covered without resorting to long-term contracts that lock in costs at the wrong moment. Our Workforce 360 research also found schedule flexibility to be a pivotal factor in engagement and retention, not just a recruiting perk. This is where ShiftKey's marketplace fits: we connect communities to a vast network of independent licensed professionals in their local areas, providing the flexibility to scale workforce access up or down as internal strategies take hold. And this brings access to a new pool of independent professionals who often can’t or don’t want to work full time, but still want to stay in the field.

The providers getting this right are running multiple plays in parallel, not just relying on one.

The Time for Planning is Now

Twelve years sounds like a lot of runway, but workforce strategy decisions made now in 2026 (pipeline investments, care model adjustments, marketplace partnerships) determine which providers have credentialed professionals available in 2030 and beyond.

The communities building strategies now will be in a fundamentally different position than those still reacting to next quarter's open shifts five years from now.

What we're hearing across the aging services field is that the framing is shifting. Leaders who once described this as a recruiting challenge are describing it as a structural one, and building accordingly. That's the right read of the data.

The 30% shortfall is a projection, not a verdict. Workforce Development Month is a reasonable moment to ask which of these four moves your organization has underway, and which one you should start next.

Sources