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North Carolina's health care workforce has recovered from crisis-level shortages seen during the Covid-19 pandemic, but challenges still remain.
A recent report prepared by RTI International found that hiring for health care systems and hospitals has improved over the past year at a level faster than the national average. However, in other care settings, the situation has worsened.
The report, prepared for the North Carolina Healthcare Association, found that total employment in the state's hospitals and health care systems increased by 6 percent from October 2022 to 2023, while vacancies dropped by 17 percent.
RTI surveyed health care systems that make up about 80 percent of hospital beds in the state.
Between 2012 and 2022, North Carolina's hospital employment increased about 12 percent. This was higher than neighboring states Georgia, Virginia, Tennessee and South Carolina, which saw increases ranging from 8 percent to 3 percent.
However, filling these roles remains a long process, especially for certain front-line jobs. Health care employers have increased pay in recent years amid intense wage competition with other employment sectors While universities in the state have tried to help address the problem by expanding four-year nursing degree programs. But the state's community colleges have been unable to significantly increase the number of associate nursing degrees awarded.
While the situation may be improving in hospitals, that is not the case in other health care settings. RTI found that the workforce crisis has worsened in recent years in nursing and residential care facilities. According to the report, these facilities in North Carolina lost more than 15,000 employees between 2019 and 2022.
North Carolina experienced one of the steepest drops in nursing and residential care employment from 2012 to 2022, with a decline about 16 percent. The national average during that time was 7 percent, while neighboring states of Georgia, Virginia, Tennessee and South Carolina saw employment drops between 1 percent and 7 percent.
This shortage of nursing home employees comes as the Biden Administration establishes minimum staffing standards for facilities.
North Carolina's aging population is one of the key factors driving the demand for health care services in the state. The report cites data from the N.C. Office of State Budget and Management, which projects that 20 percent of the state's population will be 65 or older by 2035. This is up from 12 percent as of 2000.
In addition to the aging population, the recent expansion of Medicaid in North Carolina is another factor driving demand for health care services in North Carolina. State lawmakers last year passed legislation that enables more than 600,000 people to receive health care coverage through Medicaid, a process that officially launched in December.
"While the immediate staffing crisis created by Covid-19 and the subsequent tight labor market have passed, many providers still struggle to meet staffing needs now and the ongoing demographic shifts ... point to ongoing challenges over the next decade," the report says.
In a statement on the report's release, Steve Lawler, CEO of the North Carolina Healthcare Association, said the state's providers will need to continue recent progress in addressing workforce challenges to meet future needs.
"This new report shows that North Carolina competes effectively to attract and grow top health care talent compared to neighboring states," Lawler said. "That trend will need to continue to meet the rising health care needs of our growing population."
