Some possible responses to a federal minimum wage increase, and the influences of those responses on the ultimate impacts of a minimum wage increase, are discussed in Turnover rates among NAs in nursing homes have been high for decades, ranging upwards of 100% (Mukamel et al., 2009).
How Would a Federal Minimum Wage Increase Ultimately Affect Nursing Homes?4.3. (2018). Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201; Iara.Oliveira@hhs.gov, Marie.Squillace@hhs.gov.DISCLAIMER: The opinions and views expressed in this report are those of the authors. Should I use fixed or random effects? For additional information about this subject, you can visit the DALTCP home page at

The number and national percentage of nursing homes by state are presented in Nationally, across states (48 states and the District of Columbia), Visual representation of the state-level data on nursing home staff wages and hours worked per average nursing facility suggests that, nationally, higher average wages among RNs and NAs correlate with higher average hours worked per nursing home among these nursing home staff types, but no such relationship is observable among LPNs (In examining whether state-level staffing patterns in nursing homes vary across states with distinct average wage levels, we found significant differences in average occupational hours worked for RNs and NAs across states that differ in average occupational wages (i.e., RNs and NAs in states with higher average wages work, on average, more hours than RNs and NAs in states with lower wages), but no relationship for LPNs (Further examining the relationship between average state wage levels and state-level staffing patterns in nursing homes, we found that RN hours worked were significantly higher in states in the medium average wage category (In exploring the relationship between state minimum wage levels and nursing home staffing patterns, we found a considerable amount of variation in state minimum wage levels. Wage data were drawn from BLS May 2017 National Industry-Specific Occupational Employment and Wage Estimates for Nursing Care Facilities (e.g., SNFs), which includes combined data on wages in both nursing facilities and SNFs.
Complex care activities such as wound care, medication and end-of-life care were less likely to be missed, although there were deficits in some areas.When asked to indicate the reasons why care was missed, the respondents cited:Many of the problems in the aged-care sector can be addressed with adequate staffing, and ensuring residents receive, at a minimum, the required 4 hours and 18 minutes of care each day.

Toward a model long-term services and supports system: State policy elements. Likewise, increasing the minimum wage to $15 would require an annual wage and payroll tax increase of nearly $1.5 million for LPNs in Arkansas, but direct labor costs for LPNs in California and Arizona would not increase.The effect of a minimum wage increase on employment and unemployment rates is one long-examined outcome (Mincer, 1976), particularly among food service workers (Addison et al., 2012, 2013; Card & Krueger, 1993; Dube et al., 2010), that also deserves examination among nursing home employees. The total hours worked for each nursing staff category in 2017 was then divided by the total resident census from each facility-day in 2017 to yield total facility-level staffing HPRD for each nursing occupation category.To obtain average staffing patterns at the state level (i.e., average number of facility hours), the total hours worked variable for each occupational category and each facility within each state was summed and divided by the total number of facilities within each state. Minimum required staffing levels will need to be reached by the quarter ending September 30, 2020. If they’re bed-bound and aren’t moved frequently enough, they’re at risk of developing painful pressure sores.

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