Healthcare Sectors Hit Hardest by Worker Shortages

The U.S. is not facing a single healthcare staffing crisis — it is facing dozens of them, each concentrated in specific sectors, each compounding daily. If you work in healthcare staffing or workforce planning, knowing exactly where the fault lines run is the first step toward building a real response. This post maps the sectors suffering the most, explains why each one is struggling, and gives staffing professionals and facility leaders concrete actions to take right now. Long-Term Care and Skilled Nursing Facilities No sector bleeds staff faster or more visibly than skilled nursing facilities and long-term care. CNA turnover rates routinely exceed 65% annually at many facilities, and registered nurse vacancies in this space have widened since the pandemic without recovering. The work is physically demanding, emotionally taxing, and — historically — underpaid relative to acute care settings. Facilities in rural areas face a compounding problem: a smaller local labor pool, fewer transit options for workers, and limited ability to offer the premium wages that urban or hospital-based competitors can. What staffing professionals can do right now: Build dedicated candidate pipelines specifically for long-term care. Partner with CNA training programs at community colleges and offer sponsored certification pathways as part of your placement model. Facilities that support worker credentialing before hiring report higher retention in the first year. Identify your top-performing CNAs placed in LTC settings and treat them as referral sources — peer-to-peer recruitment in this sector consistently outperforms job board advertising. Behavioral Health and Psychiatric Care Behavioral health has never had enough workers, and the demand spike that started in 2020 has not plateaued. Psychiatric nurses, licensed clinical social workers, and mental health technicians are in short supply across inpatient psychiatric units, community mental health centers, and residential treatment facilities. Many behavioral health organizations operate as nonprofits with constrained budgets, making competitive compensation a structural challenge rather than a simple fix. Burnout is severe in this sector. Workers absorb significant emotional weight, and facilities with poor scheduling practices or inadequate supervision drive skilled staff out within months. What to prioritize: When placing candidates in behavioral health settings, verify that the facility has documented debriefing protocols and clinical supervision structures. Candidates who know those supports exist are more likely to accept offers and stay. For facilities, consider requesting a staffing audit from your agency partner to identify whether your current scheduling model is contributing to turnover — not just reflecting it. Home Health and Community-Based Care Home health aides and personal care workers represent one of the fastest-growing job categories in the country by demand, and one of the hardest to fill. Low hourly wages, unreimbursed travel time between clients, and inconsistent hours make recruitment difficult. Many workers in this space hold multiple part-time positions just to maintain stable income, which raises coordination challenges and increases the risk of no-shows. The sector is also aging itself. A large portion of the current home health workforce is over 50, and younger workers are not entering the field at a replacement rate. Immediate actions for staffing agencies: Develop clear compensation transparency during the recruitment process — spell out mileage reimbursement policies, guaranteed minimum hours, and scheduling consistency before candidates accept placements. These details matter more in home health than in any other sector. Agencies that treat these as afterthoughts lose candidates to competitors who lead with them. Primary Care and Rural Clinics Physician assistant and nurse practitioner shortages in primary care are creating access gaps that ripple far beyond the clinics themselves. Rural health clinics and federally qualified health centers report some of the longest vacancy durations in the industry — often six to twelve months to fill a single advanced practice provider role. The candidate pipeline for these positions is narrow, and many graduates target urban or suburban settings where loan repayment pressures feel more manageable. For allied health professionals like medical assistants and phlebotomists, rural clinics face the same geographic and compensation constraints as long-term care, with less visibility in the staffing industry's attention. What works here: Build relationships with nursing schools and PA programs that have rural health tracks or serve students from rural communities — these graduates are more likely to accept rural placements. Highlight loan forgiveness programs, National Health Service Corps eligibility, and state-specific rural incentive programs in every candidate conversation about rural primary care roles. This information changes decisions. Rehabilitation Services: Physical and Occupational Therapy The demand for physical therapists, occupational therapists, and speech-language pathologists has outpaced the graduating class sizes for years. Skilled nursing facilities, inpatient rehabilitation centers, and pediatric therapy practices all compete for the same limited pool. Travel therapy has absorbed a significant portion of available candidates, which creates short-term coverage for facilities while widening the permanent staffing gap. Occupational therapists specializing in pediatrics or hand therapy face some of the longest recruitment timelines in the entire allied health sector. Facilities that rely on the spot market for these specialties consistently overpay and underperform on continuity of care. Actionable steps for facilities: Identify which therapy specialties are critical to your patient population and build a preferred-staffing-agency relationship specifically for those roles — not a general contract. Agencies that specialize in allied health placement will have pre-vetted candidates and faster time-to-fill than generalist firms. Request that your agency partner maintain a warm bench of qualified candidates, not just a reactive search process. Surgical and Perioperative Nursing OR nurses and surgical technologists are among the hardest healthcare workers to replace because of how long it takes to develop competency in perioperative settings. Hospitals and ambulatory surgery centers are competing intensely for a candidate pool that has not grown proportionally to the number of surgical facilities opening. Many experienced OR nurses retired early during the pandemic and did not return. Travel nursing has partially masked the shortage in this specialty, but at a cost premium that is unsustainable for many facilities operating on thin margins. For staffing agencies supporting surgical facilities: Assess whether your candidates have specialty-specific certifications like CNOR or CST — these credentials matter more in perioperative placement than in many other specialties. Facilities that prioritize these credentials in their sourcing requirements experience fewer onboarding failures and shorter time-to-independent-practice for placed workers. A Sector-by-Sector Action Checklist Audit your current candidate database by specialty and setting — identify where your pipeline is thin before a client calls with an urgent need. Develop specialty-specific intake forms for candidate interviews so your team asks the right questions for each sector, not a generic set. Create a facility needs calendar with your top clients that maps anticipated vacancies 60 to 90 days out — proactive sourcing costs less than emergency fill. Track time-to-fill by specialty and flag any role type consistently exceeding 30 days for dedicated pipeline investment. Establish at least one educational institution partnership in each major specialty your agency serves for new-graduate pipeline access. Review compensation benchmarks quarterly by sector and geography — the market is moving faster than annual updates can track. The shortage is not going to resolve on its own, and waiting for conditions to normalize is a strategy with a very poor track record. The agencies and facilities that build structured, sector-specific recruitment approaches now will be the ones with staff when their competitors are scrambling. Reliant Healthcare Solutions works with nursing homes, rehabilitation centers, clinics, and hospitals to fill critical roles in the hardest-to-staff specialties — including RNs, LPNs, CNAs, physical therapists, occupational therapists, and allied health professionals, for both per-diem coverage and permanent direct placement. If your facility is facing a staffing gap in any of the sectors covered here, or if you are a healthcare professional looking to place your skills where they are needed most, contact our team today. We know where the shortages are — and we know how to help.