March 26, 2026
LTC Imperative Completes Surveys that Support Legislative Efforts
On March 26, 2026 by Jeff Bostic
Each year, The Long-Term Care Imperative conducts a Workforce and Financial Conditions survey to gauge key metrics for the aging services sector.
Our 2026 survey shows a slightly improved picture in terms of workforce and financial conditions, but we are aware that many clouds on the horizon make further progress in 2026 difficult at best.
Workforce Shortages
The survey shows that providers across the state continue to face serious workforce shortages, with nearly 11,750 open positions statewide, including more than 7,700 aide vacancies and over 1,300 RN openings. These shortages are not abstract workforce statistics—they are already restricting access to care. Today, 35 percent of Minnesota nursing homes have people on waiting lists, and facilities are unable to accept more than 13 admissions each month on average, often because they simply do not have enough staff to safely care for additional residents.
Financial Conditions
At the same time, financial stability across the sector remains fragile. More than one-quarter of nursing facilities and over half of assisted living providers have exhausted or never had financial reserves, and most lack access to credit, leaving providers with little ability to absorb rising costs or invest in staff and facilities.
Compounding these challenges, recent policy changes are forcing providers to make difficult financial tradeoffs that threaten both the quality and affordability of care. In response to operating rate caps and other financial constraints, more than 70 percent of nursing facilities are being forced to reduce wage growth for some staff, 65 percent anticipate cutting other costs that affect residents, and nearly 60 percent will delay needed investments to improve facility infrastructure.
At the same time, new wage mandates from the Nursing Home Workforce Standards Board are expected to significantly increase operating costs in assisted living, with about half of providers reporting they will need to raise private-pay rates for residents to cover these increases, while Elderly Waiver reimbursement will not rise to match those costs.
Hindering Affordability
These converging realities are already straining affordability and limiting access to care for Minnesota seniors—and without immediate legislative action, the situation will become significantly worse. The components of the Governor’s budget proposal announced last week would make the situation dramatically worse if adopted by the Legislature. Members are strongly encouraged to contact legislators to share their opposition to that budget proposal as well as sharing talking points from our survey that illustrate the challenges providers are already facing.
The LTC Imperative also recently compiled occupancy survey results for nursing homes for calendar year 2025. Those results show occupancy continuing to improve over time, with 4th quarter 2025 average occupancy the highest since before the pandemic. The improvement is not being experienced throughout the state though, as the metro area and a couple other regions (far northwest Minnesota and the St Cloud area) are showing particularly strong gains. Meanwhile average occupancy in most other areas, and particularly in northeast and southeast Minnesota, is well below the statewide average.