To cite, please include the following: The Program on Health Workforce Research and Policy at the Cecil G Sheps Center. “NC Nursecast: A Supply and Demand Model for Nurses in North Carolina.” November 1, 2021. https://ncnursecast.unc.edu/briefs/regions/
RN Shortages by Medicaid Region
NC Nursecast estimates that by 2033, North Carolina will face an estimated shortage of 12,459 RNs (or
11% of the projected RN workforce). However, model forecasts vary by
region. Almost all of the state’s Medicaid regions will face RN
shortages in the future except the Southeast, which is projected to see
a slight surplus of RNs by 2033, likely due to the high retention of
graduates from local training institutions (Figure 1). Figure 2 shows
that, after adjusting for population size, metropolitan areas will face
far greater RN shortages than rural areas, with the Northwest/Triad
Medicaid region (including Greensboro and Winston-Salem) facing the
greatest shortages, followed by the Piedmont/Triangle (including
Raleigh-Durham-Chapel Hill), and, finally, Southcentral/Charlotte. Eastern
NC is projected to have a balance of supply and demand for RNs.
Figure 1. RN Shortage/Surplus per 10K Population, All Settings, by Medicaid Region
The nine AHEC regions provide a useful
grouping of counties through which to examine RN and LPN shortages
because they make up the major health care service areas in the state.
As such, AHEC regions reflect regional employment patterns of
nurses. Further, within the AHEC regions there are strong ties between
the community colleges and universities where nurses are educated and
the hospitals and other health care institutions that provide the vast
majority of their clinical experiences. These factors make the AHEC
regions particularly helpful in any analysis of nurse workforce trends.
Not surprisingly, NC Nursecast projects that, even after adjusting for
population, AHECs with large health care systems and hospitals in the
Wake and Northwest AHEC regions will face the largest shortages (Figure
3).
Figure 3. RN Shortage/Surplus per 10K Population, All Settings, by AHEC regions
NC Nursecast allows
users to examine the future supply and demand for nurses by setting
within a specific region. Table 1 shows, for example, that in the
Northwest AHEC region, hospitals will experience the largest shortage of
RNs in absolute numbers, but nursing home, extended care, and assisted
living facilities will face the greatest shortage as a percent of the
future projected workforce. Home health/hospice and nursing education
settings are also projected to have shortfalls relative to the size of
their projected workforce.
Table 1. Projected Registered Nurse Workforce Shortages, Northwest AHEC Region in 2033 by Setting
Setting
Difference between Projected Supply/Demand in 2033
Examining supply and demand in specific regions and by setting provides
a more nuanced understanding of future workforce needs in a given
geographic area. For example, while the South East AHEC region is
forecast to experience a small surplus in nurses overall, two settings
in South East AHEC face shortages. Home care and hospice faces an RN shortage of
44 nurses (or 6.7% of its workforce) and nursing home, extended care and
assisted living facilities face an RN shortage of 83 nurses (or 24.3% of
its workforce).
LPN Shortages by Medicaid Region
LPNs are projected to be in
shortage in every region of the state in the future. Although RN
shortages will be significantly more pronounced in metropolitan areas
(Figure 2), LPNs are almost equally in shortfall in both metropolitan
and non-metropolitan areas (Figure 4). The Western region and
Piedmont/Triangle Medicaid regions are projected to face the largest
shortages of LPNs.
Figure 4. LPN Shortage/Surplus per 10K Population, All Settings, by Metropolitan and Non-Metropolitan Areas
NC Nursecast gives
users the ability to examine nurse supply and demand by region, setting,
and nurse type. For example, the Piedmont/Triangle Medicaid region has
the second largest projected shortage of both LPNs and RNs. For LPNs,
the greatest numeric and percent shortages are in nursing home, extended
care, and assisted living facilities, followed by home health/hospice,
and mental health facilities (Table 2). For RNs, the greatest numeric
shortages are in hospitals, but nursing home, extended care and assisted
living facilities face the greatest shortfalls as a percentage of their
workforce.
Table 2. Projected Licensed Practical Nurse Workforce in 2033 in Piedmont/Triangle Region by Setting
Careful consideration must be given to interpreting forecasts.
Despite the power of the NC Nursecast tool to project region-specific estimated supply
and demand of nurses, careful consideration must be given when using
this tool for planning purposes. As explained in the NC Nursecast Projections by Setting
brief, the forecasts rely on the historical utilization
of LPNs and RNs (per population) in different employment settings by
region. They do not reflect the number of LPNs and RNs that would
be needed to fully meet patients’ needs for care or fill position
vacancies. Therefore, if a region is using the tool to make decisions
about workforce planning, additional research and expert opinions and
insights are needed to complement NC Nursecast data and adequately
reflect local trends.
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Supply & Demand
Want to learn about the future supply and demand of our state's licensed practical
nurses and registered nurses across settings and geographic regions?
This project is brought to you by The Cecil G. Sheps Center For Health Services Research at the
University of North Carolina in partnership with the North Carolina Board of Nursing.