HAP Resource Center

Fact Sheet: Pennsylvania’s Nurses Are More Than a Number

Across Pennsylvania and the nation, there are not enough qualified health care professionals to meet our growing need for care. The commonwealth must invest in growing the health care workforce. One-size-fits-all government mandates put up barriers between caregivers and patients.

Mandating staffing ratios is not the answer.

  • Government-mandated ratios do not produce more nurses to care for Pennsylvanians.
  • When workforce shortages make it impossible for hospitals to meet the mandates, they will be forced to close beds or reduce services to comply with state law. Emergency room waits will increase and access to care will decrease in many communities.
  • Health care teams make complex, real-time, evidence-based decisions to provide the best care for patients. Rigid, government-mandated ratios replace this professional judgment, reduce these complex decisions to out-of-context numbers, and put treatment processes in the hands of the government.

Only California mandates nurse ratios hospital-wide. Its law:

  • Has hurt access to care. California patients have fewer services, longer emergency department wait times, and higher costs than before the mandate.
  • Has not improved care. California’s outcomes do not consistently rank higher than other states. Pennsylvania already performs better in overall health care quality as well as several quality indicators tied to nursing.
  • Has not eased workforce shortages. As of June 2023, California has the highest demand for travel nurses among states. Pennsylvania has the fifth-highest.1

HAP supports a comprehensive strategy to sustain and grow the health care workforce that:

  • Makes health care education more affordable and accessible by funding scholarships, expanding loan forgiveness, investing in health care education programs, and offering incentives for clinicians to work as health care faculty and preceptors.
  • Helps clinicians quickly get to work by addressing licensing delays and administrative barriers.
  • Invests in and strengthens protections for health care workforce safety.
  • Promotes careers in nursing, fosters a more diverse and equitable health care workforce, and supports career advancement for health care professionals.
  • Encourages innovative care models, technology, and benefits that improve work/life harmony.
  • Empowers providers to spend more time and energy caring for patients and practicing at the top of their license and training.

Pennsylvania’s workforce shortage is among the most severe in the nation. Why?

  • An aging and retiring health care workforce
  • Too few educators and clinical training opportunities for health care professionals
  • Too few graduates of nursing and health care education programs
  • Bedside nurses expanding to advanced practice opportunities
  • More patients who need acute care
  • Stress, family obligations, and other life changes stemming from the pandemic

Growing Care Teams

Hospitals are working hard to recruit, retain, and develop caregivers. HAP’s November 2023 survey found that:

  • Nearly all are increasing pay, offering flexible schedules, and providing tuition assistance and professional development to attract and keep health professionals.
  • Many are also giving bonuses, and some are even providing child care.
  • Almost all are partnering with four-year and community colleges and high schools to develop the next generation.

Through these efforts, hospitals cut turnover for care professionals by 28%.

Despite this progress, hospitals statewide face average vacancy rates of 14% for nurses and even greater challenges in rural communities.

And, Pennsylvania is projected to have a shortfall of more than 20,000 nurses by 2026, the worst nationally.2






1 According to Qualivis
2 Mercer, “2021 U.S. Healthcare Labor Market”



Topics: Access to Care, State Advocacy, Workforce

Revision Date: 1/30/2024

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