Healthcare employment has recovered unevenly across New York since the pandemic, with the Finger Lakes adding thousands of jobs while Central New York remained nearly flat and both regions continued losing workers from nursing homes and other long-term care facilities.
A new report from the Center for Health Workforce Studies found that hospitals, clinics, nursing homes and home care agencies across upstate New York still struggle to recruit registered nurses, licensed practical nurses, therapists, primary care physicians and other essential workers. At the same time, the education pipeline is producing fewer nurses in the Finger Lakes and Central New York even as demand is projected to remain high.
The findings are contained in the center’s 2026 report on healthcare workforce supply and demand. The University at Albany-based research center examined employment, salaries, professional licenses, graduations, employer surveys and state labor projections.
Healthcare represents a larger share of New York’s economy than it does nationally. About 14.4% of all jobs in the state were in healthcare in 2024, compared with 10.6% across the United States.
But the statewide figures conceal a significant geographic divide.
New York added approximately 190,000 healthcare jobs between 2020 and 2024, an increase of nearly 16%. Downstate regions accounted for about 178,000 of those jobs, growing 23.2%, while upstate employment increased by just 12,263 jobs, or 2.9%.
Much of the statewide growth came from home healthcare in New York City. Home care employment increased more than 48% downstate but declined 2.5% across upstate New York.
Finger Lakes adds hospital jobs but loses home care workers
The Finger Lakes region — Genesee, Livingston, Monroe, Ontario, Orleans, Seneca, Wayne, Wyoming and Yates counties — added 3,391 healthcare jobs between 2020 and 2024.
Total employment increased from 66,607 to 69,998, a 5.1% gain.
Hospitals drove most of that growth. Hospital employment rose by 3,248 jobs, or 9.7%, reaching 36,842 in 2024.
Ambulatory care, which includes physician offices, outpatient centers and other services outside hospitals and home care, added 841 jobs, an increase of 5.5%.
The region moved in the opposite direction in sectors that serve older residents and people needing care at home.
Nursing home and residential care employment declined by 216 jobs, or 1.7%. Home healthcare employment fell by 482 jobs, a 9.8% decrease.
That contraction comes as the Finger Lakes population is older than the statewide population and as demand for home-based care is expected to grow.
State projections anticipate approximately 3,500 job openings each year for home health and personal care aides in the Finger Lakes through 2032. The region is also projected to have about 1,200 annual openings for registered nurses and roughly the same number for nursing assistants.
Those openings include both newly created jobs and positions left vacant by retirements or workers leaving their occupations.
Central New York healthcare employment remains nearly flat
Central New York — Cayuga, Cortland, Madison, Onondaga and Oswego counties — had approximately the same number of healthcare jobs in 2024 as it did four years earlier.
Employment increased from 39,161 jobs in 2020 to roughly 39,375 in 2024, a gain of about one-half of 1%.
The composition of the workforce changed substantially, however.
Ambulatory care employment increased by 1,221 jobs, or 8%, while home healthcare added 242 jobs, an increase of 10.8%.
Those gains were largely offset by losses in hospitals and long-term care facilities.
Hospital employment declined by 123 jobs, or 0.9%. Nursing home and residential care employment fell by 1,126 jobs, a 13.9% reduction.
The decline in long-term care was among the steepest regional losses reported in the state. It occurred despite Central New York having a larger share of residents age 65 and older than New York as a whole.
Labor projections indicate the region will need nearly 1,700 home health and personal care aides annually through 2032. More than 700 registered nurse openings are expected each year.
Nursing shortages cut across every setting
Registered nurses remain among the hardest workers to recruit and retain across hospitals, nursing homes, home care agencies and clinics in upstate New York.
More than 61% of responding upstate hospitals reported difficulty recruiting baccalaureate-prepared registered nurses. The same percentage reported trouble retaining them.
About 61.5% of hospitals also reported difficulty retaining associate-degree nurses. More than half struggled to retain LPNs, while significant shares reported difficulty recruiting respiratory therapists, laboratory technologists and surgical technicians.
Clinical laboratory technologists presented one of the most acute hospital recruitment problems. Two-thirds of responding upstate hospitals reported difficulty filling those jobs, and every hospital reporting such a problem cited a shortage of available workers or applicants.
Nursing homes and adult care facilities faced an even broader recruitment problem.
About 68% reported difficulty recruiting LPNs, 65% struggled to recruit baccalaureate-prepared RNs and 60% reported difficulty hiring associate-prepared RNs.
More than 61% had trouble recruiting speech-language pathologists. Two-thirds reported difficulty retaining nurse aide trainees.
Home care agencies reported especially severe problems hiring therapists. About 80% struggled to recruit physical therapists and speech-language pathologists, while 70% reported difficulty recruiting baccalaureate-prepared nurses.
Clinics reported the greatest difficulty filling positions that directly affect access to primary and behavioral healthcare.
Nearly 91% of responding upstate clinics reported difficulty recruiting primary care physicians. About 86% struggled to recruit psychiatrists, 75% had difficulty finding dentists and two-thirds reported problems hiring dental hygienists.
Pay, transportation and too few applicants drive shortages
Healthcare employers consistently identified an inadequate supply of workers as the central problem.
Among upstate hospitals that struggled to recruit nurses, nearly 73% cited a shortage of applicants. Every responding hospital with difficulty recruiting laboratory technologists identified the same problem.
Nursing homes reported similarly severe shortages. All facilities struggling to recruit associate-prepared RNs and speech-language pathologists cited an insufficient pool of workers. Nearly nine in 10 reported too few applicants for LPN positions.
Location and transportation were also major barriers, particularly for long-term care and home care providers.
More than 80% of nursing homes struggling to hire home health aides or nurse aide trainees cited transportation or location. The same issue was reported by 80% of facilities struggling to hire certified nurse aides.
Among upstate home care agencies, more than 81% identified transportation as a barrier to hiring home health aides, and nearly 86% cited it for personal care aides.
Pay remains central to retention.
Every upstate home care agency reporting difficulty retaining home health aides or personal care aides said workers left for better salary and benefits.
Among clinics, 100% of those struggling to retain primary care physicians cited better pay elsewhere. More than 80% said salary contributed to the departure of registered nurses, while work-life balance was another major concern.
Healthcare employers said they have responded by increasing hourly wages, offering sign-on and referral bonuses, paying more for irregular or extra shifts and creating advancement opportunities.
Other strategies include flexible scheduling, part-time and per diem work, tuition assistance, retention bonuses, employee surveys and “stay interviews” intended to identify problems before workers leave.
Training pipeline is not keeping pace with projected need
New York’s production of new registered nurses has remained almost unchanged statewide.
Nursing programs graduated 10,253 new RNs in 2020 and 10,286 in 2024, an increase of just 33 graduates.
The picture was weaker in the Finger Lakes and Central New York.
Finger Lakes RN graduations declined from 901 in 2020 to 822 in 2024, an 8.8% drop.
Central New York produced 505 RN graduates in 2020 but only 424 in 2024. LPN graduations in that region fell from 174 to 100, a decline of more than 42%.
The Finger Lakes also experienced an approximately one-third decline in LPN and social work graduates.
Nursing schools are not necessarily facing a shortage of interested students. Programs reported turning away qualified applicants because they lacked faculty, classroom space, clinical placements or authority to exceed enrollment caps.
Among RN programs that rejected qualified applicants, nearly 43% cited insufficient qualified faculty and almost 48% cited limits on the number of students they could accept.
The constraints were particularly significant in bachelor’s degree programs, where more than 72% cited faculty shortages and nearly 56% reported insufficient clinical training sites.
Demand will continue across the next decade
State projections show the workforce pressure will extend well beyond the immediate post-pandemic period.
New York is expected to have nearly 92,000 openings each year for home health and personal care aides from 2022 through 2032.
The state is also projected to need more than 17,000 registered nurses annually, nearly 14,700 nursing assistants, approximately 5,000 LPNs and more than 5,500 medical assistants.
The report says technology, including telehealth, may help providers use existing workers more efficiently. New positions such as community health workers, patient navigators and health coaches could also help coordinate care.
Those changes will not erase the underlying workforce gap.
The findings show that the Finger Lakes and Central New York are being asked to serve aging populations with fewer long-term care workers, a limited home care workforce and a nursing education system that is producing fewer graduates than it did four years ago.
Without greater training capacity, improved transportation, competitive compensation and stronger retention efforts, the report suggests that job vacancies will continue to shape where — and whether — residents can obtain care.
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