LPNs/LVNs in Long-Term Care, Hospitals, and Home Health: A Comparative Analysis

ABSTRACT Background: Demand for long-term care (LTC) in the United States is projected to surge, but the supply of LPNs/LVNs who constitute a large and growing segment of its workforce has stagnated. Purpose: The aim of this study is to compare demographic and professional characteristics of the LPN/LVN workforce across LTC, hospital, and home health settings. Methods: Data drawn from the 2024 National Nursing Workforce Survey were used to support a detailed descriptive analysis and binary logistic regression models examining potential drivers of emotional exhaustion in the LPN/LVN workforce. Results: LPNs/LVNs in LTC tend to be more racially diverse than those in hospital and home health settings. They are also more likely to report working in rural areas, holding multiple positions, and drawing a higher median salary. LPNs/LVNs working in LTC are also more likely to report higher burnout, workloads, understaffing, and intent to leave compared to their counterparts in hospitals and home health settings. Conclusion: Evidence suggests that the LTC workforce has yet to rebound from COVID-19–related attrition. This deficit, coupled with stagnant enrollment and licensure statistics over the past decade, alongside projected increases in demand for LPNs/LVNs in LTC across the country, underscores a tenuous and unsustainable future for the industry. To safeguard the care of vulnerable populations, interventions are needed that prioritize retention, incentivize reentry into practice, and deploy policies to expand the LPN/LVN pipeline.