New Health Workforce Supply and Demand Data Identifies Employment Needs, Training Challenges, and Turnover Drivers 

NC Health Talent Alliance Releases its Second Annual Health Workforce Survey Analysis 

RALEIGH, N.C. – The NC Health Talent Alliance (NC HTA) today released its annual analysis of workforce data for key healthcare jobs in the state. Now in its second year, the survey tracks changes in both supply and demand for health professionals while measuring shortages and identifying strategies to better meet statewide and regional needs. The survey focuses on registered nurses (RNs), licensed practical nurses (LPNs), and certified nursing assistants and medical assistants (CNAs/CMAs). The findings, published in a series of regional and state reports, provide concrete data on the current state of North Carolina’s health workforce and the progress being made to address shortages.  

“While anecdotal evidence of staffing challenges has existed for years, the survey—combined with complementary secondary data—offers a more detailed and contextualized picture of workforce needs across the state,”  said NC Chamber Foundation Director of Workforce Competitiveness Vincent Ginski. “We’re using this to develop regional strategies to address workforce needs since they vary greatly across the state.” 

The NC HTA’s data collection and analysis capture insights from 110 healthcare organizations for nearly 80,000 positions across 1,566 facilities. All 12 nursing programs in the University of North Carolina system and 49 community colleges provided supply data.  

HTA also conducted analyses of secondary data from Lightcast, the NC Board of Nursing, the NC Department of Health and Human Services’ Division of Health Service Regulation, and UNC Chapel Hill’s Cecil G. Sheps Center for Health Services Research. HTA was launched in 2023 by the NC Center on the Workforce for Health and the NC Chamber Foundation in collaboration with the NC AHEC regions. 

“Our goal is to ensure North Carolina has a strong and sustainable health workforce both now and in the future,” said Andy MacCracken, Director of the NC Center on the Workforce for Health. “This analysis shows what drives turnover, where demand is the greatest and how we can expand the pipeline of people entering the health care field.” 

Key Findings 

1. Nursing Education Output Is Increasing

Year-over-year growth in newly licensed RNs, LPNs, and CNAs reflects steady momentum in strengthening the state’s health talent pipelines. Increased public and private investments in nursing programs and increased cross-sector coordination are helping drive this progress.  However, challenges remain statewide and vary by region. Student outcomes vary by institutional type, following broader education trends, and chronic bottlenecks in clinical sites, faculty, and preceptors continue to constrain systemwide growth. 

• RNs: Educational output of newly licensed BSN (Bachelor of Science in Nursing) and ADN (Associate Degree in Nursing) graduates has grown 14.9 percent over three years, helping drive a 10.6 percent increase in the licensed RNs over five years (including 4.6 percent growth in just the past year). 

• LPNs: Output increased 13.4 percent over the past three years, but the overall LPN population remains 4.1 percent below pre-pandemic levels. 

• CNAs: The annual supply of CNAs meets employer demand overall, but fewer 

CNAs are practicing than the number who hold credentials. Many people who earn a CNA use it as a stepping stone to other health occupations, do not enter the health field or leave for other industries. Significant turnover is a challenge to ensuring there are enough CNAs to meet the demand. 

2. Labor Market Projections Indicate Demand is Decreasing from Pandemic Levels 

Projections suggest that annual openings, reflecting both new job growth and replacement needs from retirements, leaving healthcare or other reasons, will gradually ease by 2028, returning closer to pre-pandemic norms. This shift offers a clearer baseline for planning, reducing volatility, and enabling more predictable alignment of education pipelines with workforce needs. 

• RNs: Average projected demand for each of the next three years stands at 6,960 annual openings. The supply and demand gaps may narrow if growth continues and retention improves. 

• LPNs: Average projected demand for each of the next three years is estimated at 1,470 annual openings. While shortfalls remain today, steadier projections give industry and education partners room to close the gap with sustained output from nursing programs and improved retention. 

• CNAs: Average projected demand for each of the next three years is 9,070 openings, and there are enough licensed CNAs to fill those positions, but many do not work as CNAs or leave the health field, and there is high turnover. This means there will be ongoing shortfalls in supply. 

3. Turnover Remains a Challenge, Especially in Demanding Settings

Even with rising supply and leveling demand, chronically high turnover continues to hamper workforce stabilization. Turnover (churn rates) shows some improvement in certain roles but remains persistently high, particularly in difficult or lower-wage care environments.  

• RNs: Churn dropped from 50 percent to 42 percent statewide, reflecting possible improvements in retention practices and changing economic conditions. Yet open position rates vary by setting and remain elevated in behavioral health (40%), public health (24%), and long-term care (20%), compared with a statewide average of 13 percent. 

• LPNs: Statewide churn is 96 percent for all settings combined and exceeds 100 percent in behavioral health and long-term services and supports. Open position rates are 23 percent. 

• CNAs: Churn among CNAs exceeds 100 percent. Many individuals earn CNA credentials as stepping-stones into other health occupations, while others leave for jobs in different sectors offering similar pay with less strain. The relatively low-wage nature of these positions also means that even small pay increases from switching employers can drive turnover. 

4. Pathway to Workforce Stabilization Is Emerging, but Trajectory Needs to Be Firmer

Findings point toward a future where the state no longer faces the same annual deficit of healthcare talent that fuels long-term shortages in our health workforce. Rising numbers of graduates, coupled with demand projections slowing to pre-pandemic levels, provide reason for cautious optimism. But uneven educational completions, persistent turnover, and systemic bottlenecks continue to limit progress.  

Creating a stable health workforce will require turning the incremental gains we have seen into sustained, systemwide progress. North Carolina must not only produce more graduates but also ensure that graduates complete programs, secure local employment, and remain in the workforce long enough to reliably meet North Carolina’s healthcare needs. 

About the NC Health Talent Alliance
The NC Chamber Foundation and the NC Center on the Workforce for Health formally launched the landmark NC Health Talent Alliance public-private partnership in 2023 to aggressively address the state’s critical health care workforce shortages, and it will conduct an annual survey of health employers and educational organizations. By leveraging the U.S. Chamber Foundation’s proven Talent Pipeline Management® (TPM) framework, the Health Talent Alliance works to fill critical health sector roles by building robust talent pipelines aligned with industry demand. NC AHEC regions are implementation partners, hiring regional staff to coordinate action with regional employers, educators, and workforce entities. For more information, visit workforceforhealth.org/hta. 

About the NC Chamber Foundation
The NC Chamber Foundation is creating a strong, sustainable future for business and communities across North Carolina. Through nonpartisan research and thoughtful collaboration, the NC Chamber Foundation serves as a convener and works to disseminate information related to complex challenges, craft sound policy recommendations, track progress, and drive a future-focused vision to expand economic growth and prosperity for all North Carolinians. The work of the NC Chamber Foundation is leveraged by the NC Chamber and aligned business organizations to advocate for change that positions North Carolina as a top-10 state to live, work, and do business. For more information, visit ncchamber.com/foundation. 

About the NC Center on the Workforce for Health
The NC Center on the Workforce for Health launched in 2022 to provide a forum for health employers, workers, educators, policymakers, and other key stakeholders across the state to address critical workforce challenges, share best practices, and identify solutions. This statewide forum builds on a partnership between NC AHEC, NC Institute of Medicine, and the Sheps Center Program on Health Workforce Research and Policy to provide coordinated, persistent action and track progress with measurable outcomes. For more information, visit workforceforhealth.org. 

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