Why long-term care should be Minnesota’s next big workforce investment
By Toby Pearson | April 23, 2026 | All members
Minnesota is facing a workforce challenge that policymakers cannot afford to ignore and it’s hiding in plain sight. Long-term care is not just a healthcare issue. It is one of the largest and most essential employment sectors in our state, supporting tens of thousands of jobs across nursing homes, assisted living, and home- and community-based services. And yet, today, that workforce is in crisis.
The numbers tell the story. Minnesota’s long-term care system currently has an estimated 11,750 open caregiver positions. In January 2026, nursing facilities reported that 11.9% of nursing assistant positions were vacant and assisted living reported 8.1% of direct care positions were vacant.
At the same time, demand is accelerating. By 2035, the number of Minnesotans needing nursing home care is expected to grow by more than 20%. More than 1 in 50 Minnesotans already rely on long-term services and supports today—a number that will only increase as our population ages. This is not a distant problem. It is happening now.
Long-term care is a workforce engine—If we invest
Long-term care offers one of the most accessible and scalable career pathways in Minnesota’s economy. A certified nursing assistant can grow into a Licensed Practical Nurse, then a Registered Nurse and eventually leadership roles within a care organization. Few professions offer that kind of upward mobility without requiring decades of upfront education.
But those pathways only work if we invest in them.
States across the country are beginning to recognize this. Some are expanding tuition reimbursement and “earn while you learn” apprenticeship models. Others are creating fast-track credentialing programs, partnering with community colleges, or providing student loan forgiveness for healthcare workers who commit to long-term care settings. Immigration pathways and targeted workforce pipelines for New Americans are also emerging as critical solutions. Currently, immigrants make up nearly 35% of our workforce. Immigrants are a vital resource to long-term care in Minnesota.
Minnesota should be leading in this space, not lagging.
The cost of inaction is higher than the cost of investment
When we fail to invest in the long-term care workforce, the consequences ripple across the entire economy. Hospitals back up because patients cannot be discharged to appropriate care settings. Emergency departments become holding areas for seniors who no longer need acute care but have nowhere to go. This is not just inefficient; it is extraordinarily expensive.
At the same time, families are forced to step in.
When a daughter leaves the workforce to care for an aging parent, or a spouse reduces hours to provide support at home, that is not just a personal sacrifice, it is an economic loss for the state. Those are wages not earned, taxes not paid, and productivity not realized.
And let’s be clear: this is happening every day across Minnesota. We are effectively shifting the burden of a broken system onto families and hospitals—two places least equipped to absorb it.
A workforce competing in the wrong marketplace
Long-term care providers are not just competing with other healthcare employers. They are competing with childcare centers, retail, hospitality, and warehouse jobs—industries that often offer higher wages, more predictable hours, and less physical and emotional strain.
It is no surprise, then, that many caregivers are leaving for those opportunities. And when 9 in 10 nursing home workers report struggling to afford basic needs, the pipeline problem becomes a retention crisis. We cannot build a sustainable workforce if the economics do not work for the people doing the job.
The economic multiplier effect
Investing in the long-term care workforce is not just a cost, it is an economic multiplier.
A stronger workforce means more people employed in stable, meaningful careers. It means more seniors receiving care in the right setting, freeing up hospital capacity. It means family caregivers can remain in the workforce. It means rural communities, many of which are losing care capacity at alarming rates, can sustain local jobs and services.
In short, it keeps entire communities functioning.
A call to lead
Minnesota has long prided itself on being a national leader in healthcare innovation. But leadership requires action and right now, the long-term care workforce is telling us exactly what it needs.
We need targeted investments in training and education pipelines.
We need sustainable reimbursement that supports competitive wages.
We need policies that recognize long-term care as essential infrastructure, not an afterthought.
Because without the workforce, nothing else works. If we get this right, we can build a system that supports seniors, strengthens families, and fuels Minnesota’s economy.
If we don’t, the financial, human, and systemic costs will only continue to grow. The choice should be clear.
Toby Pearson | President/CEO | [email protected] | 952-851-2487