Supply and Demand Modeling for California’s Nursing Workforce

Key Findings#

• In 2025, 50 counties are projected to face a shortage of one or more nursing role groups, with the highest shortages in the Northern & Sierra, Central Coast, and Los Angeles County CHIS regions.
• The projected statewide shortage of Registered Nurses for 2025 is low at just over -6%, with an estimated need for 18,793 additional providers to meet forecasted demand. Certain CHIS regions, like Northern & Sierra, face a projected shortage of more than 25%, while the Sacramento Area faces a projected surplus of nearly 11%, indicating a maldistribution of providers within the state.
• By 2033, it is projected that 50 counties will face a -5% shortage or more of Registered Nurses. The overall statewide shortage will increase to just under -17%, resulting in a need for 61,141 additional providers to meet future demand.
• 2025 projections indicate there is a low surplus of Vocational Nurses statewide (6.5%). However, 25 counties are facing a shortage of Vocational Nurses, while 25 counties are facing a surplus. This indicates there is a maldistribution of Vocational Nursing providers within the state. This maldistribution is projected to worsen by 2033.
• In 2025, 35 counties are projected to face a shortage of Nurse Anesthetists, with 23 counties facing a shortage of -25% or more. Statewide, this is a projected shortage of over -20% with an estimated need for 441 additional providers to meet forecasted demand. This shortage is projected to decrease by half (-11.5%) by 2033 as the supply of Nurse Anesthetists steadily increases over time.

Note: Current data as of 2022, model projections 2023-2033.

How HCAI Created This Product#

• HCAI developed models to measure and predict the current and future supply and demand of California’s nursing workforce. These models utilize licensing data and care delivery trends broken down by role or role group to create supply projections by Full Time Equivalent (FTE). These FTEs are used in conjunction with actual reported average patient care hours and employment rates from each role or role group to determine supply and demand at the individual provider level. In addition, these models consider the current and potential future demand for each role or role grouping based on capacity and utilization rates, as well as provider-to-population ratios based on setting, to estimate demand. See HCAI’s Modeling Methodology documentation for additional details.
• Nursing professions were categorized into the following role or role groups based on role similarity and scope of practice:
  • Nurse Anesthetist: Nurse Anesthetist (NA)
  • Vocational Nurse: Licensed Vocational Nurse (LVN)
  • Registered Nurse Group: Registered Nurse (RN), Certified Nurse Specialist (CNS), Public Health Nurse (PHN), and Psychiatric Mental Health Nurse (PMHN)
• Population projections were taken from the US Department of Finance’s P-2A Total Population for California and Counties.
• Four major region types—California Community Colleges (CCC) Regions, CHIS Regions, Job First Regions, and Labor Market Regions—were used to provide multiple geographic comparisons. The breakdowns for each Region Type are listed below: