This report presents findings from the 2007 AHCA survey of nursing staff vacancy and turnover in nursing facilities. Approximately 109,900 full-time equivalent (FTE) nursing staff were needed to fill vacant direct-care positions at nursing facilities across the United States in 2007. The majority of the vacancies, nearly 60,300, were for Certified Nurse Assistant (CNA) positions. An additional 19,400 Staff Registered Nurse (RN) and 24,200 Licensed Practical Nurse (LPN) positions were estimated to be vacant. Vacancy rates among Staff RNs and LPNs were 16 percent and 11 percent, respectively. The substantial number of vacancies and the high level of turnover, 66 percent overall, among CNAs has been of particular concern. Overall, America’s nursing facilities, which provide essential facility-based long term care and services for frail, elderly, and disabled Americans, are facing a serious workforce shortage.