The following is an alert for the Q1 2024 staffing report. Download data at NursingHome411 and check out our interactive staffing map.
August 26, 2024 – Today, LTCCC is posting its latest report on staffing levels in U.S. nursing homes. LTCCC’s report is based on CMS’s Q1 2024 payroll-based journal data on nurse staff (RN, LPN, CNA, etc.) and non-nurse staff (medical directors, therapists, activities staff, etc.). The NursingHome411 staffing page provides user-friendly data (nurse staff, non-nurse staff, turnover rates, weekend staffing levels) searchable by facility name, county, and state. We also provide an interactive map displaying staffing data and rankings by state.
LTCCC’s analysis of the data indicates that most U.S. nursing homes are not providing the staffing necessary to ensure that residents are safe and receive basic clinical care, as required by federal law (necessary is as identified in a landmark 2001 federal study on nursing home staffing).
Staffing Facts for Q1 2024
- U.S. nursing homes had an average of 3.68 total nurse staff hours per resident day (HPRD), far below the 4.1 HPRD identified as the minimum necessary in the 2001 federal study.
- However, this average is higher than the minimum required in the new federal staffing standards, indicating that the standards are far less onerous than industry lobbyists are claiming. In fact, 60% of facilities are already providing 3.48 or more HPRD of nursing staff time.
- Low RN staffing time – a key indicator of safety and quality – persists in too many U.S. nursing homes, with only three in 10 nursing homes (29%) providing at least 0.75 HPRD (the amount of time identified in the federal study as necessary to ensure residents receive sufficient care).
- Half of nursing homes (52%) would meet CMS’s new RN staffing requirement 0.55 HPRD if it was in effect now.
- Louisiana nursing homes provided the lowest RN staffing ratio (0.24 HPRD), followed by Oklahoma (0.33), Texas (0.36), Missouri (0.39) and Arkansas (0.39). Smaller states such as Alaska (1.80), Hawaii (1.40), D.C. (1.06), Utah (1.06), and Maine (1.06) provided the highest RN staffing ratios.
- US nursing homes provided a ratio of 45 minutes per resident day (MPRD) of non-nurse staff, including 9.5 MPRD Activities staff, 9.5 MPRD Physical Therapy staff, 8.4 MPRD Occupational Therapy staff, 5.4 MPRD Social Work staff, and 3.9 Administrative staff MPRD.
- These data are important because they indicate the extent to which resident care is appropriately supervised, residents have access to appropriate therapy and activities services, etc…
- See LTCCC’s brief, All Staff Matter: The Vital Roles of Non-Nursing Staff in Nursing Home Quality and Safety.
- Contract employees accounted for 7.5% of all nurse staffing hours, down significantly from 10.1% a year ago in Q1 2023.
Source: CMS Payroll-Based Journal Data (Q1 2024).
Notes: (1) This report is based on the most recent payroll-based journal (PBJ) data reported by the federal Centers for Medicare & Medicaid Services (CMS). (Sources: PBJ Daily Nurse Staffing, PBJ Daily Non-Nurse Staffing, Provider Information). Visit the NursingHome411 Data Center for more information on staffing, five-star ratings, and other important nursing home data. (2) The new federal staffing requirements will not go into effect for several years. For more information, see LTCCC’s brief, The New Federal Nursing Home Staffing Standard: What You Need to Know.