The following is an alert for the Q2 2023 staffing report. Download data at NursingHome411 and check out our interactive staffing map.

November 14, 2023 – Each day, more than one million people reside in roughly 15,000 nursing homes across the United States. Unfortunately, most of these individuals have no choice but to receive care and services in understaffed facilities.

LTCCC’s analysis of federal nursing home staffing data for Q2 2023 shows that nearly four in five (78.8%) nursing home residents live in understaffed facilities providing less than the 4.1 hours per resident day (HPRD) needed to deliver sufficient clinical care and avoid unnecessary resident harm. The 4.1 HPRD threshold was determined by a landmark 2001 federal study.

LTCCC’s quarterly staffing report is based on CMS’s Q2 2023 payroll-based journal data on nurse staff (RN, LPN, CNA, etc.) and non-nurse staff (Admin, OT, PT, Activities, etc.) for 14,595 U.S. nursing homes in compliance with mandatory reporting requirements. Visit the NursingHome411 staffing page for user-friendly data (nurse staff, non-nurse staff, turnover rates, weekend staffing levels) on nursing homes in your community. Be sure to check out our interactive staffing map for staffing data and rankings by state.

We hope this report can help the public, media, and policymakers identify and assess the extent to which nursing homes in their communities provide sufficient staffing to meet basic clinical and quality of life needs.

Staffing Facts for Q2 2023

  • U.S. nursing homes collectively provided an average of 3.66 total nurse staff HPRD in the second quarter of 2023.
  • The total nurse staff HPRD for Q2 2023 is up two minutes from Q1 2023 (3.63 HPRD). The increase is driven largely by a rise in CNA HPRD, from 2.00 to 2.04.
  • The median nursing home provided 0.55 Total RN HPRD (incl. RN Admin & DON), 0.87 Total LPN (incl. LPN Admin), and 2.17 Total Nurse Aide (CNA, Med Aide/Tech, Nurse Aide in Training). Though the proposed federal standard includes a minimum of 0.55 RN HPRD, the landmark 2001 federal study established the importance of having at least 0.75 RN HPRD to meet basic clinical needs.
  • The median nursing home provided 43 minutes per resident day (MPRD) of non-nurse staff, including 8.8 MPRD of Activities staff, 7.5 MPRD of Occupational Therapy staff (incl. asst & aide), and 8.3 of Physical Therapy staff (incl. asst & aide).
  • Nationwide, contract staff accounted for 9.7% of nursing staff hours, down from 10.1% the previous quarter. In the median nursing home, however, contract staff accounted for 2.3% of nursing staff hours, indicating that most nursing homes do not rely heavily on contract staff.
  • The top five states in terms of statewide total nurse staff ratio are Alaska, Oregon, North Dakota, Maine, and Hawaii. The bottom five states are Missouri, Illinois, Texas, New Mexico, and Virginia.

P.S. Please consider sharing your comments about the proposed staffing standard staffing with your Senators and Member of Congress. Your voice matters!

Source: CMS Payroll-Based Journal Data (Q2 2023).

Note: 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.