The following is an alert for LTCCC’s Q2 2025 staffing report. Download national, state, community, and facility-level data at NursingHome411.org.

January 16, 2026 – New federal data reveal that the overwhelming majority of U.S. nursing homes are operating with insufficient staffing to meet the basic needs of their residents. According to LTCCC’s report on the latest federal staffing data, 9 in 10 nursing homes fall below their expected staffing levels and the average facility is under-staffed by 25% on a daily basis. These expectations are based on an evidence-based methodology that uses each facility’s own assessment of its residents’ needs to determine appropriate nurse staffing levels.

Additional Staffing Facts for Q2 2025

  • The average U.S. nursing home provided over one hour LESS nursing staff time per resident per day than the expected time necessary to meet resident needs (3.78 total nurse staff hours per resident day (HPRD) provided vs 4.95 HPRD needed).
  • Staffing deficits on weekends were even higher, averaging 31%. [Note: nursing homes get paid the same amount every day to provide sufficient staffing to meet their residents’ needs.]
  • Contract staff usage continues to decline since the COVID pandemic, to a rate of 6% (down from a peak of 10.5% in Q3 2022).
  • 35% report zero medical director time, despite the MD’s responsibilities for overseeing clinical care in every US nursing home.

Regional and State Insights

  • Only two states – Alaska (+21.4%) and Oregon (+2.4%) – met or exceeded their expected staffing levels while North Dakota (-2.2%) ranked third in staffing adequacy.
  • States with the worst overall staffing included:
    • Illinois once again had the largest deviation from expected staffing levels to meet resident needs (-37%).
    • Puerto Rico (-35.5%), Texas (-31.1%), Georgia (-29.5%), and Missouri (-29.5%), followed in greatest deviation from expected staffing levels.
  • CMS Region 2 (New York, New Jersey, and Puerto Rico) had the largest average deviation from expected staffing levels (-27.4%).

Note: This report is based on the most recent payroll-based journal (PBJ) data reported by the federal Centers for Medicare & Medicaid Services (CMS).