The following is an alert for the Q4 2022 staffing report. Download data at NursingHome411 and check out our interactive staffing dashboard.

July 13, 2023 – Sufficient staffing is attainable. In fact, one in four U.S. nursing homes (25.3%) provide at least 4.1 hours per resident day (HPRD), the minimum amount of time needed to ensure that residents receive clinical care.

Unfortunately, far too many nursing homes are failing to provide “sufficient nursing staff with the appropriate competencies and skills sets” as required by federal law. As a result, many residents are suffering from abuse and neglect, and are not achieving their “highest practicable physical, mental, and psychosocial well-being.”

In a new staffing report by The Long Term Care Community Coalition, federal data show that U.S. nursing homes collectively provided an average of 3.61 total nurse staff HPRD in Q4 2022. This is well below the amount needed to ensure resident care needs are met. This report is based on CMS’s Q4 2022 payroll-based journal data on nurse staff (RN, LPN, CNA, etc.) and non-nurse staff (Admin, Medical Director, Dietician, etc.) for every U.S. nursing home (in compliance with mandatory reporting requirements).

Visit the NursingHome411 staffing page for user-friendly data on nursing homes in your community or state, including nurse staff, non-nurse staff, contract workers, turnover rates, weekend staffing levels, staffing ratings, and state rankings (plus: an interactive staffing dashboard!). 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 Q4 2022

  • U.S. nursing homes, collectively, provided an average of 3.61 total nurse staff HPRD while the median nursing home provided 3.58 total nurse staff HPRD. Both numbers are well below the amount of time needed to meet the basic care needs of the nation’s 1.18 million nursing home residents.
  • The median nursing home provided 0.55 Total RN HPRD and 0.36 RN Care HPRD (the latter metric excludes RN Admin and DON). A landmark 2001 federal study established the importance of having a minimum of 0.75 RN HPRD just to meet basic clinical needs.
  • Nursing homes are turning over more than half of their staff over a 12-month period. The median total nursing staff turnover is 53%, including 50% RN turnover. Higher turnover is associated with worse quality of care.
  • Staffing levels vary considerably by CMS Region. Region 6 (Arkansas, Louisiana, New Mexico, Oklahoma, Texas) has the lowest collective total nurse staff HPRD (3.41) while Region 10 (Alaska, Idaho, Oregon, Washington) has the highest (4.35).

One in four nursing homes provide at least 4.1 total nurse staff HPRD. Source: CMS Payroll-Based Journal Data (Q4 2022).

Note: The 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.