Updated monthly from CMS data

Nursing Home Staffing Tracker

Understaffing is the strongest predictor of poor care outcomes in nursing homes. CMS recommends a minimum of 4.1 total nurse hours per resident per day and 0.5 RN hours per resident per day. This tracker identifies facilities that fall below these thresholds, using monthly CMS data.

Research finding: A 2021 study in Health Affairs found that facilities in the bottom quartile for staffing had 22% higher rates of serious deficiency citations than those in the top quartile. High nurse turnover compounds understaffing — a 40%+ RN turnover rate is a critical warning sign.

9,850

Below 4.1 hrs/day

1,016

Below 3.0 hrs/day (severe)

2,607

RN turnover >60%

13,982

Total facilities tracked

Most Understaffed Facilities

Facilities with the lowest total nurse hours per resident per day. CMS minimum: 4.1 hrs/day.

MAISON TECHE NURSING CENTER

JEANERETTE, LA

0.01

hrs/resident/day

Avoyelles Manor Nursing Home

DUPONT, LA

0.08

hrs/resident/day

HERITAGE GARDENS HEALTH CARE CENTER

LOMA LINDA, CA

0.16

hrs/resident/day

Delmar Gardens Of Lenexa

LENEXA, KS

0.17

hrs/resident/day

Madison Healthcare Services

MADISON, MN

0.32

hrs/resident/day

Santa Fe Care Center

Santa Fe, NM

0.33

hrs/resident/day

SAMARITAN KEEP NURSING HOME INC

WATERTOWN, NY

0.36

hrs/resident/day

La Bella of Morrison

MORRISON, IL

0.45

hrs/resident/day

SAMARITAN SENIOR VILLAGE, INC

WATERTOWN, NY

0.49

hrs/resident/day

REHABILITATION CENTER AT JEFFERSON HILLS, THE

JEFFERSON HILLS, PA

0.66

hrs/resident/day

LAWRENCE COUNTY MANOR

MOUNT VERNON, MO

0.86

hrs/resident/day

PARKVIEW HEALTHCARE CENTER

ANAHEIM, CA

0.88

hrs/resident/day

Bayou Vista Nursing and Rehab Center

BUNKIE, LA

0.92

hrs/resident/day

EAST CASCADE RETIREMENT COMMUNITY

MADRAS, OR

0.94

hrs/resident/day

TJ Samson Community Hospital

Glasgow, KY

0.94

hrs/resident/day

Mahoning Operating LLC

LEHIGHTON, PA

0.96

hrs/resident/day

LATIMER NURSING HOME

WILBURTON, OK

0.96

hrs/resident/day

Beaconshire Nursing Centre

Detroit, MI

1.17

hrs/resident/day

EAMC LANIER NURSING HOME

VALLEY, AL

1.24

hrs/resident/day

AICOTA HEALTH CARE CENTER

AITKIN, MN

1.27

hrs/resident/day

ROSE LINN CARE CENTER

WEST LINN, OR

1.28

hrs/resident/day

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FOUR SEASONS LIVING CENTER

SEDALIA, MO

1.36

hrs/resident/day

BHM Carrollton OpCo Inc

CARROLLTON, GA

1.40

hrs/resident/day

SOUTH COUNTY HEALTH CARE CENTER

ARNOLD, MO

1.45

hrs/resident/day

BROOKDALE SKYLINE

COLORADO SPRINGS, CO

1.46

hrs/resident/day

MIDWAY NEUROLOGICAL / REHAB CENTER

BRIDGEVIEW, IL

1.51

hrs/resident/day

KAUAI VETERANS MEMORIAL HOSPITAL

WAIMEA, HI

1.51

hrs/resident/day

HAVEN MANOR HEALTH CARE CENTER, L L C

FAR ROCKAWAY, NY

1.53

hrs/resident/day

Avir at Houston

HOUSTON, TX

1.55

hrs/resident/day

BHM Pine Knoll OpCo Inc

CARROLLTON, GA

1.57

hrs/resident/day

Highest RN Turnover Rates

RN turnover above 40% is a warning sign; above 60% indicates a serious staffing crisis. High turnover means residents regularly encounter unfamiliar staff, which directly impacts care quality.

States With Most Understaffed Facilities

Number of facilities below 4.1 total nurse hrs/resident/day.

About This Data

Staffing hours are sourced from the CMS Provider Data Catalog (provider_info dataset), updated the first Wednesday of each month. CMS collects staffing data via Payroll-Based Journal (PBJ), which requires facilities to submit actual payroll records — making this more reliable than self-reported data. Turnover rates are calculated by CMS from rolling 12-month PBJ data.

Read our full methodology →

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