Nursing home staffing hours and turnover

Staffing is the part of the CMS data most directly linked to daily experience — and the easiest to misread. Here is what the numbers mean, with national medians computed from the 14,690 facilities in this directory.

Staffing hours per resident per day

CMS reports how many hours of care each facility's residents receive per day, split into nurse aides, licensed practical nurses (LPNs) and registered nurses (RNs). The total nurse staffing figure is the sum. In this data the median facility reports about 3.68 total nurse hours per resident per day, including 0.58 RN hours; on weekends the median is about 3.26 total hours. Facilities below the median deserve extra questions about nights and weekends.

Why RN hours matter

RNs assess changes in condition, manage medications and supervise aides. A facility can have a high total hour count dominated by aide hours and still be thin on RN coverage. Compare the RN figure separately, and ask specifically who covers nights and weekends.

Turnover

CMS reports total nursing-staff turnover and RN turnover over the year. In this data the median total nursing-staff turnover is 44.9% and median RN turnover is 42.1%. Very high turnover suggests unstable staffing — which affects consistency of care, family communication and training. Low turnover is not automatically better if the facility is understaffed, but it is a good sign when staffing hours are also solid.

The abuse and special-focus flags

CMS flags facilities with abuse citations in the last three survey cycles — 10% of facilities in this directory — and special-focus status for persistent quality problems (4%). These are independent of star ratings and worth checking even for 4- and 5-star facilities.

How to check

Every facility page in this directory shows staffing hours, turnover, ownership and flags next to the CMS star ratings. Compare at least three facilities at the same level of care, and ask each one how the numbers translate into a typical day on the floor.

Written and maintained by the US Nursing Homes data team · last reviewed 2026-10-24 · sources and methodology.