Nursing Home Staffing Report: Aide Hours, Turnover, and Ownership
The median US nursing home reports 2.22 nurse aide hours per resident per day, and the median home's nursing staff turnover over the past year is 44.8%. 3,823 homes report fewer than 2 aide hours. These figures come from 14,021 homes in the CMS August 2026 release; the report updates with each monthly release.
By Team MCC · CMS Care Compare, August 2026 release
Key findings
- For-profit homes, 75% of the total, report a median of 2.14 nurse aide hours per resident per day, against 2.56 at nonprofit homes and 2.49 at government homes. Their median nursing staff turnover is 46.2%, against 40.0% at nonprofits.
- Homes in chains of 100 or more report a median of 2.05 aide hours per resident per day; independent homes report 2.49, 22% more.
- The fifth of homes with the most aide hours has a median turnover of 40.5% and an average of 3.27 health inspection stars. The fifth with the fewest has 49.1% and 2.48 stars.
- 13,957 of 14,021 homes report fewer nursing hours per resident on weekends than across the whole week; the median home drops 11%.
- 3,087 homes, 22%, report hours at or above all three thresholds of the 2024 federal minimum staffing rule, since repealed.
Staffing by ownership
CMS records each home's ownership type. For-profit homes make up 10,452 of the 14,021 homes analyzed. At the median, they report 19% fewer aide hours per resident than nonprofit homes, with higher staff turnover and more fines per home.
| Ownership | Homes | Aide hrs | All nurse hrs | Turnover | Fines per home | Abuse citation | CMS stars |
|---|---|---|---|---|---|---|---|
| For profit | 10,452 | 2.14 | 3.58 | 46.2% | 0.98 | 10.6% | 3.0 |
| Non profit | 2,703 | 2.56 | 4.24 | 40.0% | 0.64 | 5.7% | 4.0 |
| Government | 866 | 2.49 | 4.01 | 42.0% | 0.77 | 11.1% | 4.0 |
Medians for hours, turnover, and stars; means for fines (last three years) and the share of homes carrying the CMS abuse icon. Hours are per resident per day.
Chains and independent homes
CMS links a home to a chain when it shares ownership or management with other homes. At the median, homes in chains of 100 or more report the fewest aide hours per resident, 2.05 a day.
| Group | Homes | Aide hrs | All nurse hrs | Turnover | Fines per home | Abuse citation | CMS stars |
|---|---|---|---|---|---|---|---|
| Independent | 4,174 | 2.49 | 4.06 | 42.1% | 0.83 | 8.5% | 3.0 |
| Chain of fewer than 100 homes | 8,273 | 2.16 | 3.59 | 45.7% | 0.93 | 10.1% | 3.0 |
| Chain of 100 or more homes | 1,574 | 2.05 | 3.53 | 46.0% | 0.94 | 10.4% | 3.0 |
Medians for hours, turnover, and stars; means for fines (last three years) and the share of homes carrying the CMS abuse icon. Hours are per resident per day.
Aide hours, turnover, and inspections
The homes are split into five equal groups by aide hours per resident per day. The group with the most aide hours has lower median turnover, better average inspection ratings, and fewer fines per home than the group with the fewest. These are associations in one month's data, not proof that one causes the other.
| Aide hours per resident a day | Homes | Median turnover | Health inspection stars | Fines per home |
|---|---|---|---|---|
| Under 1.92 | 2,805 | 49.1% | 2.48 | 1.15 |
| 1.92 to 2.12 | 2,804 | 46.2% | 2.65 | 0.98 |
| 2.12 to 2.34 | 2,804 | 45.2% | 2.83 | 0.85 |
| 2.34 to 2.66 | 2,804 | 43.0% | 2.92 | 0.80 |
| 2.66 and over | 2,804 | 40.5% | 3.27 | 0.71 |
Groups are fifths of homes ranked by reported aide hours. Stars are the average CMS health inspection rating (1 to 5).
Weekend staffing
CMS reports each home's total nursing hours per resident on weekends alongside the figure for the whole week. 13,957 of 14,021 homes, 99.5%, report fewer hours per resident on weekends. The median home's weekend figure is 11% below its all-days figure.
The repealed 2024 minimum staffing rule
In May 2024, CMS set federal minimum nurse staffing levels for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 registered nurse hours and 2.45 nurse aide hours. Two federal district courts vacated those standards. A law signed on July 4, 2025 (Public Law 119-21) bars CMS from enforcing them until September 30, 2034, and CMS repealed them in a rule that took effect on February 2, 2026.
Measured against those thresholds on the hours each home reported, 9,045 homes meet the total, 7,807 meet the registered nurse level, 4,605 meet the aide level, and 3,087 meet all three. The share meeting all three is highest in Maine (79%), North Dakota (77%), Hawaii (71%) and lowest in Louisiana (2%), Texas (5%), Oklahoma (5%).
| State | Homes | Median aide hrs | Median turnover | Meet 2.45 aide hrs | Meet all three |
|---|---|---|---|---|---|
| Maine | 78 | 2.82 | 46.9% | 81% | 79% |
| North Dakota | 69 | 2.93 | 50.0% | 80% | 77% |
| Hawaii | 41 | 2.71 | 31.5% | 71% | 71% |
| Oregon | 121 | 3.38 | 45.5% | 99% | 64% |
| Minnesota | 319 | 2.50 | 39.3% | 55% | 54% |
| Vermont | 31 | 2.54 | 58.8% | 61% | 52% |
| Washington | 185 | 2.48 | 43.2% | 55% | 51% |
| Kansas | 280 | 2.64 | 47.4% | 63% | 48% |
| Montana | 56 | 2.51 | 53.4% | 54% | 48% |
| Wisconsin | 313 | 2.43 | 46.2% | 49% | 48% |
| Nebraska | 161 | 2.60 | 46.6% | 64% | 45% |
| South Dakota | 88 | 2.40 | 47.8% | 45% | 41% |
| Iowa | 373 | 2.44 | 41.5% | 49% | 39% |
| Idaho | 78 | 2.36 | 50.3% | 42% | 38% |
| Wyoming | 35 | 2.27 | 47.8% | 40% | 37% |
| Alabama | 218 | 2.45 | 47.0% | 50% | 34% |
| California | 1,108 | 2.57 | 36.2% | 79% | 34% |
| New Hampshire | 72 | 2.25 | 43.6% | 33% | 32% |
| Rhode Island | 68 | 2.35 | 39.5% | 37% | 31% |
| Nevada | 63 | 2.14 | 45.0% | 30% | 30% |
| Utah | 88 | 2.18 | 50.9% | 30% | 30% |
| Mississippi | 196 | 2.34 | 44.2% | 39% | 26% |
| Michigan | 412 | 2.18 | 44.6% | 27% | 24% |
| Colorado | 201 | 2.11 | 46.3% | 23% | 23% |
| Kentucky | 257 | 2.22 | 45.0% | 29% | 23% |
| Delaware | 43 | 2.18 | 41.7% | 21% | 21% |
| Connecticut | 182 | 2.20 | 35.5% | 24% | 20% |
| Pennsylvania | 634 | 2.10 | 44.3% | 21% | 20% |
| Arizona | 134 | 2.14 | 45.6% | 26% | 19% |
| South Carolina | 183 | 2.07 | 45.3% | 23% | 19% |
| Florida | 675 | 2.20 | 41.7% | 21% | 18% |
| Illinois | 629 | 2.00 | 43.1% | 21% | 18% |
| New Mexico | 64 | 2.13 | 52.7% | 23% | 17% |
| North Carolina | 393 | 2.18 | 48.8% | 27% | 16% |
| New Jersey | 338 | 2.14 | 38.9% | 20% | 16% |
| Massachusetts | 329 | 2.17 | 37.6% | 20% | 15% |
| New York | 579 | 2.12 | 38.4% | 18% | 14% |
| Virginia | 280 | 1.98 | 48.1% | 16% | 14% |
| Maryland | 216 | 2.03 | 41.5% | 13% | 13% |
| West Virginia | 119 | 1.94 | 43.2% | 15% | 13% |
| Missouri | 443 | 2.29 | 56.0% | 33% | 12% |
| Indiana | 497 | 2.16 | 45.3% | 19% | 12% |
| Ohio | 892 | 2.03 | 48.3% | 13% | 11% |
| Arkansas | 218 | 2.59 | 48.2% | 62% | 11% |
| Georgia | 335 | 2.06 | 45.9% | 20% | 9% |
| Tennessee | 298 | 2.02 | 50.0% | 15% | 8% |
| Oklahoma | 244 | 2.47 | 55.0% | 52% | 5% |
| Texas | 1,099 | 1.96 | 51.7% | 10% | 5% |
| Louisiana | 247 | 2.29 | 46.8% | 30% | 2% |
| Alaska | 16 | 4.06 | 47.9% | 88% | 88% |
| District of Columbia | 15 | 2.51 | 31.8% | 60% | 60% |
| Guam | 1 | 3.68 | 15.6% | 100% | 100% |
| Puerto Rico | 7 | 0.00 | 31.8% | 0% | 0% |
Sorted by the share of homes meeting all three thresholds; jurisdictions with fewer than 20 homes analyzed are listed last. Sources: Federal Register documents 2024-08273 and 2025-21792.
Method and data
The report uses the CMS Care Compare Provider Information file, August 2026 release, which covers 14,690 Medicare- or Medicaid-certified nursing homes. Staffing figures are the hours each home reports through Payroll-Based Journal data, per resident per day, without case-mix adjustment. 575 homes whose staffing CMS flags (no staffing data, a high number of days without a registered nurse, or data CMS could not validate) and homes missing a staffing figure are left out, leaving 14,021. Turnover is the CMS annual measure of nursing staff who left. Fines are CMS penalties from the last three years.
The data behind this report is free to download from Medical Career Center open data. Each home's own figures are on its nursing home page.
Cite this report: Team MCC, “Nursing Home Staffing Report,” Medical Career Center, August 2026 edition, medicalcareercenter.org/nursing-homes/staffing-report.