Nursing Home Staffing Ratios and Quality in the USA

Updated 30 October 2026 · Educational resource

Adequate staffing is one of the strongest predictors of quality in US nursing homes. Facilities with higher nurse and aide hours per resident day tend to have better outcomes for pressure injuries, falls, infections, and resident satisfaction. Federal regulations require sufficient staffing to meet resident needs, but minimum ratios are not uniform across all states.

How staffing is measured

CMS collects and publishes staffing data, including hours per resident day for registered nurses, licensed practical nurses, and certified nursing assistants. Care Compare displays this information alongside inspection results and quality measures. Families can compare facilities in the same region using these publicly reported figures.

What to look for

• Consistent RN coverage, especially on evening and night shifts
• Aide hours sufficient for assistance with bathing, toileting, and mobility
• Low staff turnover, which supports continuity of care
• Recent inspection findings related to staffing or neglect

During a visit, observe whether call lights are answered promptly and whether staff appear rushed or able to spend time with residents. Staffing numbers alone do not tell the full story; how staff are deployed and supported also matters.

Disclaimer: Staffing data are reported by facilities and subject to verification. This page is for educational purposes only.

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