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Nursing Home Update: Latest Data Indicate Low Staffing is Persistent & Pervasive – LTCCC

From the Long Term Care Community Coalition, August 8, 2018 – Staffing is perhaps the most important factor in a nursing home resident’s quality of care and ability to live with dignity. Unfortunately, inadequate nursing home staffing is a widespread and persistent problem. Some nursing homes provide good care, ensuring that their facilities have enough qualified care staff. However, in the absence of limits on profits or administrative expenses, too many nursing homes fail to allocate the resources necessary to maintain sufficient staffing.

Today, LTCCC announces the publication of the latest, user-friendly data on the staff assigned to provide resident care and, for the first time, select non-nursing staff, including those providing important activities and social work services. This information can help the public, news media, and policymakers identify and assess the extent to which nursing homes in their communities are providing sufficient staffing to meet basic clinical and quality of life needs. The data are for the first quarter of 2018, the most recent period reported by the federal Centers for Medicare & Medicaid Services (CMS).

Visitors to our website,, can download easy-to-use charts for every state that include (for each facility in the state in compliance with the reporting requirement):

  1. The facility’s resident census (population);
  2. Its direct care RN, LPN, and CNA staffing levels;
  3. The amount of care staff hours per resident per day for both all care staff and for RNs specifically;
  4. Select non-nursing staff hours per day, including administrators, social workers, and activities staff.

To facilitate ease of use, the individual state files are easily sortable. For example, a state file can be sorted to identify which facilities have the highest reported levels of RN care and which have the lowest.

Important additions to this update. As of this update, the data now include:

  1. City and county information (to facilitate searching and comparing facilities in a community).
  2. Non-nursing staff.
  3. Contract staff. The CMS website,, includes contract and employee staff for every job category for every day. LTCCC is posting a separate file with each facility’s average use of contract RN, LPN, and CNA contract staff for the quarter. Consistent assignment of caregivers and reducing the use of contract or agency staff are recommended to improve quality of care and life.

A few facts about the reported data:

  • US nursing homes provide an average of 3.4 total care staff hours per resident per day. A 2001 landmark federal study indicated that at least 4.1 hours is needed to meet a typical resident’s needs.
  • US nursing homes provide an average of .5 RN care staff hours per resident per day. The 2001 federal study indicated that 10 – 50% more is needed to meet a typical resident’s clinical needs.
  • US nursing homes provide an average of .2 hours activities staff time and .1 hours of social work staff time per resident per day. LTCCC believes that lower activities staff time may contribute to social isolation and impact a resident’s psychosocial well-being.

Long Term Care Community Coalition
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New York, NY 10119
United States


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