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Nursing Home Staffing Rankings

Top 100 nursing homes by RN hours per resident per day. National average: 0.68 hours. Higher staffing levels are associated with better patient outcomes. According to CMS Nursing Home Care Compare and the National Provider Identifier Registry, covering more than 14,000 Medicare- and Medicaid-certified nursing homes with over 1 million certified beds and Five-Star Quality Ratings issued since December 2008 you can search and compare here, every figure traces to its source in our methodology.

0.68
Avg RN Hours/Resident/Day
2.9/5
Avg Staffing Rating
53
States with Data

Top 100 Facilities by RN Hours

# Facility State RN Hours Staffing Rating Overall
1 COX MEDICAL CENTERS MEYER ORTHOPEDIC AND REHAB SPRINGFIELD MO 7.50 4/5 5/5
2 WYTHE CNTY COMMUNITY HOSP ECU WYTHEVILLE VA 7.24 1/5 4/5
3 THE METHODIST HOSPITAL SNF HOUSTON TX 6.89 5/5 5/5
4 CALIFORNIA PACIFIC MEDICAL CTR- DAVIES CAMPUS HOSP SAN FRANCISCO CA 6.66 5/5 5/5
5 UPSTATE UNIVERSITY HOSP AT COMMUNITY GENERAL T C U SYRACUSE NY 6.36 5/5 5/5
6 ELIZABETH SETON CHILDREN'S CENTER YONKERS NY 6.26 5/5 5/5
7 Redlands Comm Hosp D/p Snf Redlands CA 6.18 4/5 5/5
8 ALTERNATIVE HEALTHCARE SOLUTIONS LLC SAN JUAN PR 6.15 5/5 4/5
9 Fairview University Trans Serv MINNEAPOLIS MN 6.10 5/5 5/5
10 Kulana Malama EWA BEACH HI 5.71 5/5 5/5
11 SUNSHINE CHILDREN'S HOME AND REHAB CENTER OSSINING NY 5.62 5/5 5/5
12 Logan Regional Hospital Transitional Care Unit Logan UT 5.58 5/5 5/5
13 DEPT OF STATE HOSPITALS - NAPA D/P SNF NAPA CA 5.50 5/5 5/5
14 BAYLOR SCOTT & WHITE CONTINUING CARE HOSPITAL SKIL TEMPLE TX 5.34 5/5 5/5
15 THE STEVEN AND ALEXANDRA COHEN PED L T C PAVILION VALHALLA NY 5.34 4/5 5/5
16 JOHN T MATHER MEMORIAL HOSP T C U PORT JEFFERSON NY 5.33 5/5 5/5
17 GARRETT COUNTY SUBACUTE UNIT OAKLAND MD 5.33 5/5 5/5
18 CLINCH VALLEY MEDICAL CENTER RICHLANDS VA 5.20 5/5 5/5
19 TORRANCE MEMORIAL MED CTR SNF/DP TORRANCE CA 5.16 5/5 5/5
20 PHELPS HEALTH ROLLA MO 5.10 5/5 5/5
21 ZUCKERBERG SAN FRANCISCO GENERAL HOSP & TRAUMA SNF SAN FRANCISCO CA 5.05 5/5 5/5
22 SIBLEY MEM HOSP RENAISSANCE WASHINGTON DC 4.94 5/5 5/5
23 DEER'S HEAD CENTER SALISBURY MD 4.92 5/5 5/5
24 DESERT REGIONAL MEDICAL CENTER D/P SNF PALM SPRINGS CA 4.91 5/5 3/5
25 BLESSING HOSPITAL SNU QUINCY IL 4.87 5/5 5/5
26 Cornerstone Post Acute Care Of Bossier BOSSIER CITY LA 4.85 4/5 5/5
27 HOBOKEN UNIVERSITY MEDICAL CENTER TCU HOBOKEN NJ 4.79 5/5 5/5
28 PRESBYTERIAN INTERCOMM HOSP DP/SNF WHITTIER CA 4.64 5/5 5/5
29 EAST JEFFERSON GENERAL HOSPITAL - SNF METAIRIE LA 4.58 5/5 5/5
30 McLaren Lapeer Region Lapeer MI 4.56 5/5 5/5
31 TRANSITIONAL CARE UNIT AT NAZARETH HOSPITAL PHILADELPHIA PA 4.51 5/5 5/5
32 VCU HEALTH CHILDREN'S SERVICES AT BROOK ROAD RICHMOND VA 4.40 4/5 5/5
33 ST ELIZABETH EDGEWOOD SNF Edgewood KY 4.33 5/5 5/5
34 NORTON COMMUNITY HOSPITAL SNF UNIT NORTON VA 4.32 5/5 4/5
35 Baptist Health Hardin Elizabethtown KY 4.23 5/5 5/5
36 Childserve Habilitation Center Johnston IA 4.22 5/5 5/5
37 HARMON HOSPITAL - SNF LAS VEGAS NV 4.21 4/5 5/5
38 DAMAS HOSPITAL SNF PONCE PR 4.19 5/5 4/5
39 MOUNT SINAI SOUTH NASSAU T C U OCEANSIDE NY 4.15 5/5 5/5
40 COMMUNITY MEDICAL CENTER TCU TOMS RIVER NJ 4.14 5/5 5/5
41 TALLAHASSEE MEMORIAL HOSPITAL EXTENDED CARE TALLAHASSEE FL 4.13 5/5 5/5
42 UPMC NORTHWEST TRANSITIONAL CARE UNIT SENECA PA 4.13 5/5 5/5
43 COMMUNITY FIRST MEDICAL CENTER CHICAGO IL 4.07 5/5 5/5
44 HENDRICK SKILLED NURSING FACILITY ABILENE TX 4.07 5/5 5/5
45 FORREST GENERAL HOSPITAL SKILLED NURSING UNIT HATTIESBURG MS 4.07 5/5 5/5
46 BAYONNE UNIVERSITY HOSPITAL BAYONNE NJ 4.06 N/A N/A
47 HRH TRANSITIONAL CARE UNIT(A D/B/A ENTITY OF HRHS) MEADOWBROOK PA 4.05 5/5 5/5
48 HEALTHBRIDGE CHILDREN'S HOSPITAL - ORANGE D/P SNF ORANGE CA 4.01 3/5 4/5
49 LAKE REGIONAL HEALTH SYSTEMS OSAGE BEACH MO 3.99 5/5 5/5
50 GOTTLIEB MEMORIAL HOSPITAL MELROSE PARK IL 3.93 5/5 5/5
51 DEPT OF STATE HOSPITALS - METROPOLITAN SNF NORWALK CA 3.88 5/5 3/5
52 PROVIDENCE HOLY CROSS MED CTR D/P SNF MISSION HILLS CA 3.85 4/5 1/5
53 MEADVILLE MEDICAL CTR TCU MEADVILLE PA 3.84 4/5 5/5
54 LAKE CUMBERLAND REGIONAL HOSPITAL SCU SOMERSET KY 3.81 1/5 4/5
55 WILKES REGIONAL MEDICAL CTR SN NORTH WILKESBORO NC 3.81 5/5 4/5
56 PROVIDENCE CHILD CENTER PORTLAND OR 3.80 4/5 5/5
57 KETCHIKAN MED CTR NEW HORIZONS TRANSITIONAL CARE KETCHIKAN AK 3.78 4/5 1/5
58 FORT SANDERS TCU KNOXVILLE TN 3.78 5/5 5/5
59 EXCEPTIONAL CARE FOR CHILDREN NEWARK DE 3.78 5/5 5/5
60 EMANATE HEALTH INTER-COMMUNITY HOSPITAL- D/P SNF COVINA CA 3.78 5/5 5/5
61 MEADOWS ON FAIRVIEW WYOMING MN 3.77 5/5 5/5
62 ST ELIZABETH FT THOMAS SNF Fort Thomas KY 3.70 5/5 5/5
63 THE HSC PEDIATRIC SKILLED NURSING FACILITY WASHINGTON DC 3.70 1/5 3/5
64 CORDOVA COMMUNITY MED LTC CORDOVA AK 3.62 5/5 5/5
65 WHITTIER HOSPITAL MEDICAL CTR D/P SNF WHITTIER CA 3.61 4/5 4/5
66 LEHIGH VALLEY HOSPITAL TSU ALLENTOWN PA 3.57 5/5 2/5
67 THOMAS HOSPITALS SKILLED NURSING UNIT CHARLESTON WV 3.54 5/5 5/5
68 South Davis Specialty Care Bountiful UT 3.51 3/5 5/5
69 PROVIDENCE VALDEZ MEDICAL CENTER VALDEZ AK 3.49 5/5 4/5
70 SPAULDING NURSING AND THERAPY CENTER - BRIGHTON BOSTON MA 3.46 5/5 5/5
71 BARRINGTON OF CARMEL, THE CARMEL IN 3.43 4/5 5/5
72 TRANSYLVANIA REGIONAL HOSPITAL BREVARD NC 3.42 5/5 5/5
73 DWELLING PLACE AT ST CLARES DOVER NJ 3.41 3/5 5/5
74 ROLAND PARK PLACE BALTIMORE MD 3.41 5/5 5/5
75 NEURORESTORATIVE 4KIDS -BUFFALO LAS VEGAS NV 3.36 5/5 5/5
76 GREATER EL MONTE COMMUNITY HOS EL MONTE CA 3.33 4/5 4/5
77 The Transitional Care Center of Owensboro Owensboro KY 3.31 5/5 5/5
78 SINGING RIVER SKILLED NURSING FACILITY PASCAGOULA MS 3.27 4/5 3/5
79 CHI Health St. Francis Grand Island NE 3.25 4/5 4/5
80 LAREDO MEDICAL CENTER LAREDO TX 3.23 4/5 5/5
81 SHANDS JACKSONVILLE MEDICAL CENTER JACKSONVILLE FL 3.22 5/5 5/5
82 HELEN BERNARDY CENTER D/P SNF SAN DIEGO CA 3.20 4/5 5/5
83 HIRAM W DAVIS MEDICAL CTR PETERSBURG VA 3.18 5/5 5/5
84 SOUTHWEST MEDICAL CENTER SNF LIBERAL KS 3.15 4/5 4/5
85 LAWRENCE MEMORIAL HOSPITAL SNF LAWRENCE KS 3.11 4/5 4/5
86 CENTRO MEDICO WILMA N VAZQUEZ SNF VEGA BAJA PR 3.10 4/5 1/5
87 TRANSITIONAL SUB-ACUTE UNIT WYOMISSING PA 3.09 5/5 5/5
88 GULF COAST MEDICAL CENTER SKILLED NURSING UNIT FORT MYERS FL 3.09 5/5 5/5
89 CONEMAUGH MEMORIAL MEDICAL CENTER TCU JOHNSTOWN PA 3.08 5/5 5/5
90 CHILDRENS SPECIALIZED HOSPITAL TOMS RIVER TOMS RIVER NJ 3.07 5/5 5/5
91 O'CONNOR HOSPITAL D/P SNF SAN JOSE CA 3.05 5/5 5/5
92 WOOSTER COMMUNITY HOSPITAL SNF WOOSTER OH 3.04 5/5 5/5
93 Charter House Inc ROCHESTER MN 3.00 5/5 5/5
94 Spartanburg Hospital for Restorative Care SNF Spartanburg SC 2.99 5/5 5/5
95 Islands Skilled Nursing & Rehabilitation Honolulu HI 2.99 2/5 2/5
96 HELEN HAYES HOSPITAL T C U WEST HAVERSTRAW NY 2.99 5/5 5/5
97 PIH HEALTH GOOD SAMARITAN HOSPITAL D/P SNF LOS ANGELES CA 2.98 5/5 5/5
98 HICO NURSING AND REHABILITATION HICO TX 2.97 4/5 3/5
99 Courage Kenny Rehabilitation Institutes Trp GOLDEN VALLEY MN 2.96 5/5 5/5
100 SD HUMAN SERVICES CENTER - GERIATRIC PROGRAM YANKTON SD 2.95 5/5 5/5

Staffing by State

Average RN hours per resident per day by state. Click a state for detailed facility rankings.

Puerto Rico 7
Avg RN: 2.914 hrs · Rating: 3.6/5
42.9% rated 4+ stars
Guam 1
Avg RN: 2.553 hrs · Rating: 4/5
100% rated 4+ stars
Alaska 20
Avg RN: 2.148 hrs · Rating: 4.5/5
100% rated 4+ stars
District of Columbia 16
Avg RN: 1.743 hrs · Rating: 4.1/5
81.3% rated 4+ stars
Hawaii 41
Avg RN: 1.626 hrs · Rating: 4.1/5
78% rated 4+ stars
Utah 97
Avg RN: 1.181 hrs · Rating: 3.1/5
36.1% rated 4+ stars
Nevada 64
Avg RN: 1.074 hrs · Rating: 3.1/5
35.9% rated 4+ stars
Minnesota 325
Avg RN: 1.061 hrs · Rating: 4.2/5
80% rated 4+ stars
Maine 76
Avg RN: 1.048 hrs · Rating: 4/5
76.3% rated 4+ stars
Delaware 44
Avg RN: 1.032 hrs · Rating: 4/5
72.7% rated 4+ stars
Wisconsin 317
Avg RN: 0.964 hrs · Rating: 3.7/5
65.3% rated 4+ stars
Montana 58
Avg RN: 0.939 hrs · Rating: 3.6/5
56.9% rated 4+ stars
North Dakota 73
Avg RN: 0.924 hrs · Rating: 4.1/5
78.1% rated 4+ stars
Wyoming 32
Avg RN: 0.898 hrs · Rating: 3.5/5
50% rated 4+ stars
Washington 186
Avg RN: 0.882 hrs · Rating: 3.4/5
48.9% rated 4+ stars
Colorado 202
Avg RN: 0.834 hrs · Rating: 3.2/5
45% rated 4+ stars
Maryland 218
Avg RN: 0.832 hrs · Rating: 3.1/5
38.1% rated 4+ stars
Idaho 76
Avg RN: 0.829 hrs · Rating: 3.2/5
42.1% rated 4+ stars
Vermont 33
Avg RN: 0.812 hrs · Rating: 3.1/5
36.4% rated 4+ stars
South Dakota 93
Avg RN: 0.796 hrs · Rating: 3.6/5
55.9% rated 4+ stars
Pennsylvania 640
Avg RN: 0.785 hrs · Rating: 3.3/5
42.3% rated 4+ stars
Michigan 408
Avg RN: 0.775 hrs · Rating: 3.6/5
57.1% rated 4+ stars
Kentucky 265
Avg RN: 0.772 hrs · Rating: 2.7/5
29.8% rated 4+ stars
Rhode Island 69
Avg RN: 0.771 hrs · Rating: 3.6/5
59.4% rated 4+ stars
New Hampshire 69
Avg RN: 0.746 hrs · Rating: 3.1/5
39.1% rated 4+ stars
Florida 675
Avg RN: 0.733 hrs · Rating: 3.2/5
44.9% rated 4+ stars
Iowa 371
Avg RN: 0.731 hrs · Rating: 3.6/5
58.8% rated 4+ stars
Illinois 650
Avg RN: 0.726 hrs · Rating: 2.2/5
18.6% rated 4+ stars
Arizona 138
Avg RN: 0.717 hrs · Rating: 3.1/5
37.7% rated 4+ stars
Kansas 289
Avg RN: 0.712 hrs · Rating: 3.5/5
57.8% rated 4+ stars
Nebraska 174
Avg RN: 0.71 hrs · Rating: 3.4/5
52.9% rated 4+ stars
West Virginia 121
Avg RN: 0.708 hrs · Rating: 2.7/5
26.4% rated 4+ stars
Connecticut 189
Avg RN: 0.699 hrs · Rating: 3.3/5
41.8% rated 4+ stars
New York 583
Avg RN: 0.696 hrs · Rating: 2.7/5
25.4% rated 4+ stars
Virginia 285
Avg RN: 0.69 hrs · Rating: 2.5/5
22.5% rated 4+ stars
New Jersey 341
Avg RN: 0.688 hrs · Rating: 3.1/5
32.8% rated 4+ stars
Oregon 122
Avg RN: 0.681 hrs · Rating: 3.8/5
70.5% rated 4+ stars
Indiana 495
Avg RN: 0.663 hrs · Rating: 2.5/5
18.2% rated 4+ stars
California 1133
Avg RN: 0.649 hrs · Rating: 3.2/5
40.2% rated 4+ stars
Massachusetts 333
Avg RN: 0.646 hrs · Rating: 3/5
33.3% rated 4+ stars
Alabama 221
Avg RN: 0.637 hrs · Rating: 3.6/5
59.7% rated 4+ stars
Mississippi 199
Avg RN: 0.632 hrs · Rating: 3.6/5
59.3% rated 4+ stars
South Carolina 181
Avg RN: 0.631 hrs · Rating: 3/5
38.1% rated 4+ stars
Ohio 913
Avg RN: 0.629 hrs · Rating: 2.5/5
20% rated 4+ stars
New Mexico 66
Avg RN: 0.624 hrs · Rating: 2.7/5
21.2% rated 4+ stars
Tennessee 300
Avg RN: 0.615 hrs · Rating: 2.5/5
18% rated 4+ stars
North Carolina 402
Avg RN: 0.586 hrs · Rating: 2.8/5
26.4% rated 4+ stars
Georgia 350
Avg RN: 0.492 hrs · Rating: 2.3/5
19.1% rated 4+ stars
Missouri 474
Avg RN: 0.461 hrs · Rating: 2.2/5
17.7% rated 4+ stars
Texas 1132
Avg RN: 0.441 hrs · Rating: 2.1/5
11.9% rated 4+ stars
Arkansas 211
Avg RN: 0.402 hrs · Rating: 3.2/5
39.3% rated 4+ stars
Oklahoma 261
Avg RN: 0.341 hrs · Rating: 2.7/5
25.7% rated 4+ stars
Louisiana 255
Avg RN: 0.32 hrs · Rating: 2.4/5
14.1% rated 4+ stars

Source: CMS Five-Star Quality Rating System - Nursing Home Provider Information (Feb 2026). RN hours per resident per day is a CMS-reported metric based on payroll data. This is not medical advice. Methodology

Frequently Asked Questions

What are RN hours per resident per day?

RN hours per resident per day measures how many hours a registered nurse spends caring for each resident on average each day. The national average across Medicare-certified nursing homes is 0.68 hours. This metric comes from the CMS Payroll-Based Journal (PBJ) system, which facilities are required to submit quarterly.

Why does RN staffing matter for nursing home quality?

Research consistently shows that higher RN staffing correlates with fewer pressure ulcers, lower rehospitalization rates, fewer falls with injury, and better medication management. Registered nurses perform clinical assessments, wound care, and medication administration that LPNs and CNAs cannot legally provide.

How often does CMS update staffing data?

CMS updates the Payroll-Based Journal staffing data quarterly, with roughly a six-month lag from the reporting period. The star ratings derived from staffing data are refreshed monthly.

Does a higher RN hour count always mean better care?

Not necessarily. Facility acuity mix matters, post-acute facilities taking hospital discharges need more RN hours than long-stay facilities with stable residents. Small facilities can also swing dramatically quarter-to-quarter. Always review staffing alongside health inspection results, quality measures, and an in-person visit.

What is the national average RN staffing rating?

The national average CMS Staffing Rating is 2.9/5 stars. This rating is one of three components (alongside Health Inspection and Quality Measures) that make up a facility's Overall Star Rating.

Compiled from official public sources by the PlainDoctor editorial team.