Nursing Home Staffing by State (2026)
CMS reports that nursing homes in the United States provide an average of 3.90 hours of nursing care per resident per day (0.69 from registered nurses), and that 45.3% of nursing staff left over a year. State averages run from 3.40 hours in Missouri to 6.57 in Alaska.
Source: Centers for Medicare & Medicaid Services (CMS), Nursing Homes, “State US Averages”. Data updated October 1, 2026.
Ten highest values
Total nursing hours per resident per dayThe full table below is the text version of this chart. It shows the highest values only; it does not say which places are better or worse.
All states and territories
53 rows| State | Total nursing hours per resident per day | RN hours | LPN hours | Nurse aide hours | Nursing staff turnover | RN turnover |
|---|---|---|---|---|---|---|
| Alabama | 3.90 | 0.66 | 0.78 | 2.46 | 46.8% | 40.0% |
| Alaska | 6.57 | 2.03 | 0.64 | 3.91 | 48.1% | 44.6% |
| Arizona | 4.08 | 0.74 | 1.04 | 2.30 | 44.8% | 44.2% |
| Arkansas | 4.08 | 0.41 | 0.93 | 2.73 | 49.0% | 42.5% |
| California | 4.54 | 0.68 | 1.20 | 2.66 | 36.6% | 37.8% |
| Colorado | 3.69 | 0.81 | 0.68 | 2.20 | 47.0% | 44.4% |
| Connecticut | 3.90 | 0.71 | 0.87 | 2.33 | 37.3% | 38.0% |
| Delaware | 4.48 | 1.00 | 1.00 | 2.48 | 40.4% | 40.5% |
| District of Columbia | 5.08 | 1.58 | 0.66 | 2.83 | 35.8% | 31.9% |
| Florida | 3.86 | 0.73 | 0.80 | 2.33 | 41.5% | 46.1% |
| Georgia | 3.61 | 0.50 | 0.94 | 2.17 | 46.8% | 46.1% |
| Guam | 7.79 | 2.47 | 1.66 | 3.66 | 12.1% | 18.2% |
| Hawaii | 4.99 | 1.73 | 0.35 | 2.91 | 34.5% | 30.5% |
| Idaho | 3.99 | 0.84 | 0.73 | 2.41 | 49.5% | 40.7% |
| Illinois | 3.47 | 0.71 | 0.64 | 2.12 | 43.7% | 41.5% |
| Indiana | 3.73 | 0.68 | 0.78 | 2.28 | 45.9% | 40.5% |
| Iowa | 3.86 | 0.74 | 0.56 | 2.56 | 44.1% | 42.1% |
| Kansas | 4.13 | 0.73 | 0.66 | 2.74 | 48.0% | 42.6% |
| Kentucky | 3.99 | 0.80 | 0.80 | 2.39 | 45.4% | 40.8% |
| Louisiana | 3.82 | 0.31 | 1.18 | 2.32 | 47.1% | 38.7% |
| Maine | 4.39 | 1.06 | 0.46 | 2.87 | 45.3% | 39.2% |
| Maryland | 3.93 | 0.88 | 0.92 | 2.14 | 40.2% | 37.8% |
| Massachusetts | 3.94 | 0.66 | 0.97 | 2.31 | 37.6% | 42.7% |
| Michigan | 4.03 | 0.78 | 0.89 | 2.36 | 44.6% | 39.2% |
| Minnesota | 4.27 | 1.08 | 0.61 | 2.58 | 42.1% | 39.3% |
| Mississippi | 4.20 | 0.63 | 1.11 | 2.46 | 44.4% | 36.6% |
| Missouri | 3.40 | 0.46 | 0.68 | 2.26 | 56.9% | 50.0% |
| Montana | 4.02 | 0.92 | 0.54 | 2.56 | 54.6% | 48.9% |
| Nebraska | 4.12 | 0.69 | 0.68 | 2.75 | 48.5% | 43.5% |
| Nevada | 4.33 | 1.13 | 0.84 | 2.36 | 43.0% | 39.3% |
| New Hampshire | 3.87 | 0.78 | 0.76 | 2.32 | 43.4% | 40.5% |
| New Jersey | 3.90 | 0.70 | 0.94 | 2.27 | 39.3% | 37.2% |
| New Mexico | 3.58 | 0.65 | 0.71 | 2.22 | 53.5% | 54.0% |
| New York | 3.69 | 0.73 | 0.76 | 2.20 | 40.3% | 39.6% |
| North Carolina | 3.87 | 0.62 | 0.88 | 2.37 | 48.7% | 45.7% |
| North Dakota | 4.47 | 0.93 | 0.50 | 3.04 | 47.5% | 38.7% |
| Ohio | 3.71 | 0.64 | 0.95 | 2.12 | 49.0% | 44.4% |
| Oklahoma | 3.82 | 0.34 | 0.92 | 2.55 | 55.4% | 52.0% |
| Oregon | 5.13 | 0.76 | 0.89 | 3.48 | 43.5% | 49.5% |
| Pennsylvania | 3.90 | 0.78 | 0.90 | 2.22 | 44.6% | 39.4% |
| Puerto Rico | 4.43 | 3.51 | 0.92 | 0.00 | 36.7% | 33.7% |
| Rhode Island | 3.78 | 0.77 | 0.49 | 2.52 | 40.0% | 38.8% |
| South Carolina | 3.87 | 0.62 | 1.03 | 2.22 | 46.0% | 41.5% |
| South Dakota | 3.86 | 0.78 | 0.50 | 2.58 | 48.6% | 37.5% |
| Tennessee | 3.82 | 0.60 | 1.08 | 2.14 | 48.6% | 43.2% |
| Texas | 3.42 | 0.44 | 0.94 | 2.03 | 50.8% | 49.8% |
| Utah | 4.08 | 1.24 | 0.47 | 2.36 | 50.0% | 40.1% |
| Vermont | 4.30 | 0.83 | 0.85 | 2.61 | 54.8% | 43.6% |
| Virginia | 3.88 | 0.71 | 1.03 | 2.14 | 47.5% | 46.5% |
| Washington | 4.42 | 0.99 | 0.74 | 2.68 | 43.9% | 43.8% |
| West Virginia | 3.71 | 0.74 | 0.90 | 2.07 | 43.7% | 42.4% |
| Wisconsin | 4.25 | 0.98 | 0.65 | 2.61 | 46.7% | 40.1% |
| Wyoming | 3.98 | 0.96 | 0.53 | 2.50 | 52.1% | 44.8% |
| United States | 3.90 | 0.69 | 0.86 | 2.35 | 45.3% | 42.5% |
Territories appear when the source lists at least one provider there. An empty cell means the source has no value to calculate it from, not zero.
How we calculated this
These are the state and national averages that CMS itself publishes in its "State US Averages" nursing home file; we show them unchanged. Hours are paid nursing staff hours divided by the number of residents, per day (RN = registered nurse, LPN = licensed practical nurse). Turnover is the share of staff who left during the year.
Data sources and dates
- Centers for Medicare & Medicaid Services (CMS), Nursing Homes: “State US Averages”, updated October 1, 2026.
Limits of the data
Staffing hours come from payroll reports and are adjusted by CMS to the care needs of residents only in the star ratings, not in these averages. Residents of different homes need different amounts of care, so more hours are not always better or worse.
Every figure is a count, sum or average of values in the official files above; none is estimated. Read the about page for how this site works and data freshness for when each source was last refreshed.
Download and cite
Download the table as CSV One row per row of the table, English column names, no totals row.
Cite this page
US Patient Guide. “Nursing Home Staffing by State (2026).” Computed from Centers for Medicare & Medicaid Services (CMS), Nursing Homes, “State US Averages” (data updated October 1, 2026). https://uspatientguide.com/statistics/nursing-home-staffing-by-state/
See the providers in each state
Common questions
How many hours of nursing care do nursing home residents get per day?
3.90 hours per resident per day on average nationwide, according to CMS.
What is the staff turnover in nursing homes?
45.3% of nursing staff and 42.5% of registered nurses left within a year, on average (CMS).