Staffing against the rescinded federal minimums

How to read this page

• The three floors

  0.55 registered-nurse, 2.45 nurse-aide and 3.48 total nurse hours per resident day: the numeric minimums of the federal rule finalized in May 2024 and rescinded by an interim final rule effective February 2, 2026.

• Reported hours

  Hours are the payroll-based hours per resident day that CMS publishes on Provider Information, averaged over a quarter. They are not adjusted for resident acuity. Facilities with no reported hours are left out of every share.

• What is not tested

  The rule also required a registered nurse on site 24 hours a day, 7 days a week. That needs daily payroll data and is not tested here, so the true share that would have met the whole rule is lower than the all-three figure.

• The brief

  The floor that never took effect: nursing home staffing against the repealed federal minimums: the written reading of these tables, pinned to release v2026.08.

• What states require

  The minimum nursing staff each state and the District of Columbia set in statute or regulation, each checked against the legal text.

• A description, not a verdict

  A facility below a floor is not thereby found to be understaffed for its residents, and a facility above one is not thereby found to be adequately staffed. The shares describe a rule that never applied.

The headline numbers

• At or above all three floors21.8%3,110 of 14,288 facilities
• RN floor (0.55)55.0%average 0.69 RN hours per resident day
• Aide floor (2.45)32.7%average 2.32 aide hours per resident day
• Total floor (3.48)64.0%average 3.86 total nurse hours
• Weekend total hours3.42against 3.86 across the week
• Nurse turnover45.8%registered nurses 42.9%, annual
• Within a quarter hour of the total floor35.2%of facilities, either side of 3.48
• For-profit against non-profit13.0% vs 49.0%at or above all three floors

How far facilities sit from the total floor

Reported total nurse hours per resident day, less 3.48. 35.2% of facilities are within a quarter of an hour of the floor on one side or the other, so small changes in reported hours move the headline share.

• More than 1.00 hours below1.2% (167)
• 0.50 to 1.00 hours below5.9% (838)
• 0.25 to 0.50 hours below11.1% (1,585)
• Less than 0.25 hours below17.9% (2,553)
• At the floor to 0.25 hours above17.3% (2,470)
• 0.25 to 0.50 hours above13.0% (1,864)
• 0.50 to 1.00 hours above17.1% (2,448)
• More than 1.00 hours above16.5% (2,363)

By ownership, star rating and size

13.0% of for-profit facilities report hours at or above all three floors, against 49.0% of non-profit facilities. The share rises with the CMS overall star rating, from 8.8% of 1-star facilities to 43.2% of 5-star facilities; staffing is one of the three inputs to that rating, so the two are not independent. The disclosure groups are those of the ownership study. Comparisons are descriptive and control for nothing.

Ownership type

CMS overall star rating

Certified beds

Chain status

PECOS disclosure group

By state

Pick a layer. State staffing requirements differ; they are in the table of state standards. The table under the map carries every layer for every state, with the change in the all-three share since the first monthly file of 2019.

Since 2019

The share at or above all three floors was 23.0% in the 17 January 2019 file, peaked at 28.9% in the 9 October 2020 file, when resident counts fell during the pandemic and hours per resident rose, reached a low of 18.0% in the 26 April 2023 file and stands at 21.8% in the 26 August 2026 file. The series shows no step at the finalization of the rule or at its rescission. Under the phase-in CMS published, the total-hours floor was due two years after publication and the RN and aide floors three years after, later for rural facilities, so no hour floor was in force when the rule was rescinded.

Each floor on its own

All three floors by ownership type, first file of each year

Sources and method