Medicare payroll records
Nursing home staffing by state: residents per CNA and staff turnover
At the middle US nursing home, one nurse aide is on duty for every 10.7 residents at an average hour, and 44.7% of the nursing staff left in a year. That is what 14,686 nursing homes report to Medicare from their payroll (Oct 2026). Each state below opens its own figures and the nursing homes hiring there, fewest residents per aide first.
Nursing home staffing in every state
The middle nursing home of each state, fewest residents per aide on duty first. Each state opens its nursing homes hiring on this site.
| State | Residents per aide on duty | Middle half | Per licensed nurse | Staff turnover | Agency aide hours | Homes hiring here |
|---|---|---|---|---|---|---|
| Alaska15 nursing homes | 6.0 | 5.1 to 8.4 | 9.7 | 44.1% | 11.0% | 1 |
| Oregon114 nursing homes | 7.0 | 6.5 to 7.6 | 15.1 | 40.8% | 5.3% | 17 |
| North Dakota72 nursing homes | 8.0 | 7.0 to 9.0 | 16.9 | 47.6% | 11.5% | None yet |
| Maine75 nursing homes | 8.4 | 7.6 to 9.4 | 16.1 | 45.2% | 5.7% | 2 |
| Hawaii41 nursing homes | 8.9 | 7.2 to 9.8 | 12.8 | 32.8% | 8.4% | 1 |
| Kansas282 nursing homes | 9.1 | 7.7 to 10.4 | 17.9 | 47.5% | 4.3% | 17 |
| Nebraska171 nursing homes | 9.1 | 8.0 to 10.1 | 18.7 | 47.6% | 4.4% | 19 |
| Arkansas219 nursing homes | 9.2 | 8.0 to 10.1 | 18.0 | 48.5% | 1.4% | 12 |
| California1,138 nursing homes | 9.3 | 8.7 to 9.7 | 14.5 | 36% | 2.6% | 72 |
| District of Columbia13 nursing homes | 9.4 | 8.1 to 9.7 | 12.3 | 32.6% | 5.9% | None yet |
| Vermont32 nursing homes | 9.4 | 8.6 to 10.4 | 14.6 | 60.7% | 21.9% | 4 |
| South Dakota91 nursing homes | 9.5 | 8.7 to 11.0 | 19.6 | 46.5% | 10.5% | 6 |
| Wisconsin313 nursing homes | 9.5 | 8.1 to 11.1 | 15.4 | 45.7% | 7.2% | 35 |
| Iowa378 nursing homes | 9.6 | 8.5 to 10.7 | 19.2 | 41.7% | 3.9% | 37 |
| Minnesota328 nursing homes | 9.6 | 8.1 to 11.0 | 15.2 | 39.7% | 4.4% | 38 |
| Washington189 nursing homes | 9.7 | 8.6 to 10.5 | 14.3 | 43% | 3.2% | 17 |
| Wyoming34 nursing homes | 9.7 | 8.7 to 11.7 | 17.4 | 52.6% | 9.4% | 4 |
| Oklahoma263 nursing homes | 9.8 | 8.4 to 11.0 | 19.6 | 53.8% | 2.4% | 8 |
| Rhode Island68 nursing homes | 9.8 | 8.9 to 10.6 | 19.4 | 40.3% | 4.6% | 1 |
| Alabama221 nursing homes | 9.9 | 8.7 to 11.1 | 17.0 | 46.2% | 0.7% | 26 |
| Montana58 nursing homes | 10.0 | 8.2 to 12.5 | 17.2 | 55.5% | 12.5% | 7 |
| Mississippi196 nursing homes | 10.2 | 8.9 to 11.4 | 14.6 | 44.1% | 6.6% | 5 |
| Louisiana249 nursing homes | 10.3 | 9.3 to 11.7 | 17.5 | 46.4% | 4.1% | 20 |
| Missouri475 nursing homes | 10.6 | 9.4 to 12.1 | 23.0 | 56.8% | 3.2% | 81 |
| Idaho79 nursing homes | 10.7 | 9.4 to 11.5 | 15.8 | 50.5% | 3.4% | 8 |
| Kentucky260 nursing homes | 10.7 | 9.4 to 11.5 | 16.6 | 44.3% | 3.1% | 17 |
| Connecticut165 nursing homes | 10.7 | 9.5 to 11.6 | 15.8 | 35.7% | 6.0% | 48 |
| Michigan418 nursing homes | 10.9 | 9.5 to 12.0 | 15.2 | 43.8% | 3.5% | 39 |
| Utah96 nursing homes | 10.9 | 9.4 to 12.3 | 15.6 | 50.6% | 2.9% | None yet |
| Florida687 nursing homes | 10.9 | 10.0 to 11.3 | 16.7 | 42% | 1.0% | 93 |
| Delaware43 nursing homes | 10.9 | 10.1 to 11.3 | 13.5 | 40% | 3.8% | 13 |
| North Carolina405 nursing homes | 10.9 | 9.6 to 12.0 | 17.3 | 48.5% | 6.4% | 65 |
| New Jersey344 nursing homes | 10.9 | 10.1 to 11.8 | 16.6 | 38.1% | 12.7% | 64 |
| Massachusetts339 nursing homes | 11.0 | 9.9 to 11.8 | 15.6 | 36.1% | 2.7% | 49 |
| Indiana503 nursing homes | 11.0 | 9.9 to 12.0 | 17.1 | 45.5% | 2.9% | 89 |
| Nevada64 nursing homes | 11.0 | 9.7 to 12.5 | 14.0 | 43% | 2.2% | 2 |
| New Hampshire72 nursing homes | 11.0 | 9.0 to 13.1 | 15.9 | 43% | 13.1% | 5 |
| Arizona136 nursing homes | 11.1 | 9.6 to 12.5 | 14.5 | 45.8% | 3.0% | 17 |
| New York585 nursing homes | 11.1 | 10.1 to 12.3 | 17.2 | 38.3% | 7.7% | 92 |
| Pennsylvania639 nursing homes | 11.4 | 10.2 to 12.2 | 15.5 | 44.6% | 12.4% | 89 |
| South Carolina186 nursing homes | 11.4 | 9.8 to 12.8 | 15.9 | 45.7% | 8.2% | 10 |
| Colorado206 nursing homes | 11.5 | 9.9 to 12.8 | 17.5 | 46.6% | 5.3% | 18 |
| Georgia346 nursing homes | 11.5 | 9.9 to 12.8 | 17.1 | 45.8% | 2.4% | 34 |
| New Mexico68 nursing homes | 11.7 | 9.9 to 12.7 | 18.1 | 54.5% | 11.8% | 6 |
| Virginia283 nursing homes | 11.7 | 10.7 to 13.0 | 15.5 | 47.7% | 5.6% | 26 |
| Tennessee297 nursing homes | 11.7 | 10.6 to 12.8 | 15.0 | 48.7% | 4.0% | 27 |
| Ohio914 nursing homes | 11.7 | 10.5 to 12.9 | 15.9 | 48.9% | 4.6% | 71 |
| Maryland212 nursing homes | 11.8 | 10.6 to 12.7 | 14.3 | 40.9% | 8.3% | 40 |
| Illinois647 nursing homes | 11.9 | 10.3 to 13.4 | 18.9 | 43.5% | 5.1% | 113 |
| Texas1,152 nursing homes | 12.2 | 11.0 to 13.4 | 18.3 | 50.2% | 2.2% | 171 |
| West Virginia122 nursing homes | 12.3 | 10.8 to 13.4 | 15.7 | 42.3% | 2.9% | 3 |
Residents per aide on duty averages the day's 24 hours (day shifts have more aides, nights fewer). Licensed nurses are RNs and LPNs. Turnover is the share of nursing staff who left in a year. Agency aide hours is the share of the state's nurse aide hours worked by agency (contract) staff, 1 Apr to 30 Jun 2026.
Nursing home staffing by who owns the home
The middle home of each ownership group, as Medicare groups owners.
| Owner | Homes | Residents per aide on duty | Per licensed nurse | Staff turnover | Average overall rating |
|---|---|---|---|---|---|
| Non-profit | 2,853 | 9.3 | 14.8 | 40.1% | 3.6 of 5 |
| Government | 948 | 9.6 | 16.1 | 42.1% | 3.4 of 5 |
| For-profit | 10,885 | 11.1 | 16.8 | 46.1% | 2.9 of 5 |
Nursing home chains by staffing
The 126 operators with 20 or more nursing homes on Medicare's record, fewest residents per aide on duty at their middle home first. A name opens its jobs here when this site reads them.
| Chain | Homes | Residents per aide on duty | Staff turnover | Agency aide hours | Average overall rating |
|---|---|---|---|---|---|
| AvamereOR, WA | 27 | 7.4 | 36.9% | 0.4% | 3.3 of 5 |
| Advanced Health CareUT, NV, AZ, CO, ID, OH and 5 more | 26 | 7.6 | 46.2% | 1.6% | 4.7 of 5 |
| Central Arkansas Nursing CentersAR, OK | 38 | 7.8 | 51.1% | 0.0% | 3.6 of 5 |
| Presbyterian Homes & ServicesMN, IA, WI | 21 | 7.9 | 33.3% | 1.4% | 4.2 of 5 |
| Regency Pacific ManagementWA, OR, HI | 27 | 8.0 | 43.5% | 1.1% | 4 of 5 |
| Life Care ServicesNC, IL, TX, FL, IN, IA and 12 more | 43 | 8.1 | 36% | 3.3% | 4.2 of 5 |
| Vetter Senior LivingNE, MO | 22 | 8.3 | 33.3% | 0.0% | 4.1 of 5 |
| The Springs ArkansasAR | 26 | 9.0 | 50.9% | 0.0% | 3.5 of 5 |
| Mgm HealthcareMO, OK | 27 | 9.0 | 62.3% | 0.7% | 2.4 of 5 |
| Corporate Interface ServicesCA | 40 | 9.2 | Not reported | 3.6% | 2.7 of 5 |
| Americare Senior LivingKS, MO | 23 | 9.2 | 50.6% | 7.5% | 3.6 of 5 |
| Aspen Skilled HealthcareCA, AZ | 35 | 9.3 | 40% | 1.2% | 3.7 of 5 |
| Southern Administrative ServicesAR | 35 | 9.3 | 44% | 0.0% | 3.9 of 5 |
| Longwood Management CorporationCA | 38 | 9.3 | 38.4% | 0.3% | 2.2 of 5 |
| David JohnsonCA, NV | 50 | 9.4 | 35.7% | 0.4% | 3.2 of 5 |
| Nhs ManagementAL, AR, FL | 43 | 9.4 | 50% | 0.0% | 2.9 of 5 |
| Anthony & Bryan AdamsAR, MO | 38 | 9.6 | 50% | 0.0% | 3.9 of 5 |
| Cambridge Healthcare ServicesCA | 32 | 9.6 | 38.6% | 0.0% | 2.6 of 5 |
| Recover-Care HealthcareKS, CO, OH | 27 | 9.8 | 50.6% | 0.7% | 2.6 of 5 |
| Generations HealthcareCA, NV | 27 | 9.8 | 34.8% | 0.0% | 4.1 of 5 |
| Ethica HealthGA | 50 | 9.8 | 43.6% | 0.1% | 3.5 of 5 |
| WindsorCA | 22 | 9.8 | 39.9% | 0.2% | 2.5 of 5 |
| Links Healthcare GroupCA, TN | 32 | 9.8 | 39.7% | 1.1% | 3.1 of 5 |
| Otterbein SeniorLifeOH, IN | 20 | 9.9 | 49% | 0.7% | 3.4 of 5 |
| Central Management CompanyLA | 21 | 9.9 | 43.8% | 0.0% | 2.7 of 5 |
| Acts Retirement-Life CommunitiesPA, FL, MD, DE, AL, NC and 3 more | 27 | 10.0 | 18.2% | 0.0% | 4.9 of 5 |
| The Beebe FamilyLA, MS | 48 | 10.0 | 45.8% | 2.3% | 2.9 of 5 |
| Accura HealthcareIA, NE, MN, SD | 44 | 10.0 | 43.3% | 5.2% | 2.7 of 5 |
| TLC ManagementIN, FL, OH | 20 | 10.1 | 41.2% | 1.5% | 3.9 of 5 |
| PACS GroupCA, SC, OH, CO, OR, WA and 10 more | 277 | 10.1 | 44.7% | 8.0% | 3 of 5 |
| Allaire Health ServicesNJ, PA, VT, FL | 21 | 10.2 | 49.6% | 7.6% | 2.8 of 5 |
| Benedictine Health SystemMN, ND, MO, WI | 23 | 10.2 | 45.9% | 11.0% | 2.8 of 5 |
| Circle B EnterprisesMO, AZ | 36 | 10.2 | 58.3% | 0.0% | 2.6 of 5 |
| Nexcare Health SystemsMI | 20 | 10.2 | 42.3% | 0.0% | 4 of 5 |
| Venza Care ManagementAL, KY, LA, NC, DE, MD and 2 more | 30 | 10.3 | 54.1% | 3.4% | 2.4 of 5 |
| Mission Health CommunitiesKS, MN, WI | 29 | 10.3 | 43.5% | 1.2% | 3 of 5 |
| Campbell Street ServicesIA, KS, MN | 25 | 10.4 | 70% | 0.8% | 2 of 5 |
| Evergreen Healthcare GroupWA, OR, WY, MT, SD, NV | 43 | 10.4 | 50% | 5.7% | 2.3 of 5 |
| Good Samaritan SocietyMN, IA, NE, SD, KS, ND and 3 more | 92 | 10.4 | 42.5% | 3.3% | 3 of 5 |
| Stern ConsultantsIL, MA, NY | 22 | 10.4 | 42.1% | 1.0% | 2.7 of 5 |
| National Health Care AssociatesCT, ME, NY, VT, MA, NH | 42 | 10.6 | 34.7% | 3.5% | 3.2 of 5 |
| Gold Fl Trust IIFL | 36 | 10.7 | 46.2% | 0.8% | 3.4 of 5 |
| Bridges HealthOK | 33 | 10.7 | 52% | 1.6% | 3.4 of 5 |
| Care InitiativesIA | 43 | 10.7 | 42.4% | 0.0% | 3 of 5 |
| Principle Long Term CareNC, VA | 37 | 10.7 | 48.2% | 10.6% | 2.9 of 5 |
| The Blossoms Rehab & Nursing CenterAR | 23 | 10.7 | 60% | 6.2% | 2.6 of 5 |
| AltercareOH | 22 | 10.8 | 50% | 2.5% | 3.2 of 5 |
| MedilodgeMI | 53 | 10.8 | 46.8% | 0.0% | 3.2 of 5 |
| Summit CareFL | 22 | 10.8 | 44.9% | 0.0% | 3.3 of 5 |
| National Healthcare CorporationTN, SC, MO, AL, GA, NC and 2 more | 72 | 10.8 | 45.9% | 0.0% | 4.1 of 5 |
| Solaris HealthcareFL | 22 | 10.9 | 38.7% | 0.0% | 4.1 of 5 |
| James & Judy LincolnMO, AR | 55 | 10.9 | 55.3% | 3.3% | 2.6 of 5 |
| Signature HealthcareKY, TN, IN, NC, VA | 67 | 11.0 | 42.7% | 0.9% | 3.1 of 5 |
| American Senior CommunitiesIN | 90 | 11.0 | 43.6% | 0.8% | 3.9 of 5 |
| Eden Senior CareWI, MN, PA | 21 | 11.0 | 46.5% | 8.0% | 2.5 of 5 |
| Tutera Senior Living & Health CareIL, MO, KS, AL, IA | 24 | 11.0 | 55.4% | 5.2% | 2.3 of 5 |
| Life Care Centers of AmericaTN, CO, FL, IN, MA, WA and 20 more | 194 | 11.0 | 40.8% | 1.1% | 3.4 of 5 |
| Benjamin LandaFL, KY, NY, NJ | 48 | 11.1 | 42.4% | 6.2% | 3.4 of 5 |
| Nexion HealthTX, MS, LA | 51 | 11.1 | 44.5% | 3.3% | 2.3 of 5 |
| CareOneNJ, MA, CT, PA | 37 | 11.1 | 27.5% | 0.0% | 3.5 of 5 |
| Sovereign Healthcare HoldingsFL, NC, GA | 43 | 11.1 | 45.9% | 0.6% | 3.8 of 5 |
| Stonegate Senior LivingTX, OK | 24 | 11.2 | 55.3% | 1.7% | 2.5 of 5 |
| Excelsior Care GroupFL, NY, NJ | 33 | 11.2 | 42.1% | 3.4% | 2.8 of 5 |
| The Ensign GroupTX, CA, AZ, CO, UT, WA and 11 more | 347 | 11.2 | 44% | 1.6% | 3.3 of 5 |
| Aston HealthFL | 38 | 11.2 | 54.4% | 1.1% | 2.7 of 5 |
| Centers Health CareNY, NJ | 36 | 11.2 | 50% | 13.6% | 2.3 of 5 |
| Ciena Healthcare/Laurel Health CareMI, OH, NC, VA | 80 | 11.2 | 43.4% | 0.0% | 2.9 of 5 |
| Harborview Health SystemsGA, FL, NC | 22 | 11.3 | 48.1% | 2.5% | 2 of 5 |
| Legacy HealthcareIL, IA, SD, AL | 96 | 11.3 | 44.8% | 11.5% | 3 of 5 |
| Touchstone CommunitiesTX | 25 | 11.3 | 47.2% | 2.9% | 2.8 of 5 |
| Trilogy Health ServicesIN, OH, KY, MI, WI | 127 | 11.3 | 40% | 0.2% | 4.2 of 5 |
| Liberty Senior LivingNC, TN | 37 | 11.3 | 52.3% | 10.3% | 2.9 of 5 |
| North Shore HealthcareWI, MN, MI, ND | 57 | 11.4 | 38.8% | 2.4% | 2.8 of 5 |
| Hcf ManagementOH, PA | 22 | 11.4 | 37.7% | 0.0% | 2.9 of 5 |
| Villa HealthcareMI, OH | 21 | 11.4 | 47.8% | 2.5% | 2.6 of 5 |
| Complete CareNJ, WI, MD, CT, DE, IL and 2 more | 85 | 11.5 | 47.3% | 11.2% | 3.3 of 5 |
| Simcha Hyman & Naftali ZanziperKY, FL, NC, TN, OH, VA | 79 | 11.5 | 50% | 1.6% | 2.8 of 5 |
| Cascadia HealthcareID, WA, OR, MT, AZ | 47 | 11.5 | 52.7% | 5.0% | 3.2 of 5 |
| Aviata Health GroupFL | 50 | 11.6 | 50.8% | 0.1% | 2.3 of 5 |
| Cch HealthcareOH, NC, TN | 33 | 11.6 | 60.1% | 12.7% | 2.7 of 5 |
| Marquis Health ServicesPA, MA, NJ, VA, RI, MD and 3 more | 90 | 11.6 | 40.8% | 0.4% | 3 of 5 |
| Atlas HealthcareNJ, MA, CT, MD | 30 | 11.6 | 48.3% | 5.4% | 3.5 of 5 |
| The Alden NetworkIL, WI | 27 | 11.7 | 38.4% | 2.8% | 2.9 of 5 |
| Personal Healthcare ManagementNY, MA | 21 | 11.7 | 47.1% | 0.4% | 2.9 of 5 |
| HMG HealthcareTX, KS | 31 | 11.8 | 50.5% | 0.1% | 3.2 of 5 |
| Saber Health GroupPA, VA, NC, OH, DE, IN | 126 | 11.8 | 47.5% | 7.0% | 3 of 5 |
| PruittHealthGA, NC, SC, FL | 97 | 11.8 | 41.3% | 0.0% | 3.1 of 5 |
| Ephram LahaskyMA, MN, OH, MD, NH, AL and 3 more | 22 | 11.8 | 53.5% | 9.8% | 1.8 of 5 |
| Autumn Lake HealthcareMD, NJ, CT, WV, WI | 59 | 11.8 | 44.5% | 18.3% | 2.9 of 5 |
| CareRite CentersNY, TN, FL, NJ | 34 | 11.9 | 38.2% | 6.5% | 3.8 of 5 |
| OPCO Skilled ManagementTX, NM, MO, AZ | 68 | 11.9 | 54% | 1.6% | 2.4 of 5 |
| Hill Valley HealthcareVA, WA, WV, OR, MD, TN | 43 | 11.9 | 52.8% | 12.7% | 1.9 of 5 |
| Brickyard HealthcareIN | 23 | 12.0 | 44.4% | 4.2% | 2.7 of 5 |
| Foundations Health SolutionsOH | 64 | 12.0 | 39.4% | 0.0% | 4.2 of 5 |
| Majestic CareIN, OH, MI | 29 | 12.0 | 50.2% | 0.0% | 2.6 of 5 |
| Lifeworks RehabVA, NC, MD, DE, PA | 64 | 12.1 | 54.3% | 6.9% | 2.2 of 5 |
| CommuniCare Health ServicesWV, OH, IN, MD, VA | 109 | 12.1 | 42.8% | 0.8% | 3.3 of 5 |
| Diversicare HealthcareAL, MS, KS, TX, TN | 44 | 12.2 | 44.7% | 0.0% | 2.7 of 5 |
| Haven HealthAZ | 20 | 12.2 | 45.9% | 0.1% | 2.9 of 5 |
| Avardis HealthNC, VA, MS, PA | 38 | 12.3 | 50.9% | 0.8% | 2.1 of 5 |
| Gulf Coast Ltc PartnersTX | 20 | 12.3 | 53.3% | 1.7% | 2.4 of 5 |
| Atrium CentersMI, OH, WI, KY | 26 | 12.3 | 47.7% | 0.6% | 2.9 of 5 |
| Optalis Health & RehabilitationMI, OH | 36 | 12.3 | 55.8% | 7.6% | 2.5 of 5 |
| Genesis HealthCarePA, WV, NM, CA, NH, NJ and 12 more | 183 | 12.4 | 45.5% | 4.8% | 2.4 of 5 |
| Priority ManagementLA, TX | 38 | 12.4 | 52.6% | 8.2% | 2.7 of 5 |
| Infinity Healthcare ConsultingIN, TN, IL | 70 | 12.4 | 44.8% | 5.1% | 2.2 of 5 |
| The Charly Bello Family, the Maze Family, the Swain Family, & Walter MyersCO, MT, NV | 22 | 12.4 | 53.8% | 0.1% | 1.8 of 5 |
| Arcadia CareIL, OH | 25 | 12.5 | 46.9% | 4.1% | 1.7 of 5 |
| Fundamental HealthcareTX, SC, MD, NV, IN, WI | 66 | 12.6 | 47.3% | 12.7% | 2.5 of 5 |
| Avir Health GroupTX | 118 | 12.6 | 56.9% | 1.7% | 2.2 of 5 |
| Monarch Healthcare ManagementMN | 45 | 12.6 | 46.7% | 9.0% | 2.1 of 5 |
| Champion CareWI, TN, NJ | 23 | 12.6 | 53.2% | 5.2% | 2.4 of 5 |
| Wellsential HealthTX | 67 | 12.6 | 43.9% | 0.0% | 2.8 of 5 |
| Aperion CareIL, IN | 33 | 12.7 | 45.6% | 0.5% | 2.1 of 5 |
| Embassy HealthcareOH, PA | 33 | 12.7 | 49.2% | 0.6% | 2.1 of 5 |
| Empire Care Centers.GA | 21 | 12.7 | 55.9% | 1.0% | 1.8 of 5 |
| Cantex Continuing CareTX | 37 | 12.7 | 46.7% | 0.0% | 3.3 of 5 |
| Journey HealthcareGA, KY, WV, OH | 34 | 12.8 | 55.8% | 0.6% | 1.8 of 5 |
| Focused Post Acute Care PartnersTX | 25 | 12.9 | 53.6% | 0.0% | 2 of 5 |
| Aom HealthcareOH | 20 | 13.0 | 61% | 11.4% | 2.9 of 5 |
| Advanced Healthcare SolutionsTX | 28 | 13.1 | 48.3% | 0.6% | 3 of 5 |
| Ignite Medical ResortsTX, MO, OK, IN, IL, KS | 22 | 13.1 | 55.5% | 0.3% | 3 of 5 |
| Eduro HealthcareTX, MT, SD, CA, NM, ND and 1 more | 34 | 13.1 | 58.7% | 7.0% | 2.4 of 5 |
| Creative Solutions in HealthcareTX | 150 | 13.3 | 52.2% | 0.0% | 2.3 of 5 |
| Lionstone CareOH | 28 | 13.4 | 58.4% | 9.4% | 2.8 of 5 |
| Reliant Care ManagementMO, KS | 35 | 18.4 | 69.9% | 0.0% | 1.3 of 5 |
Nursing home staffing: common questions
What is the CNA to resident ratio in US nursing homes?
At the middle US nursing home, one nurse aide is on duty for every 10.7 residents at an average hour; the middle half of nursing homes run from 9.3 to 12.0. That is the day's 24 hours averaged: day shifts have more aides on the floor and nights fewer, so a day-shift CNA usually has fewer residents than this and a night-shift CNA more. Licensed nurses (RNs and LPNs) have 16.4 residents each at the middle home. From what 14,686 nursing homes report to Medicare from their payroll (Oct 2026).
Which states' nursing homes have the most nurse aides per resident?
Fewest residents per aide on duty at the state's middle nursing home: Alaska (6.0), Oregon (7.0), North Dakota (8.0), Maine (8.4) and Hawaii (8.9). Most residents per aide: West Virginia (12.3), Texas (12.2), Illinois (11.9), Maryland (11.8) and Ohio (11.7). Each state's page lists the nursing homes hiring there with their own figures.
How much of a nursing home's staff leaves in a year?
At the middle US nursing home, 44.7% of nursing staff (aides, LPNs and RNs) left in a year, and 40.9% of its registered nurses. The middle state home's turnover is lowest in District of Columbia (32.6%), Hawaii (32.8%) and Connecticut (35.7%) and highest in Vermont (60.7%), Missouri (56.8%) and Montana (55.5%).
Which nursing home chains have the most aides per resident?
Of the 126 chains with 20 or more nursing homes, the fewest residents per aide on duty at the chain's middle home: Avamere (7.4, 27 homes), Advanced Health Care (7.6, 26 homes), Central Arkansas Nursing Centers (7.8, 38 homes), Presbyterian Homes & Services (7.9, 21 homes) and Regency Pacific Management (8.0, 27 homes). The most: Reliant Care Management (18.4, 35 homes), Lionstone Care (13.4, 28 homes), Creative Solutions in Healthcare (13.3, 150 homes), Eduro Healthcare (13.1, 34 homes) and Ignite Medical Resorts (13.1, 22 homes). Each home differs from its chain's middle one.
Do non-profit nursing homes have better staffing than for-profit ones?
By what every nursing home reports to Medicare (Oct 2026): the middle for-profit home has one aide on duty for every 11.1 residents and the middle non-profit home one for every 9.3, a government home 9.6. A median 46.1% of a for-profit home's nursing staff left in a year, against 40.1% at a non-profit one. 10,885 of the 14,686 homes are for-profit. Each home differs; its own page here shows its figures.
Which states' nursing homes rely most on agency CNAs?
From 1 Apr to 30 Jun 2026, agency (contract) staff worked 4.9% of all nurse aide hours in US nursing homes and 7.0% of nurse hours; 5,669 of 14,452 homes used some. The most in Vermont (21.9%), New Hampshire (13.1%), New Jersey (12.7%), Montana (12.5%) and Pennsylvania (12.4%); the least in Alabama (0.7%), Florida (1.0%) and Arkansas (1.4%). Travel and agency healthcare jobs are listed every night.
How is residents per aide on duty worked out?
Medicare publishes the nurse aide hours each nursing home's residents get a day, from the hours its payroll reports (the Payroll-Based Journal). Residents per aide on duty is 24 divided by that figure: a home giving each resident 2.4 aide hours a day has, at an average hour, one aide on duty for every 10 residents. Nurse aides include CNAs, aides in training and medication aides.
Where can I find nursing home jobs?
Nursing home jobs lists every open job at the nursing homes and senior care employers this site reads, by state and kind of job, and each nursing home's page here shows its staffing beside its open jobs.
Sources and method
Each nursing home's reported nurse aide, LPN and RN hours per resident per day and its nursing staff turnover, as Medicare publishes them from the Payroll-Based Journal. Residents per staff member on duty is 24 divided by the hours per resident per day. A state's figure is its middle nursing home's (the median), with the middle half beside it; homes that reported no hours are left out of that figure. CareJobs.Now reads the file each month Medicare refreshes it.
- Centers for Medicare & Medicaid Services, Nursing Home Provider Information (Care Compare), Oct 2026, published 1 Oct 2026
- Centers for Medicare & Medicaid Services, Payroll Based Journal Daily Nurse Staffing, 1 Apr to 30 Jun 2026
Cite this page
CareJobs.Now. (2026). Nursing home staffing by state: residents per CNA and staff turnover. Data as of 1 Oct 2026. https://carejobs.now/nursing-home-staffing