Q1 2026 U.S. Nursing Home Staffing Rankings by State and Region

U.S. Nursing Home PBJ Staffing Rankings by State and Region (Q1 2026)

Rank	State	FacilitiesNursing Homes	Residents	SFFs & Candidates	Total HPRDTotal HPRD	RN HPRDRN HPRD	Nurse Aide HPRDNA	% Contract% Ctr	For ProfitFor-profit
Rank	State	FacilitiesNursing Homes	Residents	SFFs & Candidates	Total HPRDTotal HPRD	RN HPRDRN HPRD	Nurse Aide HPRDNA	% Contract% Ctr	For ProfitFor-profit	1	Alaska	15	656	—	5.73	1.72	3.30	12.8%	30.0%
2	Oregon	125	7,376	—	4.91	0.64	3.36	6.2%	86.7%
3	Hawaii	42	3,450	—	4.63	1.60	2.67	6.9%	60.5%
4	North Dakota	70	4,495	—	4.57	0.92	3.11	11.7%	5.6%
5	District Of Columbia	16	2,030	—	4.43	1.27	2.51	6.7%	41.2%
6	California	1,142	101,161	—	4.36	0.59	2.61	2.3%	87.0%
7	Maine	78	5,089	—	4.35	1.06	2.84	9.2%	71.8%
8	Vermont	33	2,444	—	4.25	0.79	2.54	23.2%	66.7%
9	Washington	187	14,327	—	4.21	0.90	2.53	3.7%	79.3%
10	Minnesota	335	20,284	—	4.19	1.05	2.52	5.2%	30.2%
11	Wisconsin	322	17,659	—	4.19	0.95	2.57	8.8%	60.4%
12	Mississippi	198	14,709	—	4.09	0.60	2.40	6.2%	77.7%
13	Delaware	42	3,847	—	4.05	0.79	2.27	5.7%	72.7%
14	Arkansas	218	16,892	—	4.05	0.40	2.71	2.0%	90.5%
15	Nebraska	175	9,690	—	4.01	0.66	2.66	7.1%	39.4%
16	Kansas	292	14,936	—	4.01	0.67	2.64	4.8%	58.4%
17	Michigan	418	36,011	—	3.95	0.70	2.31	3.3%	77.0%
18	Montana	60	3,399	—	3.91	0.89	2.49	11.6%	56.7%
19	Utah	97	5,911	—	3.91	1.11	2.30	2.8%	71.1%
20	Idaho	79	4,537	—	3.90	0.80	2.34	4.9%	81.2%
21	Alabama	223	21,926	—	3.88	0.63	2.46	0.9%	84.4%
22	Nevada	64	6,166	—	3.88	0.85	2.15	2.7%	86.4%
23	Arizona	139	12,256	—	3.87	0.63	2.21	3.3%	87.1%
24	Kentucky	263	21,692	—	3.85	0.71	2.34	3.2%	82.0%
25	New Hampshire	72	5,929	—	3.85	0.74	2.33	13.1%	61.6%
26	Iowa	387	20,234	—	3.80	0.71	2.53	4.7%	54.1%
27	Oklahoma	270	16,573	—	3.79	0.32	2.54	2.2%	88.7%
28	Massachusetts	339	33,475	—	3.79	0.61	2.22	5.0%	72.7%
29	Florida	686	74,940	—	3.76	0.70	2.29	1.1%	79.8%
30	South Dakota	92	4,812	—	3.76	0.79	2.49	9.1%	32.3%
31	Tennessee	302	25,379	—	3.75	0.56	2.11	4.0%	81.5%
32	Maryland	219	23,257	—	3.73	0.74	2.06	8.0%	81.4%
33	Pennsylvania	644	67,659	—	3.69	0.65	2.13	11.3%	62.8%
34	New Jersey	347	42,500	—	3.68	0.59	2.19	11.6%	82.5%
35	Rhode Island	71	6,889	—	3.67	0.69	2.45	5.4%	84.7%
36	Connecticut	190	19,698	—	3.66	0.61	2.20	6.0%	80.1%
37	North Carolina	408	35,901	—	3.65	0.53	2.26	8.0%	83.5%
38	Louisiana	256	23,567	—	3.64	0.26	2.25	3.6%	81.2%
39	Ohio	917	67,570	—	3.64	0.60	2.08	4.6%	84.8%
40	Indiana	506	36,762	—	3.63	0.62	2.23	3.4%	56.4%
41	South Carolina	186	17,182	—	3.62	0.53	2.10	7.2%	79.7%
42	Wyoming	35	1,983	—	3.61	0.86	2.27	7.5%	47.2%
43	Colorado	208	15,668	—	3.59	0.76	2.14	5.9%	83.3%
44	Virginia	287	28,576	—	3.58	0.56	2.02	5.7%	76.1%
45	West Virginia	122	9,644	—	3.56	0.67	2.00	3.9%	81.3%
46	New York	590	98,717	—	3.55	0.68	2.16	9.8%	69.5%
47	New Mexico	68	5,771	—	3.52	0.60	2.20	14.2%	85.3%
48	Georgia	349	31,544	—	3.50	0.46	2.11	3.3%	69.4%
49	Missouri	476	34,951	—	3.34	0.40	2.27	3.9%	79.3%
50	Texas	1,163	88,185	—	3.33	0.40	2.00	2.2%	70.3%
51	Illinois	656	62,809	—	3.26	0.65	1.97	5.4%	81.3%

Terms Explained

Residents: Total residents across all facilities in the state.

Contract %: Percentage of staffing hours provided by contract/temporary staff.

SFFs & Candidates: Special Focus Facilities (SFFs) are nursing homes with a history of serious quality issues. SFF Candidates are facilities being monitored for potential SFF designation.

Median: Shows the median value across all facilities (50% of facilities are above, 50% are below). Each facility counts equally regardless of size. Applies to states, CMS Regions, and national data.

Exclude Admin/DON: Excludes administrative and Director of Nursing hours from staffing calculations. Specifically excludes: RN Admin, RN DON, and LPN Admin hours. Averages are weighted by facility census (via total resident days), so larger facilities contribute more to the average than smaller facilities. Applies to states, CMS Regions, and national data.

Rankings: How state and regional ranks are calculated.

Q1 2026 U.S. Nursing Home Staffing Rankings by State and Region

U.S. Nursing Home PBJ Staffing Rankings by State and Region (Q1 2026)

Terms Explained

State SFF & Candidates

Terms Explained