In nursing homes, staffing is the star rating

Line up America's 14,700 nursing homes by their CMS overall star rating and the staffing numbers climb in lockstep: 5-star homes give residents 70% more RN time than 1-star homes, and their staff leave at far lower rates. Nationally, the median home turns over 45% of its nursing staff every year.

45%median annual nursing-staff turnover

65%turnover at the worst decile of homes

13,393homes reporting

RN hours per resident per day, by overall star

1-star homes 0.46 hrs

2-star homes 0.53 hrs

3-star homes 0.57 hrs

4-star homes 0.62 hrs

5-star homes 0.78 hrs

Staff turnover, by overall star

1-star homes 55%

2-star homes 49%

3-star homes 46%

4-star homes 43%

5-star homes 38%

Medians across ~2,674 homes per star tier. Every nursing-home profile shows its own staffing hours and turnover.

Read this carefully: Correlation, not causation: better-resourced homes can afford more staff AND do other things well. Case-mix differs. But the gradient is monotonic across all five stars, in both staffing hours and turnover — families touring a home should ask about both.

Source: CMS Care Compare, Nursing Home Provider Information (staffing hours, turnover, ratings). Computed 2026-06-12; reproducible from the analysis code against the files hashed on the methodology page.

Workforce stability is a quality measure. The organizations that see their operational data early can act before it becomes a rating.

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