Facilities News Spotlight

2023-03-13 Spotlight on Nursing Home Administrator Hours

LTCCC Alert: Nursing Home Administrator Hours Down 20% Since Pandemic

Long Term Care Community Coalition March 9, 2023

Editor’s note: This communication and referenced report is courtesy of  our colleagues  from the Long Term Care Community Coalition in New York. We are grateful for their research and willingness to share.]


I am writing to share our latest nursing home staffing alert (below). Though highly-paid industry lobbyists continue to bemoan staffing “challenges” and demand more money to provide sufficient staffing*, the latest data indicate that the percent of facilities that are sufficiently staffed has remained fairly constant at around 25%. This indicates that safe staffing is possible but, in the absence of a specific government mandate and enforcement of federal care standards, too many operators will maximize profits by cutting staffing to unsafe levels.

Also, in case you missed it, we have posted the recording and slides from February’s extraordinary webinar presentation by the NYS Attorney General’s office on their ground-breaking cases against three major nursing home operators, alleging serious fraud and profiteering at the expense of basic resident safety and dignity. We thank the NYS Medicaid Fraud Control Unit for its outstanding work and encourage other state MFCUs to undertake similar efforts to protect residents, families, and the integrity of the public funds that pay for most nursing home care.

Richard Mollot, Executive Director

*NOTE: Nursing homes are already paid and required to have sufficient staff to meet the care and psycho-social needs of residents. affairs, to ensure that resident care needs are met. According to federal law, nursing homes must be administered “effectively and efficiently to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.”

LTCCC Alert: Nursing Home Administrator Hours

Down 20% Since Pandemic

In a new staffing report by The Long Term Care Community Coalition, we find that nursing home administrators are providing less time in their facilities compared to before the COVID-19 pandemic. According to payroll-based journal data, nursing home administrators provided an average of 4.7 minutes per resident day (total of 6.17 hours per day) in the third quarter of 2022. This is a 20% decline from the 5.9-minute per resident day (total of 8.44 hours per day) in Q3 2019.

LTCCC’s new staffing report contains Q3 2022 data on nurse staff (RN, LPN, CNA, etc.) and non-nurse staff (Admin, Medical Director, Dietician, etc.) for every U.S. nursing home (in compliance with mandatory reporting requirements). Visit the NursingHome411 staffing page for user-friendly data on nursing homes in your community or state, including nurse staff, non-nurse staff, contract workers, turnover rates, weekend staffing levels, staffing ratings, and state rankings (plus: an interactive staffing dashboard!). We hope this report can help the public, media, and policymakers identify and assess the extent to which nursing homes in their communities provide sufficient staffing to meet basic clinical and quality of life needs.

Staffing Facts for Q3 2022

  • Federal data show that a majority of nursing homes continue to provide insufficient staffing levels (3.61 Total Nurse Staff Hours Per Resident Day (HPRD), 0.59 RN Staff HPRD on average) to meet the basic care needs of the nation’s 1.16 million nursing home residents.

Important Note: Industry lobbyists are claiming that they need help to meet staffing standards. In fact, inadequate staffing has been a persistent problem for decades due to the fact that nursing homes are rarely held accountable when they put profits over the safety of their residents and staff.

  • Only one in four (25.8%) nursing homes met the total care staff threshold(4.10 HPRD), as determined by a landmark 2001 federal study.
  • Roughly half of nursing homes lost at least one administrator in the previous 12 months (among the 10,000 nursing homes with available administrative turnover data).
  • At least 2,100 nursing homes lost at least two administrators in the previous 12 months.
  • Nursing homes are increasingly reliant on contract staff, which accounted for 10.5% of all nurse staff hours in Q3 2022, up from 5.0% in Q1 2021.

Note: The report is based on the most recent payroll-based journal (PBJ) data reported by the federal Centers for Medicare & Medicaid Services (CMS). (Sources: PBJ Daily Nurse Staffing, PBJ Daily Non-Nurse Staffing, Provider Information). Visit the NursingHome411 Data Center for more information on staffing, five-star ratings, and other important nursing home data.

Administrator Turnover by Nursing Home:

Number of admins who left within 12 months (Source: CMS Provider Info)

Pie chart - 0 admins left is about 1/2, 1 left is over 1/4, 2 left is about an 1/8 and 3+ left is a sliver.

Staffing by State: Check out our interactive dashboard to see your state’s staffing levels for each nurse staffing position.