Nursing Staff Turnover in Nursing Homes by State
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In its Sep 2026 file, whose turnover figures cover January 1 to December 31, 2025, CMS reports total nursing staff turnover for 13,538 of 14,690 nursing homes. The average across those homes is 45.8%. CMS describes this measure as the percentage of nursing staff that left the nursing home over a twelve-month period. This is a simple average: each home counts once, whatever its size.
- Homes in the CMS data14,690
- Homes with turnover reported13,538
- Average turnover45.8%
These figures describe the homes in each state as a group, not any one home. To look at one home, search by name, city or ZIP code.
By state
Select a column heading to sort the table.
| Alabama | 224 | 212 | 46.9% |
|---|---|---|---|
| Alaska | 20 | 14 | 50.4% |
| Arizona | 140 | 128 | 45.2% |
| Arkansas | 221 | 203 | 49.5% |
| California | 1,165 | 1,006 | 36.7% |
| Colorado | 210 | 190 | 47.1% |
| Connecticut | 191 | 184 | 37.4% |
| Delaware | 44 | 41 | 41.3% |
| District of Columbia | 17 | 15 | 34.0% |
| Florida | 694 | 646 | 41.4% |
| Georgia | 356 | 339 | 46.0% |
| Guam | 1 | 1 | 15.6% |
| Hawaii | 43 | 42 | 36.4% |
| Idaho | 80 | 75 | 50.3% |
| Illinois | 666 | 624 | 44.5% |
| Indiana | 507 | 483 | 45.9% |
| Iowa | 387 | 360 | 44.0% |
| Kansas | 296 | 273 | 48.1% |
| Kentucky | 267 | 258 | 46.4% |
| Louisiana | 265 | 238 | 47.6% |
| Maine | 78 | 67 | 46.7% |
| Maryland | 221 | 213 | 40.2% |
| Massachusetts | 341 | 321 | 38.2% |
| Michigan | 422 | 393 | 44.1% |
| Minnesota | 338 | 299 | 42.2% |
| Mississippi | 202 | 187 | 45.7% |
| Missouri | 487 | 425 | 56.0% |
| Montana | 61 | 53 | 54.8% |
| Nebraska | 180 | 165 | 48.7% |
| Nevada | 66 | 61 | 45.1% |
| New Hampshire | 73 | 69 | 44.1% |
| New Jersey | 348 | 332 | 39.7% |
| New Mexico | 68 | 64 | 53.3% |
| New York | 593 | 561 | 40.3% |
| North Carolina | 419 | 394 | 49.0% |
| North Dakota | 72 | 65 | 48.8% |
| Ohio | 922 | 887 | 48.7% |
| Oklahoma | 283 | 230 | 55.5% |
| Oregon | 128 | 116 | 47.4% |
| Pennsylvania | 656 | 604 | 44.5% |
| Puerto Rico | 9 | 5 | 35.7% |
| Rhode Island | 72 | 65 | 40.6% |
| South Carolina | 187 | 174 | 45.9% |
| South Dakota | 96 | 87 | 48.2% |
| Tennessee | 303 | 284 | 48.9% |
| Texas | 1,177 | 1,051 | 55.3% |
| Utah | 97 | 86 | 50.7% |
| Vermont | 33 | 31 | 55.4% |
| Virginia | 289 | 277 | 48.1% |
| Washington | 193 | 180 | 45.1% |
| West Virginia | 123 | 115 | 44.1% |
| Wisconsin | 323 | 315 | 46.9% |
| Wyoming | 36 | 30 | 51.8% |
| United States | 14,690 | 13,538 | 45.8% |
Homes = all homes in the CMS file for that state. Average turnover is across the homes with a reported value. The "United States" row covers the homes in all the rows above.
Download this table (CSV). Each column comes twice: as shown on this page and as a plain value. Please credit Nursing Home Checker and CMS.
How we calculated this
- Field: "Total nursing staff turnover" in the Provider Information file. CMS's Technical Users' Guide describes it as "The percentage of nursing staff that left the nursing home over a twelve-month period", counting registered nurses, licensed practical nurses and nurse aides, and both regular employees and agency staff who worked enough hours to be counted.
- How CMS calculates it: from Payroll-Based Journal data, a person counts as having left after a gap of at least 90 consecutive days with no work at the home; turnover is the number of employment spells that ended this way divided by the number of eligible employment spells.
- Month: the Sep 2026 Provider Information file, whose turnover figures cover January 1 to December 31, 2025 (CMS data collection interval file). This is a snapshot, not a comparison over time.
- Homes included: the 13,538 homes with a reported value. CMS does not report the measure for some homes, for example those with fewer than five eligible nursing staff (registered nurses, licensed practical nurses and nurse aides) or with missing or invalid staffing data for any of the six quarters it uses.
- Average: a simple average across homes, not weighted by the number of residents or staff.
- Each home is counted in the state listed for it in the Sep 2026 Provider Information file. The table has a row for each place where that file lists homes: 50 states, the District of Columbia, Guam and Puerto Rico.
More data reports
- Star rating changes29.7% of the homes compared had a higher overall rating in Sep 2026 than in Sep 2025; 24.6% had a lower one.
- Nurse staffing hoursAverage reported nurse staffing: 3.77 hours per resident per day in CMS's Oct 2023 file (April–June 2023) and 3.85 in its Sep 2026 file (January–March 2026).
- Weekend staffingAverage reported nurse staffing: 3.86 hours per resident per day overall, 3.42 on weekends (Sep 2026 file: January–March 2026).
- Changes of ownershipCMS's September 29, 2026 file lists a change of ownership effective from September 30, 2023 to September 29, 2026 for 1,452 homes (10.1%). The file lists no change effective after May 8, 2026.
- Changes since last month544 homes had a higher overall rating in the Sep 2026 file than in the Aug 2026 file; 404 had a lower one.
- Fines and payment denialsCMS lists 2,689 fines totaling $105,022,269 at 2,147 homes with a penalty date from September 2, 2025 to September 1, 2026.
- Special Focus FacilitiesThe Sep 2026 CMS file lists 87 Special Focus Facilities and 440 candidates.
Source: CMS Provider Data Catalog, Nursing homes including rehab services: Provider Information, data processed Sep 2026, and Nursing Home Data Collection Intervals for the same month.
Updated each time CMS publishes new data. Calculated by Nursing Home Checker; these are not CMS's own figures. Report an error