U.S. News Ranking Exposes Critical Staffing Shortages at Nursing Homes, With Only 5% Meeting CMS Proposal’s Requirements

The U.S. News & World Report’s 2024 Best Nursing Homes ratings released Tuesday reveals that only fewer than 5% of nursing homes across the country will meet both the current federal staffing requirements and the newly proposed standards by the Biden administration.

The report comes on the heels of the end of the comment period for the Centers for Medicare & Medicaid Services’ (CMS) minimum staffing proposal for the skilled nursing sector, during which stakeholders accumulated more than 45,000 comments, many in opposition to the mandate.

The U.S. News methodology, which prioritizes positive patient outcomes and sufficient staffing levels, evaluated more than 15,000 nursing homes. And of these, only 701 nursing homes succeeded in meeting both the existing federal requirements and the more stringent staffing standards recently proposed by the Biden administration.


Furthermore, 436 nursing homes consistently failed to meet the current federal requirements mandating a registered nurse’s availability for at least eight hours a day, seven days a week. This persistent failure points to a systemic issue in meeting the most basic staffing standards.

Significantly, nursing homes that met both the existing and proposed staffing standards were found to be 54 times more likely to be rated a “Best Nursing Home” by the U.S. News, underscoring the correlation between staffing levels and overall quality of care.

“Nursing homes that have earned the recognition of the U.S. News have a track record of achieving better outcomes for patients and residents, and maximizing the amount of care they receive from nurses and other staff,” said Daniel Lara Agudelo, health data analyst at the U.S. News.


Meanwhile, 445 nursing homes that received high ratings of 4 or 5 stars from CMS surprisingly received lower ratings of 1 or 2 out of 5 by the U.S. News.

Nearly one in five, or more than 2,800 nursing homes (19%) of the total, were recognized as “Best Nursing Homes” by the U.S. News in short-term rehabilitation, or long-term care, or both categories.

And, over 1,800 U.S. cities and towns have at least one “Best Nursing Home,” while 2,549 have at least one “Below Average”-rated facility, the report noted.