Report pinpoints nursing home staffing shortages in Iowa and the nation

Newly reported federal data shows the overwhelming majority of nursing homes in Iowa and the United States are operating with too few staff to meet residents’ basic needs.

Eleven of Iowa’s 410 nursing homes were staffed at least 40 percent below the level expected to meet residents’ needs during the third quarter of 2024, according to the data. Among the 50 states, Iowa ranked in the middle of the pack, with staffing levels that averaged 20 percent below expectations.

According to federal data compiled by the Centers for Medicare and Medicaid and then analyzed by the nonprofit Long Term Care Community Coalition, nine in 10 nursing homes across the country were staffed below the level expected based on resident needs.

The report comes as Congress considers budgetary proposals that include instructions requiring the U.S. Department of Health and Human Services to delay, until January 2035, enforcement of new minimum staffing standards for nursing homes.

Richard Mollot, LTCCC’s executive director, said the coalition’s methodology for calculating resident needs isn’t based on arbitrary benchmarks, but on each facility’s firsthand evaluation of its own residents’ condition and medical needs.

“It gives residents, families, operators, and policymakers a clear and meaningful way to gauge whether a nursing home is adequately staffed to ensure safe, appropriate care,” he said.

In the third quarter of 2024, the study shows, the average U.S. nursing home provided 3.73 total nurse staff hours per resident, per day. Based on resident acuity, the national average expected staffing level was 4.94 hours. As a result, the median nursing home fell 25 percent short of expected staffing levels, according to the coalition.

Only two states — Alaska, where staffing levels averaged 21 percent above expectations, and Oregon, where the homes were staffed 2.5 percent above expectations — met or exceeded their expected staffing levels.

The states with the worst overall staffing averages included Illinois, where the homes averaged 37.7 percent below expected levels, followed by Texas, New Mexico, Missouri, Georgia and Virginia, all of which were at least 30 percent below expected levels.

Lowest-rated Iowa homes are in rural and urban areas

The new report indicates there’s insufficient data on staffing for 13 of Iowa’s 410 nursing homes. Of the remaining 397 homes, 34 are reported to be staffed at or above the expected level.

There are 11 Iowa nursing homes that were staffed at a level at least 40 percent below the expected level based on each home’s assessment of residents’ needs. State records show that of those 11 homes, seven were cited by state inspectors for insufficient nursing staff at some point during the past 10 years.

The 11 Iowa homes that were staffed at least 40 percent below the expected level are:

This article first appeared in the Iowa Capital Dispatch.