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 first-hand evaluation of its own residents’ condition and medical needs.

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% short of expected staffing levels, according to the coalition. Only two states — Alaska, where staffing levels averaged 21% above expectations, and Oregon, where the homes were staffed 2.5% 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% below expected levels, followed by Texas, New Mexico, Missouri, Georgia and Virginia, all of which were at least 30% below expected levels.

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% 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% below the expected level are:

Adel Acres in Dallas County: 47.5% below. The home was last cited for insufficient nursing staff in December 2021.

Oakland Manor in Pottawattamie County: 46% below. The home was last cited for insufficient nursing staff in August 2023.

Aspire of Pleasant Valley in Scott County: 45.3% below. The home was last cited for insufficient nursing staff in September 2024.

Mount Ayr Health Care Center in Ringgold County: 44.3% below. The home has not been cited for insufficient nursing staff in the past 10 years.

Bettendorf Health Care Center in Scott County: 43.8% below. The home was last cited for insufficient nursing staff in January 2025, October 2022 and May 2022.

Aspire of Perry in Dallas County: 43.1% below. The home was last cited for insufficient nursing staff in October 2024, September 2024 and September 2023.

Panora Specialty Care in Guthrie County: 42.8% below. The home was last cited for insufficient nursing staff in January 2025.

Good Samaritan Home of Saint Ansgar in Mitchell County: 42.7% below. The home has not been cited for insufficient nursing staff in the past 10 years.

Grundy Care Center in Grundy County: 42.4% below. The home was last cited for insufficient nursing staff in November 2024 and August 2024.

Maple Manor Village in Butler County: 41.4% below. The home has not been cited for insufficient nursing staff in the past 10 years.

Kingsley Specialty Care in Plymouth County: 40% below. . The home has not been cited for insufficient nursing staff in the past 10 years.