In 45 states, fewer than half of nursing facilities currently meet all three staffing minimums required in the final federal rule that the Centers for Medicare and Medicaid Services (CMS) released in April, and in 28 states, less than a quarter do, according to a new KFF analysis. The share of facilities that meet these requirements ranges from 5% or lower in four states (AR, TN, TX and LA) to 50% or higher in five states (AK, ND, ME, HI and OR) and DC.
In rural areas, 20% of nursing facilities currently meet these standards, compared to 18% in urban areas. Despite having similar starting points, nursing facilities in urban areas have two fewer years to comply with all provisions of the rule, facing a deadline of May 2027 compared to May 2029 in rural areas. Though they face different challenges, urban and rural facilities currently have similar staffing patterns and both face potential staffing shortages. Rural facilities may struggle to find staff because there are fewer available workers, while urban facilities may struggle because available workers have more job options.
