By Memphis Senior Advisor Care Team · October 29, 2026
Across 29 CMS-certified nursing homes in Shelby, Fayette and Tipton counties, median total nurse staffing is 3.55 hours per resident per day and median nursing staff turnover is 55.6% (CMS data as of October 1, 2026). Compare any home you are considering with those medians, then ask about nights and weekends.
Why staffing matters more than the lobby
When families tour a nursing home, they see the entrance, the dining room and a sample room. What they rarely see is the 2 a.m. shift, which is when staffing is thinnest and when call lights go unanswered longest. CMS's payroll-based staffing data is the best public window into that reality, because it is built from the hours staff were actually paid, not from schedules.
Two measures carry the most information. Total nurse staffing hours per resident per day adds registered nurses, licensed practical nurses and nurse aides. Turnover measures how many nursing staff left during the year. A home with adequate hours and low turnover usually has caregivers who know residents' routines; high turnover often means more agency staff and less continuity.
What the Memphis-area numbers look like
The table summarizes CMS's figures for the 29 certified nursing homes in the three counties that report them (minimum, 25th percentile, median, 75th percentile, maximum):
| Measure | Min | 25th pct | Median | 75th pct | Max |
|---|---|---|---|---|---|
| Total nurse hours per resident per day | 2.32 | 3.44 | 3.55 | 4.05 | 7.40 |
| RN hours per resident per day | 0.31 | 0.48 | 0.56 | 0.71 | 1.80 |
| Total nursing staff turnover (%) | 33.7 | 45.5 | 55.6 | 58.3 | 70.3 |
Each nursing home page on this site shows that home's own numbers next to these medians, along with weekend staffing where CMS reports it, registered-nurse turnover, and the number of administrators who have left.
How to use the numbers on a tour
Start with the gap. A home well below the median on total nurse hours should be able to explain why, for example a resident population that needs less hands-on care. A home with turnover well above the median should be asked how many aides on each shift are agency staff and how new staff are oriented to residents with dementia.
Then ask about the shifts the data cannot see in detail: how many aides cover your parent's hall on nights and weekends, who the charge nurse is overnight, and how long call lights typically take to be answered. Visit once in the evening or on a weekend to see for yourself.
What staffing data does not cover
CMS data covers nursing homes only. Tennessee assisted-care living facilities report no staffing hours publicly; the rule requires an awake responsible attendant at all times, a licensed nurse available as needed and, on secured units, one awake attendant physically on the unit around the clock, but sets no building-wide ratio. For ACLFs, ask for the staffing schedule and the secured unit's daily staffing record, which the rule requires the facility to keep.
Reading the other CMS staffing fields
Beyond total hours and turnover, CMS publishes registered-nurse hours per resident per day, weekend staffing, registered-nurse turnover and the number of administrators who have left in the measurement period. RN hours matter because registered nurses assess changes in condition and catch problems early. Weekend staffing often runs lower than weekday staffing, and a large weekend drop is worth asking about. Repeated administrator turnover can signal instability at the top.
CMS also adjusts staffing for how sick a home's residents are, the case-mix measures in its data. A home caring for many short-stay rehab patients with complex needs should have more nursing hours than a home with mostly long-term residents.
How staffing connects to inspections and ratings
CMS's staffing star rating is built from these hours, and the overall rating combines staffing with health inspections and quality measures. When a home's staffing is low and its inspection history shows citations for things like falls, pressure ulcers or call-light response, the pieces fit together. When staffing is strong but inspections are poor, ask what the inspections found; the problem may be systems rather than headcount.
Each nursing home page on this site puts the staffing figures next to the latest inspection results, fines, Tennessee's own disciplinary actions and the closest alternatives, so those comparisons can be made in one place.
Questions that cut to the point
On a tour, ask three questions that staffing data alone cannot answer. How many residents does one aide care for on the night shift on my parent's hall? How many of last week's shifts were filled by agency staff? Who would notice, and how fast, if my parent's condition changed at 3 a.m.? The answers, compared with the CMS figures for that home, give a much clearer picture than either alone.
Write the answers down and compare them across homes. Families who do this consistently tend to choose homes where the answers and the data agree.
Frequently asked questions
What is a good staffing level for a nursing home?
There is no single number, but comparing a home's total nurse hours per resident day with the local median is a practical first test.
Where does CMS get staffing data?
From payroll-based journal data nursing homes submit, which reflects hours actually paid.
Is high turnover always bad?
Not always, but it often means less continuity and more agency staff. Ask how the home manages it.
Do assisted living facilities report staffing?
Not publicly in Tennessee. Ask each ACLF for its staffing schedule.
