State Spotlight

Nursing Home Ratings in Vermont: Data Analysis of Quality, Safety, and Staffing

Vermont has 34 nursing homes averaging 4.36 HPRD — 0.46 hours above the national average of 3.90. 100% meet the CMS benchmark.

Calm body of water with scenic landscape in Vermont

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Data updated quarterly

This analysis reflects the most recent CMS data release (Q3 2025). Staffing figures, grades, and benchmarks are refreshed every quarter as new federal data becomes available.

Nursing Home Staffing in Vermont: What Families Need to Know

Vermont is one of the strongest states in the country for nursing home staffing — and the data backs it up. Across 34 facilities serving roughly 2,450 residents on any given day, the state averages 4.36 total nurse hours per resident per day (HPRD), well above the national average of 3.90. An impressive 100% of facilities meet the CMS staffing benchmark, and 85.3% earn a B grade or better.

Families here have meaningfully better options than in most of the country. But even in a strong state, quality varies — 3 facilities (8.8%) still fall to D or F. Knowing which homes stand out, and which fall short, takes more than a state average.

Vermont relies heavily on temporary agency staff — 21.93% of all nursing hours come from contract workers. That's well above the national average of roughly 5%. High agency use means residents frequently encounter unfamiliar caregivers who may not know their medication schedules, dietary needs, or baseline behaviors.

Explore the full Vermont profile → View facility rankings, county breakdowns, and trend data on our Vermont state page.


The Vermont Nursing Home Landscape

Vermont operates 34 Medicare and Medicaid certified nursing homes serving approximately 2,450 residents daily. Staffing levels range from well above the research recommendation to critically understaffed — a spread that makes facility-level data essential for any family evaluating care options.

The state averages 4.36 total nurse HPRD, which is 0.46 hours above the national average of 3.90. RN coverage averages 0.83 HPRD (national: 0.68), and 52.94% of facilities meet the 0.75 RN research recommendation. The grade distribution shows 29 facilities (85.3%) earning a B or better, while 3 (8.8%) fall to D or F.


Vermont by the Numbers

Avg Total HPRD
4.36
National: 3.90
Avg RN HPRD
0.83
National: 0.68
Meet CMS Benchmark
100%
National: 65.8%
Weekend Drop-off
18.05%
Lower is better

Grade Distribution

A+
Excellent
4
11.8% · Excellent — well above research standard
A
Very Good
10
29.4% · Very good — meets research recommendation
B
Good
15
44.1% · Good — meets CMS benchmark
C
Below Standard
2
5.9% · Below standard
D
Poor
3
8.8% · Poor — significantly understaffed
F
Critical
0
0.0% · Critical — dangerously understaffed

Staffing Compared to the National Average

Additional Metrics

  • Median HPRD: 4.14 (less skewed by outliers than the average)
  • Meet Research Recommendation (4.10): 52.94% of facilities
  • RN Recommendation (0.75): 52.94% of facilities
  • Agency/Contract Staff: 21.93% of total hours

What This Means for Families

Vermont's RN staffing of 0.83 HPRD meets or exceeds the 0.75 research recommendation at the state level, with 52.94% of individual facilities reaching that threshold. This is a genuine strength — adequate RN coverage means residents have clinical oversight that catches problems early.

Weekend staffing deserves attention. The average 18.05% drop on Saturdays and Sundays means residents receive meaningfully less care on weekends. Since most family visits happen on weekends, the staffing level you observe may actually be better than the weekend norm at many facilities.

The 21.93% agency staff rate is notable. While temporary workers help fill gaps, high agency reliance means residents frequently see unfamiliar faces — staff who don't know their preferences, medications, or baseline behaviors. Care continuity suffers.


How Nursing Home Ratings Are Calculated

Our letter grades are based on Hours Per Resident Day (HPRD) — the total nursing staff hours a facility provides divided by its daily resident count. This metric normalizes for facility size, so a 200-bed home and a 20-bed home are measured on the same scale.

The grade thresholds are anchored to two evidence-based benchmarks:

  • 3.48 HPRD — the staffing level CMS established through formal rulemaking as an appropriate standard. (The regulatory requirement was subsequently suspended, but the underlying research remains valid and widely cited.)
  • 4.10 HPRD — the level recommended by the landmark CMS-commissioned STRIVE study as the minimum to prevent quality problems.

Grades A+ and A correspond to facilities meeting or exceeding the research recommendation. Grade B meets the CMS benchmark. Grades C through F fall below in progressively concerning ways.

All data comes from CMS Staffing & Quality Data — daily reports that every nursing home is legally required to submit. No facility pays to be rated. No rating is influenced by advertising or referral relationships.

Learn more about how HPRD is calculated in our guide to nursing home staffing metrics.


Key Takeaways for Families in Vermont

  • Check the facility-level grade, not just the state average. Vermont's 4.36 HPRD average masks a range from A+ to F. Every facility is different.

  • RN staffing is the most important single metric. Only 52.94% of Vermont facilities meet the 0.75 RN recommendation. Prioritize homes with strong registered nurse coverage — that's where clinical problems get caught early.

  • Ask about weekends. Vermont facilities drop staffing by 18.05% on weekends on average. A weekend visit may not reflect typical staffing — check the daily data.

  • Look at the trend direction. A facility that's improving from C toward B may be a better choice than one declining from B toward C. Four quarters of trend data reveal the direction.

  • Review the inspection history. Staffing data measures resources; inspection data measures outcomes. A facility with thin staffing and repeated citations is showing two different signals pointing the same direction.

  • Use the comparison tool to evaluate finalists side by side across every metric — staffing, grades, weekend patterns, inspection history, and CMS star ratings.


Frequently Asked Questions

How are nursing homes rated in Vermont?

Vermont nursing homes receive CMS Five-Star ratings based on health inspections, staffing levels, and quality measures. Our analysis adds letter grades (A+ through F) based on total nursing hours per resident per day, computed from federal staffing and quality data published by CMS. Vermont currently has 14 facilities earning A+ or A, and 3 earning D or F.

What is considered a good nursing home rating?

A facility with a B grade or better (3.48+ HPRD) meets the CMS benchmark standard. An A or A+ (4.10+ HPRD) meets the research recommendation for avoiding quality problems. In Vermont, 85.3% of facilities reach B or better.

How many nursing homes are in Vermont?

Vermont has 34 Medicare and Medicaid certified nursing homes serving approximately 2,450 residents daily.

What factors affect nursing home ratings in Vermont?

Key factors include total nurse staffing hours, registered nurse coverage, weekend staffing consistency, reliance on temporary agency staff, health inspection deficiency history, and clinical quality measures such as fall rates and infection rates.

How can families compare nursing homes in Vermont?

Our comparison tool allows side-by-side evaluation of any two Vermont facilities across staffing grades, HPRD levels, weekend drop-off, agency usage, CMS star ratings, and inspection history. You can also explore the Vermont state page for county-level breakdowns and rankings.