Missouri

Nursing Home Staffing Profile — 2025Q3

478 facilities34,753 residents3.48 avg HPRD

vs National Average

-0.41 HPRD

National avg: 3.90 · Missouri: 3.48

📋

Missouri ranks among the lower-performing states for nursing home staffing, with an average of 3.48 HPRD — 0.41 hours below the national average. Only 42.9% of facilities meet the CMS staffing benchmark of 3.48 HPRD, compared to 65.8% nationally. RN staffing averages 0.46 HPRD, with 7.3% of facilities meeting the 0.75 research recommendation.

3.48

Average Total HPRD

All nursing staff combined

▼ 0.41 vs national

0.46

Average RN HPRD

Recommended: 0.75

▼ 0.22 vs national

42.9%

Meet CMS Benchmark

205 of 478 facilities

16.3%

Avg Weekend Drop-off

Staffing reduction on Sat/Sun

3.9%

Avg Agency Staff

Contractor/temp worker hours

—

Had Zero-RN Days

Data unavailable

3.40

Median HPRD

50th percentile (less skewed by outliers)

F-Rated Facilities

Under 2.5 HPRD — critically understaffed

Grade Distribution

How Missouri's 478 facilities grade out

HPRD Distribution

Where facilities fall across the staffing spectrum

Staffing by Ownership Type

For-profit facilities consistently staff lower than non-profit and government-run homes

For-Profit

3.32

avg HPRD

379 facilities (79%)

Non-Profit

4.22

avg HPRD

77 facilities (16%)

Government

3.67

avg HPRD

22 facilities (5%)

💡 Non-profit facilities in Missouri average 0.90 more HPRD than for-profit ones — about 27% higher staffing.

▲ Best Staffed in Missouri

Top 5 by total nurse HPRD

A+

COX MEDICAL CENTERS MEYER ORTHOPEDIC AND REHAB

LAKE REGIONAL HEALTH SYSTEMS

OSAGE BEACH

7.89 HPRD

RN: 4.04

COTTAGES OF LAKE ST LOUIS

LAKE SAINT LOUIS

6.31 HPRD

RN: 0.63

MCCRITE PLAZA AT BRIARCLIFF SKILLED FACILITY

KANSAS CITY

6.19 HPRD

RN: 0.81

▼ Most Understaffed in Missouri

Bottom 5 by total nurse HPRD

478

LAWRENCE COUNTY MANOR

FOUR SEASONS LIVING CENTER

SOUTH COUNTY HEALTH CARE CENTER

MYERS NURSING & CONVALESCENT CENTER

⚖️

Compare Two Facilities Side by Side

Pick any two Missouri nursing homes and see how they stack up across every metric

Open Comparison Tool →

County Breakdown

Staffing metrics by county in Missouri — click a county to see individual facilities

Avg HPRD— total nurse hours per resident per day:≥ 3.48 meets federal benchmark,3.0–3.47 below benchmark,< 3.0 critically low

Meet Benchmark— share of facilities in the county at or above the 3.48 HPRD federal minimum:≥ 50%35–49%< 35%

County	Facilities ↓	Avg HPRD	RN HPRD	Meet Benchmark	Grades
▸St. Louis	67	3.82	0.43	56.7%	Mixed F/C
▸Jackson	39	3.25	0.42	33.3%	Mixed F/D
▸Greene	21	3.69	0.86	28.6%	Mixed C/D
▸St. Charles	14	4.16	0.52	85.7%	Mixed C/A
▸St. Louis City	12	3.21	0.27	58.3%	Mixed D/F
▸Jefferson	10	3.03	0.32	30.0%	Mixed D/F
▸Boone	9	3.80	0.52	44.4%	Mixed D/C
▸Clay	9	3.93	0.49	55.6%	Mixed D/C
▸Cass	8	3.34	0.40	25.0%	Mixed D/B
▸St. Francois	8	3.30	0.51	37.5%	Mixed C/B
▸Cape Girardeau	8	3.82	0.48	62.5%	Mixed C/B
▸Cole	8	3.90	0.43	50.0%	Mostly C
▸Franklin	7	3.26	0.39	28.6%	Mixed D/C
▸Stoddard	7	3.73	0.46	71.4%	Mostly C
▸Jasper	7	3.31	0.32	28.6%	Mixed F/C
▸Phelps	6	4.25	1.37	33.3%	Mixed C/A+
▸Buchanan	6	3.24	0.51	50.0%	Mostly D
▸New Madrid	5	3.19	0.33	0.0%	Mixed C/D
▸Scott	5	3.55	0.41	60.0%	Mixed D/B
▸Camden	5	4.18	1.29	40.0%	Mixed D/A+
▸Pettis	5	3.30	0.27	40.0%	Mostly D
▸Howell	5	3.75	0.51	80.0%	Mixed C/D
▸Butler	5	3.19	0.49	40.0%	Mixed C/D
▸Lafayette	5	3.51	0.34	60.0%	Mixed D/F
▸Johnson	5	2.98	0.35	20.0%	Mostly F
▸Newton	5	3.11	0.43	20.0%	Mostly D
▸Clinton	4	2.88	0.29	25.0%	Mixed D/C
▸Callaway	4	3.42	0.40	25.0%	Mixed D/B
▸Polk	4	3.44	0.43	25.0%	Mixed C/D
▸Livingston	4	3.65	0.73	75.0%	Mixed B/C
▸Platte	4	3.57	0.46	75.0%	Mixed D/B
▸Webster	4	3.30	0.41	25.0%	Mixed C/B
▸Dunklin	4	3.58	0.46	75.0%	Mostly C
▸Lawrence	4	2.67	0.36	25.0%	Mixed B/C
▸Cooper	4	3.16	0.38	50.0%	Mixed C/D
▸Nodaway	4	3.34	0.72	25.0%	Mostly C
▸Miller	4	2.93	0.43	25.0%	Mixed B/C
▸Wright	3	3.34	0.56	33.3%	Mostly C
▸Barry	3	3.71	0.55	66.7%	Mixed A/B
▸Bates	3	3.67	0.57	66.7%	Mostly B
▸Benton	3	3.47	0.41	66.7%	Mostly C
▸Chariton	3	2.83	0.28	0.0%	Mostly D
▸Christian	3	3.39	0.41	33.3%	Mixed B/D
▸Crawford	3	3.30	0.25	33.3%	Mostly F
▸Dent	3	4.01	0.72	33.3%	Mostly C
▸Gasconade	3	2.98	0.34	0.0%	Mostly D
▸Henry	3	3.26	0.32	33.3%	Mostly D
▸Iron	3	3.59	0.55	33.3%	Mixed B/D
▸Lewis	3	3.76	0.40	100.0%	Mostly D
▸Lincoln	3	2.64	0.23	0.0%	Mostly F
▸Macon	3	3.40	0.51	33.3%	Mostly D
▸Marion	3	4.41	0.42	100.0%	Mixed B/C
▸Montgomery	3	2.26	0.33	0.0%	Mostly F
▸Morgan	3	3.68	0.55	33.3%	Mostly C
▸Randolph	3	2.87	0.28	0.0%	Mostly F
▸Taney	3	2.87	0.28	0.0%	Mostly D
▸Texas	3	3.50	0.49	33.3%	Mostly C
▸Vernon	3	3.33	0.40	33.3%	Mostly C
▸Wayne	2	2.99	0.37	50.0%	Mixed D/F
▸Ray	2	3.50	0.39	50.0%	Mixed C/D
▸Moniteau	2	3.06	0.32	0.0%	Mostly D
▸Madison	2	3.71	0.37	50.0%	Mixed C/F
▸Carroll	2	3.09	0.23	50.0%	Mostly F
▸St. Clair	2	4.01	0.55	50.0%	Mixed B/D
▸Caldwell	2	3.24	0.41	0.0%	Mixed C/D
▸Adair	2	3.84	0.26	100.0%	Mixed D/F
▸Pemiscot	2	3.88	0.32	100.0%	Mostly D
▸Ste. Genevieve	2	3.08	0.34	0.0%	Mixed C/F
▸Saline	2	2.94	0.36	50.0%	Mixed C/F
▸Perry	2	2.98	0.25	0.0%	Mixed D/F
▸Audrain	2	3.88	0.44	100.0%	Mixed B/D
▸Washington	2	3.03	0.39	0.0%	Mostly D
▸Shelby	2	3.95	0.55	100.0%	Mixed B/C
▸De Kalb	2	3.50	0.39	50.0%	Mixed C/D
▸Pike	2	2.99	0.34	0.0%	Mostly D
▸Holt	2	3.14	0.36	0.0%	Mostly D
▸Cedar	2	3.46	0.47	50.0%	Mostly C
▸Mississippi	2	3.66	0.54	100.0%	Mixed B/C
▸Laclede	2	2.99	0.26	0.0%	Mixed D/F
▸Pulaski	2	3.31	0.37	0.0%	Mostly D
▸Grundy	2	3.31	0.28	50.0%	Mixed D/F
▸Dallas	2	3.38	0.50	50.0%	Mostly C
▸Andrew	2	3.74	0.48	50.0%	Mixed C/D
▸Linn	2	3.62	0.71	100.0%	Mostly B
▸Harrison	1	3.52	0.52	100.0%	Mostly C
▸Sullivan	1	2.26	0.24	0.0%	Mostly F
▸Knox	1	3.86	0.56	100.0%	Mostly B
▸Mc Donald	1	2.90	0.48	0.0%	Mostly D
▸Worth	1	3.24	0.55	0.0%	Mostly C
▸Maries	1	2.33	0.13	0.0%	Mostly F
▸Mercer	1	3.41	0.51	0.0%	Mostly C
▸Douglas	1	3.24	0.56	0.0%	Mostly C
▸Monroe	1	3.36	0.23	0.0%	Mostly F
▸Warren	1	3.25	0.32	0.0%	Mostly D
▸Daviess	1	3.15	0.49	0.0%	Mostly C
▸Oregon	1	3.28	0.55	0.0%	Mostly C
▸Osage	1	3.80	0.62	100.0%	Mostly B
▸Ozark	1	2.73	0.63	0.0%	Mostly D
▸Dade	1	4.16	0.46	100.0%	Mostly C
▸Clark	1	3.55	0.48	100.0%	Mostly C
▸Carter	1	3.57	0.65	100.0%	Mostly B
▸Ralls	1	2.67	0.38	0.0%	Mostly D
▸Reynolds	1	3.00	0.45	0.0%	Mostly D
▸Ripley	1	3.34	0.56	0.0%	Mostly C
▸Bollinger	1	3.34	0.59	0.0%	Mostly C
▸Barton	1	3.71	0.70	100.0%	Mostly B
▸Schuyler	1	4.02	0.44	100.0%	Mostly C
▸Shannon	1	3.09	0.27	0.0%	Mostly D
▸Atchison	1	2.90	0.32	0.0%	Mostly D
▸Howard	1	2.95	0.32	0.0%	Mostly D
▸Hickory	1	2.85	0.37	0.0%	Mostly D
▸Gentry	1	3.06	0.35	0.0%	Mostly D

HPRD Range in Missouri

The spread between best and worst staffed facilities

3.02

25th pctile

3.40

Median

3.80

75th pctile

Source: CMS Staffing & Quality Data — 2025Q3 · data.cms.gov

Staffing grades are based on CMS-published thresholds and research recommendations. CMS is not affiliated with and does not endorse this website.