Rural-Urban Comparisons of Nursing Staff Turnover Among Skilled Nursing Facilities
Link
Date
09/2025
Description
This study assessed facility-level turnover rates for nursing and registered nurse (RN) personnel across levels of rurality and by region. A total of 14,986 facilities were included in the August 2023 data released by the Centers for Medicare & Medicaid Services. Of those facilities, 72.3% were in urban areas.
Key Findings:
- Across all facilities, the average percentage of total nursing staff turnover during the year 2022 was 53.5 ± 15.9%. The average total nursing-hours-per-resident ratio was 3.8 ± 1.0 hours.
- RN-specific turnover in skilled nursing facilities was higher in urban areas (51.5%) compared to rural areas (47%).
- There was no clear pattern of turnover across various regions of the United States.
- Nurse staff hours per resident per day, although statistically significantly different, showed negligible differences between urban and rural facilities.
Center
University of South Carolina Rural Health Research Center
Authors
Michael Wirth, Nick Yell, Peiyin Hung, Elizabeth Crouch