Nursing Home Ratings in Louisiana: A Data Analysis of Quality, Safety, and Staffing
Louisiana has the highest rate of F-rated nursing homes in the nation — 54.7% earn the lowest grade. Only 3.5% of facilities meet the RN staffing recommendation. Here's the full data analysis.
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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.
A State Where Finding Good Care Is the Exception, Not the Rule
In most states, families searching for a nursing home can expect to find a range of options — some good, some mediocre, some concerning. In Louisiana, the data tells a different story. Here, finding a well-staffed nursing home isn't just harder than average. It's statistically rare.
Louisiana's 256 nursing homes serve approximately 23,368 residents daily. The state's average total nurse staffing of 3.84 HPRD looks close to the national average of 3.90. But that average hides one of the most alarming staffing distributions in the country. When you break down the numbers by facility, 140 of Louisiana's 256 nursing homes — 54.7% — receive an F grade, the lowest possible rating. Add in the 88 D-rated facilities, and 89.1% of Louisiana nursing homes score below the CMS staffing standard.
The RN staffing picture is even more stark. Louisiana averages just 0.33 RN hours per resident per day — less than half the national average. Only 3.5% of facilities meet the 0.75 HPRD research recommendation. That means in a state of 256 nursing homes, roughly 9 have adequate registered nurse coverage.
For families in Louisiana, this isn't abstract data. It means the nursing home down the street, the one the hospital discharge planner recommended, the one with the friendly staff at the front desk — there's a better than even chance its staffing levels earn the lowest grade in our system.
This report analyzes nursing home ratings in Louisiana using the most recent federal staffing and quality data published by CMS. Explore the full Louisiana state profile for interactive data.
The Louisiana Nursing Home Landscape
The Scale
Louisiana operates 256 Medicare and Medicaid certified nursing homes caring for approximately 23,368 residents daily. The state's nursing home industry has historically faced challenges related to hurricane exposure, workforce shortages, and Medicaid reimbursement rates. Every facility submits daily staffing data to CMS, providing a detailed picture of how many nursing hours each resident actually receives.
The Crisis
The data reveals a systemic staffing crisis unlike any other state. Louisiana's grade distribution is inverted compared to the national pattern — instead of a bell curve centered around B and C, Louisiana's curve is crushed to the bottom:
- A+ and A combined: 8 facilities (3.1%)
- D and F combined: 228 facilities (89.1%)
The registered nurse shortage is especially severe. At 0.33 RN HPRD, Louisiana has one of the lowest RN coverage rates in the nation, and only 3.5% of facilities meet the research-recommended level. RN staffing is critical because registered nurses are the only staff qualified to perform clinical assessments, manage complex medication regimens, and make the judgment calls that prevent emergencies.
Meanwhile, Louisiana's LPN staffing is among the highest nationally at 1.18 HPRD — suggesting that facilities are substituting less expensive LPN hours for the RN coverage that clinical evidence shows residents need.
What Families Want to Know
With such an extreme staffing landscape, how can families in Louisiana identify the few facilities that do provide adequate care, and what should they know about the risks of choosing a facility in the bottom tier?
What the Data Reveals
Our analysis maps every measurable dimension of nursing home quality across Louisiana to help families understand where the exceptions exist and what the data says about the broader crisis. See how Louisiana compares to every other state on the rankings page.
Louisiana by the Numbers: Key Data Insights
The Most Alarming Grade Distribution in the Nation
No state comes close to Louisiana's concentration of F-rated facilities. More than half of the state's nursing homes provide less than 2.5 total nurse hours per resident per day — a level that research consistently associates with inadequate care.
The chart above makes the problem visual: the red F bar dwarfs every other grade combined. In a normally distributed state, the tallest bar would be at C or B. In Louisiana, it's at F.
The LPN-for-RN Substitution Problem
Louisiana's staffing model is fundamentally different from most states — and not in a good way. The state has relatively strong overall HPRD (3.84, close to the national 3.90), but the composition of that staffing is heavily skewed away from RN coverage.
The pattern is unmistakable: Louisiana has more LPN and CNA hours than the national average, but less than half the RN hours. The total looks acceptable; the composition does not. This is what makes Louisiana's situation so dangerous — the headline HPRD number obscures a critical clinical gap. Learn more about why the staffing mix matters in our guide to HPRD and staffing grades.
CMS Benchmark Compliance
This creates the misleading impression that most Louisiana facilities are "passing." They're passing on total hours while failing on the quality of those hours.
Weekend Staffing: Steep Drops
Louisiana's weekend staffing drops by an average of 18.1% — worse than the national average of about 15-16%. Combined with already-low RN coverage, weekend care in many Louisiana facilities means significantly reduced clinical oversight.
Agency Staff: Low Usage
Contract/agency staff account for only 4.8% of hours. As with other low-staffing states, this isn't reassuring in context — it suggests facilities are operating chronically short-staffed rather than temporarily supplementing their workforce. Track how agency reliance is changing nationally on the trends page.
Grade Distribution
Only 11 facilities in all of Louisiana earn a B or better. Finding one of these is the first challenge; getting admitted to one (they tend to have waiting lists) is the second.
Understanding the Stakes
The Problem Families Face
Families in Louisiana face a healthcare landscape where the default option is likely inadequate. Hospital discharge planners may recommend nearby facilities based on bed availability, not staffing quality. Families under time pressure accept placements without understanding that the facility they're choosing is statistically likely to be in the bottom tier nationally.
What Transparent Data Makes Possible
With facility-level data, the calculus changes. Families can identify the 11 facilities earning a B or better — and understand that these are genuinely exceptional in the Louisiana context. They can also see the degree to which D and F-rated facilities fall short, giving them the evidence they need to push back on rushed placements or explore alternatives like in-home care.
Use the facility comparison tool to evaluate any two Louisiana nursing homes side by side across every metric.
Our Commitment
This analysis doesn't change Louisiana's staffing crisis, but it arms families with information the system doesn't readily provide. When 140 facilities in your state earn an F grade, knowing which ones don't isn't a luxury — it's a necessity.
How Nursing Home Ratings Are Calculated
Our Staffing Grades
Letter grades are based on Hours Per Resident Day (HPRD) — total nursing staff hours divided by daily resident count. The thresholds are anchored to two evidence-based benchmarks: the 3.48 HPRD CMS standard and the 4.10 HPRD research recommendation from the CMS-commissioned STRIVE study. Both RN and total staffing are graded separately; the overall grade reflects the lower of the two.
Learn more in our guide to understanding HPRD and staffing grades.
Why Louisiana's Grades Are So Low
Louisiana's problem isn't total hours — it's the RN component. Many facilities that might earn a C or B on total HPRD are pulled down to D or F by their extremely low RN coverage. When a facility has 3.5 total HPRD but only 0.20 RN HPRD, the RN grade drags the overall assessment down. This is by design — research shows that RN staffing is the single strongest predictor of resident outcomes.
What Goes Into the Data
Every nursing home must submit daily staffing data to CMS. This includes hours worked by every employee, broken down by role and employment type, combined with daily resident census counts.
Key Takeaways for Families in Louisiana
If you're evaluating nursing homes in Louisiana, here are the most important things the data tells us.
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Accept that the search will be harder here. Only 11 of 256 Louisiana facilities earn a B or better. Knowing this upfront prevents false expectations and helps families plan accordingly — including considering facilities in neighboring states or in-home care alternatives.
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RN staffing should be your primary filter. With only 3.5% of facilities meeting the RN recommendation, finding a home with adequate registered nurse coverage is the single most important differentiator in Louisiana.
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Don't trust the total HPRD alone. Louisiana's near-average total staffing hides the worst RN coverage in the country. Always check the RN-specific numbers, not just the overall HPRD.
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Weekend visits are revealing. With an 18.1% average weekend drop, visiting on a Saturday gives you a more realistic picture of the care your loved one will receive most of the time.
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The 7 A+ facilities are genuinely exceptional. These facilities are operating at a level that's rare anywhere in the country, but especially so in Louisiana. If one is accessible to you, investigate it seriously. Browse the full list on the Louisiana state page.
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Consider the inspection history alongside staffing. Low staffing and repeated citations together paint a clearer picture than either metric alone. Use the comparison tool to evaluate candidates side by side.
Frequently Asked Questions
How are nursing homes rated in Louisiana?
Louisiana nursing homes receive CMS Five-Star ratings and our letter grades (A+ through F) based on total nursing hours per resident per day. Louisiana has the highest rate of F-rated facilities in the nation — 140 of 256 facilities (54.7%) earn the lowest grade, primarily due to extremely low registered nurse staffing. See the full breakdown on the Louisiana state page.
What is considered a good nursing home rating in Louisiana?
Any facility earning a B or better in Louisiana is performing well above the state norm. Only 11 of 256 facilities reach this level. Given the state's challenges, even a C-grade facility is providing meaningfully better care than the majority. For RN staffing, look for any facility above 0.50 HPRD — even that modest level puts it well above the state average of 0.33.
How many nursing homes are in Louisiana?
Louisiana has 256 Medicare and Medicaid certified nursing homes serving approximately 23,368 residents daily.
Why does Louisiana have so many poorly rated nursing homes?
Multiple factors contribute: chronic RN workforce shortages, heavy reliance on LPNs as substitutes for RNs, Medicaid reimbursement rates that make RN recruitment difficult, and a historical staffing model that prioritizes aide hours over clinical coverage. The result is facilities that may have adequate total staffing but lack the registered nurse oversight that drives quality outcomes.
How can families compare nursing homes in Louisiana?
Our comparison tool lets you evaluate any two facilities side by side. Given Louisiana's challenging landscape, we recommend starting with the RN HPRD filter to identify facilities above 0.50, then comparing inspection histories and weekend staffing patterns among the candidates. Track how Louisiana is trending on our trends page.