Alabama

Nursing Home Staffing Profile — 2025Q3

223 facilities21,698 residents3.92 avg HPRD

vs National Average

+0.02 HPRD

National avg: 3.90 · Alabama: 3.92

📋

Alabama ranks among the higher-performing states for nursing home staffing, with an average of 3.92 HPRD — 0.02 hours above the national average. Only 73.5% of facilities meet the CMS staffing benchmark of 3.48 HPRD, compared to 65.8% nationally. RN staffing averages 0.64 HPRD, with 26.9% of facilities meeting the 0.75 research recommendation.

3.92

Average Total HPRD

All nursing staff combined

▲ 0.02 vs national

0.64

Average RN HPRD

Recommended: 0.75

▼ 0.04 vs national

73.5%

Meet CMS Benchmark

164 of 223 facilities

20.7%

Avg Weekend Drop-off

Staffing reduction on Sat/Sun

1.0%

Avg Agency Staff

Contractor/temp worker hours

—

Had Zero-RN Days

Data unavailable

3.95

Median HPRD

50th percentile (less skewed by outliers)

F-Rated Facilities

Under 2.5 HPRD — critically understaffed

Grade Distribution

How Alabama's 223 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

3.88

avg HPRD

188 facilities (84%)

Non-Profit

4.06

avg HPRD

26 facilities (12%)

Government

4.39

avg HPRD

9 facilities (4%)

💡 Non-profit facilities in Alabama average 0.18 more HPRD than for-profit ones — about 5% higher staffing.

▲ Best Staffed in Alabama

Top 5 by total nurse HPRD

ASPIRE PHYSICAL RECOVERY CENTER AT HOOVER, LLC

HOOVER

5.33 HPRD

RN: 0.92

SHELBY RIDGE NURSING HOME

HENRY COUNTY HEALTH AND REHABILITATION FACILITY

ABBEVILLE

5.10 HPRD

RN: 0.70

▼ Most Understaffed in Alabama

Bottom 5 by total nurse HPRD

223

EAMC LANIER NURSING HOME

BIRMINGHAM NURSING AND REHABILITATION CENTER EAST

MAGNOLIA HAVEN HEALTH AND REHABILITATION CENTER

DIVERSICARE OF ONEONTA

ONEONTA

2.84 HPRD

RN: 0.50

⚖️

Compare Two Facilities Side by Side

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

Open Comparison Tool →

County Breakdown

Staffing metrics by county in Alabama — 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
▸Jefferson	34	3.79	0.55	64.7%	Mixed C/B
▸Mobile	17	3.98	0.69	82.3%	Mixed B/A
▸Madison	12	3.90	0.74	83.3%	Mixed B/A
▸Montgomery	8	3.85	0.53	50.0%	Mixed C/B
▸Baldwin	7	3.99	0.79	71.4%	Mixed A/C
▸Etowah	6	4.10	0.58	100.0%	Mostly B
▸Tuscaloosa	6	4.00	0.63	83.3%	Mixed C/B
▸Calhoun	5	3.96	0.71	80.0%	Mixed B/C
▸Marshall	5	4.12	0.63	60.0%	Mixed B/C
▸Walker	5	3.77	0.69	80.0%	Mostly B
▸Lauderdale	5	3.87	0.70	80.0%	Mixed B/C
▸Cullman	4	4.34	0.73	100.0%	Mostly B
▸Franklin	4	3.72	0.81	75.0%	Mixed B/A
▸Elmore	4	3.60	0.64	75.0%	Mixed B/C
▸Morgan	4	3.70	0.63	50.0%	Mostly C
▸St. Clair	4	3.62	0.53	50.0%	Mixed C/B
▸Tallapoosa	4	4.32	0.72	100.0%	Mostly B
▸Colbert	3	3.22	1.00	0.0%	Mostly C
▸Chambers	3	2.58	0.43	0.0%	Mostly C
▸Covington	3	4.12	0.63	100.0%	Mixed A/B
▸Dallas	3	3.52	0.46	33.3%	Mostly C
▸De Kalb	3	3.97	0.65	100.0%	Mostly B
▸Houston	3	4.56	0.55	100.0%	Mostly C
▸Jackson	3	4.11	0.79	100.0%	Mostly B
▸Marion	3	3.94	1.00	66.7%	Mostly A
▸Russell	3	4.05	0.66	66.7%	Mixed A/C
▸Shelby	3	4.20	0.43	100.0%	Mostly D
▸Talladega	3	4.31	0.66	100.0%	Mixed A/B
▸Lee	2	4.28	0.49	100.0%	Mixed B/D
▸Butler	2	4.32	0.43	100.0%	Mostly C
▸Perry	2	3.42	0.56	50.0%	Mixed B/C
▸Pickens	2	4.54	0.71	100.0%	Mixed A/B
▸Limestone	2	3.89	0.52	100.0%	Mixed B/C
▸Randolph	2	3.86	0.70	100.0%	Mixed A/C
▸Coffee	2	4.21	0.72	50.0%	Mixed B/C
▸Hale	2	3.46	0.57	50.0%	Mixed B/C
▸Clarke	2	4.14	0.79	100.0%	Mostly B
▸Marengo	2	4.62	0.67	100.0%	Mostly B
▸Geneva	2	3.61	0.65	50.0%	Mixed B/C
▸Dale	2	3.65	0.54	50.0%	Mostly C
▸Clay	2	3.87	0.51	50.0%	Mostly C
▸Winston	2	4.12	0.60	100.0%	Mostly B
▸Blount	2	3.36	0.56	50.0%	Mixed B/D
▸Escambia	2	4.75	0.65	100.0%	Mostly B
▸Monroe	2	4.40	0.65	100.0%	Mostly B
▸Crenshaw	1	3.79	0.36	100.0%	Mostly D
▸Coosa	1	4.76	0.55	100.0%	Mostly C
▸Sumter	1	3.61	0.57	100.0%	Mostly B
▸Conecuh	1	4.43	0.50	100.0%	Mostly C
▸Fayette	1	4.41	0.93	100.0%	Mostly A
▸Autauga	1	4.36	0.81	100.0%	Mostly A
▸Greene	1	3.31	0.50	0.0%	Mostly C
▸Henry	1	5.10	0.70	100.0%	Mostly B
▸Bibb	1	3.41	0.43	0.0%	Mostly C
▸Cleburne	1	4.35	0.58	100.0%	Mostly B
▸Lamar	1	3.61	0.82	100.0%	Mostly B
▸Lawrence	1	3.54	0.61	100.0%	Mostly B
▸Lowndes	1	3.42	0.96	0.0%	Mostly C
▸Macon	1	2.73	0.46	0.0%	Mostly D
▸Barbour	1	4.01	0.61	100.0%	Mostly B
▸Choctaw	1	3.42	0.80	0.0%	Mostly C
▸Chilton	1	3.24	0.69	0.0%	Mostly C
▸Cherokee	1	4.93	0.77	100.0%	Mostly A
▸Pike	1	2.85	0.40	0.0%	Mostly D
▸Washington	1	4.28	0.68	100.0%	Mostly B
▸Bullock	1	4.61	0.40	100.0%	Mostly C
▸Wilcox	1	4.65	0.50	100.0%	Mostly C

HPRD Range in Alabama

The spread between best and worst staffed facilities

3.45

25th pctile

3.95

Median

4.35

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.