Iowa

Nursing Home Staffing Profile — 2025Q3

382 facilities19,884 residents3.82 avg HPRD

vs National Average

-0.08 HPRD

National avg: 3.90 · Iowa: 3.82

📋

Iowa ranks among the lower-performing states for nursing home staffing, with an average of 3.82 HPRD — 0.08 hours below the national average. Only 66.0% of facilities meet the CMS staffing benchmark of 3.48 HPRD, compared to 65.8% nationally. RN staffing averages 0.73 HPRD, with 37.7% of facilities meeting the 0.75 research recommendation.

3.82

Average Total HPRD

All nursing staff combined

▼ 0.08 vs national

0.73

Average RN HPRD

Recommended: 0.75

▲ 0.05 vs national

66.0%

Meet CMS Benchmark

252 of 382 facilities

16.6%

Avg Weekend Drop-off

Staffing reduction on Sat/Sun

4.2%

Avg Agency Staff

Contractor/temp worker hours

—

Had Zero-RN Days

Data unavailable

3.69

Median HPRD

50th percentile (less skewed by outliers)

F-Rated Facilities

Under 2.5 HPRD — critically understaffed

Grade Distribution

How Iowa's 382 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

3.69

avg HPRD

214 facilities (56%)

Non-Profit

3.96

avg HPRD

157 facilities (41%)

Government

4.26

avg HPRD

11 facilities (3%)

💡 Non-profit facilities in Iowa average 0.27 more HPRD than for-profit ones — about 7% higher staffing.

▲ Best Staffed in Iowa

Top 5 by total nurse HPRD

A+

Childserve Habilitation Center

Grand Meadows Senior Living & Health Care

Deerfield Health Care Center

Urbandale

5.85 HPRD

RN: 1.56

Arbor Springs of West Des Moines L L C

▼ Most Understaffed in Iowa

Bottom 5 by total nurse HPRD

382

Heartland Care Center

Crystal Heights Care Center

Northgate Care Center

Pine Acres Rehabilitation and Care Center

Accura Healthcare of Newton East, LLC

Newton

2.88 HPRD

RN: 0.55

⚖️

Compare Two Facilities Side by Side

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County Breakdown

Staffing metrics by county in Iowa — 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
▸Polk	28	4.17	0.89	71.4%	Mixed B/C
▸Linn	17	3.88	0.75	76.5%	Mixed B/C
▸Black Hawk	12	3.76	0.66	58.3%	Mixed B/C
▸Dubuque	12	4.25	0.93	91.7%	Mixed B/A
▸Scott	11	3.82	0.72	72.7%	Mixed B/C
▸Dallas	10	4.20	0.78	80.0%	Mixed A/C
▸Woodbury	8	3.87	0.72	62.5%	Mixed C/B
▸Johnson	7	3.95	0.65	85.7%	Mixed B/C
▸Story	7	4.24	0.91	85.7%	Mixed B/A+
▸Lee	6	4.15	0.82	83.3%	Mixed B/C
▸Warren	6	3.61	0.55	66.7%	Mostly C
▸Henry	6	3.97	0.83	66.7%	Mixed A/B
▸Pottawattamie	6	3.90	0.69	83.3%	Mixed B/A
▸Sioux	5	3.96	0.75	60.0%	Mixed B/C
▸Mitchell	5	3.91	0.88	60.0%	Mixed B/C
▸Marshall	5	3.71	0.58	40.0%	Mostly C
▸Jasper	5	3.67	0.76	40.0%	Mixed A/D
▸Cherokee	5	3.46	0.60	60.0%	Mixed C/B
▸Clayton	5	3.70	0.87	40.0%	Mostly C
▸Plymouth	5	3.78	0.89	60.0%	Mixed B/C
▸Palo Alto	5	3.49	0.82	40.0%	Mostly C
▸Muscatine	5	4.04	0.62	80.0%	Mixed B/C
▸Clinton	4	3.73	0.71	75.0%	Mixed B/C
▸Cedar	4	3.48	0.67	50.0%	Mixed B/C
▸Kossuth	4	3.94	0.97	75.0%	Mixed A/B
▸Poweshiek	4	3.89	0.85	50.0%	Mixed A/C
▸Marion	4	3.67	0.64	75.0%	Mixed B/C
▸Benton	4	4.13	0.55	75.0%	Mostly C
▸Iowa	4	3.55	0.68	50.0%	Mixed C/A
▸Grundy	4	3.87	0.74	75.0%	Mixed C/A
▸Webster	4	3.68	0.79	50.0%	Mixed C/A
▸Boone	4	3.84	0.79	75.0%	Mostly B
▸Fayette	4	3.49	0.52	50.0%	Mixed C/B
▸Bremer	4	4.19	0.71	100.0%	Mostly B
▸Washington	4	4.17	0.69	100.0%	Mixed A/B
▸Montgomery	4	3.60	0.77	50.0%	Mixed B/C
▸Tama	4	3.30	0.50	25.0%	Mixed C/D
▸Cerro Gordo	4	4.00	0.54	75.0%	Mixed C/A
▸Butler	4	3.56	0.51	75.0%	Mostly C
▸Hardin	4	3.77	0.67	100.0%	Mostly B
▸Wright	3	3.32	0.51	66.7%	Mostly D
▸Allamakee	3	3.47	0.74	33.3%	Mixed A/C
▸Appanoose	3	3.81	0.74	100.0%	Mixed A/B
▸Calhoun	3	3.71	0.72	66.7%	Mostly C
▸Carroll	3	3.90	0.54	66.7%	Mostly C
▸Cass	3	3.47	0.62	33.3%	Mostly C
▸Des Moines	3	3.86	0.85	66.7%	Mixed A/B
▸Emmet	3	3.75	0.86	100.0%	Mostly B
▸Floyd	3	3.86	0.64	66.7%	Mixed A/B
▸Franklin	3	3.86	0.58	100.0%	Mostly C
▸Hamilton	3	3.68	0.60	66.7%	Mostly C
▸Hancock	3	3.87	0.67	100.0%	Mixed A/B
▸Harrison	3	3.72	0.58	100.0%	Mostly C
▸Howard	3	3.79	0.67	100.0%	Mostly B
▸Jackson	3	3.74	0.82	66.7%	Mixed A/B
▸Lyon	3	3.78	0.93	33.3%	Mostly C
▸Mahaska	3	3.15	0.31	0.0%	Mixed C/D
▸Monona	3	4.15	0.65	100.0%	Mostly C
▸Obrien	3	3.56	0.86	33.3%	Mostly C
▸Page	3	3.77	0.49	100.0%	Mixed B/C
▸Sac	3	4.04	0.77	100.0%	Mixed A/B
▸Wapello	3	3.55	0.76	66.7%	Mostly B
▸Winnebago	3	3.31	0.58	0.0%	Mostly C
▸Winneshiek	3	3.71	0.61	66.7%	Mostly B
▸Ida	2	3.80	0.76	100.0%	Mixed B/C
▸Ringgold	2	3.24	0.81	0.0%	Mostly C
▸Adair	2	3.25	0.61	0.0%	Mostly C
▸Crawford	2	3.48	0.81	50.0%	Mixed B/C
▸Shelby	2	3.47	0.73	50.0%	Mixed B/D
▸Clay	2	3.69	0.74	50.0%	Mixed B/C
▸Chickasaw	2	3.18	0.91	0.0%	Mixed C/D
▸Taylor	2	3.50	0.85	50.0%	Mostly C
▸Union	2	3.78	0.76	50.0%	Mixed A/C
▸Keokuk	2	3.11	0.55	0.0%	Mostly C
▸Jones	2	3.33	0.67	0.0%	Mostly C
▸Louisa	2	3.53	0.78	50.0%	Mostly C
▸Buchanan	2	3.84	0.87	50.0%	Mixed A/C
▸Jefferson	2	3.46	0.65	50.0%	Mixed B/C
▸Guthrie	2	3.36	0.64	0.0%	Mostly C
▸Audubon	2	3.65	0.56	100.0%	Mixed B/C
▸Osceola	2	4.37	1.08	50.0%	Mixed A+/C
▸Worth	2	3.95	0.89	50.0%	Mixed A/C
▸Fremont	2	3.70	0.47	100.0%	Mixed B/D
▸Dickinson	2	3.71	0.54	100.0%	Mixed B/C
▸Pocahontas	2	3.50	0.62	50.0%	Mixed B/C
▸Decatur	2	3.72	0.50	100.0%	Mostly C
▸Humboldt	1	4.99	0.99	100.0%	Mostly A
▸Wayne	1	3.41	0.62	0.0%	Mostly C
▸Monroe	1	3.22	0.58	0.0%	Mostly C
▸Davis	1	3.97	0.94	100.0%	Mostly B
▸Greene	1	3.52	0.67	100.0%	Mostly B
▸Mills	1	5.00	0.67	100.0%	Mostly B
▸Lucas	1	3.15	0.72	0.0%	Mostly C
▸Van Buren	1	3.33	0.42	0.0%	Mostly C
▸Adams	1	3.08	0.68	0.0%	Mostly C
▸Buena Vista	1	4.51	0.94	100.0%	Mostly A
▸Clarke	1	3.42	0.66	0.0%	Mostly C
▸Delaware	1	4.05	0.90	100.0%	Mostly B
▸Madison	1	3.54	0.47	100.0%	Mostly C

HPRD Range in Iowa

The spread between best and worst staffed facilities

3.36

25th pctile

3.69

Median

4.15

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.