If you’re keeping tabs on nursing home quality in America, you might be wondering what’s changed recently. Let’s dive into the latest numbers from June 2025, and I’ll walk you through what they mean for residents and families.
First, let’s address the big picture. As of June 2025, we’re looking at 14,754 nursing homes across the country, providing about 1.57 million beds for our seniors. While this might sound like a lot, it’s worth noting that we’ve actually seen a gradual decline over the years. Back in January 2014, we had nearly 900 more facilities and about 90,000 more beds. This shrinking number of facilities is something we should keep an eye on, especially as our elderly population continues to grow.
What’s particularly interesting is the pace of change. Just from May to June 2025, we lost 5 facilities and 55 beds. That might not sound like much, but if you project this monthly trend annually, we’re looking at 60 facilities and 660 beds disappearing each year. Now, before you panic, remember that some of this variation comes from data reporting issues – facilities might close temporarily for renovations, or there could be delays in updating the database. But the overall trend is clear: the nursing home landscape is shrinking while our aging population is expanding. This mismatch raises important questions about where future seniors will receive care.
The good news? The occupancy rates have held steady at 78.2% compared to last month. This stability is important because it suggests no major disruptions in the nursing home sector, though we should note that about one-fifth of beds remain unused, which tells an interesting story about how Americans are choosing care options.
This 78.2% occupancy rate deserves a deeper look. It means that nationally, we have about 343,000 empty beds. That’s enough to house the entire elderly population of several states! Why aren’t these beds filled? Part of it is economics – nursing home care is expensive, averaging over $8,000 per month for a semi-private room. Part of it is preference – more families are choosing home care or assisted living options when possible. And part of it is geography – those empty beds might be in rural areas while the demand is in cities. For families, this means you might have more negotiating power than you think, especially if you’re flexible about location.
When it comes to quality ratings, June brought some movement in both directions. About 480 nursing homes saw their ratings improve, while 410 facilities experienced a downgrade. To put this in perspective, that’s about 6% of all facilities seeing some change in their rating this month. Now, I noticed something odd in the data that’s worth explaining. The numbers show some discrepancies between different reporting periods – for instance, one dataset shows 2,630 five-star facilities while another shows 2,754. These variations likely stem from the timing of data collection and processing delays at CMS. What’s consistent, though, is the overall distribution: roughly 18-19% of facilities earn five stars, while about 23% struggle with one-star ratings. The remaining homes are spread fairly evenly across the two-, three-, and four-star ratings, with a small number of newer facilities still awaiting their first rating.
Let’s talk about what these star ratings actually mean for you and your loved ones. A five-star facility isn’t just bragging rights – it typically means better health inspection scores, appropriate staffing levels, and quality measures that show residents are receiving good care. On the flip side, a one-star facility might have serious deficiencies. But here’s where it gets complicated: a facility can have a great staffing rating but poor inspection results, or vice versa. That’s why the overall rating considers multiple factors. The fact that nearly a quarter of facilities have just one star should be a wake-up call for the industry and regulators alike.
One area that deserves special attention is staffing levels, particularly given the Department of Health and Human Services’ 2023 push for increased registered nurse presence in facilities. Currently, residents are receiving an average of about 40 minutes (0.671 hours) of registered nurse time per day, along with roughly 2.3 hours from nursing aides. The total staff time, including all types of care providers, averages about 3.9 hours per resident per day. While these numbers haven’t changed much from last month, they’re slightly up from last year, suggesting a slow but positive trend in staffing levels.
Let me break down what these staffing hours really mean in practical terms. That 40 minutes of registered nurse time? It’s spread across an entire 24-hour day, which means during any given shift, a registered nurse might only spend 10-15 minutes directly with each resident. The bulk of hands-on care comes from nursing aides, who provide help with daily activities like bathing, dressing, and eating. The year-over-year improvement is encouraging – we’ve gone from 0.650 to 0.671 hours of RN time, which might not sound like much, but across thousands of facilities, that represents millions of additional hours of skilled nursing care annually.
What’s particularly telling is comparing these numbers to what experts recommend. The Centers for Medicare and Medicaid Services has suggested that residents need at least 0.75 hours of RN time daily for adequate care. We’re still falling short of that benchmark. For nursing aide time, the recommendation is 2.8 hours per resident per day, and we’re at 2.32 hours. These gaps might explain why some residents feel rushed during care or why call buttons sometimes go unanswered for longer than families would like.
Inspections, which are crucial for maintaining standards, show some concerning patterns. While 50 new inspections were conducted in June, many facilities haven’t seen an inspector in over a year. This lag, a lingering effect of the COVID-19 pandemic, represents a significant departure from the required annual inspection schedule. For families and residents, this means it’s more important than ever to stay engaged with your facility’s management and keep an eye on conditions yourself.
The inspection backlog is more serious than it might first appear. Before COVID-19, facilities could expect an annual inspection like clockwork. These inspections aren’t just bureaucratic exercises – they uncover real problems like medication errors, inadequate infection control, or unsafe conditions. With only 50 inspections completed in June across nearly 15,000 facilities, at this rate it would take 25 years to inspect every facility once! Of course, the actual pace varies by state, and some areas are catching up faster than others. But if your loved one’s facility hasn’t been inspected in over 18 months, that’s a red flag worth investigating.
Looking at these numbers as a whole, what do they tell us? While the nursing home landscape isn’t experiencing any dramatic shifts, we’re seeing subtle changes that matter. The slight decline in total facilities combined with steady occupancy rates suggests that while some facilities are closing, others are absorbing that capacity. The movement in quality ratings shows that facility performance isn’t static – homes can and do improve, but they can also decline if they don’t maintain their standards.
There’s another trend worth watching: the consolidation of the nursing home industry. When facilities close, they’re often absorbed by larger chains rather than replaced by new independent operators. This can be both good and bad. Large chains might have better resources for training and quality improvement, but they might also prioritize profits over patient care. As a consumer, it’s worth knowing who owns your facility and whether they have a track record of quality across their other properties.
For families and residents, this data suggests several key takeaways. First, if you’re looking for a nursing home, you have options – the 78.2% occupancy rate means many facilities have space available. Second, while there are plenty of high-performing facilities (those with four and five stars), there’s also a significant number of homes that need improvement. This makes it crucial to research thoroughly and visit facilities in person before making a decision.
Here’s my practical advice based on these numbers: Start your search early, even if you don’t need care immediately. With nearly 3,500 one-star facilities out there, you can’t afford to wait until a crisis forces a quick decision. Use the CMS Nursing Home Compare website to check ratings, but don’t stop there. Visit during different times of day, including evenings and weekends when staffing might be lighter. Talk to residents and their families. Ask specific questions about staff turnover – high turnover often correlates with quality problems.
Finally, the staffing numbers, while showing slight improvement over the past year, remind us that it’s important to ask specific questions about staffing when evaluating a facility. How many registered nurses are on duty during each shift? What’s the ratio of aids to residents? These questions become even more important given the current inspection delays.
Don’t be shy about asking for specific staffing schedules. A facility that’s transparent about its staffing is usually one that has nothing to hide. Ask about weekend and night shift coverage specifically – these are often when facilities are most thinly staffed. And remember, the numbers I’ve shared are averages. Some facilities far exceed these standards while others fall short. Your job is to figure out which category your potential facility falls into.
Remember, while these statistics and ratings are helpful guides, they’re just part of the picture. Your personal observations, conversations with staff and residents, and the general feeling you get from a facility should all play a role in your decision-making process. Keep using these monthly updates as one tool in your toolbox for making informed decisions about nursing home care.
The nursing home industry continues to struggle. Yes, we have fewer facilities and persistent staffing challenges, and the inspection system is still catching up from pandemic disruptions. These aren’t sudden crises but ongoing trends that families should be aware of. The data also shows positive signs – some facilities are improving their ratings, staffing levels are inching upward, and the steady occupancy rate suggests the system is functioning, just differently than it did a decade ago. By staying informed and asking the right questions, you can find quality care for your loved ones even in this challenging environment. The key is to use data like this as your starting point, not your ending point, in the search for the right nursing home.