Nursing home minimum staffing requirements by US state — hours per resident day, RN coverage mandates, and penalty structures after the 2026 federal repeal
State-by-state comparison of legally mandated minimum staffing levels for nursing homes (skilled nursing facilities). Each record is one state with the total hours of nursing care per resident per day (HPRD), the RN-specific HPRD minimum, the CNA-specific HPRD minimum, whether a 24/7 RN is required, the RN coverage requirement (hours per day), the penalty for noncompliance, and the statutory citation. The federal CMS minimum (3.48 HPRD + 24/7 RN) was REPEALED in December 2025, effective February 2026, and a moratorium through October 2034 was enacted via the One Big Beautiful Bill Act. States are now the only authority. New York requires 3.5 HPRD (2.2 CNA + 1.1 licensed nurse); South Carolina requires 1.63 hours from non-licensed staff; many states have no specific HPRD requirement. Answers 'what is the minimum nursing staff my state requires per resident', 'is there still a federal nursing home staffing minimum', and 'what are the penalties for understaffing'.
The data
| State | Total HPRD minimum | RN HPRD minimum | CNA HPRD minimum | RN on-site requirement | Penalty for noncompliance | Regulatory citation | Federal standard status |
|---|---|---|---|---|---|---|---|
| New York | 3.5 | none specified | 2.2 | none specified | civil penalty up to $2,000 per day for each day in a quarter of noncompliance | Public Health Law § 2895-b and 10 NYCRR 415.13 | repealed |
| South Carolina | none specified | none specified | 1.63 | at least one licensed nurse per shift for each staff work area | none specified | 2025-2026 Appropriations Act (2025 Act No. 69 (H.4025)), proviso 31.17; R61-17, Code of State Regulations | repealed |
Where this came from
Every record above links the page it was taken from and quotes the sentence that states it. These are the 2 sources this dataset was assembled from.
- health.ny.govhttps://www.health.ny.gov/facilities/nursing/minimum_staffing/
- dph.sc.govhttps://dph.sc.gov/sites/scdph/files/2025-08/Nursing_Home_Staffing_Ratios_Memo_08.25.2025.pdf
Machine-readable
- data.jsonThe whole dataset — every record with its source URL and source quote.
- Open Knowledge Format bundleOne JSON object per line — every record's frontmatter and quoted span exactly as it is held here, in one fetch.
- How this is made and checkedWhat "verified against source" does and does not mean.