Staffing Levels Drive 2024 Best Nursing Home Results

Earlier this month, U.S. News released their 2024 Best Nursing Homes ratings. Of the 15,007 nursing homes rated, only 2,800 (19%) were recognized as a Best Nursing Home by the magazine.

This rating system differs from the criteria of the Centers for Medicare & Medicaid Services (CMS) 5-star quality rating system. For the last few years, staffing levels have continued to play a larger role in the U.S. News ratings since more Payroll Based Journal data has been made publicly available with progressively broader data points to consider. The use of this data, interestingly enough, reflects the interests of consumers as potential patients and their loved ones, as well as academics and policymakers.

Key findings from the 2024 Best Nursing Homes list includes:

  • 436 nursing homes failed to meet the current rule of 8 hours of RN coverage with 8 hours per patient day on 20% or more days
  • Less than 5% of nursing homes evaluated could meet the existing RN rule and the proposed staffing mandate
  • 445 nursing homes received 4 or 5 stars from CMS, but were given a 1 or a 2 by U.S. News

How does this differ from the CMS star ratings?

The U.S. News rating system does not include overall or domain-specific ratings in their calculations, but they do rely on CMS data. The magazine rating system relies heavily on the following criteria to determine rankings:

  • Patient and resident outcomes
  • Staffing levels
  • Process measures

It’s important to note that these metrics are emphasized over inspection results, which the CMS uses in their own calculations.

How healthcare facilities can rate better next year

No matter whether your post-acute care facility wants to improve your 5-star quality rating or land on U.S. News’ 2025 list of Best Nursing Homes, the primary pain point you need to remedy is your staffing. We’ve come up with five ways you can source and hire the healthcare talent you need below.

Cover tuition for interested applicants 

This strategy has a hefty price tag upfront, but will pay off in dividends once the talent pool is replenished with fresh graduates. You could essentially create your own candidate pool to hire from if you choose to offer graduates pursuing healthcare careers. While most might only think of offering scholarships to graduating high school seniors, you could further diversify your talent pool by offering your CNAs assistance paying for nursing school. Of course, you could also offer to cover the cost of CNA training for fresh high school graduates in exhange for them working for you. 

Partner with local schools

Another way you could tap into freshly graduated talent would be to partner with your local technical and vocational schools that offer degrees and certifications in the healthcare field. You can offer your facility to program for these students to complete their clinical hours on real patients instead of dummies, so the students gain real, hands-on experience — and you receive help completing some of the most essential patient care tasks for your team. You could offer program graduates guaranteed employment at your facility, which would be a great match since the students will already be familiar with your facility and they’ll be trained to your standards. 

Offer what healthcare workers really want

The second highest most sought after aspect of an employer — after pay, of course — was schedule flexibility, according to our 2023 State of Healthcare Hiring Report. In healthcare, it’s common for employees to work 10 to 12 hour shifts — sometimes multiple days in a row. This can wear down anyone, leading to compassion fatigue. While you are trying to do more with less employees, there are still ways to give your workers what they need and want. You could allow them to pick their shifts instead of assigning them so they could feel empowered about their work and personal lives. 

Develop talent from within

Returning to that same study from earlier, the third most valued benefit of an employer was career growth opportunities. The difficulty here lies in the fact that there are so many career pathways that one could pursue in the healthcare field. To make things simple, your facility should prioritize developing career paths available to each position at your organizations. It’s important for retention that your employees can see a future with you in their next role so that they don’t feel stagnant in what they’re currently doing. You could also consider creating a mentorship program to develop talent from within your organization — and encourage workers to pursue some of the scholarships available to them to advance their career with you!


If you’re not pleased with your results in U.S. News’ 2024 Best Nursing Homes, you’ll need to prioritize hiring to increase your patient to employee ratio. While it can be easier said than done to hire healthcare talent these days, Hireology can help! As the leading healthcare ATS, our platform has everything you need to quickly identify quality candidates and get them hired faster. Schedule a demo to see how!



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