90% of U.S. nursing homes understaffed, Iowa among hardest hit

IOWA, UNITED STATES — Nearly 90% of United States nursing homes lack sufficient staff to meet residents’ basic needs, with Iowa facilities ranking among the most understaffed. 

Federal data shows 11 Iowa nursing homes operated at 40% or more below required staffing levels in late 2024, raising alarms about patient safety and care quality.

U.S. nursing homes grapple with widespread staffing crisis

The overwhelming majority of United States nursing homes are dangerously understaffed, failing to meet even basic care standards for elderly and vulnerable residents. 

LTC data compiled by the Long Term Care Community Coalition (LTCCC) reveals that 90% of facilities are understaffed below what is expected of them, with the median nursing home being 25% behind needed personnel. 

Alaska and Oregon only matched or surpassed staffing benchmarks that averaged 21% above expectations, while in such states as Illinois, with 37.7% below, or Texas, with 30% below, severe shortages occurred.

The staffing crisis stems from chronic underfunding and workforce shortages, compounded by delayed federal enforcement of new minimum staffing rules until 2035. 

Richard Mollot, LTCCC’s executive director, warns that current staffing gaps measured against each facility’s own assessments of resident needs pose dire risks.

“It gives residents, families, operators, and policymakers a clear and meaningful way to gauge whether a nursing home is adequately staffed to ensure safe, appropriate care,” he said.

Iowa’s nursing homes reflect severe shortages in U.S.

Iowa’s nursing homes mirror the national crisis, with 11 facilities operating at 40% or more below required staffing levels in late 2024. 

Among the worst facilities were Bettendorf Health Care Center, which has been cited three times since 2022 and is staffed 43.8% below the required levels, and Aspire of Pleasant Valley, which is staffed 45.3% below those levels. Seven of the 11 homes had been cited for insufficient staffing in the past decade, yet problems persist.

Both rural and urban facilities suffer from severe understaffing, with Adel Acres at 47.5% below and Oakland Manor at 46% below. 

With only 34 of Iowa’s 410 homes meeting benchmarks, advocates demand urgent policy reforms to protect residents.

Offshore staffing gains traction as solution 

As Iowa facilities like Bettendorf Health Care Center operate below required staffing levels, healthcare administrators can turn to offshore staffing to recruit qualified international nurses and aid this pending crisis. 

This move provides immediate relief to understaffed facilities while maintaining care standards, offering a potential remedy as most of the U.S. nursing homes report critical staffing gaps that become a hindrance in providing medical support to communities. 

Global healthcare staffing firms now play a key role in helping nursing homes meet federal requirements amid the ongoing workforce crisis.