The findings coincide with sweeping 2025 reconciliation law changes, including delays to the federal staffing rule and reductions in Medicaid funding flexibility, that increase financial and compliance risk for skilled nursing operators.
A Look at Nursing Facility Characteristics in 2025
Between 2015 and 2025, the average count of deficiencies per nursing facility increased from 6.8 to 9.5, an increase of 40%. The share of facilities reporting serious deficiencies between 2015 and 2025 increased from 17% to 27%. A 2023 report on nursing home staffing by Abt Associates found that better-staffed nursing homes are typically cited for fewer deficiencies or violations of federal regulations, suggesting there may be a relationship between the increase in deficiencies and the general decrease in staffing levels over the 10-year time period.
Chidambaram, Priya, and Alice Burns. “A Look at Nursing Facility Characteristics in 2025.” KFF, 17 December 2025. https://www.kff.org/medicaid/a-look-at-nursing-facility-characteristics/
KFF: Increased Numbers of Deficiencies Cited at Nursing Facilities May Reflect Insufficient Staffing
KFF suggests that, possibly as the result of insufficient staffing levels, deficiencies have increased. Facilities are cited with more total deficiencies (deficiencies increased by 31%, from 6.8 deficiencies in 2015 to 8.9 deficiencies in 2023) and with more deficiencies classified at the two highest levels of severity (actual harm or immediate jeopardy deficiencies) (17% of facilities in 2015 and 26% of facilities in 2023 were cited with harm or jeopardy deficiencies).
— Center for Medicare Advocacy, January 11, 2024
“The idea of having to source and pay for … increased staffing without funding is completely ridiculous and will lead to SNFs slashing beds and shuttering across the country. I believe that if major changes are not implemented now, we will see closures of at least 25% to 50% of the current nursing homes in the next five to 10 years.”
— McKnight’s Long-Term Care News, January 08, 2024
KFF: Nursing Home Deficiencies Jumped Almost 10% Since 2015 and Staffing Levels Are To Blame
“While there is ample evidence that higher levels of staffing are associated with better quality and fewer deficiencies in care, there are ongoing questions about how such care will be financed and whether there are sufficient workers to meet the needs of an aging population, in nursing facilities and in other settings.”
— Skilled Nursing News, January 05, 2024
