Knoxville Senior AdvisorBy Knoxville Senior Advisor Care Team · September 24, 2026
The median certified nursing home in the seven counties reports 3.49 total nurse hours per resident per day and 52.9% nursing staff turnover. 6 homes report turnover above 60%. Staffing is the CMS figure most worth asking about on a visit.
Why staffing numbers matter
Families judge a nursing home by how quickly a call light is answered and whether the aide knows their mother's name. Both depend on how many people are working and how long they stay. CMS collects payroll data from every certified nursing home, which makes staffing one of the few quality measures built on records rather than self-reported surveys.
We took CMS's Provider Information file dated October 1, 2026 for the 30 certified homes in Knox, Blount, Anderson, Loudon, Sevier, Roane and Union counties.
The table
Hours are total nurse staffing (registered nurses, licensed practical nurses and nurse aides) per resident per day, as reported. Turnover is the share of nursing staff who left over a year. The staffing rating is CMS's one-to-five-star score.
How to read it
Short-stay units score high on hours almost by design. Transitional care units attached to hospitals and Medicare-only rehab homes care for sicker, shorter-stay patients, and CMS adjusts its staffing star for that mix while the raw hours in this table are not adjusted. Compare long-term homes with long-term homes.
Turnover is the more revealing number for long stays. A home losing more than half its nursing staff each year is constantly training new aides, which shows up in small ways: a missed preference, a skipped walk, a call light that rings longer.
Questions to ask
Ask how many residents each aide is assigned on day, evening and night shifts, and on weekends. Ask what share of the staff are agency workers. Ask how long the director of nursing and the night charge nurse have been there. Ask what the home is doing about turnover, if it is high, and be skeptical of answers that blame the labor market alone.
Then visit at 7 p.m. on a weekday and on a Saturday morning. The difference between those visits and a scheduled Tuesday tour is the most honest staffing data you will get.
Administrator turnover
CMS also counts how many administrators have left each home during its measurement period. Leadership changes ripple down: new administrators bring new policies, and frequent changes can unsettle staff. Each home's page on this site shows the count where CMS reports it. Ask how long the current administrator and director of nursing have been in their roles, and what the plan is if either leaves.
A home with steady leadership and moderate turnover is often a better long-term bet than one with impressive hours but a revolving door at the top.
Weekend staffing
CMS reports weekend nurse staffing separately because many homes run thinner on Saturdays and Sundays. Compare a home's weekend hours with its weekday total on its page. A large drop is worth a direct question, and a weekend visit is worth the trip.
Where this fits with ratings
CMS's overall star rating blends inspections, staffing and quality measures. A home can earn a good overall rating with average staffing, or a weak one despite strong hours because of an inspection result. Each home's page on this site shows the ratings, hours, turnover, deficiencies and fines side by side with the seven-county medians.
Frequently asked questions
What is a good nurse staffing level for a nursing home?
There is no single target, but the seven-county median is 3.49 total nurse hours per resident per day; compare long-term homes with similar residents.
Why does a hospital transitional care unit have such high staffing?
It cares for short-stay patients recovering from hospital treatment, who need more nursing time. Raw hours are not adjusted for that.
Where does this data come from?
CMS's Care Compare Provider Information file, built from payroll-based journal submissions by each certified home.
