Columbia Senior AdvisorBy Columbia Senior Advisor Care Team · September 12, 2026
Across the 27 Midlands nursing homes with CMS payroll data, total nurse staffing runs from 2.96 to 7.39 hours per resident per day, with a median of 3.83. Median nursing staff turnover is 45.8%.
Why staffing matters more than a single star
CMS's overall rating blends three things: health inspections, staffing and quality measures. A home can earn a respectable overall score while its staffing sits near the bottom, and staffing is what residents feel at 6 a.m. when they need help to the bathroom. Since 2016 CMS has drawn staffing from payroll records rather than self-reported snapshots, which makes the numbers harder to dress up.
Two figures matter most: total nurse staffing hours per resident per day, which counts registered nurses, licensed practical nurses and nurse aides together, and turnover, the share of nursing staff who left over a year. High hours with low turnover usually mean residents see the same faces.
The Midlands numbers, home by home
This table lists every certified home in the six counties with reported staffing, sorted from most to fewest nursing hours:
Source: CMS Care Compare Provider Information, data as of October 1, 2026.
Reading the spread
Homes at the top of the table are often small, church-affiliated or attached to a retirement campus, where long-stay residents dominate and budgets allow richer staffing. Homes near the bottom are more often large, short-stay rehab operations where the census turns over quickly. Neither pattern is a rule, and the table is a starting point for questions, not a verdict.
Turnover deserves its own look. A home with 46% turnover replaces nearly half its nursing staff in a year. Ask how many aides on each shift are agency staff and how long the night charge nurse has been there.
What staffing data cannot tell you
Payroll hours are averages across the building and the quarter. They do not show whether a particular hall is short on a particular weekend, how well aides are trained in dementia care, or whether the same aide is assigned to your parent each day. They also lag: a home that changed operators recently may look very different now.
That is why the visit still matters. Go at a mealtime and again in the evening, count staff on the hall, and watch how long call lights stay on.
Using the numbers on a tour
Take the home's row from the table to the tour. If hours are below the Midlands median, ask how the home covers bathing and meals with fewer hands. If turnover is high, ask about retention bonuses and how new aides are oriented. If RN hours are low, ask who assesses a resident whose condition changes at night.
Every nursing home page on this site shows the same figures with the median beside them, plus the latest inspection date, deficiency counts and any DPH enforcement order.
How staffing connects to the outcomes families care about
Research on nursing homes has linked higher nurse staffing, and especially registered nurse time, to fewer pressure ulcers, fewer hospital readmissions and better infection control. That is why CMS weights staffing in its star ratings and why South Carolina inspectors pay attention to whether care plans are actually carried out on every shift.
For a family, the link is more practical. A hall with enough aides answers call lights in minutes rather than half an hour, gets residents up for breakfast, and has time to walk with a resident instead of using a wheelchair for convenience. When you visit, ask how many residents each aide is assigned on day, evening and night shifts. The answer is easier to picture than hours per resident per day.
Frequently asked questions
What is a good nurse staffing level for a nursing home?
There is no single right number, but the Midlands median is 3.83 total nurse hours per resident per day; homes well above it generally have more hands available.
Where does CMS get staffing data?
From payroll-based journal records that nursing homes submit to CMS each quarter.
Does South Carolina publish nursing home staffing?
Staffing data for certified homes comes from CMS; DPH licenses and inspects homes and publishes enforcement orders.
Is high turnover always a bad sign?
Not always, but it usually means residents see more unfamiliar caregivers, so ask how the home trains and keeps staff.
What does RN hours per resident per day mean?
It is the average time registered nurses spend per resident each day, from CMS's payroll data; RNs assess changes in condition and supervise care.
Which Midlands nursing home reports the most nursing hours?
In the current CMS data, South Carolina Episcopal Home at Still Hope reports the most total nurse staffing hours per resident per day among Midlands homes.
