Georgia looks manageable on total staffing hours — 51.6% fall below the 3.48 HPRD benchmark. But the RN-specific data reveals a different story: 65.5% of Georgia nursing homes are below the 0.55 RN benchmark. Facilities are meeting aggregate hours by loading up on CNAs while registered nurse coverage remains critically thin. No state HPRD floor amplifies the risk.
Georgia sets no minimum hours per resident day. Only the federal RN presence standard applies: 8 consecutive hours on-site per day. No numerical HPRD threshold exists at the state level.
51.6% of Georgia facilities fail total HPRD but 65.5% fail the RN benchmark — a 14-point divergence. Facilities are substituting CNAs for RN hours, masking the severity of the clinical staffing gap.
Georgia recorded 326 CMS penalty actions over three years including 15 penalties of $100,000 or more. Fulton County (Atlanta) has the highest facility concentration and shows 72% below the RN benchmark.
| County | Facilities | Avg HPRD | RN HPRD | Below 3.48 | Below 0.55 RN | Zero-RN Days | Stability Score |
|---|---|---|---|---|---|---|---|
| Fulton | 18 | 3.49 | 0.411 | 12 (67%) | 13 (72%) | 0.1 | 81.3 |
| De Kalb | 17 | 3.77 | 0.529 | 7 (41%) | 10 (59%) | 0.2 | 82.0 |
| Cobb | 13 | 3.65 | 0.488 | 6 (46%) | 10 (77%) | 0.0 | 83.1 |
| Chatham | 11 | 3.9 | 0.601 | 5 (45%) | 7 (64%) | 0.4 | 78.0 |
| Gwinnett | 11 | 4.03 | 0.63 | 2 (18%) | 4 (36%) | 0.2 | 82.2 |
| Bibb | 11 | 3.44 | 0.403 | 7 (64%) | 9 (82%) | 0.2 | 81.3 |
| Richmond | 10 | 3.69 | 0.566 | 3 (30%) | 5 (50%) | 0.0 | 80.8 |
| Floyd | 8 | 4.02 | 0.62 | 2 (25%) | 5 (63%) | 1.3 | 78.8 |
| Muscogee | 7 | 4.62 | 0.564 | 0 (0%) | 4 (57%) | 0.1 | 81.1 |
| Houston | 5 | 4.24 | 0.4 | 1 (20%) | 4 (80%) | 0.6 | 77.1 |
| Hall | 5 | 3.63 | 0.536 | 2 (40%) | 2 (40%) | 0.0 | 81.7 |
| Glynn | 5 | 4.45 | 0.854 | 2 (40%) | 1 (20%) | 0.0 | 81.3 |
| Baldwin | 4 | 3.87 | 0.894 | 2 (50%) | 3 (75%) | 0.5 | 79.3 |
| Clarke | 4 | 3.34 | 0.4 | 3 (75%) | 3 (75%) | 0.0 | 80.9 |
| Clayton | 4 | 3.32 | 0.287 | 3 (75%) | 4 (100%) | 0.0 | 82.1 |
Georgia’s hidden RN gap creates strong agency demand. With 65.5% below the RN benchmark and only 3.07% average contract dependency, there is significant unmet demand for RN and clinical staffing — especially in the Atlanta metro.
Facilities that look adequately staffed on total HPRD but fail the RN benchmark are often under-rated by CMS — and potentially undervalued by sellers who don’t see the gap. Our data surfaces these opportunities across all 351 Georgia facilities.
Total HPRD compliance can mask RN-specific deficits. Georgia operators need facility and county-level RN benchmarks to accurately assess their competitive position and anticipate survey risk.
