Illinois requires 3.8 HPRD for skilled nursing facilities — the highest state minimum in the country. But 56% of facilities still fall below the 3.48 industry benchmark. The reason is Cook County: 200 facilities averaging just 3.40 HPRD with 60% below benchmark. Outside Chicago, suburban counties show strong RN coverage but thin total hours. At 5.64% contract staffing, Illinois has meaningful agency demand already in place.
210 ILCS 45: 3.8 HPRD for skilled nursing facilities, 2.5 HPRD for intermediate care. IDPH conducts annual inspections with unannounced surveys.
Cook County alone accounts for 30% of all Illinois nursing homes. Average HPRD is 3.40 — below even the 3.48 industry benchmark, let alone the state’s own 3.8 requirement. 120 facilities are non-compliant on total hours.
Despite the total hour gap, Illinois has strong registered nurse coverage. Suburban counties like Du Page (1.075), Kane (0.986), and Lake (0.967) lead the state. The problem is total hours, not nurse composition.
| County | Facilities | Avg HPRD | RN HPRD | Below 3.48 | Below 0.55 RN | Zero-RN Days | Stability Score |
|---|---|---|---|---|---|---|---|
| Cook | 200 | 3.40 | 0.800 | 120 (60%) | 70 (35%) | 0.0 | 83.7 |
| Du Page | 38 | 3.64 | 1.075 | 15 (39%) | 2 (5%) | 0.0 | 83.1 |
| Kane | 25 | 3.56 | 0.986 | 13 (52%) | 2 (8%) | 0.0 | 83.1 |
| Lake | 24 | 3.77 | 0.967 | 13 (54%) | 1 (4%) | 0.0 | 85.2 |
| Madison | 17 | 3.49 | 0.510 | 10 (58%) | 11 (64%) | 0.2 | 80.9 |
| Will | 16 | 3.38 | 0.776 | 68% | 37% | 0.2 | 81.6 |
| St. Clair | 15 | 3.53 | 0.419 | 53% | 73% | 1.1 | 79.0 |
| Winnebago | 13 | 3.75 | 0.699 | 46% | 30% | 0.0 | 82.8 |
| Peoria | 11 | 3.53 | 0.518 | 54% | 63% | 0.6 | 83.1 |
| McHenry | 10 | 3.94 | 1.152 | 50% | 0% | 0.2 | 82.8 |
| La Salle | 9 | 3.59 | 0.799 | 33% | 11% | 0.0 | 83.1 |
| Tazewell | 8 | 3.45 | 0.501 | 50% | 75% | 0.8 | 80.2 |
| Rock Island | 8 | 3.47 | 0.449 | 50% | 75% | 0.0 | 84.1 |
| Sangamon | 8 | 3.41 | 0.515 | 62% | 50% | 2.1 | 78.7 |
| Whiteside | 7 | 2.91 | 0.542 | 57% | 71% | 0.3 | 78.3 |
Illinois already has established agency demand at 5.64% — and 370 facilities that can’t meet the 3.48 benchmark with permanent staff alone. Cook County is the single largest concentration of understaffed facilities in the Midwest.
200 facilities in one county, 60% below benchmarks, with the highest state requirement in the country. Any operator who can improve staffing in Cook County has a clear path to star rating improvements and valuation gains.
No other state demands more nursing hours per resident. Our data shows exactly where each facility stands relative to the state’s 3.8 requirement and county peers — before IDPH tells you.
