This article reports on a second national survey of higher education institutions in the USA to answer the question "Who teaches mathematics content courses for prospective elementary teachers, and what are these instructors' academic and teaching backgrounds?" and addresses valuable information not collected with the first survey conducted in 2010. We surveyed 1740 institutions and a faculty member from each of 413 institutions (23.7%) participated in the survey. The survey results demonstrate that the majority of these institutions are not meeting the recommendations of the Conference Board of Mathematical Sciences (2012) and the Association of Mathematics Teacher Educators (2017) for prospective elementary teachers to take at least 12 semester-hour credits of mathematics content designed specifically for them. The data do indicate that there is movement toward more activity-based approaches for these courses as compared to the 2010 survey. Additionally, there is an increase in these courses having instructors with doctorates in mathematics education as well as an increase in instructors having grades 7-12 teaching experience. Most instructors for these courses do not have elementary teaching experience and have likely not had opportunities to think deeply about the important ideas in elementary mathematics. While most institutions still do not provide training and/or support for these instructors, formalized support and training appear to be increasing since the 2010 survey.