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Nursing Home Staffing Ratio Lookup
Search 15,000+ U.S. nursing homes by facility name, city, or ZIP code. See RN, LPN, and CNA hours per resident per day — compared to your state and national CMS averages.
3.89
Total HPRD
national avg
0.69
RN HPRD
national avg
0.94
LPN HPRD
national avg
2.27
CNA HPRD
national avg
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State-level staffing averages, top facilities, and city breakdowns.
How to Read Staffing Data
RN Hours (HPRD)
Registered Nurse hours per resident per day. RN oversight drives care quality — advocates should target ≥ 1.0 hr/day. National average: 0.69.
LPN/CNA Hours
Licensed practical nurses handle medication management; CNAs deliver direct hands-on care (bathing, feeding, mobility). Combined target: ≥ 3.5 hr/day.
Weekend Staffing
Weekend RN hours often drop 10–20% below weekday levels. Facilities that maintain consistent 7-day staffing typically have better outcomes.
Federal & State Minimum Staffing Requirements
CMS finalized a federal minimum staffing rule in 2024 — the first-ever federal floor. Several states have adopted higher minimums that exceed it.
| State / Jurisdiction | Min Total HPRD | Min RN HPRD | RN On-Site Req. |
|---|---|---|---|
| Federal (CMS 2024 Rule) | 3.48 | 0.55 | 24 hrs/day |
| California | 3.50 | 1.00* | 24 hrs/day |
| Minnesota | 3.70 | 0.65 | 24 hrs/day |
| Massachusetts | 3.58 | 0.55 | 24 hrs/day |
| New York | 3.50 | 0.55 | 24 hrs/day |
| New Jersey | 3.00† | 0.55 | 24 hrs/day |
| All other states | ≥ 3.48 | ≥ 0.55 | 24 hrs/day |
* California measures direct-care hours per patient day; 1.0 RN HPRD applies to skilled nursing facilities. † New Jersey state rule predates the federal floor and is being updated to comply. Source: CMS, 88 Fed. Reg. 13740 (Apr. 2024); state health codes.
Frequently Asked Questions
- What are nursing home staffing ratios?
- Staffing ratios measure how many hours of care each nursing home resident receives daily from registered nurses (RN), licensed practical nurses (LPN), and certified nursing assistants (CNA). They are expressed as hours per resident per day (HPRD). Higher HPRD generally means more individualized care.
- What is the national average nursing home staffing level?
- As of 2024, the CMS national average is approximately 3.89 total nursing hours per resident per day (HPRD), with 0.69 RN hours, 0.94 LPN hours, and 2.27 CNA hours. Facilities above these averages are generally better staffed.
- Does CMS require a minimum staffing level?
- Yes. CMS finalized a federal minimum staffing rule in 2024 requiring at least 3.48 total nursing HPRD and 0.55 RN HPRD, with RN on-site 24 hours per day. Many state regulations set higher minimums — California requires the most at 3.5 HPRD of direct care.
- What is a good RN staffing level for a nursing home?
- Research consistently links higher RN HPRD to better resident outcomes. Facilities with 1.0+ RN HPRD are generally considered well-staffed. The federal minimum (0.55) and national average (0.69) are floors — advocate for facilities at or above 1.0 when possible.
- How is staffing data collected?
- CMS collects staffing data quarterly through the Payroll-Based Journal (PBJ) system — a direct payroll submission requirement that replaced self-reported data in 2016. PBJ data is more accurate than older self-reported figures and is updated in the Care Compare database.
- Does weekend staffing differ from weekday?
- Yes — studies consistently show nursing homes staff 10–20% fewer RN hours on weekends than weekdays. This is a significant quality indicator; low weekend RN coverage is associated with higher emergency transfer rates. Our tool shows weekend RN HPRD separately.
- What does staff turnover mean for nursing home quality?
- High staff turnover (the national average is ~52% annually) disrupts care continuity, increases injury rates, and correlates with lower CMS star ratings. Facilities with turnover below 30% typically provide more consistent, higher-quality care.
- What is the difference between CMS staffing rating and HPRD?
- The CMS staffing star rating (1–5) is a composite that compares a facility's case-mix-adjusted HPRD to national averages. The raw HPRD numbers give more granular insight — a 3-star facility might still have adequate RN staffing while a 4-star facility could be stronger in CNA hours.
Data source: CMS Payroll-Based Journal (PBJ) via CMS Care Compare. Updated quarterly. Not a substitute for professional care advice.