California PBJ Nursing Home StaffingCalifornia PBJ Staffing
1,059 providers • 92,782 residents • 4.37 HPRD
4.37 HPRD (rank: 5)4.37 HPRD · Rk 50.59 RN HPRD2.3% contract
California's statewide staffing ratio is 4.37 HPRD in Q4 2025. California's statewide staffing ratio is up (+0.06) since Q4 2024. This level is above the national ratio of 3.76 HPRD and ranks #5 out of 51 states.
California
Direct staff excludes Admin/DON. State min. (~3.56 HPRD) may reflect calculated equivalents by MACPAC. Direct staff excludes Admin/DON. State min. (~3.56 HPRD) may reflect calculated equivalents by MACPAC.
California
California
California
CA Staffing Stats
| Metric | California | CMS Region 9CMS Region 9 includes American Samoa, Arizona, California, FM, Guam, Hawaii, MH, the Northern Mariana Islands, Nevada, and PW.Regional figures are calculated from facility-level data using the same methodology as the state figures. | U.S. | State rankRanks compare the 50 states and D.C. by the displayed metric value. A higher or lower rank is not inherently positive or negative for every metric, including contract staffing share and rural-facility share. |
|---|---|---|---|---|
| Total Nurse Staffing HPRD | 4.37 | 4.31-0.06 vs CA | 3.76-0.60 vs CA | #5 of 51 |
| Direct Care Nurse HPRD | 4.11 | 4.04-0.06 vs CA | 3.50-0.61 vs CA | #5 of 51 |
| RN HPRD | 0.59 | 0.63+0.05 vs CA | 0.62+0.03 vs CA | #40 of 51 |
| RN Direct Care HPRD | 0.46 | 0.50+0.03 vs CA | 0.43-0.03 vs CA | #27 of 51 |
| Nurse Aide HPRD | 2.62 | 2.56-0.06 vs CA | 2.28-0.33 vs CA | #8 of 51 |
| Contract Staff Percentage | 2.3% | 2.5%+0.2 pts vs CA | 5.3%+3.0 pts vs CA | #46 of 51 |
| Median Case-Mix HPRD (Acuity) | 4.00 | 3.88-0.12 vs CA | 3.74-0.26 vs CA | #11 of 51 |
| Rural Facilities (Share) | 3% | 5%+1.7 pts vs CA | 27%+24.0 pts vs CA | #48 of 51 |
PBJ320 High-Risk (252)
PBJ320 high-risk PBJ320 high-risk uses CMS-assigned indicators only (PBJ320 does not assign them): Special Focus Facility or SFF Candidate; abuse icon; one-star overall; one-star staffing. nursing homes in California (252 facilities).
| Facility | Census | CMS ratings | Indicators | Total HPRD |
|---|---|---|---|---|
| Loading facilities… | ||||
Methodology
Staffing from CMS Payroll-Based Journal (PBJ) public files (2017–2025), plus Provider Information and chain data where shown. State staffing context via MACPAC (2022). Methodology · PBJ explained.
Metrics
- Hours Per Resident Day (HPRD): Total staff hours ÷ average residents. Example: 350 hours for 100 residents = 3.5 HPRD.
- Direct Care (excl. Admin, DON): Hours per resident day for direct care staff only (RN, LPN, CNA, NAtrn, MedAide), excluding administrative and supervisory roles.
- Contract Staff %: Share of hours provided by contract staff.
- Census: Average number of residents during the period.
Note: Some states set minimums (e.g., NJ, CA, NY at 3.5 HPRD); a federal 3.48 minimum was recently overturned (2025). A 2001 federal study linked 4.1 HPRD to better outcomes in that study. Staffing needs vary by resident acuity (case-mix), day, and shift. Estimates on PBJ Takeaway assume roughly 60% of staff are CNAs.
Data transparency
The PBJ Dashboard pulls directly from CMS data and is carefully vetted for accuracy. Still, sometimes a bug sneaks into the jelly. That could mean: a systemic CMS data reporting issue (e.g., Q2 2017 contract staffing, missing data in 2020 due to COVID) or there could be a coding error on our part. If you spot something that looks off, please let me know via the contact form so I can set things right.
Trend charts omit quarters with implausible submitted HPRD (total/direct below 0.25; RN, LPN, and aide use role floors and neighbor-quarter rules). Full criteria.
Rankings, within-state percentiles, CMS flags (including abuse icon): How metrics are calculated.