Iowa PBJ Nursing Home StaffingIowa PBJ Staffing
386 providers • 19,956 residents • 3.81 HPRD
3.81 HPRD (rank: 27)0.71 RN HPRD4.2% contractIA Min. ~1.76-2.06 HPRD
Iowa reported 3.81 HPRD (≈ 6.3 residents per total staff) in Q3 2025. HPRD is up 0.03 since Q3 2024. This level is near the national ratio of 3.77 HPRD and ranks #27 out of 51 states.
Put another way… On a 30-bed floor at a typical Iowa nursing home you'd see about 4.8 staff members, including 3.2 nurse aides. For the entire 52-resident facility (Iowa average), that's about 8.3 total staff, including 5.5 nurse aides.
Iowa
Direct staff excludes Admin/DON. State min. (~1.76-2.06 HPRD) may reflect calculated equivalents by MACPAC. Direct staff excludes Admin/DON. State min. (~1.76-2.06 HPRD) may reflect calculated equivalents by MACPAC.
Iowa
Iowa
Iowa
Iowa PBJ Metrics
| Metric | Value | National Rank |
|---|---|---|
| Total Nurse Staffing HPRD | 3.81 | #27 of 51 |
| Direct Care Nurse HPRD | 3.53 | #28 of 51 |
| RN HPRD | 0.71 | #20 of 51 |
| RN Direct Care HPRD | 0.49 | #24 of 51 |
| Nurse Aide HPRD | 2.54 | #14 of 51 |
| Contract Staff Percentage | 4.2% | — |
Special Focus Facilities
Iowa has facilities in the Special Focus Facility program. Select a tab to view Current SFFs, Candidates, Graduates, or facilities no longer in Medicare/Medicaid.
| Facility | Months | Residents | Total HPRD | Ownership |
|---|---|---|---|---|
| Garden View Care Center (Shenandoah) | 8 | 36 | 3.66 | For-Profit |
| Pine Acres Rehabilitation and Care Center (West Des Moines) | 10 | 80 | 2.86 | For-Profit |
Methodology
This dashboard uses CMS Payroll-Based Journal (PBJ) data (2017–2025), along with other public datasets (Provider Information, Affiliated Entity). State staffing standards via MACPAC (2022).
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.
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