Massachusetts PBJ Nursing Home StaffingMassachusetts PBJ Staffing

339 providers • 33,019 residents • 3.81 HPRD

Phoebe J
PBJ Takeaway: Massachusetts

3.81 HPRD (rank: 28)0.61 RN HPRD5.7% contractMA Min. ~3.64 HPRD

Massachusetts reported 3.81 HPRD (≈ 6.3 residents per total staff) in Q3 2025. HPRD is up 0.04 since Q3 2024. This level is near the national ratio of 3.77 HPRD and ranks #28 out of 51 states.

Put another way… On a 30-bed floor at a typical Massachusetts nursing home you'd see about 4.8 staff members, including 2.8 nurse aides. For the entire 97-resident facility (Massachusetts average), that's about 15.4 total staff, including 9.1 nurse aides.

320 Consulting
Total Staffing: Massachusetts
Total Staffing

Massachusetts

Massachusetts Total Staffing

Direct staff excludes Admin/DON. State min. (~3.64 HPRD) may reflect calculated equivalents by MACPAC. Direct staff excludes Admin/DON. State min. (~3.64 HPRD) may reflect calculated equivalents by MACPAC.

RN Staffing: Massachusetts
RN Staffing

Massachusetts

Massachusetts RN Staffing
Resident Census: Massachusetts
Resident Census

Massachusetts

Massachusetts Resident Census
Contract Staff %: Massachusetts
Contract Staff %

Massachusetts

Massachusetts Contract Staff %
Massachusetts PBJ Metrics
MetricValueNational Rank
Total Nurse Staffing HPRD3.81#28 of 51
Direct Care Nurse HPRD3.49#32 of 51
RN HPRD0.61#35 of 51
RN Direct Care HPRD0.42#35 of 51
Nurse Aide HPRD2.24#36 of 51
Contract Staff Percentage5.7%
Special Focus Facilities

Massachusetts has facilities in the Special Focus Facility program. Select a tab to view Current SFFs, Candidates, Graduates, or facilities no longer in Medicare/Medicaid.

FacilityMonthsResidentsTotal HPRDOwnership
Medway Country Manor Skilled Nursing & Rehabilitat (Medway)11133.28For-Profit
Pine Knoll Nursing Center (Lexington)3683.40For-Profit

Source: CMS Special Focus Facility program

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.

Request custom PBJ analysis for litigation and investigative reporting.Request custom PBJ analysis.