Missouri PBJ Nursing Home StaffingMissouri PBJ Staffing
478 providers • 34,751 residents • 3.39 HPRD
3.39 HPRD (rank: 49)0.40 RN HPRD3.9% contract
Missouri reported 3.39 HPRD (≈ 7.1 residents per total staff) in Q3 2025. HPRD is up 0.11 since Q3 2024. This level is below the national ratio of 3.77 HPRD and ranks #49 out of 51 states.
Put another way… On a 30-bed floor at a typical Missouri nursing home you'd see about 4.2 staff members, including 2.9 nurse aides. For the entire 73-resident facility (Missouri average), that's about 10.3 total staff, including 7.0 nurse aides.
Missouri
Direct staff excludes Admin/DON. Direct staff excludes Admin/DON.
Missouri
Missouri
Missouri
Missouri PBJ Metrics
| Metric | Value | National Rank |
|---|---|---|
| Total Nurse Staffing HPRD | 3.39 | #49 of 51 |
| Direct Care Nurse HPRD | 3.18 | #49 of 51 |
| RN HPRD | 0.40 | #48 of 51 |
| RN Direct Care HPRD | 0.27 | #48 of 51 |
| Nurse Aide HPRD | 2.32 | #29 of 51 |
| Contract Staff Percentage | 3.9% | — |
Special Focus Facilities
Missouri 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 |
|---|---|---|---|---|
| Lincoln County Nursing & Rehab (Troy) | 3 | 79 | 2.75 | For-Profit |
| Belleview Valley Nursing Home (Belleview) | 12 | 90 | 2.55 | For-Profit |
| Aspen Point Health and Rehabilitation (Saint Charles) | 21 | 54 | 3.13 | 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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