Nebraska's statewide staffing ratio is 4.01 HPRD in Q1 2026. Nebraska's statewide staffing ratio is down slightly (−0.03) since Q1 2025. This level is above the national ratio of 3.75 HPRD and ranks #15 out of 51 states.
Nebraska
Direct staff excludes Admin/DON. Direct staff excludes Admin/DON.
Nebraska
Nebraska
Nebraska
47 facilities flagged for staffing or quality concerns.
| Facility | City | CMS ratings | Risk flags | Total HPRD |
|---|---|---|---|---|
| Accura Healthcare of KenesawKenesaw | Kenesaw | 1★ | 2.86 HPRD | |
| Accura Healthcare of NelighNeligh | Neligh | 1★1★S | 4.01 HPRD | |
| Accura Healthcare of TekamahTekamah | Tekamah | 1★1★S | 2.91 HPRD | |
| Adept Nursing & Rehab of Blue HillBlue Hill | Blue Hill | 1★ | 3.62 HPRD | |
| Adept Nursing & Rehab of Grand IslandGrand Island | Grand Island | 1★1★S | 2.86 HPRD |
Latest state staffing metrics for Nebraska.
| Metric | Nebraska | CMS Region 7CMS Region 7 includes Iowa, Kansas, Missouri, and Nebraska.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 | 4.01 | 3.66-0.35 vs NE | 3.75-0.27 vs NE | #15 of 51 |
| Direct Care Nurse HPRD | 3.74 | 3.41-0.33 vs NE | 3.48-0.27 vs NE | #13 of 51 |
| RN HPRD | 0.66 | 0.56-0.10 vs NE | 0.62-0.04 vs NE | #28 of 51 |
| RN Direct Care HPRD | 0.45 | 0.38-0.07 vs NE | 0.44-0.01 vs NE | #31 of 51 |
| Nurse Aide HPRD | 2.66 | 2.45-0.21 vs NE | 2.26-0.40 vs NE | #7 of 51 |
| Contract Staff Percentage | 7.1% | 4.7%-2.4 pts vs NE | 5.3%-1.8 pts vs NE | #17 of 51 |
| Median Case-Mix HPRD (Acuity) | — | 3.42 | 3.74 | #39 of 51 |
| Rural Facilities (Share) | 64% | 52%-12.7 pts vs NE | 27%-37.1 pts vs NE | #9 of 51 |
State rank reflects the displayed value, not necessarily stronger or weaker performance.
Largest organizations linked to facilities in CMS owner data.
Most facilities linked in CMS owner data (Nebraska).
| Organization | Facilities |
|---|---|
| Aaron J Dunlap | 21 |
| Brian W Stuhr | 21 |
| Eldora D Vetter | 21 |
| Glenn A Vanekeren | 21 |
| Jack D Vetter | 21 |
| Vetter Senior Living | 21 |
| Vsl Vetter Health Services LLC | 21 |
| Ari Silberstein | 11 |
Recent CMS change-of-ownership activity.
37 ownership changes at 37 Nebraska facilities · 01/01/2016 – 02/01/2026.
Showing 10 of 37
Daily PBJ data, employee rosters, and facility-level analysis.
Staffing from CMS Payroll-Based Journal (PBJ) public files (2017–2026), plus Provider Information and chain data where shown. State staffing context via MACPAC (2022). Methodology · PBJ explained.
Metrics
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.