Nebraska PBJ Nursing Home StaffingNebraska PBJ Staffing
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.
- Q2 2025: 4.15
- Q3 2025: 4.15
- Q4 2025: 4.09
- Q1 2026: 4.01
Staffing hours per resident day for Nebraska, calculated by PBJ320 from CMS’s quarterly PBJ nurse staffing files.
Nebraska
Direct staff excludes Admin/DON. Direct staff excludes Admin/DON.
Nebraska
Nebraska
Nebraska
Explore Nebraska
PBJ320 High-risk facilities in Nebraska
52 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 O'NeillO' Neill | O' Neill | 1★ | 3.77 HPRD | |
| Accura Healthcare of TekamahTekamah | Tekamah | 1★1★S | 2.91 HPRD | |
| Adept Nursing & Rehab of Blue HillBlue Hill | Blue Hill | 1★ | — |
Staffing snapshot
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%-12.8 pts vs NE | 27%-37.1 pts vs NE | #9 of 51 |
State rank reflects the displayed value, not necessarily stronger or weaker performance.
Ownership groups in Nebraska
Most facilities linked in CMS owner data (Nebraska).
Ownership changes in Nebraska
37 ownership changes at 37 Nebraska facilities · 01/01/2016 – 02/01/2026.
Showing 10 of 37
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How these figures are calculatedMethods, definitions, and data sources
Staffing from CMS Payroll-Based Journal (PBJ) public nurse files (2017–2026), plus Provider Information (September 2026 processing snapshot) and chain data where shown. State staffing context via March 2022 compendium. Methodology · PBJ guide.
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.