Puerto Rico PBJ Nursing Home StaffingPuerto Rico PBJ Staffing
Puerto Rico's statewide staffing ratio is 3.47 HPRD in Q1 2026. Puerto Rico's statewide staffing ratio is down (−0.72) since Q1 2025. This level is below the national ratio of 3.75 HPRD.
- Q2 2025: 3.11
- Q3 2025: 2.89
- Q4 2025: 3.54
- Q1 2026: 3.47
Puerto Rico
Direct staff excludes Admin/DON. Direct staff excludes Admin/DON.
Puerto Rico
Puerto Rico
Puerto Rico
Explore Puerto Rico
PBJ320 High-risk facilities in Puerto Rico PBJ320 high-risk uses CMS-assigned indicators only (PBJ320 does not assign them): Special Focus Facility or SFF Candidate; abuse icon; one-star overall; one-star staffing.
2 facilities flagged for staffing or quality concerns.
| Facility | City | CMS ratings | Risk flags | Total HPRD |
|---|---|---|---|---|
| Centro De Cuidado Prolongado San LucasRio Piedras | Rio Piedras | 1★1★S | — | |
| Multy Medical Skilled Nursing FacilityRio Piedras | Rio Piedras | 1★ | 1.89 HPRD |
Staffing snapshot
Latest state staffing metrics for Puerto Rico.
| Metric | Puerto Rico | CMS Region 2CMS Region 2 includes New Jersey, New York, Puerto Rico, and the U.S. Virgin Islands.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 | 3.47 | 3.59+0.12 vs PR | 3.75+0.27 vs PR | — |
| Direct Care Nurse HPRD | 2.97 | 3.39+0.42 vs PR | 3.48+0.51 vs PR | — |
| RN HPRD | 2.82 | 0.66-2.16 vs PR | 0.62-2.20 vs PR | — |
| RN Direct Care HPRD | 2.34 | 0.50-1.84 vs PR | 0.44-1.90 vs PR | — |
| Nurse Aide HPRD | 0.00 | 2.16+2.16 vs PR | 2.26+2.26 vs PR | — |
| Contract Staff Percentage | 5.2% | 10.3%+5.2 pts vs PR | 5.3%+0.1 pts vs PR | — |
| Median Case-Mix HPRD (Acuity) | — | 3.78 | 3.74 | — |
| Rural Facilities (Share) | 0% | 8%+8.1 pts vs PR | 27%+27.3 pts vs PR | #52 of 51 |
State rank reflects the displayed value, not necessarily stronger or weaker performance.
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How these figures are calculatedMethods, definitions, and data sources
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
- 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.