Tennessee PBJ Nursing Home StaffingTennessee PBJ Staffing

301 providers • 24,802 residents • 3.79 HPRD

Phoebe J
PBJ Takeaway: Tennessee

3.79 HPRD (rank: 31)0.57 RN HPRD3.6% contractTN Min. ~2.06 HPRD

Tennessee reported 3.79 HPRD (≈ 6.3 residents per total staff) in Q3 2025. HPRD is up 0.06 since Q3 2024. This level is near the national ratio of 3.77 HPRD and ranks #31 out of 51 states.

Put another way… On a 30-bed floor at a typical Tennessee nursing home you'd see about 4.7 staff members, including 2.7 nurse aides. For the entire 82-resident facility (Tennessee average), that's about 13.0 total staff, including 7.4 nurse aides.

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Total Staffing: Tennessee
Total Staffing

Tennessee

Tennessee Total Staffing

Direct staff excludes Admin/DON. State min. (~2.06 HPRD) may reflect calculated equivalents by MACPAC. Direct staff excludes Admin/DON. State min. (~2.06 HPRD) may reflect calculated equivalents by MACPAC.

RN Staffing: Tennessee
RN Staffing

Tennessee

Tennessee RN Staffing
Resident Census: Tennessee
Resident Census

Tennessee

Tennessee Resident Census
Contract Staff %: Tennessee
Contract Staff %

Tennessee

Tennessee Contract Staff %
Tennessee PBJ Metrics
MetricValueNational Rank
Total Nurse Staffing HPRD3.79#31 of 51
Direct Care Nurse HPRD3.50#30 of 51
RN HPRD0.57#42 of 51
RN Direct Care HPRD0.37#42 of 51
Nurse Aide HPRD2.15#42 of 51
Contract Staff Percentage3.6%
Special Focus Facilities

Tennessee 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
Eaton Creek Post Acute (Nashville)4963.69For-Profit
Church Hill Post-Acute and Rehabilitation Center (Church Hill)3953.83For-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.

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