We track Payroll-Based Journal records for 14,710 certified nursing facilities across 11 quarters of data — RN coverage, employee and contract hours, zero-RN days, weekend patterns, and turnover. This is the most granular staffing data CMS publishes, and we publish it back as research, reports, and reference data.
Nursing home staffing is the single most heavily documented operational metric in long-term care. CMS requires every certified facility to submit daily payroll records under Section 6106 of the Affordable Care Act, producing a dataset of 14.5 million daily records across 14,710 facilities. Other parts of facility operations — ownership, financials, quality — are reported at monthly, annual, or incident-based cadences. Staffing is reported every day.
The federal staffing benchmarks published in 2024 — 3.48 total hours per resident per day, 0.55 RN hours per resident per day, and 24/7 RN presence — remain the industry standard for evaluating staffing adequacy even after the federal mandate was repealed in December 2025. State-level enforcement now carries most of the accountability weight, and state minimums vary dramatically. Twelve states have no staffing floor at all. Five states fine facilities directly for understaffing. The remaining states rely on CMS survey findings as the primary enforcement mechanism.
Our work in this research area is to make the daily staffing data usable. We ingest the full PBJ dataset, normalize it against facility master records, split employee and contract hours across every nursing category, and compute composite scores from documented formulas. See the methodology page for how the data is built and the regulatory landscape for the state-by-state enforcement picture. Home health agency workforce intelligence — visit volume, VBP payment adjustments, and service area signals — is covered separately under the Industry research area.
14,710 facilities • 14.5M staffing records • 419K violations • 50 states
