The Short Version
Across 14,358 nursing homes with at least 60 valid PBJ days, average total nurse staffing is 3.71 hours per resident day. Weekend staffing is 15.2% lower than weekdays on average, and contract or agency labor accounts for 5.3% of all measured nursing care hours nationally — though most facilities use far less (the typical facility relies on agency staff for under 5% of its hours, with reliance concentrated in a minority of homes).
Facilities
14,358
National HPRD
3.71
Weekend Drop
15.2%
Contract Share
5.3%
25 Largest Weekend Staffing Drops
Ranked by the largest percent decline in total nurse hours per resident day on Saturdays and Sundays versus weekdays.
| Rank | Facility | City / State | Weekend drop | HPRD | Contract | Score |
|---|---|---|---|---|---|---|
| 1 | MITCHELL COUNTY NURSING AND REHABILITATION CENTER | COLORADO CITY, TX | 77.2% | 1.66 | 0.0% | 20 |
| 2 | INDEPENDENCE CARE CENTER OF PERRY COUNTY | PERRYVILLE, MO | 65.8% | 1.26 | 0.0% | 20 |
| 3 | SHAKER PLACE REHABILITATION AND NURSING CENTER | ALBANY, NY | 60.5% | 3.01 | 0.0% | 24 |
| 4 | PARKDALE HEALTH AND REHAB | Price, UT | 54.8% | 3.25 | 2.8% | 16 |
| 5 | BEDFORD CO NURSING HOME | BEDFORD, VA | 50.9% | 0.23 | 0.0% | 20 |
| 6 | RIVERVIEW NURSING CENTER | MOKANE, MO | 46.6% | 1.94 | 0.0% | 20 |
| 7 | TYBEE ISLAND CARE CENTER LLC | TYBEE ISLAND, GA | 46.5% | 1.14 | 23.0% | 2 |
| 8 | RICHLAND BEAN BLOSSOM HEALTH CARE CENTER | ELLETTSVILLE, IN | 44.7% | 1.93 | 0.0% | 20 |
| 9 | BINGHAM MEMORIAL SKILLED NURSING & REHABILITATION | BLACKFOOT, ID | 43.9% | 8.04 | 0.0% | 45 |
| 10 | BLESSING HOSPITAL SNU | QUINCY, IL | 43.3% | 7.03 | 0.0% | 45 |
| 11 | PLEASANT MANOR NURSING & REHAB | ASHDOWN, AR | 42.7% | 4.46 | 0.0% | 42 |
| 12 | WYOMING RETIREMENT CENTER | Basin, WY | 41.9% | 0.81 | 0.0% | 20 |
| 13 | CLEVELAND PINES | Shelby, NC | 41.5% | 3.16 | 0.1% | 20 |
| 14 | GOLDEN VILLA | ATLANTA, TX | 41.1% | 2.62 | 2.6% | 11 |
| 15 | OAKLAND NURSING CENTER | Southfield, MI | 40.8% | 0.51 | 0.0% | 20 |
| 16 | PORTAGEPOINTE | Hancock, MI | 40.7% | 0.64 | 0.0% | 20 |
| 17 | SINGING RIVER SKILLED NURSING FACILITY | PASCAGOULA, MS | 40.2% | 9.87 | 0.0% | 45 |
| 18 | BRISTOL HEALTH & REHAB CENTER | BRISTOL, PA | 40.2% | 4.53 | 0.3% | 34 |
| 19 | MOUNTAINVIEW NURSING HOME | Spartanburg, SC | 39.9% | 2.06 | 12.2% | 4 |
| 20 | UNION CO HEALTH AND REHAB CENTER, INC | NEW ALBANY, MS | 39.3% | 5.08 | 0.0% | 44 |
| 21 | HOOSIER VILLAGE | INDIANAPOLIS, IN | 38.8% | 5.42 | 0.0% | 44 |
| 22 | BRIAR CREEK HEALTH CENTER | Charlotte, NC | 38.8% | 11.26 | 0.0% | 45 |
| 23 | MONTICELLO HOUSE | MEDIA, PA | 38.3% | 2.08 | 7.1% | 6 |
| 24 | DUNKLAU GARDENS | Fremont, NE | 37.7% | 1.65 | 6.6% | 6 |
| 25 | BROOKMONT HEALTHCARE AND REHABILITATION CENTER | EFFORT, PA | 37.5% | 3.06 | 13.0% | 9 |
25 Most Reliable Staffing Patterns
Ranked by the composite staffing reliability score, which rewards higher daily HPRD, smaller weekend drops, lower volatility, and lower contract labor share.
| Rank | Facility | City / State | Weekend drop | HPRD | Contract | Score |
|---|---|---|---|---|---|---|
| 1 | WESTMINSTER-CANTERBURY OF LYNCHBURG INC | LYNCHBURG, VA | 4.9% | 5.84 | 0.0% | 93 |
| 2 | KAWEAH HEALTH SKILLED NURSING CENTER | VISALIA, CA | 4.3% | 6.95 | 0.0% | 92 |
| 3 | SHERMAN VILLAGE HCC | NORTH HOLLYWOOD, CA | 5.4% | 4.91 | 0.0% | 92 |
| 4 | JOHN KNOX VILLAGE OF POMPANO BEACH | POMPANO BEACH, FL | 6.5% | 5.41 | 0.0% | 92 |
| 5 | GOODWIN HOUSE ALEXANDRIA | ALEXANDRIA, VA | 7.1% | 5.26 | 0.0% | 92 |
| 6 | LEONARD FLORENCE CENTER FOR LIVING | CHELSEA, MA | 8.0% | 7.46 | 0.0% | 92 |
| 7 | MCCLURE POST ACUTE | OAKLAND, CA | 1.1% | 4.45 | 0.0% | 91 |
| 8 | CHAPMAN GLOBAL MEDICAL CENTER D/P SNF | ORANGE, CA | 2.8% | 8.50 | 0.0% | 91 |
| 9 | CALIFORNIA HEALTHCARE AND REHABILITATION CENTER | VAN NUYS, CA | 5.4% | 4.68 | 0.0% | 91 |
| 10 | STUDIO CITY REHABILITATION CENTER | STUDIO CITY, CA | 5.6% | 4.69 | 0.0% | 91 |
| 11 | CONTINUING CARE AT MARIS GROVE | GLEN MILLS, PA | 6.5% | 4.92 | 0.0% | 91 |
| 12 | HOLLYWOOD PRESBYTERIAN MEDICAL CENTER D/P SNF | LOS ANGELES, CA | 7.3% | 7.77 | 0.0% | 91 |
| 13 | GLADSTONE SUB-ACUTE AND REHAB CENTER | GLENDORA, CA | 7.3% | 4.96 | 0.0% | 91 |
| 14 | A GRACE SUB ACUTE & SKILLED CARE | SAN JOSE, CA | 7.4% | 5.59 | 0.0% | 91 |
| 15 | EDDY VILLAGE GREEN | COHOES, NY | 7.8% | 5.47 | 0.0% | 91 |
| 16 | ADVENTIST HEALTH DELANO | DELANO, CA | 8.3% | 6.39 | 0.0% | 91 |
| 17 | MISSION CARE CENTER | RIVERSIDE, CA | 8.7% | 6.41 | 0.0% | 91 |
| 18 | BAYSHIRE YORBA LINDA POST-ACUTE | YORBA LINDA, CA | -7.1% | 4.90 | 0.0% | 90 |
| 19 | BATON ROUGE GEN MED CTR, SNF | BATON ROUGE, LA | -0.8% | 5.61 | 0.0% | 90 |
| 20 | LIVIA HEALTH AND SENIOR LIVING | EAST HANOVER, NJ | 3.1% | 4.68 | 0.0% | 90 |
| 21 | GREENSPRING VILLAGE | SPRINGFIELD, VA | 3.8% | 5.34 | 0.0% | 90 |
| 22 | WESTCHESTER MANOR AT PROVIDENCE PLACE | High Point, NC | 4.7% | 4.68 | 0.0% | 90 |
| 23 | ROSEWOOD POST ACUTE | PLEASANT HILL, CA | 4.7% | 4.46 | 0.0% | 90 |
| 24 | KNOLLS WEST POST ACUTE LLC | VICTORVILLE, CA | 6.8% | 4.63 | 0.0% | 90 |
| 25 | AVAMERE TRANSITIONAL CARE AT SUNNYSIDE | SALEM, OR | 7.3% | 4.95 | 0.0% | 90 |
Methodology
This report uses CMS Payroll-Based Journal daily nurse staffing data for CY2025Q4. A facility-day is included only when the resident census is greater than zero and total nurse hours are nonnegative. Facilities need at least 60 valid days to receive a score.
Total nurse hours per resident day, or HPRD, is calculated from six core CMS staffing categories: director of nursing, RN administration, RN, LPN administration, LPN, and CNA hours. Nursing aide trainee and medication aide hours are excluded from the HPRD numerator, but included in both the numerator and denominator for the contract/agency labor share.
Weekend drop compares average Saturday and Sunday HPRD with average weekday HPRD for the same facility. Volatility is the coefficient of variation of daily HPRD. Contract share is contract hours divided by total hours across the same staffing categories used for that measure.
The reliability score is the rounded mean of four national percentile components: mean HPRD, weekend drop, volatility, and contract share. HPRD is scored higher-is-better; weekend drop, volatility, and contract share are inverted so that more reliable staffing receives a higher score.
This measures staffing inputs, not clinical outcomes or resident experience. It should be read alongside inspection findings, quality measures, and a current facility visit.
For broader context, see the nursing home quality by state report and the frozen-model trend report.