RN hours per resident per day measures how many hours a registered nurse spends caring for each resident on average each day. The national average across Medicare-certified nursing homes is 0.685 hours. This metric comes from the CMS Payroll-Based Journal (PBJ) system, which facilities are required to submit quarterly.

Research consistently shows that higher RN staffing correlates with fewer pressure ulcers, lower rehospitalization rates, fewer falls with injury, and better medication management. Registered nurses perform clinical assessments, wound care, and medication administration that LPNs and CNAs cannot legally provide.

CMS updates the Payroll-Based Journal staffing data quarterly, with roughly a six-month lag from the reporting period. The star ratings derived from staffing data are refreshed monthly.

Not necessarily. Facility acuity mix matters, post-acute facilities taking hospital discharges need more RN hours than long-stay facilities with stable residents. Small facilities can also swing dramatically quarter-to-quarter. Always review staffing alongside health inspection results, quality measures, and an in-person visit.

The national average CMS Staffing Rating is 3/5 stars. This rating is one of three components (alongside Health Inspection and Quality Measures) that make up a facility's Overall Star Rating.