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California

Nursing Home Staffing Profile — 2025Q3

1,139 facilities100,043 residents4.52 avg HPRD

vs National Average

+0.62 HPRD

National avg: 3.90 · California: 4.52

📋

California ranks among the higher-performing states for nursing home staffing, with an average of 4.52 HPRD — 0.62 hours above the national average. Only 97.1% of facilities meet the CMS staffing benchmark of 3.48 HPRD, compared to 65.8% nationally. RN staffing averages 0.65 HPRD, with 22.0% of facilities meeting the 0.75 research recommendation.

4.52

Average Total HPRD

All nursing staff combined

▲ 0.62 vs national

0.65

Average RN HPRD

Recommended: 0.75

▼ 0.03 vs national

97.1%

Meet CMS Benchmark

1106 of 1139 facilities

12.5%

Avg Weekend Drop-off

Staffing reduction on Sat/Sun

2.4%

Avg Agency Staff

Contractor/temp worker hours

—

Had Zero-RN Days

Data unavailable

4.23

Median HPRD

50th percentile (less skewed by outliers)

F-Rated Facilities

Under 2.5 HPRD — critically understaffed

Grade Distribution

How California's 1,139 facilities grade out

HPRD Distribution

Where facilities fall across the staffing spectrum

Staffing by Ownership Type

For-profit facilities consistently staff lower than non-profit and government-run homes

For-Profit

4.30

avg HPRD

867 facilities (76%)

Non-Profit

5.43

avg HPRD

95 facilities (8%)

Government

6.21

avg HPRD

21 facilities (2%)

💡 Non-profit facilities in California average 1.13 more HPRD than for-profit ones — about 26% higher staffing.

▲ Best Staffed in California

Top 5 by total nurse HPRD

A+

Redlands Comm Hosp D/p Snf

PRESBYTERIAN INTERCOMM HOSP DP/SNF

ALL SAINTS HEALTHCARE SUBACUTE

DEPT OF STATE HOSPITALS - NAPA D/P SNF

TOTALLY KIDS REHABILITATION HOSPITAL - D/P SNF

LOMA LINDA

10.10 HPRD

RN: 1.47

▼ Most Understaffed in California

Bottom 5 by total nurse HPRD

1139

HERITAGE GARDENS HEALTH CARE CENTER

PARKVIEW HEALTHCARE CENTER

Shandin Hills Behavior Therapy Center

Crestwood Wellness and Recovery Center

REDDING

2.55 HPRD

RN: 0.27

⚖️

Compare Two Facilities Side by Side

Pick any two California nursing homes and see how they stack up across every metric

Open Comparison Tool →

County Breakdown

Staffing metrics by county in California — click a county to see individual facilities

Avg HPRD— total nurse hours per resident per day:≥ 3.48 meets federal benchmark,3.0–3.47 below benchmark,< 3.0 critically low

Meet Benchmark— share of facilities in the county at or above the 3.48 HPRD federal minimum:≥ 50%35–49%< 35%

County	Facilities ↓	Avg HPRD	RN HPRD	Meet Benchmark	Grades
▸Los Angeles	363	4.56	0.60	97.8%	Mixed D/C
▸San Diego	80	4.64	0.74	98.8%	Mixed B/A
▸Orange	71	4.73	0.63	97.2%	Mixed D/C
▸Alameda	68	4.41	0.70	100.0%	Mixed B/A
▸Riverside	53	4.53	0.56	96.2%	Mostly D
▸San Bernardino	53	4.70	0.62	94.3%	Mixed D/C
▸Santa Clara	48	4.44	0.78	95.8%	Mixed B/A
▸Sacramento	36	4.40	0.73	100.0%	Mixed B/C
▸Contra Costa	30	4.36	0.70	100.0%	Mixed C/A
▸Fresno	29	4.21	0.53	93.1%	Mixed D/C
▸San Joaquin	24	4.27	0.50	95.8%	Mixed C/D
▸Ventura	19	4.69	0.71	94.7%	Mixed C/A
▸Sonoma	17	4.35	0.67	100.0%	Mixed B/C
▸Stanislaus	17	3.97	0.45	88.2%	Mixed D/C
▸San Francisco	17	5.24	1.73	100.0%	Mixed A+/B
▸Kern	16	4.30	0.47	93.8%	Mostly D
▸Tulare	16	4.50	0.43	100.0%	Mixed D/F
▸Santa Barbara	14	4.33	0.66	92.9%	Mixed C/B
▸Monterey	14	4.54	0.78	100.0%	Mixed A+/A
▸San Mateo	14	4.45	0.81	92.9%	Mixed A/B
▸Marin	11	4.57	0.77	100.0%	Mixed C/A
▸Placer	10	4.18	0.62	100.0%	Mixed B/C
▸Merced	10	4.18	0.33	100.0%	Mostly D
▸Shasta	10	4.58	0.67	90.0%	Mixed C/D
▸Butte	9	4.29	0.45	100.0%	Mixed D/C
▸Solano	8	4.76	0.95	100.0%	Mixed A/C
▸Santa Cruz	7	4.05	0.63	100.0%	Mixed A/B
▸Napa	6	5.80	1.73	100.0%	Mixed A+/A
▸San Luis Obispo	6	5.24	0.76	100.0%	Mixed D/A+
▸Yolo	6	4.18	0.87	83.3%	Mixed A/B
▸Humboldt	5	5.07	0.50	100.0%	Mostly C
▸Madera	5	4.05	0.44	80.0%	Mostly D
▸Nevada	5	4.07	0.63	100.0%	Mostly D
▸Sutter	4	4.01	0.63	100.0%	Mostly B
▸El Dorado	4	4.24	0.76	100.0%	Mixed B/A
▸Mendocino	4	3.77	0.44	75.0%	Mixed C/D
▸Lake	3	3.85	0.36	66.7%	Mixed C/D
▸Kings	3	4.06	0.19	100.0%	Mostly F
▸Imperial	3	4.01	0.26	100.0%	Mostly D
▸Tehama	2	4.07	0.26	100.0%	Mixed D/F
▸Colusa	2	6.11	0.48	100.0%	Mixed B/F
▸Inyo	2	4.35	0.54	100.0%	Mixed B/C
▸Plumas	2	5.49	0.71	100.0%	Mixed A/B
▸Tuolumne	2	4.64	0.85	100.0%	Mixed A+/D
▸San Benito	1	4.52	0.95	100.0%	Mostly A
▸Modoc	1	4.93	0.33	100.0%	Mostly D
▸Mariposa	1	6.20	0.56	100.0%	Mostly B
▸Lassen	1	3.70	0.45	100.0%	Mostly C
▸Glenn	1	3.70	0.24	100.0%	Mostly F
▸Trinity	1	5.97	0.39	100.0%	Mostly D
▸Del Norte	1	3.39	0.24	0.0%	Mostly F
▸Yuba	1	4.03	0.64	100.0%	Mostly B
▸Calaveras	1	4.04	0.35	100.0%	Mostly D
▸Amador	1	4.44	1.00	100.0%	Mostly A
▸Siskiyou	1	4.95	1.02	100.0%	Mostly A

HPRD Range in California

The spread between best and worst staffed facilities

4.01

25th pctile

4.23

Median

4.64

75th pctile

Source: CMS Staffing & Quality Data — 2025Q3 · data.cms.gov

Staffing grades are based on CMS-published thresholds and research recommendations. CMS is not affiliated with and does not endorse this website.