North Dakota PBJ Nursing Home StaffingNorth Dakota PBJ Staffing

73 providers • 4,526 residents • 4.55 HPRD

Phoebe J
PBJ Takeaway: North Dakota

4.55 HPRD (rank: 4)0.90 RN HPRD12.6% contract

North Dakota reported 4.55 HPRD (≈ 5.3 residents per total staff) in Q3 2025. HPRD is down 0.04 since Q3 2024. This level is above the national ratio of 3.77 HPRD and ranks #4 out of 51 states.

Put another way… On a 30-bed floor at a typical North Dakota nursing home you'd see about 5.7 staff members, including 3.9 nurse aides. For the entire 62-resident facility (North Dakota average), that's about 11.8 total staff, including 8.1 nurse aides.

320 Consulting
Total Staffing: North Dakota
Total Staffing

North Dakota

North Dakota Total Staffing

Direct staff excludes Admin/DON. Direct staff excludes Admin/DON.

RN Staffing: North Dakota
RN Staffing

North Dakota

North Dakota RN Staffing
Resident Census: North Dakota
Resident Census

North Dakota

North Dakota Resident Census
Contract Staff %: North Dakota
Contract Staff %

North Dakota

North Dakota Contract Staff %
North Dakota PBJ Metrics
MetricValueNational Rank
Total Nurse Staffing HPRD4.55#4 of 51
Direct Care Nurse HPRD4.27#4 of 51
RN HPRD0.90#8 of 51
RN Direct Care HPRD0.64#10 of 51
Nurse Aide HPRD3.13#3 of 51
Contract Staff Percentage12.6%
Special Focus Facilities

North Dakota 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
Good Samaritan Society - Bottineau (Bottineau)23433.45Non 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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