Guide
PBJ Staffing Data, Explained for Operators
The short version
PBJ stands for Payroll-Based Journal, the payroll-verified staffing hours every nursing home reports to CMS each quarter. CMS turns that data into the facility’s Staffing star rating using six measures: three about how many nursing hours residents actually get (adjusted for how sick they are) and three about staff turnover. Hours are compared to national thresholds, and a few data problems can drop a facility straight to one star no matter how the hours look.
What PBJ actually is
Payroll-Based Journal is the system nursing homes use to report their staffing to CMS every quarter. Unlike the older self-reported staffing snapshots, PBJ hours are tied to payroll records, which makes them auditable and much harder to inflate. CMS uses a full quarter of daily hours and counts only the days when at least one resident was present.
Hours per resident day, adjusted for acuity
The core of the rating is hours per resident day (HPRD): nursing hours divided by the number of residents, per day. But a facility caring for sicker residents needs more hours to deliver the same level of care, so CMS case-mix adjusts the hours using each facility’s resident acuity (from MDS assessments and the PDPM case-mix groups).
Two things follow from that. You cannot compare two facilities’ raw hours directly, because the adjustment changes what “enough” means for each one. And the comparison is national: adjusted hours are measured against national thresholds, not ranked within the state the way the health inspection rating is.
The six measures
The staffing rating is built from six measures, in two groups:
Staffing levels (case-mix adjusted hours per resident day)
- Total nursing hours per resident day across all days (RN + LPN + nurse aide)
- RN hours per resident day across all days
- Total nursing hours per resident day on weekend days
Turnover (over a twelve-month period)
- Percentage of nursing staff who left the facility
- Percentage of RNs who left the facility
- Number of administrators who left the facility
Points from all six are summed into a total staffing score, and that score maps to a one to five star rating using national cut points. The staffing rating then feeds the overall Five-Star rating (a 5-star staffing rating can add a star to the overall; a 1-star staffing rating subtracts one).
What trips people up
A facility can earn one star on the numbers, but it can also be dropped to one star automatically, no matter how strong its hours look, for a handful of data problems:
- Four or more days in the quarter with no RN hours while residents were present. This is the big one: a facility with strong overall staffing but a few uncovered RN days still lands at one star for the quarter.
- Not submitting staffing data by the deadline.
- Audit discrepancies between the hours reported and the hours payroll can verify.
Two more that surprise people:
- Weekends are scored on their own. One of the six measures looks only at weekend staffing, so staffing well Monday through Friday but thin on weekends shows up.
- Turnover counts, not just hours. Half of the six measures are about how many nurses and administrators left, not how many hours were worked.
See how your staffing compares
SNF Insights shows each facility’s PBJ staffing levels and turnover next to its market, so you can see how your hours and stability stack up against the facilities that actually look like yours.
This guide is a practical overview for informational purposes and reflects the CMS Five-Star Technical Users’ Guide (April 2026). CMS updates its methodology from time to time; the linked guide is the official source. SNF Insights is independent and is not affiliated with or endorsed by CMS.