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CMS PBJ

CMS Payroll-Based Journal (PBJ) Daily Nurse Staffing

U.S. Centers for Medicare and Medicaid Services · Tier-1 · research-only (never on individual profiles)

Research-only

PBJ collects payroll-derived daily nurse-staffing hours for ~14,700 Medicare-certified nursing homes since 2016 (mandatory replacement for self-reported staffing surveys). RN, LPN, CNA hours per resident per day; weekend coverage; contract-staff share; midnight-census denominator. The federal 3.48 nurse-hour minimum was rescinded December 3, 2025; PBJ data continues to publish.

What Fonteum uses it for

How this source shows up on Fonteum.

Drives the brand-hub `/staffing` editorial surface with the facility-level staffing fields represented in the loaded PBJ data.

What this source does NOT mean

Not real-time. PBJ is payroll-derived from facility submissions, with quarterly publication. Not a quality measure — higher hours correlate with better outcomes but are not deterministic.

What this dataset answers

Research and data questions this source supports.

  • Analyze actual-versus-expected staffing levels at nursing homes using daily nurse staffing records — the data underlying CMS's staffing star rating.
  • Build a nursing home staffing crisis study that surfaces which states and chains have the highest rate of understaffed facilities.
  • Cross-reference PBJ staffing data with CMS Care Compare NH star ratings to identify facilities with high star ratings but low actual staffing.
  • Support M&A diligence on nursing home chains with historical staffing data as a quality proxy before CMS deficiency surveys complete.
  • Power a workforce analytics study on healthcare labor supply and demand using PBJ daily staffing records as the ground truth.

Dataset size: Hundreds of millions of daily staffing records annually

Fields used

Per-field display contract.

Fields listed below show their configured `display_allowed` flag from the §94 provenance schema. Fields marked write-locked are captured for audit and are not rendered on profile pages.

Renders on profile

5 fields
ccnCMS Certification Number
rn_hprdRN HPRD
total_nurse_hprdTotal nurse HPRD
weekend_total_nurse_hprdWeekend HPRD
contract_staff_shareContract-staff share
Limitations

What we can’t infer from this source.

  • Suppression for facilities reporting <90 days in a measure period — render `<DataAvailabilityState>` with explicit reason.
  • Census denominator is midnight-only; rapid intra-day census shifts not visible.
  • Federal 3.48 minimum rescinded December 3, 2025 (effective February 2, 2026); per-facility transparency now the only mechanism for staffing accountability.
Source metadata

Authority, license, publisher cadence.

Authority

U.S. Centers for Medicare and Medicaid Services

Tier

Tier-1 · research-only (never on individual profiles)

Publisher / configured cadence

Declared or configured cadence: Quarterly (Q1/Q2/Q3/Q4 PBJ publication; daily-granularity per facility per day). Not evidence of the latest loaded source date.

License

U.S. government public-domain works (17 U.S.C. § 105). Attribution required: 'Source: CMS Payroll-Based Journal · Snapshot {YYYY-MM-DD}'. License ↗

Attribution requirement

Source: CMS Payroll-Based Journal · Snapshot {YYYY-MM-DD}

ToS & usage notes

What the source allows.

U.S. government public-domain works. PDC publishes the dataset at data.cms.gov/provider-data/topics/nursing-homes with explicit redistribution rights.

Sample provenance

What a single field looks like in the graph.

This worked example shows the provenance shape used when a surfaced field has populated source, last-checked, display-rule, and confidence metadata. Individual fields may omit unavailable values.

Field

Per-facility RN HPRD (display)

Sample value

0.78 RN hours per resident per day · weekend 0.62 · contract-staff 18%

Provenance line

Source: CMS Payroll-Based Journal · Q2 2025 publication · Display rule: per-facility RN HPRD + weekend HPRD + contract-staff share render on /staffing module

How to access

Official API, bulk download, and Fonteum endpoints.

Official API / download

Official API endpoint ↗

Frequently asked

Common questions about CMS PBJ.

What is the CMS Payroll-Based Journal (PBJ) staffing dataset?
The Payroll-Based Journal (PBJ) is a CMS mandatory electronic submission system for nursing facilities. Long-term care facilities must submit daily staffing data drawn directly from payroll records for every nursing, therapy, and administrative staff category. PBJ data is the source of truth for the CMS Care Compare staffing star rating and for the nurse staffing public reporting requirements under the Staffing Accountability Reform (STAR) Act.
What staffing categories does PBJ cover?
PBJ covers all nursing staff categories: Registered Nurses (RN), Licensed Practical Nurses / Licensed Vocational Nurses (LPN/LVN), Certified Nurse Aides (CNA), Nurse Aide Trainees, Medication Aides, and Physical, Occupational, and Speech therapy staff. Each submission includes daily hours worked by type, not just headcount, enabling per-resident-day staffing rate calculations.
Where can I download CMS PBJ staffing data?
CMS publishes the PBJ daily nurse staffing dataset at data.cms.gov/quality/payroll-based-journal-pbj-daily-nurse-staffing. The dataset is updated quarterly. It is U.S. government public-domain data available as CSV downloads at no cost.
What is the federal minimum staffing rule for nursing homes?
In April 2024, CMS published the long-term care minimum staffing final rule requiring Medicare- and Medicaid-certified nursing homes to provide a minimum of 3.48 total nurse staffing hours per resident per day (HPRD), including at least 0.55 HPRD of RN time. The rule also requires 24/7 RN presence. Implementation is phased by state and facility type through 2026–2029. PBJ data is the primary compliance monitoring source.
How does PBJ data differ from the staffing data on the CMS Care Compare nursing home profile?
CMS Care Compare shows quarterly-average staffing rates (RN hours per resident per day and total nurse hours per resident per day) derived from PBJ submissions. The raw PBJ dataset provides the underlying daily submissions, enabling more granular analysis: day-of-week staffing patterns, weekend versus weekday gaps, and quarter-by-quarter trend analysis across facilities.
See also
  • /sources → The generated source-catalog subset — documented datasets Fonteum cites.
  • /data-provenance → The provider graph — pipeline diagram, source-family clusters, field-level provenance examples, display rules.
  • /methodology → Documented sourcing, publisher cadence, observed freshness, and corrections policy.
  • /editorial-policy → Independence, sourcing, conflicts, corrections, retractions.

What’s on file, by the numbers

Platform snapshot · 2026-08-11

13.4Mproviders & companiesProviders, organizations, owners, and facilities on file
26.2Msource-linked factsSource-linked field facts in the dated platform snapshot
90sources with dataDistinct snapshot source IDs with at least one positive record count
73fresh sourcesDistinct source IDs whose latest positive-data snapshot falls within the preceding 45 days
111sources integratedActive registry rows; integration does not establish a load
13state Medicaid jurisdictionsDistinct states represented in the state-exclusions serving table

Integrated, with-data, and fresh-observation counts are separate. No platform-wide source-completeness count is published. Completeness is source-specific and must be evaluated against the named source's expected scope. State coverage is a separate jurisdiction measure.

Source authority is record-specific

Use the issuer named on the record.

Fonteum spans federal, state, and global public publishers. A source page or returned record identifies its issuer and dataset where that metadata is available. A platform registry count does not assign every page to one authority or establish loaded, fresh, or complete coverage.

Browse source records and their stated limitations →

Reproducible by design

Inspect the evidence each published figure actually supplies.

Source and date

Research pages expose the named public file and observation date where those fields are available. Source-file SHA-256 coverage is separate; facts do not currently link deterministically to signatures.

Available derivation

Studies with a retained release and committed derivation link the SQL or method used. Other studies state the evidence and reproduction limits they actually have.

Daily observations

Dated table row-count observations can detect local drift. They do not imply that an upstream publisher released or Fonteum ingested new data that day.

Named medical review

Reviewed by Jennifer Montecillo, MD, medical reviewer. Non-practicing medical reviewer.

Read the full provenance and attestation methodology →

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