Free · no account · rules checked October 13, 2026
California Nursing Home Staffing Calculator
California requires 3.5 direct care service hours per patient day, at least 2.4 of them from certified nurse assistants, every day.
Counted California's way and the way CMS counts it for Care Compare, side by side, with staff per shift for any target you choose. An estimate for planning, not legal advice.
California: California requires 3.5 direct care service hours per patient day, at least 2.4 of them from certified nurse assistants, every day. CDPH checks each day, midnight to midnight. A week or quarter average above 3.5 can still hide days below it.
Source: California Department of Public Health, AFL 21-11 (3.5 DHPPD staffing audits). Checked October 13, 2026.
California counts skilled nursing patients only, averaged from counts at midnight, 8 AM and 4 PM.
Direct caregivers under CDPH AFL 21-11. They count toward the 3.5.
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How the nursing home staffing calculator works
Enter your residents and nursing hours
One day, a week or a quarter. Total hours by job, or the number of people on each shift.
Pick a target
Your state if it is one we checked (New York, Florida, Illinois, California), your own number, or none for the CMS count alone.
Read both counts and the staff per shift
The CMS count, your state's own count, warnings CMS acts on, and how many RNs, LPNs and CNAs each shift needs for the target.
What California counts
- Counts RNs, LVNs, psychiatric technicians, certified nurse assistants and nurse assistants in an approved training program (aides in training count toward the 3.5 but not the 2.4).
- Leaves out meal periods, paid or unpaid, and administrative and other non-nursing work, so this calculator leaves out RN and LPN admin hours.
- Medication aides are not on the direct caregiver list, so this calculator leaves out medication aide hours.
- Director of nursing hours: CDPH credits up to 40 hours a week in a facility licensed for 59 beds or less, and in 60 beds or more only documented nursing time beyond the DON's required hours. This calculator leaves DON hours out, so its California number can come out lower than CDPH's.
- The census is skilled nursing patients only (no subacute, intermediate care, special treatment program patients or bed holds), averaged from counts at midnight, 8 AM and 4 PM.
CDPH checks each day, midnight to midnight. A week or quarter average above 3.5 can still hide days below it.
- CDPH counts the MDS assessment time of a licensed nurse as direct care. If you reported that time as admin, add it to RN or LPN hours for California.
Source: California Department of Public Health, AFL 21-11 (3.5 DHPPD staffing audits). Read on October 13, 2026.
Worked example
For one day with 100 residents, 40 RN, 80 LPN and 220 CNA hours, plus 8 director of nursing, 8 RN admin, 10 aide-in-training and 20 medication aide hours: Direct care service hours: 3.50 against 3.50, at the target. Certified nurse assistant: 2.20 against 2.40, short by 0.20. Counted the CMS way, the same day is 3.86.
California nursing home staffing: questions
- What is the minimum nurse staffing in California nursing homes?
- California requires 3.5 direct care service hours per patient day, at least 2.4 of them from certified nurse assistants, every day. CDPH checks each day, midnight to midnight. A week or quarter average above 3.5 can still hide days below it.
- What counts toward California's staffing hours?
- Counts RNs, LVNs, psychiatric technicians, certified nurse assistants and nurse assistants in an approved training program (aides in training count toward the 3.5 but not the 2.4). Leaves out meal periods, paid or unpaid, and administrative and other non-nursing work, so this calculator leaves out RN and LPN admin hours. Medication aides are not on the direct caregiver list, so this calculator leaves out medication aide hours. Director of nursing hours: CDPH credits up to 40 hours a week in a facility licensed for 59 beds or less, and in 60 beds or more only documented nursing time beyond the DON's required hours. This calculator leaves DON hours out, so its California number can come out lower than CDPH's. The census is skilled nursing patients only (no subacute, intermediate care, special treatment program patients or bed holds), averaged from counts at midnight, 8 AM and 4 PM.
- How do you calculate California's staffing hours per resident day?
- For one day with 100 residents, 40 RN, 80 LPN and 220 CNA hours, plus 8 director of nursing, 8 RN admin, 10 aide-in-training and 20 medication aide hours: Direct care service hours: 3.50 against 3.50, at the target. Certified nurse assistant: 2.20 against 2.40, short by 0.20. Counted the CMS way, the same day is 3.86.
- Is California's count the same as Care Compare's?
- No. Care Compare counts every PBJ nursing job code (directors of nursing, admin nurses, aides in training and medication aides included) and adjusts for acuity before giving stars. The calculator shows both counts side by side.
- Is this legal advice?
- No. It is an estimate for planning, not legal advice. Confirm with your state agency and CMS. We read California's rule at its source on October 13, 2026.
An estimate for planning, not legal advice. Confirm with your state agency and CMS. Rules checked October 13, 2026; laws and CMS methods change.
The nursing home staffing calculator for every state. Other checked states: New York, Florida, Illinois.