How much lower is nursing home staffing on weekends?

15% lower nationally in January to March 2026: 3.33 nursing hours per resident per day on weekends against 3.92 on weekdays, across 14,487 homes' daily payroll records. Registered nurse hours ran 39% lower (0.43 against 0.70).

Which state has the largest weekend staffing gap?

Among states with 20 or more homes, Mississippi, where weekend staffing ran 21% below weekdays in January to March 2026. The smallest gap was in Florida (12%).

How many nursing homes cut weekend staffing by 20% or more?

2,593 of 14,470 homes (18%) had weekend nursing hours per resident at least 20% below their weekday level in January to March 2026; 82 had no weekend drop at all.

Where does this data come from?

CMS Payroll Based Journal daily nurse staffing: every certified home reports the hours each type of nursing staff worked each day, and the daily resident census. NursingHomeClear added the hours and resident days up by quarter. For the latest quarter our totals match the staffing CMS publishes on Care Compare for 14,333 of 14,335 homes.

Weekend Nurse Staffing in Nursing Homes, by State

Name: Weekend and weekday nurse staffing in US nursing homes, by state, January to March 2026
Creator: NursingHomeClear
License: https://creativecommons.org/licenses/by/4.0/

Key findings

15% fewer nursing hours per resident on weekends nationally (3.33 against 3.92 hours a day). For registered nurses the drop was 39% (0.43 against 0.70).
2,593 homes (18%) had weekend staffing at least 20% below their weekdays, and 123 (1%) at least 30% below. 82 homes (1%) had no weekend drop.
Among states with 20 or more homes, the gap was largest in Mississippi (21%) and smallest in Florida (12%). 36 of 52 states and territories had a gap of 15% or more.
For-profit homes: 17% of 10,769 for-profit homes cut weekend staffing by 20% or more, against 20% of 3,701 nonprofit and government homes.
Contract and agency staff worked 5.3% of all nursing hours nationally in January to March 2026, down from 6.0% in April to June 2025.

CMS already counts weekend staffing in each home's staffing star (weekend hours are one of its six staffing measures). Families can see any home's own weekday and weekend figures on its page here, in the staffing section.

Every state

Hours per resident per day in January to March 2026, all nursing staff and registered nurses, weekdays against weekends. Sorted by the weekend gap; click a column to sort by it.

State	Homes	Weekdays	Weekends	Weekend gap	RN weekdays	RN weekends	RN gap	Contract share
Puerto Rico	8	3.76	2.77	26%	3.09	2.16	30%	5.2%
Mississippi	197	4.35	3.44	21%	0.70	0.35	50%	6.2%
Alabama	223	4.13	3.27	21%	0.74	0.35	53%	0.9%
Louisiana	256	3.86	3.10	20%	0.30	0.16	47%	3.6%
Arkansas	218	4.28	3.47	19%	0.45	0.27	40%	2.0%
South Dakota	91	3.97	3.25	18%	0.91	0.50	45%	9.1%
Idaho	79	4.11	3.37	18%	0.91	0.51	44%	4.9%
West Virginia	122	3.75	3.08	18%	0.80	0.36	55%	3.9%
South Carolina	186	3.81	3.13	18%	0.61	0.33	46%	7.2%
North Dakota	70	4.81	3.96	18%	1.06	0.57	46%	11.7%
Georgia	349	3.68	3.03	18%	0.52	0.32	38%	3.3%
Washington	187	4.44	3.66	18%	1.00	0.65	35%	3.7%
Tennessee	302	3.95	3.27	17%	0.64	0.37	42%	4.0%
Wyoming	35	3.80	3.15	17%	0.97	0.59	39%	7.5%
Virginia	287	3.76	3.12	17%	0.65	0.36	45%	5.7%
Vermont	33	4.47	3.71	17%	0.91	0.51	44%	23.2%
Michigan	418	4.14	3.45	17%	0.81	0.43	47%	3.3%
Missouri	476	3.50	2.93	16%	0.45	0.28	38%	3.9%
Texas	1,162	3.50	2.93	16%	0.44	0.32	27%	2.2%
Nebraska	175	4.21	3.53	16%	0.74	0.47	36%	7.1%
Utah	97	4.10	3.44	16%	1.24	0.80	35%	2.8%
Indiana	506	3.80	3.19	16%	0.70	0.43	39%	3.4%
Hawaii	41	4.86	4.08	16%	1.76	1.19	32%	6.9%
New Mexico	68	3.69	3.10	16%	0.67	0.44	34%	14.2%
New York	588	3.72	3.13	16%	0.77	0.46	40%	9.8%
Kentucky	263	4.04	3.40	16%	0.81	0.48	41%	3.2%
Montana	60	4.10	3.46	16%	0.99	0.64	35%	11.6%
Iowa	384	3.98	3.36	16%	0.81	0.48	41%	4.7%
Arizona	139	4.05	3.43	15%	0.70	0.45	36%	3.3%
Colorado	208	3.75	3.18	15%	0.84	0.56	33%	5.9%
Kansas	290	4.19	3.56	15%	0.75	0.46	39%	4.8%
Alaska	15	5.99	5.09	15%	1.87	1.35	28%	12.8%
North Carolina	408	3.82	3.25	15%	0.61	0.35	43%	8.0%
Minnesota	335	4.38	3.73	15%	1.19	0.69	42%	5.2%
Ohio	917	3.80	3.24	15%	0.69	0.40	42%	4.6%
Nevada	64	4.05	3.46	15%	0.92	0.67	27%	2.7%
Wisconsin	322	4.36	3.74	14%	1.08	0.64	41%	8.8%
Illinois	655	3.40	2.92	14%	0.71	0.52	27%	5.4%
Oregon	125	5.12	4.40	14%	0.73	0.41	44%	6.2%
New Hampshire	72	4.01	3.45	14%	0.83	0.53	36%	13.1%
Maryland	219	3.88	3.34	14%	0.82	0.54	34%	8.0%
Rhode Island	70	3.82	3.30	14%	0.78	0.49	37%	5.4%
Massachusetts	339	3.94	3.41	13%	0.69	0.43	38%	5.0%
Oklahoma	270	3.94	3.42	13%	0.34	0.26	24%	2.2%
Connecticut	190	3.80	3.31	13%	0.70	0.39	44%	6.0%
Delaware	42	4.21	3.67	13%	0.90	0.52	42%	5.7%
Maine	78	4.52	3.95	13%	1.20	0.74	38%	9.2%
New Jersey	347	3.82	3.34	13%	0.66	0.43	35%	11.6%
Pennsylvania	644	3.82	3.34	13%	0.74	0.45	39%	11.3%
California	1,141	4.52	3.97	12%	0.65	0.45	31%	2.3%
Florida	686	3.90	3.44	12%	0.78	0.51	35%	1.1%
District of Columbia	16	4.59	4.05	12%	1.36	1.05	23%	6.7%
United States	14,487	3.92	3.33	15%	0.70	0.43	39%	5.3%

Download: states (CSV) · every home (CSV, 14,470 rows). Free to reuse with credit to NursingHomeClear and CMS (CC BY 4.0).

Four quarters, nationally

Quarter	Weekdays	Weekends	Gap	Contract share
April to June 2025	3.96	3.33	16%	6.0%
July to September 2025	3.95	3.33	16%	5.5%
October to December 2025	3.93	3.34	15%	5.3%
January to March 2026	3.92	3.33	15%	5.3%

The largest chains

Chains CMS tracks with 30 or more homes, summed over the homes that reported payroll data in January to March 2026. Sorted by size.

Chain	Homes reporting	Weekdays	Weekends	Weekend gap	Contract share
The Ensign Group	343	3.91	3.25	17%	1.7%
PACS Group	274	3.98	3.49	12%	7.4%
Life Care Centers of America	193	3.97	3.30	17%	1.2%
Genesis Healthcare	184	3.59	3.10	14%	7.0%
Creative Solutions in Healthcare	148	3.30	2.71	18%	0.0%
Trilogy Health Services	127	4.10	3.49	15%	0.2%
Saber Healthcare Group	126	3.58	3.05	15%	7.8%
Avir Health Group	118	3.31	2.83	15%	2.5%
Communicare Health	110	3.59	3.04	15%	1.2%
Pruitthealth	96	3.70	2.88	22%	0.0%
Legacy Healthcare	95	3.48	3.16	9%	12.1%
Good Samaritan Society	91	3.89	3.20	18%	1.7%
Marquis Health Services	90	3.64	3.11	15%	1.7%
American Senior Communities	90	3.68	2.98	19%	1.1%
Complete Care	85	3.65	3.20	12%	9.9%
Ciena Healthcare/Laurel Health Care	81	3.78	3.17	16%	0.7%
Simcha Hyman & Naftali Zanziper	79	3.51	3.04	13%	2.6%
National Healthcare Corporation	71	3.96	3.29	17%	0.0%
Infinity Healthcare Consulting	70	3.02	2.61	14%	1.1%
Opco Skilled Management	68	3.23	2.72	16%	2.6%
Signature Healthcare	67	3.92	3.14	20%	1.1%
Wellsential Health	67	3.28	2.76	16%	0.1%
Fundamental Healthcare	66	3.43	2.92	15%	12.1%
Lifeworks Rehab	64	3.57	2.97	17%	7.4%
Foundations Health Solutions	63	3.68	3.16	14%	0.2%
Autumn Lake Healthcare	59	3.68	3.25	12%	17.3%
North Shore Healthcare	58	3.74	3.23	14%	2.9%
James & Judy Lincoln	56	3.25	2.72	16%	4.5%
Medilodge	53	4.14	3.26	21%	0.1%
Nexion Health	51	3.81	3.21	16%	2.7%
Ethica Health	50	3.63	3.01	17%	0.2%
Aviata Health Group	48	3.48	3.15	9%	0.1%
David Johnson	48	4.35	3.85	11%	0.0%
Benjamin Landa	48	3.58	3.07	14%	6.9%
The Beebe Family	48	4.07	3.15	23%	1.9%
Cascadia Healthcare	47	3.96	3.27	17%	6.5%
Monarch Healthcare Management	45	3.59	3.11	13%	11.5%
Diversicare Healthcare	44	3.38	2.75	19%	0.5%
Nhs Management	43	4.14	3.27	21%	0.0%
Sovereign Healthcare Holdings	43	3.77	3.27	13%	1.2%
Care Initiatives	43	3.48	2.98	14%	0.0%
Hill Valley Healthcare	43	3.60	3.06	15%	13.6%
Evergreen Healthcare Group	43	4.04	3.39	16%	6.5%
Life Care Services	42	5.14	4.44	14%	4.0%
National Health Care Associates	42	3.92	3.38	14%	5.3%
Accura Healthcare	41	3.62	3.02	17%	4.7%
Principle Long Term Care	40	3.70	3.24	12%	9.6%
Corporate Interface Services	39	4.35	3.85	11%	3.8%
Central Arkansas Nursing Centers	38	4.69	3.85	18%	0.8%
Anthony & Bryan Adams	38	4.07	3.20	21%	0.4%
Longwood Management Corporation	38	4.43	4.01	9%	0.4%
Aston Health	38	3.59	3.18	11%	2.3%
Priority Management	38	3.49	2.86	18%	8.4%
Avardis Health	38	3.32	2.79	16%	1.0%
Careone	37	3.85	3.35	13%	0.6%
Liberty Senior Living	37	3.56	3.12	12%	14.5%
Cantex Continuing Care	37	3.54	2.94	17%	0.8%
Circle B Enterprises	36	3.79	3.09	18%	0.1%
Optalis Health & Rehabilitation	36	3.79	3.22	15%	7.5%
Centers Health Care	36	3.76	3.15	16%	14.4%
Gold Fl Trust II	35	3.86	3.41	12%	1.3%
Aspen Skilled Healthcare	35	4.52	4.01	11%	2.0%
Southern Administrative Services	35	4.39	3.64	17%	1.5%
Eduro Healthcare	34	3.32	2.71	18%	7.4%
Carerite Centers	34	3.48	2.95	15%	7.7%
Reliant Care Management	34	2.24	1.91	15%	0.0%
Excelsior Care Group	33	3.33	3.04	9%	5.2%
Journey Healthcare	33	3.38	2.85	16%	1.3%
Aperion Care	33	3.19	2.68	16%	2.1%
Cch Healthcare	33	3.92	3.27	17%	17.9%
Embassy Healthcare	33	3.44	3.12	9%	0.9%
Bridges Health	33	3.74	3.28	12%	1.6%
Links Healthcare Group	32	4.28	3.80	11%	1.3%
Cambridge Healthcare Services	32	4.24	3.73	12%	0.0%
Hmg Healthcare	31	3.50	2.91	17%	0.7%
Atlas Healthcare	30	3.78	3.30	13%	7.4%

Method

Source: CMS Payroll Based Journal Daily Nurse Staffing, one file per quarter (2025Q2: 1,322,867 facility days; 2025Q3: 1,332,804 facility days; 2025Q4: 1,321,304 facility days; 2026Q1: 1,303,830 facility days). Each row is one home on one day: hours worked by registered nurses (including the director of nursing and RNs with administrative duties), licensed practical nurses and nurse aides (including aides in training and medication aides), split into employees and contract staff, and the resident census for that day.

Hours per resident per day = all hours worked in the period divided by all resident days in the period, so large homes count in proportion to their residents. Weekends are Saturday and Sunday. Days with no residents on the census are left out. The weekend gap is (weekday figure minus weekend figure) divided by the weekday figure. Home-level shares count homes with at least 60 days with residents in the quarter (14,470 homes).

Check: for January to March 2026, our total for each home matches the staffing CMS publishes on Care Compare for 14,333 of 14,335 homes (within 0.01 hours). These are hours paid and reported by the homes; CMS audits the submissions, and the numbers are not adjusted for how sick residents are. A home's weekend drop can have reasons the data does not show; it is a measure of staff time, not a finding about care.

Common questions

How much lower is nursing home staffing on weekends?: 15% lower nationally in January to March 2026: 3.33 nursing hours per resident per day on weekends against 3.92 on weekdays, across 14,487 homes' daily payroll records. Registered nurse hours ran 39% lower (0.43 against 0.70).
Which state has the largest weekend staffing gap?: Among states with 20 or more homes, Mississippi, where weekend staffing ran 21% below weekdays in January to March 2026. The smallest gap was in Florida (12%).
How many nursing homes cut weekend staffing by 20% or more?: 2,593 of 14,470 homes (18%) had weekend nursing hours per resident at least 20% below their weekday level in January to March 2026; 82 had no weekend drop at all.
Where does this data come from?: CMS Payroll Based Journal daily nurse staffing: every certified home reports the hours each type of nursing staff worked each day, and the daily resident census. NursingHomeClear added the hours and resident days up by quarter. For the latest quarter our totals match the staffing CMS publishes on Care Compare for 14,333 of 14,335 homes.

Reporters and researchers: write to editor@nursinghomeclear.com for a state or county cut of this data.

Nursing homes run 15% thinner on weekends