A hospital weather report for the nurses working inside it.
You wouldn’t plan a trip without checking the weather. Why accept a hospital job without checking the conditions? Look beyond the posting at nursing workforce, contract reliance, staffed capacity, and the questions management still needs to answer.
Before you accept the jobSee the conditions behind the offer.
Is the workforce recovering? Are travelers filling the gaps? Are more patients competing for fewer staffed beds? Follow the evidence—and the questions it cannot answer.
444facility identities listed
56California counties
30reviewed pilot profiles · 26 audited / 4 pending
0manufactured safety scores
The public reports are the raw material. The reconstruction is the work.
The Observatory does not merely display pages from a state filing. It connects separate reporting systems, reconciles hospital identities and campus boundaries, preserves incompatible years and denominators, tests whether comparisons are defensible, and leaves contradictions visible when the evidence will not support a clean answer.
The California Nursing Observatory is an independent, free resource for nurses, researchers, journalists, and anyone seeking a clearer view of hospital workforce conditions. Public records are presented alongside their limitations—not manufactured scores or claims the evidence cannot support.
Have California hospitals returned to their pre-pandemic baseline?
That question opened a bigger one: what can publicly reported data actually tell us about the condition of the nursing-care system?
A weather station for the nursing-care system.
What the question became
A weather report for the hospital.
A weather report does not rely on temperature alone. It reads temperature, wind, pressure, and visibility together to describe the conditions.
We do the same with publicly reported hospital data: consider nursing capacity, contract dependence, staffed beds, patient demand, and operational pressure together—and see how much of the picture emerges.
The result is not a made-up safety score. It is a clearer view of the conditions, the changing signals, and what remains out of sight.
What can you do with a hospital forecast?
A job posting tells you the hospital is hiring. The Observatory helps you investigate the conditions behind the offer—and ask the questions the posting leaves out.
01 / Before you apply
See past the recruiting pitch.
This helps you prepare, not decide. Is this hospital rebuilding its nursing workforce—or still leaning on travelers? Check contract reliance, reported nursing hours, and staffed beds before you sign.
02 / Before the interview
Walk in with sharper questions.
Missing information is a reason to ask, not evidence that a problem does not exist. Does the charge nurse carry patients? Are there dedicated break nurses, resource nurses, and real orientation? Use the missing answers to guide the conversation.
03 / When you compare offers
Compare conditions—not promises.
This supports comparison, not a claim that unlike hospitals are interchangeable. Put workforce, contract labor, and staffed capacity side by side. See what each hospital reports, what changed, and where meaningful information is missing.
04 / When you raise concerns
Bring evidence into the room.
Observed patterns are not proof of causation, unsafe care, or a legal violation. Support staffing-committee discussions, workplace questions, union conversations, community inquiries, or requests for information with cited public records.
05 / If you already work there
Check what your experience lines up with.
A hospital-wide filing never replaces the bedside story. Does the public record reflect the pressure you feel? Compare contract dependence, staffing capacity, and historical trends with what you see on the floor.
06 / When the system stays quiet
See what hospitals do not disclose.
UNKNOWN stays visible. UNKNOWN never becomes zero. Missed breaks, actual assignments, unit turnover, educator support, and workplace harm often disappear from public reporting. The blank spaces matter too.
Compare the forecast.
Two hospitals. Two different conditions. See what the public record reveals before you decide where to work.
Start with a county, search by hospital name, and compare the measures without an invented safety score.
First hospital
Second hospital
These hospitals have different ownership models (investor-owned versus nonprofit). Their benchmarks use separate ownership-matched peer groups where sufficient records exist.
Publicly reported measureDoctors Medical Center - ModestoMemorial Hospital Modesto
Contract RN shareHow much reported nursing work came from contract, agency, or registry nurses.2024 workforce report
Doctors Medical Center - Modesto2.0%
Memorial Hospital Modesto1.8%
RN hours per patient dayHospital-wide reported RN intensity—not your unit assignment or a staffing ratio.2024 workforce report
Doctors Medical Center - Modesto12.9
Memorial Hospital Modesto17.4
Pre-pandemic contract baselineThe hospital's own historical contract reliance when its earlier identity can be matched.2018–2019 baseline
Doctors Medical Center - Modesto6.2%
Memorial Hospital Modesto2.8%
Staffed versus licensed bedsBeds reported with staffing compared with the hospital's reported licensed beds.2025 capacity report
Doctors Medical Center - Modesto342 / 461
Memorial Hospital Modesto316 / 419
Staffed share of licensed bedsReported staffed beds divided by reported licensed beds—not a closed-unit count.2025 capacity report
Doctors Medical Center - Modesto74.2%
Memorial Hospital Modesto75.4%
Ownership and sizePeer context uses reporting category, ownership, and licensed-bed size when at least five usable matches exist.Facility reporting context
Doctors Medical Center - Modestoinvestor-owned · 400+ beds
Memorial Hospital Modestononprofit · 400+ beds
Evidence availableWhether the facility received additional pilot review or has descriptive public data only.Evidence review status
Doctors Medical Center - ModestoVerified pilot
Memorial Hospital ModestoReviewed · filing pending
Contract reliance is below the peer median · below its own pre-pandemic level · 74.2% of licensed beds reported staffed · combined campus/license reporting scope.
Contract reliance is below the peer median · below its own pre-pandemic level · 75.4% of licensed beds reported staffed.
Still unknown for both: actual assignments, charge-nurse coverage, missed breaks, overtime, turnover, acuity, and unit-specific conditions.
Find a California hospital.
444 hospitals · Most listings are not yet independently reviewed · Most listings are not yet independently reviewed
444 hospitalsNo composite scores · Unknown never means zero
Ask the public record.
How much does this hospital rely on contract nurses? How does it compare with similar hospitals? What share of licensed beds are staffed? Choose a hospital and get answers grounded in the available public record. Answers are generated from CNO's own dataset and may be incomplete or out of date. Always verify a figure against the linked source before citing it, and treat any answer outside the published metrics as unverified.
What can the evidence tell you?
Start with the questions public records can answer. We will show the numbers, explain their context, and flag what still needs to be asked in an interview.
What the larger pilot actually found.
Thirty hospitals received facility-specific review. These findings describe the reliability and limits of their public records, not whether any hospital or nursing unit is safe.
Facility-level evidence review30 of 30 reviewed
Hospital identity, reporting category, financial-filing status, workforce figures, capacity records, and comparison boundaries were examined.
Financial filing status26 audited · 4 pending
Hospitals with financial filings still in process remain visible and clearly distinguished from hospitals with audited filings.
Reported staffed beds exceed reported licensed beds in two hospital records. Capacity percentages are withheld until the reporting scopes can be reconciled.
Reported contract shares or RN intensity cannot be independently recreated from the other displayed fields. Different source definitions and 2024-versus-2025 reporting windows remain visible.
What changed at the five hospitals we studied?
These findings describe only Doctors Modesto, Memorial Modesto, UC Davis, San Joaquin General, and Adventist Sonora. They are not statewide results.
Hospital-wide RN hours per patient day3 of 5 declined
Doctors Modesto, UC Davis, and Adventist Sonora reported fewer RN hours per inpatient day. Memorial Modesto and San Joaquin General reported more.
Number of staffed hospital beds3 of 5 increased
Memorial Modesto, UC Davis, and Adventist Sonora added staffed beds. Doctors Modesto and San Joaquin General each reported 21 fewer.
How much licensed-bed capacity was used3 of 5 increased
Licensed-bed occupancy increased at Memorial Modesto, UC Davis, and Adventist Sonora; it decreased at Doctors Modesto and San Joaquin General.
RN share of nursing labor hoursAll 5 increased
Each pilot hospital reported a larger RN share of combined RN, LVN, and aide hours. The measure does not reveal whether support staffing was sufficient.
Five different stories.
Select a hospital, then change the evidence layer. Unlike time windows remain visibly separate.
Community / for-profit
Doctors Medical Center – Modesto
Facility RN proxy 2022 · 2023 · 2024
Facility RN proxy-4.0%2022–2024 · hospital-wide
Med-surg RN HPPD-15.6%2022–2023 · cost center
Weighted inpatient RN HPPD-11.8%2022–2023 · varying unit blend
Supported interpretation
Facility RN intensity fell 4.0% in 2022–2024. In the earlier unit window, med-surg and weighted inpatient RN HPPD fell 15.6% and 11.8%. The unit evidence localizes the earlier change, but it is not shift-level staffing.
Best next evidence
Quarterly unit staffing, acuity, overtime, missed-break and ratio records.
Functional nursing capacity has four parts.
The pilot is strongest in resources and demand. Sustainability and care completion remain the decisive gaps.
1
Nursing resources
How much nursing capacity was available?
Partly observable2
Work demand
What was nursing being asked to absorb?
Partly observable3
Workforce sustainability
Can the workforce continue doing it?
Mostly missing4
Care completion
Was necessary nursing work completed?
Mostly missing
Unknown is a finding—not reassurance.
These measures may determine whether reported capacity translated into workable nursing conditions.
Missed meal and rest breaksImmediate overload signalNo reliable public facility feed located
Overtime and mandatory overtimeWhether nominal capacity is sustainableFragmented labor records
Turnover, vacancies and first-year attritionWorkforce stabilityNot consistently public by hospital
Missed or delayed nursing careWhether necessary nursing work was completedRarely collected for public use
Acuity and assignment complexityDemand per nurse, not merely patient countUnavailable in standardized public data
Every ladder rung stays inspectable.
Sources, age, denominator, definition, missingness and limitations remain visible. This is not a safety rating, causal claim or statewide trend.
Never pool unlike hospitalsPeer type and service mix remain visible.
Never hide missingnessUnavailable information stays unknown.
Never equate capacity with safetySafety requires direct evidence.
Never manufacture one scoreThe contradictions are important.
Follow every source back to its original file.
These source files document the original longitudinal pilot only. Statewide directory records and 2025 capacity figures have separate reporting scope and should not be represented as coming from these six files.
