Each tab follows the same three steps: work out how many people you need on every shift, convert those seats to hours and FTEs, then price the hours.
California (Title 22, §70217) and Oregon (HB 2697, 2023) both set minimum RN-to-patient ratios in law for most hospital unit types. Oregon's med-surg ratio tightened from 1:5 to 1:4 on July 1, 2026. Click a unit to load it. Use these as a starting point and confirm them against current law, your acuity, your skill mix and your staffing plan.
Why 4.679 FTEs per seat and not 4.2 or 5?
One seat covered 24/7 needs 24 × 365 = 8,760 hours a year. A full-time employee on a 36-hour week works 36 × 52 = 1,872 hours. 8,760 ÷ 1,872 = 4.679. If your FT week is 40 hours, change it in Shared assumptions and every tab updates (40 hrs gives 4.21 FTE per seat). The figure doesn't include PTO, sick time or orientation, so add a replacement factor if you budget for those.
How are benefits calculated? Do per diem and differentials get them?
You choose this under Shared assumptions. Include benefits (on by default) adds a benefits load at the Benefits % of salary you enter (default 25%). Benefits apply to sets which wages the load is calculated on. Total salary (the default) covers everything you pay: full-time wages, per-diem pay and differentials. Full-time base wages only leaves per diem and differentials unloaded, which matches organizations where per-diem staff don't get benefits. The difference only shows up when you have per diem or differentials. For example, 3 FT + 1 per-diem seat at $44/hr, 24/7, costs $1,927,200 on total salary vs $1,830,840 on FT-only. Turn benefits off to see salary only: every Benefits column, tile and CSV cell then shows $0.
What is HPPD?
Hours per patient day is all staff hours divided by patient days (census × covered days). The Nursing Unit tab counts every role you list, so it is total nursing care HPPD, not RN only. The default unit (6 RNs, 1 charge RN, 3 techs for 24 patients) works out to 10.0 HPPD.
How does the "Current RNs / shift" gap check work?
Enter how many RNs you actually staff and StaffingCalc compares that with the RNs your target ratio requires. If you're short, it shows the yearly cost of closing the gap with full-time RNs (with benefits) next to the cost of covering it with overtime at 1.5× (no benefits). The gap check doesn't change the budget totals.
How are telesitting savings split up?
Gross savings is the current cost minus the proposed cost. That figure is broken into the lower-wage site (current sitters × wage difference), the ratio change and pooling (fewer sitters at the new wage), and "other", which covers per-diem mix and rounding so the lines add up exactly. Net savings subtracts any added tech or AI cost.
Ratio or HPPD: which method should I use?
A ratio sets a patient load for each nurse, which is how California and many staffing plans are written. An HPPD target is a budget approach: the unit gets a fixed number of RN care hours for each patient day, and you convert that to people on shift. RNs per shift = census × RN HPPD ÷ covered hours per day. For example, 24 patients × 6 RN HPPD ÷ 24 hrs = 6 RNs, the same as 1:4. Pick whichever your plan or budget uses. The other roles keep their own ratio or fixed count either way.
What is the non-productive (relief) factor?
An FTE is paid for 1,872 hours on a 36-hour week, but some of those hours go to vacation, holidays, sick time and education, and someone else has to cover the seat then. Enter those hours per FTE and StaffingCalc adds relief FTEs: relief FTE = productive FTE × non-productive hrs ÷ (FT hrs − non-productive hrs). Example: 46.8 productive FTE with 200 non-productive hours gives 46.8 × 200 ÷ 1,672 = 5.6 relief FTE, so 52.4 FTE to hire. Some quick methods divide by total paid hours instead (46.8 × 200 ÷ 1,872 = 5.0), which comes out a little low. Only count meal breaks if another person actually relieves the seat. The relief factor changes the headcount to hire, not the cost, because paid time off is assumed to be inside your benefits %.
How does StaffingCalc round staff per shift?
You can't schedule a fraction of a person, so computed staff per shift (RNs, ratio-based roles and sitters) is turned into whole people. There are three options. Round to nearest is the default: .5 and above rounds up, so 5.4 → 5, 5.5 → 6, 6.25 → 6 and 6.5 → 7. Always round up never leaves a fraction uncovered (6.25 → 7), which is the conservative choice when a ratio is a legal maximum. No rounding shows the exact workload, which is handy when fractions are shared across units. Exact results such as 264 ÷ 12 = 22 are never bumped to 23. Fixed per-shift counts and overrides are used as entered.
Which states set nurse ratios in law?
California (Title 22, §70217) and Oregon (HB 2697, 2023) both set minimum RN-to-patient ratios in law for most unit types. Oregon's med-surg ratio changed from 1:5 to 1:4 on July 1, 2026. Massachusetts sets ICU ratios, and many other states require staffing plans or committees instead of fixed ratios. Pick a state and unit preset to turn on the ratio check. Laws change, so confirm the current rule before you rely on it.
Why does the state ratio check always round up?
A ratio law sets the most patients one nurse may have at any time, so 26 med-surg patients at 1:5 need 6 nurses, not 5.2 rounded down to 5. Your rounding choice still sets the budget, but if it leaves you below the state minimum, StaffingCalc shows a red "State ratio not met" warning. In HPPD mode, the ratio field becomes a floor: if the HPPD target gives fewer nurses than the ratio requires, you get a warning. Set the ratio first, then use HPPD to check the budget.
What does "Counts toward RN ratio" on a fixed role do?
Fixed roles such as a charge nurse or triage RN are added after rounding, so they never soak up patient workload. In California and Oregon, a charge nurse counts toward the ratio only while taking a patient assignment, and the ED triage RN doesn't count. Tick the box only if the role takes patients. Its people are then subtracted from the RN row.
How do share links and Copy results work?
Copy share link puts every input you changed, plus your role list, into the link itself (after the #). Anyone who opens it sees the same scenario, and nothing is uploaded anywhere. Copy results copies a plain-text summary of the current tab, ready to paste into an email or chat.
How are payroll tax and benefits different?
Benefits (health, retirement, PTO accrual and so on) use the Benefits % setting. Payroll tax is the employer's share of FICA plus unemployment and workers' comp. It applies to all salary on every tab and defaults to 0 so the base totals don't change. 7.65% is the employer FICA rate; add your own unemployment and workers' comp rates.
How do day/night inputs and census percentiles work?
With day/night on, each half of the day gets its own census, ratio and current staff. Hours and cost use the average of the two shifts, and the state check looks at each shift. A percentile census uses average + z × standard deviation (a normal approximation; real census is often skewed, so check it against your history). A band shows the cost at a low and high census.
How do LVN/LPN share and differentials work?
The LVN/LPN share is taken from the licensed seats each shift and rounded down so RN seats are never understated. With a state preset selected the share is capped at 50% (California allows LVNs to make up no more than half of licensed nurses). Night and weekend differentials are blended into a per-hour add-on: night share × night rate + (weekend days ÷ coverage days) × weekend rate.
How are agency, overtime and per diem compared?
For the shift gap, each option is priced for the same hours: FT hire (wage + benefits + tax), overtime (wage × OT multiplier, with benefits if they apply to all salary), per diem (rate + load) and agency (bill rate, all-in). The cheapest is flagged. Turnover and vacancy costs are shown separately and are not added to the budget total.
What are the telesitting ROI figures based on?
Your inputs only. The 3.3 falls per 1,000 patient days default is an example rate, not a benchmark. Fall cost, reduction and setup default to 0 so nothing is assumed. Payback = setup ÷ monthly benefit. 3-year ROI = (3 × annual benefit − setup) ÷ (setup + 3 × annual tech cost).
How do saved scenarios work?
Type a name and click Save scenario on any calculator tab. The Scenarios tab lists them. Tick up to six to compare cost, FTEs and key metrics side by side, load one to keep editing, or export the comparison to CSV. Scenarios are kept in this browser only.
How does the Emergency Dept tab work?
Each shift's workload = arrivals × nursing hours per visit (optionally weighted by ESI level and a LOS/complexity factor). RNs = workload ÷ (shift hours × target utilization), plus boarded patients at their inpatient ratio. Care RNs are then raised to the core-staff floor and the state minimum, and fixed roles such as triage are added after rounding. Patients present for the state check are estimated as arrivals ÷ shift hours × length of stay. The tab rounds up by default. Check peak hours separately, because Oregon caps ED assignments at 5 at any time.
What is the AORN 9-step method on the OR tab?
Room coverage hours per week × staff per room ÷ paid hours per FTE gives basic FTEs. Then it adds benefit-relief FTEs, indirect staff, call-replacement and orientation FTEs. The example blocks (8 rooms 7a–3p weekdays plus one overnight room), 2.5 staff per room and the 67% RN share follow AORN's worked example. Replace them with your own schedule.
How are couplets counted on the L&D tab?
A couplet is one mother and her baby. California sets 1:4 couplets with no more than 8 patients per RN, and 1:6 for mothers only. Oregon sets mother-baby at 1:8 and counts each person, which works out to the same 4 couplets per RN. Each area is rounded up separately, and charge RNs are added on top. California has no well-baby ratio in this tool, so enter your own nursery ratio.
What does acuity-weighted staffing do?
Enter patients by acuity level and the RN hours per patient day each level needs (from your patient classification system; the levels shown are examples). RNs per shift = total RN hours ÷ covered hours per day. The state ratio is still checked as a floor, because California requires a classification system on top of the ratios.
What do the Workforce tools do?
The demand curve compares required staff by hour with your staggered shifts and lists short hours. The FLSA section compares overtime under the 40-hour week with the 8-and-80 system for a 12-hour pattern. The rotation generator builds a simple 2-week starting schedule: no more than 3 shifts in a row, and day and night teams kept separate. It is not a replacement for scheduling software.
What is the Compliance log?
A shift-by-shift record of required vs actual staff and the variance, kept only in this browser. It counts plan deviations per unit over a rolling 30 days and warns above Oregon's 6, and it exports to CSV. It isn't an official record system.
Where is my data stored?
Only in this browser's local storage. Nothing is sent to a server. Reset defaults clears your inputs; saved scenarios stay until you delete them.
StaffingCalc is an independent planning aid. It isn't legal, regulatory or clinical advice. Check ratios against your state's rules and your facility's staffing plan.