Two federal filings name the buildings that are short of people right now. Neither of them is a job board, and almost nobody in staffing reads either one.
Every staffing agency in a given market is working the same list. Somebody posts a job, three agencies see it the same morning, and the race is to whoever calls first with a body. It is a race you can win occasionally and never win consistently, because you are all reading the same page.
The interesting question is the one the job board cannot answer: which facilities are short of people and have not posted anything?
A building can be desperate and silent. Those two things are not in tension — they are the normal case.
A nursing home that is under-staffed does not necessarily advertise. It runs the floor short. It mandates overtime. It calls the agency it already uses and asks for one more CNA, and when that agency cannot fill it, the shift runs light. A plant behaves the same way: it works the people it has past forty hours rather than open a requisition it is not confident it can fill.
Posting a job is a decision with its own cost and its own internal politics. Being short of people is a fact. The two are related, but loosely, and the gap between them is where the orders are.
Every certified nursing home in the United States reports its actual nursing hours to CMS through the Payroll Based Journal — not an estimate, payroll data. CMS separately publishes, for each facility, the nursing hours per resident per day that facility should be delivering given the measured acuity of the residents actually living there. That second figure is the case-mix expected number, and it is specific to the building.
Subtract one from the other and you have a gap in hours per resident per day. Multiply by residents, multiply by 365, divide by the hours in a nursing full-time year, and the gap stops being a ratio and becomes a count of people:
Run nationally, that arithmetic returns roughly 100,000 missing nurse full-time equivalents across about 14,700 nursing homes. Not a market-size estimate — a federal filing, building by building, name and address attached.
The same shape exists in manufacturing and distribution, in a different file. Establishments above a size threshold file OSHA Form 300A every year, and that form carries total hours worked and average employee count. Divide one by the other and you have hours per head.
A normal full-time year is about 2,080 hours. An establishment reporting 2,400 hours per head is telling the federal government, in writing, that it is covering demand with overtime instead of headcount:
Across the roughly 94,000 in-scope establishments, about 31% are running above the 2,080 line.
Three reasons, none of them clever.
The files are not convenient. They arrive as large flat exports with inconsistent facility naming and no geography beyond an address. Matching them to a real drive-time territory, deduplicating campuses that file twice, and dropping the records where somebody typed the hours wrong is a few days of work per market — and it has to be redone as the files refresh.
They are lagging. OSHA 300A is an annual filing; PBJ is quarterly. Neither tells you about a requisition opened on Tuesday. They tell you about a structural shortfall that has been running for months, which is a different and in some ways better thing to know.
And staffing sales has been organised around job boards for twenty years. The boards are immediate, they are easy, and they are where the competition is. Reading a federal payroll file is not what the job has looked like.
The call changes. Instead of “I saw your posting for a CNA,” which every agency in the county also saw, it is a conversation about the building — what its own filings say about coverage, and whether the overtime it is running is cheaper than the agency hours it is avoiding.
The ordering changes too. Combine the silent signal with the live one and the ranking is different from what the job board suggests: a facility that is both structurally short and advertising this week is a far better call than one doing either alone.
And the map changes. Overlay the agency’s own contract register and the cheapest orders show up immediately — buildings within fifteen miles of an account they already hold, where the paperwork exists and the relationship exists and only the order is missing.