Nursing homes currently face heightened survey scrutiny only when they self-report zero RN hours for four or more days in a quarter. SNFs reporting sub-8-hour RN coverage remain unflagged despite violating minimum staffing rules.
If OIG’s recommendations are eventually adopted, an estimated 5% more facilities could be flagged for follow-up.
CMS Use of Staffing Data To Inform State Oversight of Nursing Homes
“Although States reported that the PBJ data have been useful, CMS did not provide States with all the information they need to effectively oversee the minimum requirement to provide 8 RN hours every day, as well as the broader requirement to provide sufficient staffing to meet residents’ needs. CMS does not identify all nursing homes with fewer than 8 RN hours. Instead, CMS targets nursing homes with zero RN hours. States could better target their oversight if CMS identified all nursing homes that had more than zero but fewer than 8 hours of RN coverage.”
Office of Inspector General, U.S. Department of Health and Human Services. CMS Use of Staffing Data To Inform State Oversight of Nursing Homes. Office of Inspector General, 29 May 2025. https://oig.hhs.gov/reports/all/2025/cms-use-of-staffing-data-to-inform-state-oversight-of-nursing-homes/
CMS Resists OIG Call for More Intense Use of Nursing Home Staffing Data
The OIG acknowledged the Payroll-Based Journal staffing reports have been useful but asked CMS for more complex analysis and pass-along reporting about them. CMS demurred, saying it had already taken numerous steps over the last year alone to help heighten scrutiny and identify potential understaffing.
— McKnight’s Long-Term Care News, June 10, 2025
As OIG Urges More Oversight of Nursing Home Staffing, CMS Pushes Back Citing ‘Limited Resources’
“CMS did not agree with OIG’s recommendation to inform states of nursing homes that appear from PBJ data to violate the required number of RN hours, arguing in its response that this move would place an undue burden on state survey agencies (SAs) without a corresponding increase in inspection resources. Due to “limited resources,” CMS has had to make choices – and currently flags the most at-risk nursing homes for survey agencies, which include nursing homes that report zero hours of RN staffing for four or more days in a quarter.”
— Skilled Nursing News, June 9, 2025
