PBJ Policy & Enforcement | Latest News On CMS Rule Changes

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PBJ Policy & Enforcement

PBJ technical specifications changed

March 16, 2026

Our Take: CMS made minor updates to the PBJ data specification for uploaded PBJ files. Users can no longer submit more than 22.5 hours per employee ID. XML files are required to use…

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CMS Special Focus Facility program ‘crack down’ on troubled nursing homes ends use of staffing

January 28, 2026

Our Take: A CMS memo originally added staffing to the Special Focus Facility program but later shifted away from staffing. SNFs in the SFF program face escalating civil monetary penalties beginning at program…

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CMS updates PBJ Policy Manual after three years with no changes

June 30, 2025

Our Take: CMS released PBJ Policy Manual Version 2.7 in June 2025. Updates include explicitly requiring that nursing hours be worked on-site to be included in PBJ, establishing a 22.5-hour daily maximum per…

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New Surveyor guidance increases PBJ oversight

March 10, 2025

Our Take: CMS issued revised surveyor guidance effective April 28, 2025, covering PBJ reporting, nursing services, psychotropic medications, infection prevention, and other compliance areas. Surveyors are provided PBJ reports and trained to review…

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CMS updates staffing & turnover measures on Care Compare

October 4, 2024

Our Take: CMS issued memo announced updates to Nursing Home Care Compare staffing ratings and quality measures driven by the MDS transition from Section G to GG. Updates to the case-mix methodology came…

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CMS finalizes minimum staffing rule, elicits strong reactions

April 22, 2024

Our Take: On April 22, 2024, CMS issued the first-ever federal minimum nurse staffing standards for Medicare & Medicaid-certified long-term care facilities. The rule requires 3.48 total nursing hours per resident day (HPRD),…

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Proposed rule digest: Feds’ value-based changes present ‘long overdue’ opening for SNFs

April 6, 2023

Our Take: CMS finalized the FY 2024 SNF Prospective Payment System rule, delivering a 4.0% payment increase of approximately $1.4 billion while overhauling the Value-Based Purchasing program. VBP sees new measures tied to…

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MedPAC’s recommendations: state staffing policies could hamper federal mandate

September 30, 2022

Our Take: MedPAC analysts used PBJ data at the Commission’s September 2022 meeting to show staffing shifts in SNFs, including a near-tripling of contract staff hours between 2019 and 2021. The Commission declined…

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CMS directs states to strengthen nursing home staffing and quality through Medicaid

August 25, 2022

Our Take: On August 22, 2022, CMS issued a CMCS Informational Bulletin directing states to use existing Medicaid authority and payment tools to improve nursing home staffing levels, worker compensation, and quality of…

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CMS issues significant updates to improve the safety and quality care for long-term care residents

June 30, 2022

Our Take: Effective with the July 2022 refresh, CMS added six staffing measures to the Five-Star Quality Rating System, incorporating weekend staffing levels and annual staff turnover, while limiting the overall star bonus…

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PBJ News Topics

Read about PBJ regulations, research & news impacting SNFs

Most Recent PBJ News

Democratic bills revive minimum staffing debate

March 30, 2026

Minimum Staffing Roundup

Our Take: CMS repealed the nursing home minimum staffing rule in early 2026 following court defeats. Key provisions…

CMS nursing home funding campaign grows to $200 million

March 16, 2026

Minimum Staffing Roundup

Our Take: CMS has expanded its nursing home staffing campaign from $75 million to $200 million. Proposed with…

The effects of labor unions on nurse staffing ratios

March 2, 2026

PBJ Research & Analysis

Our Take: A Health Affairs study of 321 newly unionized nursing homes from 2013 to 2021 found that…

Did state staffing mandates add direct care staff or hurt SNF finances?

March 2, 2026

PBJ Research & Analysis

Our Take: A study of 6,849 nursing homes in 22 states found that state minimum staffing mandates raised…

Medical Director compliance under increasing federal and state scrutiny

February 23, 2026

Latest PBJ News

Our Take: Federal regulators and state lawmakers are intensifying scrutiny of SNF medical directors. OIG is actively reviewing…

State Attorneys General ask CMS for staffing rule on for-profit SNFs

February 1, 2026

Minimum Staffing Roundup

Our Take: Following CMS’s repeal of a federal staffing mandate, attorneys general from 18 states are urging the…

SNF benchmarking report points to value based care, Medicare Advantage, and PBJ scrutiny

January 30, 2026

Latest PBJ News

Our Take: Plante Moran’s 2025 SNF Benchmarking Report analyzes data from over 12,000 skilled nursing facilities. They highlighted…

AHCA: Nursing homes added 40,700 jobs in 2025 as turnover, agency use declined

January 28, 2026

PBJ Research & Analysis

Our Take: AHCA/NCAL’s January 2026 Nursing Home Workforce Report shows that the nursing home sector added 40,700 jobs…

CMS Special Focus Facility program ‘crack down’ on troubled nursing homes ends use of staffing

January 28, 2026

PBJ Policy & Enforcement

Our Take: A CMS memo originally added staffing to the Special Focus Facility program but later shifted away…

Medicaid staffing bonus increases nurse levels

January 26, 2026

PBJ Research & Analysis

Our Take: A study found that an Illinois Medicaid bonus program increased nurse staffing by 12.2% and reduced…

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