PBJ Research & Analysis | Studies Shaping Post-Acute Care

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PBJ Research & Analysis

Do Medicaid payment rates cover the costs of care in nursing homes?

October 11, 2024

Our Take: A October 2024 ASPE report analyzed 13,285 nursing homes across 44 states and found that Medicaid reimbursement covers just 82 cents per dollar of actual care cost. 40% of SNFs are…

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Medical director presence and time in US nursing homes

September 2, 2024

Our Take: A peer-reviewed study found that 36.1% of U.S. nursing homes reported zero medical director presence in Q1 2023, based on federal PBJ data from 2017–2023. The findings raise compliance and PBJ…

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Nursing Home Compare star ratings before versus after a change in nursing home ownership

July 29, 2024

Our Take: A study of 15,471 SNFs found that CMS Five-Star ratings declined slightly following ownership changes between 2016 and 2022. The primary driver is lower staffing ratings, with RN hours per resident…

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The relationship between nursing home staffing and health outcomes revisited

July 16, 2024

Our Take: A JAMDA study using 2017–2019 PBJ data found that staffing type, not just total hours, produces meaningfully different and sometimes opposite quality outcomes. RNs are linked to fewer hospitalizations and ER…

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Top factors in nurses ending health care employment between 2018 and 2021

April 9, 2024

Our Take: A cross-sectional study of 7,887 nurses found that after planned retirement, burnout (26%), insufficient staffing (21%), and family obligations (18%) were the top reasons nurses left healthcare employment. Critically, 41% of…

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Tunneling and hidden profits in health care: study finds 63% of nursing home profits concealed through related-party transactions

March 14, 2024

Our Take: A working paper by UCLA & Lehigh economists finds that 63% of nursing home profits are concealed from regulators through inflated payments to related-party real estate and management companies. This “tunneling”…

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Nursing homes increasingly rely on staffing agencies for direct care nursing

February 14, 2024

Our Take: A study of PBJ data found that agency nursing staff in SNFs nearly doubled from 23% to nearly 50% between 2018 and 2022. Agency hours rose from 3% to 11% of…

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Nursing home staffing: Share of immigrant CNAs grew as US-born staff numbers fell

January 8, 2024

Our Take: A Health Affairs study found that foreign-born CNAs became an increasingly critical share of the nursing home workforce as native-born CNA numbers fell 39% between 2010 and 2021. Higher immigrant concentrations…

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High-quality nursing home dementia care is not only a matter of adding staff

December 29, 2023

Our Take: A study concluded that high-dementia facilities still underperformed on antipsychotic use and activities of daily living despite increased RN and CNA hours. The study indicated that increased staffing alone cannot close…

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High staff turnover linked to decreased quality of care in SNFs

October 9, 2023

Our Take: Two October 2023 JAMA studies show that increases in nursing staff turnover is connected to higher citation counts and lower CMS quality measure scores. The second study associated labor union presence…

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PBJ News Topics

Read about PBJ regulations, research & news impacting SNFs

Most Recent PBJ News

Industry analyses project $6.5B annual cost and widespread compliance gaps

April 18, 2026

Minimum Staffing Roundup

Our Take: Multiple analyses drawing from AHCA/NCAL, Altarum, and independent consultants project that CMS’s minimum staffing mandate will…

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…

PBJ technical specifications changed

March 16, 2026

PBJ Policy & Enforcement

Our Take: CMS made minor updates to the PBJ data specification for uploaded PBJ files. Users can no…

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…

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