Provider advocates slam ‘unfair’ media take down of nursing home staffing compliance

Dec 1, 2022 | Minimum Staffing

USA Today Analysis Called Unfair and Misguided

PBJ data fed into a media analysis of staffing levels compliance by USA Today.  Yet some assumptions and judgements conveyed in the article relied on policies that preceded the payroll-based journal program and failed to acknowledge current enforcement policies applied by CMS.

Key industry associations strongly pushed back against a story they felt mischaracterized enforcement in the skilled nursing industry.


Many nursing homes are poorly staffed. How do they get away with it?

Regulators have allowed thousands of nursing homes across America to flout federal staffing rules by going an entire day and night without a registered nurse on duty, a USA TODAY investigation has found.

Nearly all of them got away with it: Only 4% were cited by government inspectors. Even fewer were fined.

When other nursing home caregivers are added into the equation, one-third of U.S. facilities fell short of multiple benchmarks the federal government has created for nurse and aide staffing.

A USA TODAY investigation has documented, for the first time, how rarely the federal government enforces decades-old staffing guidelines and rules for nursing homes.


Frazer, Jayme and Penzenstadler, Nick. Many Nursing Homes Are Poorly Staffed. How Do They Get Away With It? 2 Dec. 2022,


Provider advocates slam ‘unfair’ media take down of nursing home staffing compliance

A major provider organization Thursday called out a newspaper’s national investigation into nursing home staffing as “unfair and mischaracterized.”

USA Today’s lengthy article focused on staffing benchmarks set by federal agencies, understaffing of facilities and the harm it causes residents and staff, and the low percentage of citations compared to the number of understaffed facilities the paper found in its investigation.

The American Health Care Association told McKnight’s Long-Term Care News in an email that USA Today’s use of the 4.1 HPRD recommendation from 2001 and CMS STRIVE calculations to analyze today’s nursing home staffing levels is unfair since nursing homes are not required to meet these standards.

“We are extremely disappointed in USA Today’s unfair and mischaracterized reporting,” AHCA leaders said. “The analysis that USA Today bases their claims on is flawed. The vast majority of nursing homes are committed to providing surveyors with accurate, complete information, and the current payroll-based journal reporting system is auditable and robust; 99% of nursing homes are currently meeting the federal government’s process to determine sufficient staffing.”


Bush, Joe. “Provider Advocates Slam ‘Unfair’ Media Take Down of Nursing Home Staffing Compliance.” McKnight’s Long-Term Care News, 2 Dec. 2022,


USA Today Report Blasts Nursing Home Staffing Patterns, Enforcement — Industry Leaders Push Back

USA TODAY on Thursday published a lengthy article on nursing home staffing patterns and staffing-related related inspections and enforcement mechanisms. The article describes an investigation carried out by the newspaper, which found that the federal government falls short on enforcing staffing guidelines for nursing homes, with grave consequences for residents.

Leaders with industry groups pushed back on the article, saying that the focus is misplaced, with more attention needed on the workforce crisis besetting the sector.

AHCA Senior Vice President Holly Harmon was quoted in the USA TODAY article, as was an ACHA press release from the summer, which stated that 94% of nursing homes need to increase staffing to meet Biden’s prospective minimum staffing mandates, costing $10 billion a year.

“A new, federal staffing mandate without the available workforce and financial resources necessary to meet it would reinforce a punitive process that hasn’t been working for decades,” she said.


Grebbin, Shelby. “USA Today Report Blasts Nursing Home Staffing Patterns, Enforcement — Industry Leaders Push Back.” Skilled Nursing News, 2 Dec. 2022,