PBJ News Topic

PBJ Research & Analysis

Invisible staffing churn in nursing homes: CMS turnover metrics miss a growing short-term workforce

April 18, 2026

Our Take: A Health Affairs Scholar study found that CMS’ turnover metric is likely understating real facility churn where they lean on contract labor or fast-turn new hires. Data analyzed in 2022-2023 found…

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The effects of labor unions on nurse staffing ratios

March 2, 2026

Our Take: A Health Affairs study of 321 newly unionized nursing homes from 2013 to 2021 found that unionization increased LPN staffing by roughly 2.7 hours per day while decreasing RN staffing by…

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

March 2, 2026

Our Take: A study of 6,849 nursing homes in 22 states found that state minimum staffing mandates raised direct care staffing by roughly 5% without harming facility finances or increasing closures. Industry advocates…

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COVID-19 public funding’s impact on nursing homes

November 4, 2024

Our Take: A 2024 Health Affairs study found that COVID-19 public health emergency funds masked declining nursing home finances. Nonprofit facilities lost $31.18 per resident day by 2022 once PHE funds were reduced.…

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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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Study shows that higher spending on nursing home staff is not tied to better staffing levels

February 6, 2023

Our Take: A Health Affairs study found that nursing homes with higher Medicaid resident shares spent more of their revenue on nursing staff, yet still had lower staffing levels. The findings demonstrated that…

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Study shows that REIT ownership linked to decline in RN staffing, increases in LPN, CNA use

January 25, 2023

Our Take: A 2023 study in Health Affairs found that REIT investment in nursing homes is associated with a statistically significant decline in registered nurse hours per resident day and increases in LPN…

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Nursing home staffing levels did not change significantly during COVID-19

May 3, 2021

Our Take: A May 2021 Health Affairs study using CMS PBJ data found that while total nursing hours in SNFs declined during the first nine months of COVID-19, nurse staff hours per resident…

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New research examines if nursing home staff turnover a good quality metric

March 1, 2021

Our Take: Research using PBJ staffing data shows nursing home staff turnover is associated with quality outcomes, but questions remain about whether turnover alone fully reflects facility performance. Labor shortages and market conditions…

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PBJ News Topics

Read about PBJ regulations, research & news impacting SNFs

Most Recent PBJ News

Staffing lawsuits increase scrutiny on employment levels & wages

July 1, 2026

Latest PBJ News

Our Take: Multiple lawsuits all turn on the same underlying evidence: payroll-based journal hours, timecards, and staffing schedules…

PBJ Reporting Moving to iQIES System

June 30, 2026

PBJ Policy & Enforcement

Our Take: CMS is retiring “QIES,” its first PBJ submission system. Starting August 17, 2026, all staffing data…

New US DOL joint employer rule impacts senior care

June 26, 2026

Latest PBJ News

Our Take: The U.S. Department of Labor proposed a new joint employer rule under the Fair Labor Standards…

SCOTUS Upholds Administration’s Decision to Strip TPS From Haitian & Syrian Immigrants

June 25, 2026

Latest PBJ News

Our Take: The Supreme Court ruled 6-3 that federal courts cannot block the Trump administration’s termination of Temporary…

OIG Audit Finds CMS’s PBJ Oversight Fell Short: 5% of RN Staffing Hours Unsupported

June 18, 2026

Our Take: A new HHS Office of Inspector General (OIG) audit found that CMS was not effective in…

Tort Immunity and Nursing Home Staffing

June 1, 2026

PBJ Research & Analysis

Our Take: A study of 13,205 nursing homes found that states giving SNFs immunity from COVID-19 liability reduced…

Is minimum staffing at play in the mid-term elections?

May 20, 2026

Minimum Staffing Roundup

Our Take: Senate Democrats outlined plans to revive nursing home staffing standards, expand Medicare-covered home care, and tighten…

NJ SNF sues CMS over PBJ audits, citing no appeal rights

April 22, 2026

Latest PBJ News

Our Take: A New Jersey skilled nursing facility filed a federal lawsuit on April 21, 2026, alleging that…

SNF pay rate proposals bring heightened CMS enforcement

April 10, 2026

PBJ Policy & Enforcement

Our Take: CMS has proposed a 2.4% Medicare rate increase for SNFs in FY 2027 while simultaneously expanding…

Minnesota SNF wage floor implementation delayed as CMS review restarts and provider associations file federal lawsuit

April 9, 2026

Latest PBJ News

Our Take: Minnesota’s Nursing Home Workforce Standards Board was created in 2023 to set binding wage floors and…

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