PBJ News Topic

PBJ Policy & Enforcement

FY 25 SNF Prospective Payment System Proposed Rule

May 1, 2024

Our Take: CMS issued the FY 2025 SNF Prospective Payment System proposed rule, which includes a 4.1% payment rate increase, expanded civil monetary penalties and updates to the SNF Value-Based Purchasing program. A…

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1 in 5 nursing facilities would meet fully-implemented minimum staffing standards

April 22, 2024

Our Take: In April, 2024, CMS released a final rule establishing minimum nurse staffing standards for nursing facilities, including 3.48 total hours per resident day (HPRD), A KFF analysis using Payroll Based Journal…

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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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Minimum staffing rule advances toward finalization despite opposition

April 16, 2024

Our Take: The proposed minimum staffing rule moved steadily from proposal through OMB review in April 2024. The Biden Administration publicly committed to finalizing despite widespread provider opposition and having to review 46,000…

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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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Connecticut staffing mandate brings $55M in unexpected costs.

February 28, 2024

Our Take: Connecticut’s nursing home staffing mandate generated $55 million in unanticipated Medicaid liability after a state health agency imposed RN-specific hour requirements beyond legislative intent. The rule that was in effect for…

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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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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…

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

April 18, 2026

PBJ Research & Analysis

Our Take: A Health Affairs Scholar study found that CMS’ turnover metric is likely understating real facility churn…

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…

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