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PBJ Research & Analysis

Study suggests staffing shortages during the pandemic strained nursing homes

July 27, 2023

Our Take: A study in JAMA Network Open used PBJ data from eight U.S. markets to document how COVID-19-era staffing shortages drove administrators to adopt agency staffing, overtime, and admission reductions to maintain…

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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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To advance information on quality of care, CMS makes nursing home staffing data available

January 30, 2022

Our Take: CMS began publicly posting nursing home staff turnover rates and weekend staffing levels on Care Compare in January 2022, using PBJ data since 2016. These turnover and weekend measures will be…

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PBJ news digest: CMS enforcement focus, census reporting changes, and data validation best practices

October 13, 2021

Our Take: CMS has sharpened its enforcement posture around SNF staffing, while simplifying PBJ file submission specifications. Accurate, human-reviewed quarterly submissions remain essential as regulatory pressures translate directly into Five-Star staffing ratings. ▼…

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Maggots, rape and yet five stars: how U.S. ratings of nursing homes mislead the public

March 16, 2021

Our Take: The payroll-based journal data collection is a new playground for journalists and researchers. The more data you have, the more you can analyze and interpret it. The New York Times claimed…

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OIG reports on CMS use of data on nursing home staffing: progress and opportunities to do more

March 9, 2021

Our Take: An OIG review found CMS is making progress using PBJ staffing data to improve transparency. However OIG recommended CMS add turnover and staff tenure data to Care Compare to strengthen oversight…

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CMS announces updates to Five Star Quality Rating System

November 30, 2020

Our Take: CMS announced that all three Five Star Quality Rating System domains, Health Inspections, Quality Measures, and Staffing, will resume full updates with the January 27, 2021 quarterly refresh. The update coincides…

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PBJ audits and F-Tags

October 22, 2019

Our Take: CMS uses PBJ data to flag facilities for audit and to set staffing star ratings, with RN hours and reporting accuracy serving as the primary pressure points. Understanding what CMS is…

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CMS: hundreds more buildings could receive one-star staffing ratings under new rules

April 30, 2019

Our Take: In April 2019, CMS updated Nursing Home Compare and the Five-Star Quality Rating System with significant changes to staffing, health inspection, and quality measure ratings. For staffing, the threshold triggering an…

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CMS peels back curtain on why providers receive PBJ audits

November 29, 2018

Our Take: Audits of PBJ data were introduced in the shift to PBJ from the prior staffing data collection method. With triggered or random audits, CMS verifies reported data is consistent with payroll…

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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…

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…

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…

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