PBJ News Topic

Minimum Staffing Roundup

Staffing Minimums digest: Federal legislation, State mandates, Agency costs, and Legal challenges

July 28, 2022

Our Take: Federal and state efforts to impose minimum staffing requirements on SNFs are intensifying, even as providers face a labor shortage, rising agency costs, and inadequate Medicaid reimbursement. Legal challenges, proposed PBJ-linked…

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Research on COVID staffing finds policy action can stabilize staffing levels

July 22, 2022

Our Take: A cohort study published in JAMA Health Forum found that severe COVID-19 outbreaks caused lasting declines in nursing staff levels, with total staffing hours falling 5.5% below pre-outbreak levels 16 weeks…

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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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Study shows weekend and daily variation in nursing home staffing led to poorer clinical quality

March 14, 2022

Our Take: A 2022 study in JAMA Network Open analyzed PBJ data from 13,339 nursing homes and found that daily variation in RN and CNA staffing levels was significantly and negatively associated with…

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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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OIG Study: HHS watchdog probes enforcement of nursing home staffing standards

August 30, 2020

Our Take: The HHS Office of Inspector General’s review of how CMS enforces nursing home staffing requirements signals continued federal scrutiny of staffing compliance and reporting accuracy. Skilled nursing facilities should expect increased…

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Study finds nursing homes rarely have enough RNs on staff

July 30, 2019

Our Take: A review of PBJ staffing data found that most nursing homes rarely met expected registered nurse (RN) staffing levels based on resident acuity and CMS expectations. The findings highlight the growing…

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Research claims that under competitive pressure, nursing homes appear to game rating system

July 18, 2019

Our Take: This research examined whether nursing homes near Five-Star staffing thresholds increased reported staffing after CMS raised staffing cutoffs, without corresponding improvement in a key resident outcome. ▼ For skilled nursing facilities,…

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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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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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