PBJ News Topic

PBJ Policy & Enforcement

CMS updates PBJ Policy Manual after three years with no changes

June 30, 2025

Our Take: CMS released PBJ Policy Manual Version 2.7 in June 2025. Updates include explicitly requiring that nursing hours be worked on-site to be included in PBJ, establishing a 22.5-hour daily maximum per…

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Congress considers how or whether to block staffing mandate

June 29, 2025

Our Take: From late 2024 through mid-2025, Congress mulled ways to repeal the minimum staffing mandate. A budget reconciliation strategy ended when the Senate Parliamentarian ruled an outright repeal violated the Byrd Rule.…

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Staffing mandate struck down in Texas court ruling

June 3, 2025

Our Take: The Northern District of Texas vacated the 24/7 registered nurse (RN) and daily staff-hours-per-resident day (HPRD) requirements. The Judge noted that staffing mandates are an improper attempt to contravene Congress’s careful…

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OIG looks at CMS use of staffing data to inform state oversight of nursing homes

May 29, 2025

Our Take: A May 2025 OIG evaluation found that CMS is not fully using PBJ data to help states identify nursing homes falling short of the required 8 hours of daily RN coverage.…

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New Jersey SNF staffing mandate triggers fines, lawsuit and a court ruling

May 19, 2025

Our Take: New Jersey’s 2020 minimum staffing law has triggered at least $425,000 in fines against nursing homes in just six weeks, prompting six providers and the Health Care Association of NJ to…

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Staffing mandate challenged by 20 state attorneys and provider associations in Iowa

April 29, 2025

Our Take: A coalition of 20 state attorneys general and provider groups challenged the staffing mandate in federal court, arguing CMS is exceeding its statutory authority. The District Court of Northern Iowa declined…

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What do State staffing rules tell us?

April 24, 2025

Our Take: States with the toughest nursing home staffing mandates are struggling to enforce them. Governors have paused penalties and PBJ data confirms widespread non-compliance. A growing number of states are turning to…

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New Administration signals repeal of staffing mandate

April 1, 2025

Our Take: From election night through early 2025, the Trump administration has consistently signaled that repealing the Biden-era nursing home staffing mandate is a near-term priority. New reporting indicates the White House may…

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New Surveyor guidance increases PBJ oversight

March 10, 2025

Our Take: CMS issued revised surveyor guidance effective April 28, 2025, covering PBJ reporting, nursing services, psychotropic medications, infection prevention, and other compliance areas. Surveyors are provided PBJ reports and trained to review…

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AHCA files legal challenge to staffing mandate in Texas

January 20, 2025

Our Take: AHCA, LeadingAge, the Texas Health Care Association, and the state of Texas filed coordinated federal lawsuits challenging CMS’s authority to impose a minimum staffing mandate on SNFs. They argue the rule…

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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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