PBJ News Category

Nursing HPRD & Turnover

Nov 14 2023

LPN Exclusion Triggers Confusion & Questions

News Digest: Mandated Nursing Minimums Ignores Key Nursing Role CNA's, LPN's and RN's form the backbone of skilled nursing facilities.  All three roles are used in calculating and determining a facility's Five Star staffing rating.  Yet the proposed rule for minimum staffing completely ignores...
Nov 12 2023

How Can Facilities Get Ready for Minimum Staffing Requirements?

News Digest: Resolving Staffing Shortages Is Key to Compliance with Mandate PBJ data and labor force participation data illustrate the challenge for the senior care industry to add staff to the required levels.  Various studies and interpretations of minimum rules show that compliance will be an...
Oct 31 2023

Ideas Emerge to Overcome Workforce Shortages

News Digest: Minimum Staffing Rules Incent Plan to Hire More Nurses As some view a minimum staffing requirement as almost an inevitability, strategies begin to emerge to accomplish tactics such as increasing the available pool of nursing, lowering turnover of current staff, and improving hiring...
Oct 09 2023

New Research on Health Care Staff Turnover and Quality of Care at Nursing Homes

News Digest: Research into union impact on turnover and retentionIn this cross-sectional study of 1.45 million facility-weeks (corresponding to 13 826 unique facilities), within a given facility periods of greater turnover of nursing staff were associated with lower quality of care along multiple...
Sep 01 2023

OIG: Nursing Homes Reported Wide-Ranging Challenges Preparing for Public Health Emergencies and Natural Disasters

News Digest: OIG finds challenges with nursing homes pandemic preparationAlthough most nursing homes met Federal emergency preparedness requirements, an estimated 77 percent reported challenges with preparedness activities intended to ensure that resident care needs are met during an emergency....
Jul 30 2023

Research Shows Impact of PPP Loans on Staffing in US Nursing Homes

PBJ research report and related news: Did staffing hours change among nursing homes that received forgivable loans through the Paycheck Protection Program (PPP), which required recipients to appropriate 60% to 75% of the loan toward staffing? In this economic analysis of 6008 US nursing homes, 12...
Jul 30 2023

Study suggests staffing shortages during the pandemic strained nursing homes

PBJ research report and related news: Staffing shortages have been widely reported in US nursing homes during the COVID-19 pandemic, but traditional quantitative research analyses have found mixed evidence of staffing shortfalls. In this study, qualitative and quantitative data from 40 US nursing...
May 30 2023

Research finds nurse staffing shortages linked to 10 percent jump in resident deaths

PBJ research report and related news:Staffing shortages at nursing homes during the COVID-19 pandemic may have impacted care providers’ staffing hours and affected residents’ care and outcomes. This study examines the association of staffing shortages with staffing hours and resident deaths in...
May 26 2023

Study recommends adding measures of staffing instability to Care Compare

PBJ research report and related news: This study examines how measures of staffing—turnover and instability—are associated with one another and how they independently contribute to quality of care in nursing homes.  A total of 11,840 nursing homes nationally reporting data on daily staffing and...
Apr 18 2023

White House Order Aims to Tie Nursing Home Medicare Payments to Worker Retention

News Digest: Biden order ties medicare rates and turnover ...The roadmap focuses on four priorities: 1) connecting people to good jobs; 2) ensuring we have the skilled, diverse workforce for our transformational investments; 3) boosting education and training efforts so every community can meet...
Apr 06 2023

Feds’ value-based changes present ‘long overdue’ opening for SNFs

News digest: CMS releases updated rulesNew CMS skilled nursing facility value based purchasing (SNF VBP) measures take effect October 1, 2023 that will determine Medicare Part A rates beginning October 1, 2025. It is imperative that administrators, DONs, finance, QAPI and operations leaders be...
Mar 29 2023

Plaintiffs’ lawyers gaining edge against nursing homes with staffing issues

Plaintiffs’ lawyers gaining edge against nursing homes with staffing issuesPlaintiff attorneys looking to jam up nursing homes now have a plethora of data points on which to base their cases, thanks to the workforce crisis, legal experts said. “The plaintiffs’ bar would argue – and a lot of times...
Jan 30 2023

OIG: Pandemic Data Shows Major Changes Needed in Nursing Home Staffing, Surveys, Infection Control

PBJ research report and related news: This is the second report in the series and builds on the first OIG report by focusing on nursing homes themselves. It looks at the extent to which they had residents who were diagnosed with COVID-19 or likely COVID-19, and the characteristics of nursing homes...
Jan 30 2023

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

PBJ research report and related news: REIT investment was associated with average relative staffing increases of 2.15 percent and 1.55 percent for licensed practical nurses (LPNs) and certified nursing assistants (CNAs), respectively. After the three largest REIT deals were excluded, REIT...
Jan 30 2023

Research Finds Staffing Stability Is Marker of Better Quality of Nursing Homes

PBJ research report and related news: This study examined whether staffing instability, defined as the percentage of days below average staffing levels, is associated with nursing home quality when controlling for average staffing levels. Findings included: staffing instability of licensed...
Jan 25 2023

Federal Bill Aims to Aid Nursing Home Labor Shortage with TNA Program Extension

Federal Bill Aims to Aid Nursing Home Labor Shortage with TNA Program ExtensionA bill that aims to address staffing shortages in nursing homes by allowing temporary nursing aides (TNAs) awaiting certification to remain in the workforce past typical time limits was reintroduced on Wednesday....
Oct 07 2022

States get needed nurse aide waiver relief but workers’ fates uncertain

Skilled nursing providers in at least 15 states averted the loss of thousands of frontline workers Thursday, when the Centers for Medicare & Medicaid Services let expire a blanket national waiver allowing the use of non-certified nurse aides. Those states had been awarded new waivers through...
medicare payment advisory commission medpac logo
Sep 30 2022

MedPAC’s recommendations: state staffing policies could hamper federal mandate

A federal minimum staffing mandate is on the horizon for nursing homes at the beginning of 2023. Providers and experts wonder just how the proposed mandate might address historic staffing shortages without resources or support.

Aug 25 2022

Medicaid nursing facility payment approaches

CMS encourages states to assess their approach to payments to long-term care providers and utilize flexibilities provided by section 1902(a)(30)(A) of the Social Security Act (the Act) in establishing Medicaid base and supplemental payments, as appropriate, to provide adequate, performance-driven...
Aug 05 2022

Study of Antipsychotic Use Connection to Staffing Levels

Researchers reported a 0.75% decrease in inappropriate antipsychotic prescribing per unit increase in overall staff-to-patient ratio. There was a 3.09% decrease in inappropriate antipsychotic prescribing per unit increase in licensed staff hours.

Aug 01 2022

Research shows COVID-19 vaccination mandates don’t negatively affect nursing home staffing

State COVID-19 vaccination mandates increased vaccinations among direct caregivers without negatively affecting staffing levels, according to the results of a study published Friday in JAMA Health Forum. The researchers studied vaccination rates and staffing shortages that were reported via the...
Aug 01 2022

Nursing home staff turnover up 25 percent from last year

The national nursing home staff turnover rate for all employees is up 25% from last year. That’s according to findings included in the 45th annual Nursing Home Salary & Benefits Report released Thursday by Hospital & Healthcare Compensation Service. The average national turnover rate...
Jul 30 2022

Research on COVID staffing finds policy action can stabilize staffing levels

Provider and policy action is needed to counter the effects of staff absences and departures, particularly during infectious disease outbreaks such as COVID-19, that may put nursing home residents at risk, according to the authors of a study published in the journal JAMA Health Forum.

May 30 2022

Study confirms lower turnover linked to higher quality of care

Nursing home providers should consider implementing innovative strategies for retaining workers after a new study found that low staff turnover was consistently associated with higher quality of care, researchers said. “While these actions are challenging — especially given that nursing homes are...
Apr 30 2022

CMS Releases Skilled Nursing Facility PPS Proposed Rule for FY23

CMS is also seeking feedback on including a Nursing Home Staff Turnover measure in the VBP program. The measure uses data from the CMS payroll-based journal system and reports annual turnover for nurses.

Apr 04 2022

Nursing Facility Staffing Shortages During the COVID-19 Pandemic

Nursing Facility Staffing Shortages During the COVID-19 PandemicThe disproportionate impact of the COVID-19 pandemic on nursing facility residents and staff has brought increased attention to long-standing workforce issues that can affect care quality and safety, such as staffing shortages and...
Mar 30 2022

Study Shows Weekend and Daily Variation in Nursing Home Staffing Led to Poorer Clinical Quality

Daily variation in nursing home staffing was associated with poorer clinical quality in Medicare and Medicaid-certified nursing homes, suggesting that reporting staffing variation could help provide new quality improvement information, according to a study published in JAMA Network Open....
Mar 28 2022

State of Skilled Nursing Facilities Today, Planning for the Future

What are the four key findings and what can nursing home leaders do today to put themselves on the path of recovery? Some of the answers include strategic planning, operational assessments, and self-evaluation. Nursing facilities should work now to determine changes that can be made – clinically,...
Jan 30 2022

To Advance Information on Quality of Care, CMS Makes Nursing Home Staffing Data Available

the Centers for Medicare & Medicaid Services (CMS) will begin posting for the first time ever, staff turnover rates and weekend staff levels for nursing homes on the Medicare.gov Care Compare website today

Sep 21 2021

U.S. Bill Would Require More Staffing And Curtail Arbitration In Nursing Homes

Nursing homes would face minimum staffing requirements and a prohibition on pre-dispute arbitration agreements, among other significant potential changes included in legislation introduced last week by a group of Democratic senators.

May 30 2021

Study Finds Nursing Home Staffing Hours Held Steady or Rose During Pandemic

In the May issue of Health Affairs, a new study of government data show nursing home staffing levels during the COVID-19 pandemic held steady or actually increased, dispelling at least in part prior research and coverage in the media that staffing hours declined during the crisis.

Mar 30 2021

OIG Reports on CMS Use of Data on Nursing Home Staffing: Progress and Opportunities to Do More

However, CMS has opportunities to better use the staffing information that nursing homes report. Specifically, the staffing information that CMS provides on Care Compare could be more useful to consumers if it included data on nurse staff turnover and tenure, as required by Federal law. CMS...
Mar 16 2021

Marys Take: Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public

Nursing homes have manipulated the influential star system in ways that have masked deep problems — and left them unprepared for Covid-19. The piece, as you may have already deduced speaks to Nursing Home Compare, the Five-Star Rating System and Payroll Based Journal (PBJ).

Mar 10 2021

Research on How Skilled Nursing Facility Staffing Impacted by New Payment Rules

Skilled nursing facility (SNF) staffing levels across several provider types have fallen since Medicare implemented new payment rules meant to drive value over volume of services, according to a new Health Affairs study. The study published last week found that physical therapist and occupational...
Mar 05 2021

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

here are a few sub-questions we need to break down to answer before answering this one larger question. These sub-questions include: Is nursing staff turnover at nursing homes a big problem? Is nursing staff turnover correlated with quality of care? Does using nursing staff turnover as a quality...
Aug 30 2020

OIG Study: HHS Watchdog Probes Enforcement Of Nursing Home Staffing Standards

The inspector general at the Department of Health and Human Services this month launched an examination into federal oversight of skilled nursing facilities amid signs some homes aren’t meeting Medicare’s minimum staffing requirements. The review comes on the heels of a Kaiser Health News and New...
Dec 12 2019

Staffing takes a front seat when driving quality of care

In CMS’s new rating methodology, facilities are rewarded for staffing more RNs — and punished when they don’t have enough. Ratings on the staffing domain are based on two measures: the number of RN hours per resident per day and total nursing hours (combined RN, LPN, and nurse aide hours) per...
Nov 30 2019

Research Claims that Under Competitive Pressure, Nursing Homes Appear to Game Rating System

In a new article with Amanda Sharkey at the University of Chicago, Ody-Brasier took advantage of a tightening of regulations to study how closely star ratings actually track a patient outcome known to be highly correlated with quality of care. In April of 2012, the Centers for Medicare and...
Jul 30 2019

Study finds nursing homes rarely have enough RNs on staff

RN staffing levels fall much lower than CMS standards in most nursing homes, according to a study published July 1 in Health Affairs. “Seventy-five percent of nursing homes were almost never in compliance with what CMS expected their RN staffing level to be,” the study’s authors...
Jan 01 2019

A New Focus on Nursing Facility Staffing

The Medicare Requirements of Participation state that a facility must provide sufficient nursing staff on a 24-hour basis and a registered nurse for at least eight consecutive hours per day, seven days a week. With this new topic, OIG will be examining nursing staffing levels that are reported by...
Nov 30 2018

CMS Strengthens Nursing Home Oversight and Safety to Ensure Adequate Staffing

Centers for Medicare & Medicaid Services (CMS) announced actions that will bolster nursing home oversight and improve transparency in order to ensure that facilities are staffed adequately to provide high-quality care. These actions include sharing data with states when potential issues arise...
Sep 06 2018

House Hearing Focuses on Nursing Home Safety and Quality

This week, the House Committee on Energy and Commerce (E&C) Subcommittee on Oversight and Investigations held a hearing entitled “Examining Efforts to Ensure Quality of Care and Resident Safety in Nursing Homes.” The purpose of the hearing was to explore the roles of the Centers for Medicare...
Jan 06 2017

Ask the Payment Expert about … acuity-based staffing

What is acuity-based staffing and how do we know what our acuity is?

We have multiple ways that acuity is evaluated in a facility.

The best is to use available information with the Resource Utilization Groups (RUGs) levels.

PBJ News by Topic

All Topics
CMS' PBJ Policies
PBJ news in the topic includes CMS' PBJ Policies
Five Star Staffing Ratings
PBJ news in the topic includes Five Star Staffing Ratings
Minimum Staffing
PBJ news in the topic includes Minimum Staffing HPRDD
Nursing HPRD & Turnover
PBJ news in the topic includes Nursing Hours per resident day & staff turnover and RN nursing hours
PBJ Audits by CMS
PBJ news in the topic includes PBJ Audits by CMS
Research Studies of PBJ Data
PBJ news in the topic includes Research Studies of PBJ Data
Rules for PBJ Reporting
PBJ news in the topic includes CMS Rules for PBJ Reporting and submission
State Mandates & Medicaid
PBJ news in the topic includes state nursing homes staffing mandates or state Medicaid funding for staffing
Survey & FTags for Staffing
PBJ news in the topic Survey & FTags for Staffing