PBJ Research Studies published in

Medicare Payment Advisory Commission

All PBJ Research Studies

All

43

2017 & 2016

2

2018

3

2019

4

2020

3

2021

7

2022

9

2023

15

2024

0

jama network

Nov 30, 2023

Health Care Staff Turnover and Quality of Care at Nursing Homes

PUBLISHED: October 9, 2023 Related News Coverage Within-facility variation in staff turnover was associated with decreased quality of care. These findings suggest that efforts...

Read More

individual unpublished

Nov 30, 2023

Effects of Mandatory Staffing Requirements on Quality Indicators in Long-Term Care

PUBLISHED: November 2023 Related News Coverage Long term care facilities continue to struggle to improve the quality of care, which affects publicly reported data and reimburs...

Read More

Nov 30, 2023

Audit of Nursing Homes’ Nurse Staffing Hours Reported in CMS’s Payroll-Based Journal

The Office of the Inspector General announced a new research study in November 2023. Scheduled to be issued in 2025, the research study will audit the PBJ reporting of staffi...

Read More

Sep 30, 2023

Nursing Home Capabilities and Collaboration to Ensure Resident Care During Emergencies

PUBLISHED: September 2023 Related News Coverage Although most nursing homes met Federal emergency preparedness requirements, an estimated 77 percent reported challenges with p...

Read More

Sep 30, 2023

Staffing Mandate Analysis In-Depth Analysis on Minimum Nurse Staffing Levels & Local Impact

Updated September 2023 | Updated December 2022 | Published July, 2022 Related News Coverage On April 11, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a ...

Read More

jama network

Jul 27, 2023

Examination of Staffing Shortages at US Nursing Homes During the COVID-19 Pandemic

PUBLISHED: July 27, 2023 Related News Coverage Staffing shortages have been widely reported in US nursing homes during the COVID-19 pandemic, but traditional quantitative rese...

Read More

jama network

Jul 27, 2023

Association of Receipt of Paycheck Protection Program Loans With Staffing Patterns Among US Nursing Homes

PUBLISHED: July 27, 2023 Related News Coverage Did staffing hours change among nursing homes that received forgivable loans through the Paycheck Protection Program (PPP), whic...

Read More

Jul 27, 2023

New Dimensions of Staffing Patterns in Nursing Homes and Nursing Home Quality: Comparing Staffing Instability to Staffing Turnover

PUBLISHED: July 27, 2023 Related News Coverage This study examines how measures of staffing—turnover and instability—are associated with one another and how they independently...

Read More

Jun 30, 2023

Nursing Home Staffing Study: Comprehensive Report

PUBLISHED: June 2023 Related News Coverage A comprehensive report prepared under contract to CMS by ABT Associates summarizes results from a Nursing Home Staffing Study includ...

Read More

May 8, 2023

Staffing Shortages, Staffing Hours, and Resident Deaths in U.S. Nursing Homes During the COVID-19 Pandemic

PUBLISHED: May 08, 2023 Related News Coverage Staffing shortages at nursing homes during the COVID-19 pandemic may have impacted care providers’ staffing hours and affected re...

Read More

health affairs journal

Feb 28, 2023

Understanding Nursing Home Spending And Staff Levels In The Context Of Recent Nursing Staff Recommendations

PUBLISHED: February 2023 Related News Coverage This study examined the proportion of facility revenues spent on nursing staff, as well as nursing staff levels in hours worked ...

Read More

Jan 30, 2023

Assessment of CMS’s Early Use of Payroll-Based Journal Data To Improve Enforcement of Nursing Home Staffing Standards

Expected Issue Date 2024 Announced January 2023 October 2022, CMS began to provide State Survey Agency surveyors (State surveyors) with extracts of Payroll-Based Journal (PBJ)...

Read More

Jan 30, 2023

More Than a Thousand Nursing Homes Reached Infection Rates of 75 Percent or More in the First Year of the COVID-19 Pandemic

PUBLISHED: January 2023 Related News Coverage This is the second report in the series and builds on the first OIG report by focusing on nursing homes themselves. It looks at t...

Read More

health affairs journal

Jan 25, 2023

The Role Of Real Estate Investment Trusts In Staffing US Nursing Homes

PUBLISHED: January 25, 2023 Related News Coverage REIT investment was associated with average relative staffing increases of 2.15 percent and 1.55 percent for licensed practic...

Read More

jama network

Jan 10, 2023

Association of Staffing Instability With Quality of Nursing Home Care

Published: January 10, 2023 Related News Coverage This study examined whether staffing instability, defined as the percentage of days below average staffing levels, is associa...

Read More

Sep 29, 2022

Nursing facility staffing

Published: September 29, 2022 Related News Coverage Federal staffing requirements have been unchanged since 1987. 38 states and DC have implemented stricter minimum staffing ...

Read More

Sep 29, 2022

State Policy Levers to Address Nursing Facility Staffing Issues

Published: March, 2022 Related MEDPAC Publications MEDPAC comments to CMS on Proposed Rule MEDPAC transcript of Public Meeting (including Nursing Facility Staffing discussion)...

Read More

journal of american geriatrics society

Aug 8, 2022

Severe neighborhood deprivation and nursing home staffing in the United States

Published: August 8, 2022 Related News Coverage Significant staffing disparities were observed within facilities located in severely deprived neighborhoods. Targeted intervent...

Read More

Aug 1, 2022

Association between long-term care facility staffing levels and antipsychotic use in US long-term care facilities

Published: August 1, 2022 Related News Coverage This study sought to examine the association between staffing and antipsychotic prescribing in LTC facilities. These findings p...

Read More

jama network

Jul 29, 2022

Association of State COVID-19 Vaccine Mandates With Staff Vaccination Coverage and Staffing Shortages in US Nursing Homes

Published: July 29, 2022 Related News Coverage This cohort study of nursing homes in 38 states found that states with a vaccine mandate experienced an increase in staff vaccin...

Read More

jama network

Jul 22, 2022

Staffing Patterns in US Nursing Homes During COVID-19 Outbreaks

Published: July 22, 2022 Related News Coverage Findings In this cohort study of 2967 nursing homes in 2020, owing to increased absences and departures, there were statisticall...

Read More

journal of american geriatrics society

May 7, 2022

Association between staff turnover and nursing home quality – evidence from payroll-based journal data

Published: May 7, 2022 Related News Coverage PBJ Central Notes: This study is of particular interest as it was funded by a grant from CMS. Authors include Evan Shulman, curre...

Read More

Mar 21, 2022

The Need for an Economically Feasible Nursing Home Staffing Regulation: Evaluating an Acuity-Based Nursing Staff Benchmark

Published: March 21, 2022 Despite concerns about the adequacy of nursing home (NH) staffing, the federal agency responsible for NH certification and regulation has never adopt...

Read More

jama network

Mar 14, 2022

Daily Variation in Nursing Home Staffing and Its Association With Quality Measures

Published: March 14, 2022 Related News Coverage Is daily variation in nursing home staffing associated with quality, and does it offer additional information to measures of av...

Read More

health services research

Sep 6, 2021

Association between Nursing Home Staff Turnover and Infection Control Citations

Published: September 6, 2021 We estimated the association between nurse turnover and the probability of an infection control citation and the scope of the citation while contr...

Read More

Aug 9, 2021

Additional Reporting on Key Staffing Information and Stronger Payment Incentives Needed for Skilled Nursing Facilities

Published: March 9, 2021, Revised August 10, 2021 CMS has taken important steps to build a new source for data on nursing home staffing and to use these data to better inform ...

Read More

health affairs journal

Jul 14, 2021

Larger Nursing Home Staff Size Linked To Higher Number Of COVID-19 Cases In 2020

Published: July 14, 2021 Staff in skilled nursing facilities (SNFs) are essential health care workers, yet they can also be a source of COVID-19 transmission. We used detailed...

Read More

health affairs journal

May 30, 2021

Nursing Home Staffing Levels Did Not Change Significantly During COVID-19

Published: May 2021 Related News Coverage Prior research and the popular press have anecdotally reported inadequate nursing home staffing levels during the COVID-19 pandemic. ...

Read More

health affairs journal

Mar 30, 2021

Medicare’s New Patient Driven Payment Model Resulted In Reductions In Therapy Staffing In Skilled Nursing Facilities

Published: March 2021 Related News Coverage Medicare’s Patient Driven Payment Model (PDPM) significantly altered the way skilled nursing facilities (SNFs) are paid, removing t...

Read More

health affairs journal

Mar 30, 2021

High Nursing Staff Turnover In Nursing Homes Offers Important Quality Information

Published: March 2021 Related News Coverage Nursing staff turnover has long been considered an important indicator of nursing home quality. However, turnover has never been re...

Read More

Mar 9, 2021

CMS Use of Data on Nursing Home Staffing: Progress and Opportunities To Do More

Published: March 9, 2021 Related News Coverage CMS has taken important steps to build a new source for data on nursing home staffing and to use these data to better inform con...

Read More

Sep 17, 2020

Impact of Medication Assistant use on Nursing Home Staffing Levels and Inspection Results

Published: September 17, 2020 The purpose of this case study is to describe inspection outcomes 1-2 years after the addition of Medication Assistants (MAs) and the reduction o...

Read More

Aug 3, 2020

Some Nursing Homes’ Reported Staffing Levels in 2018 Raise Concerns; Consumer Transparency Could Be Increased

Published: August 3, 2020 Related News Coverage Nurse staffing is a key contributor to the quality of care provided in nursing homes. This review, initiated before the COVID-1...

Read More

health services sage publications

Jun 29, 2020

Appropriate Nurse Staffing Levels for U.S. Nursing Homes

Published: June 29, 2020 US nursing homes are required to have sufficient nursing staff with the appropriate competencies to assure resident safety and attain or maintain the ...

Read More

Nov 8, 2019

Payroll-based Staffing Measures for Nursing Homes

Published: November 8, 2019 The Centers for Medicare & Medicaid Services (CMS) developed the Payroll-Based Journal (PBJ) system for nursing homes to electronically submit ...

Read More

health affairs journal

Jul 30, 2019

Daily Nursing Home Staffing Levels Highly Variable, Often Below CMS Expectations

Published: July 2019 Related News Coverage Staffing is an important quality measure that is included on the federal Nursing Home Compare website. New payroll-based data reveal...

Read More

strategic management journal

Jul 18, 2019

Under Pressure: Reputation, Ratings, and Inaccurate Self-reporting in the Nursing Home Industry

Published: July 18, 2019 Related News Coverage This paper examines firms’ strategic responses to reputational pressures in a critical healthcare domain—the U.S. nursing ...

Read More

kaiser health news

May 3, 2019

Look-Up: How Nursing Home Staffing Fluctuates Nationwide

Published: May 2, 2019 Related News Coverage This tool shows how Medicare rates overall staffing and registered nurse staffing by facility. It also shows the average number o...

Read More

individual unpublished

Aug 15, 2018

Special Focus Nursing Facilities That “Have Not Improved:” Poor Care for Residents, Overall Ratings Artificially Boosted by 5-Star Ratings in Self-Reported Quality Measures

Published: August 15, 2018 The Centers for Medicare & Medicaid Services (CMS) identifies some of the worst performing nursing facilities in the country as Special Focus Fa...

Read More

kaiser health news

Jul 13, 2018

It’s Almost Like a Ghost Town.’ Most Nursing Homes Overstated Staffing for Years

Published: July 2018 Related News Coverage Medicare has lowered its star ratings for staffing levels in 1 in 11 of the nation’s nursing homes — almost 1,400 of them — because ...

Read More

Apr 3, 2018

Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2009 Through 2016

Published: April 3, 2018 Nursing facilities are one part of the long-term care delivery system that also includes home and community based services, but their relatively high ...

Read More

Aug 11, 2017

Nursing Home Response to Nursing Home Compare: The Provider Perspective

Published: August 11, 2017 Nursing Home Compare (NHC) publishes composite quality ratings of nursing homes based on a five-star rating system, a system that has been subject t...

Read More

health affairs journal

Apr 30, 2016

Use of Nursing Home Compare Website Appears Limited By Lack of Awareness and Initial Mistrust of the Data

Published: April 2016 In December 2008 the Centers for Medicare and Medicaid Services (CMS) launched a five-star rating system of nursing homes as part of Nursing Home Compare...

Read More

Aug 11, 2017

Nursing Home Response to Nursing Home Compare: The Provider Perspective

Published: August 11, 2017 Nursing Home Compare (NHC) publishes composite quality ratings of nursing homes based on a five-star rating system, a system that has been subject t...

Read More

health affairs journal

Apr 30, 2016

Use of Nursing Home Compare Website Appears Limited By Lack of Awareness and Initial Mistrust of the Data

Published: April 2016 In December 2008 the Centers for Medicare and Medicaid Services (CMS) launched a five-star rating system of nursing homes as part of Nursing Home Compare...

Read More

individual unpublished

Aug 15, 2018

Special Focus Nursing Facilities That “Have Not Improved:” Poor Care for Residents, Overall Ratings Artificially Boosted by 5-Star Ratings in Self-Reported Quality Measures

Published: August 15, 2018 The Centers for Medicare & Medicaid Services (CMS) identifies some of the worst performing nursing facilities in the country as Special Focus Fa...

Read More

kaiser health news

Jul 13, 2018

It’s Almost Like a Ghost Town.’ Most Nursing Homes Overstated Staffing for Years

Published: July 2018 Related News Coverage Medicare has lowered its star ratings for staffing levels in 1 in 11 of the nation’s nursing homes — almost 1,400 of them — because ...

Read More

Apr 3, 2018

Nursing Facilities, Staffing, Residents and Facility Deficiencies, 2009 Through 2016

Published: April 3, 2018 Nursing facilities are one part of the long-term care delivery system that also includes home and community based services, but their relatively high ...

Read More

Nov 8, 2019

Payroll-based Staffing Measures for Nursing Homes

Published: November 8, 2019 The Centers for Medicare & Medicaid Services (CMS) developed the Payroll-Based Journal (PBJ) system for nursing homes to electronically submit ...

Read More

health affairs journal

Jul 30, 2019

Daily Nursing Home Staffing Levels Highly Variable, Often Below CMS Expectations

Published: July 2019 Related News Coverage Staffing is an important quality measure that is included on the federal Nursing Home Compare website. New payroll-based data reveal...

Read More

strategic management journal

Jul 18, 2019

Under Pressure: Reputation, Ratings, and Inaccurate Self-reporting in the Nursing Home Industry

Published: July 18, 2019 Related News Coverage This paper examines firms’ strategic responses to reputational pressures in a critical healthcare domain—the U.S. nursing ...

Read More

kaiser health news

May 3, 2019

Look-Up: How Nursing Home Staffing Fluctuates Nationwide

Published: May 2, 2019 Related News Coverage This tool shows how Medicare rates overall staffing and registered nurse staffing by facility. It also shows the average number o...

Read More

Sep 17, 2020

Impact of Medication Assistant use on Nursing Home Staffing Levels and Inspection Results

Published: September 17, 2020 The purpose of this case study is to describe inspection outcomes 1-2 years after the addition of Medication Assistants (MAs) and the reduction o...

Read More

Aug 3, 2020

Some Nursing Homes’ Reported Staffing Levels in 2018 Raise Concerns; Consumer Transparency Could Be Increased

Published: August 3, 2020 Related News Coverage Nurse staffing is a key contributor to the quality of care provided in nursing homes. This review, initiated before the COVID-1...

Read More

health services sage publications

Jun 29, 2020

Appropriate Nurse Staffing Levels for U.S. Nursing Homes

Published: June 29, 2020 US nursing homes are required to have sufficient nursing staff with the appropriate competencies to assure resident safety and attain or maintain the ...

Read More

health services research

Sep 6, 2021

Association between Nursing Home Staff Turnover and Infection Control Citations

Published: September 6, 2021 We estimated the association between nurse turnover and the probability of an infection control citation and the scope of the citation while contr...

Read More

Aug 9, 2021

Additional Reporting on Key Staffing Information and Stronger Payment Incentives Needed for Skilled Nursing Facilities

Published: March 9, 2021, Revised August 10, 2021 CMS has taken important steps to build a new source for data on nursing home staffing and to use these data to better inform ...

Read More

health affairs journal

Jul 14, 2021

Larger Nursing Home Staff Size Linked To Higher Number Of COVID-19 Cases In 2020

Published: July 14, 2021 Staff in skilled nursing facilities (SNFs) are essential health care workers, yet they can also be a source of COVID-19 transmission. We used detailed...

Read More

health affairs journal

May 30, 2021

Nursing Home Staffing Levels Did Not Change Significantly During COVID-19

Published: May 2021 Related News Coverage Prior research and the popular press have anecdotally reported inadequate nursing home staffing levels during the COVID-19 pandemic. ...

Read More

health affairs journal

Mar 30, 2021

Medicare’s New Patient Driven Payment Model Resulted In Reductions In Therapy Staffing In Skilled Nursing Facilities

Published: March 2021 Related News Coverage Medicare’s Patient Driven Payment Model (PDPM) significantly altered the way skilled nursing facilities (SNFs) are paid, removing t...

Read More

health affairs journal

Mar 30, 2021

High Nursing Staff Turnover In Nursing Homes Offers Important Quality Information

Published: March 2021 Related News Coverage Nursing staff turnover has long been considered an important indicator of nursing home quality. However, turnover has never been re...

Read More

Mar 9, 2021

CMS Use of Data on Nursing Home Staffing: Progress and Opportunities To Do More

Published: March 9, 2021 Related News Coverage CMS has taken important steps to build a new source for data on nursing home staffing and to use these data to better inform con...

Read More

Sep 29, 2022

Nursing facility staffing

Published: September 29, 2022 Related News Coverage Federal staffing requirements have been unchanged since 1987. 38 states and DC have implemented stricter minimum staffing ...

Read More

Sep 29, 2022

State Policy Levers to Address Nursing Facility Staffing Issues

Published: March, 2022 Related MEDPAC Publications MEDPAC comments to CMS on Proposed Rule MEDPAC transcript of Public Meeting (including Nursing Facility Staffing discussion)...

Read More

journal of american geriatrics society

Aug 8, 2022

Severe neighborhood deprivation and nursing home staffing in the United States

Published: August 8, 2022 Related News Coverage Significant staffing disparities were observed within facilities located in severely deprived neighborhoods. Targeted intervent...

Read More

Aug 1, 2022

Association between long-term care facility staffing levels and antipsychotic use in US long-term care facilities

Published: August 1, 2022 Related News Coverage This study sought to examine the association between staffing and antipsychotic prescribing in LTC facilities. These findings p...

Read More

jama network

Jul 29, 2022

Association of State COVID-19 Vaccine Mandates With Staff Vaccination Coverage and Staffing Shortages in US Nursing Homes

Published: July 29, 2022 Related News Coverage This cohort study of nursing homes in 38 states found that states with a vaccine mandate experienced an increase in staff vaccin...

Read More

jama network

Jul 22, 2022

Staffing Patterns in US Nursing Homes During COVID-19 Outbreaks

Published: July 22, 2022 Related News Coverage Findings In this cohort study of 2967 nursing homes in 2020, owing to increased absences and departures, there were statisticall...

Read More

journal of american geriatrics society

May 7, 2022

Association between staff turnover and nursing home quality – evidence from payroll-based journal data

Published: May 7, 2022 Related News Coverage PBJ Central Notes: This study is of particular interest as it was funded by a grant from CMS. Authors include Evan Shulman, curre...

Read More

Mar 21, 2022

The Need for an Economically Feasible Nursing Home Staffing Regulation: Evaluating an Acuity-Based Nursing Staff Benchmark

Published: March 21, 2022 Despite concerns about the adequacy of nursing home (NH) staffing, the federal agency responsible for NH certification and regulation has never adopt...

Read More

jama network

Mar 14, 2022

Daily Variation in Nursing Home Staffing and Its Association With Quality Measures

Published: March 14, 2022 Related News Coverage Is daily variation in nursing home staffing associated with quality, and does it offer additional information to measures of av...

Read More

jama network

Nov 30, 2023

Health Care Staff Turnover and Quality of Care at Nursing Homes

PUBLISHED: October 9, 2023 Related News Coverage Within-facility variation in staff turnover was associated with decreased quality of care. These findings suggest that efforts...

Read More

individual unpublished

Nov 30, 2023

Effects of Mandatory Staffing Requirements on Quality Indicators in Long-Term Care

PUBLISHED: November 2023 Related News Coverage Long term care facilities continue to struggle to improve the quality of care, which affects publicly reported data and reimburs...

Read More

Nov 30, 2023

Audit of Nursing Homes’ Nurse Staffing Hours Reported in CMS’s Payroll-Based Journal

The Office of the Inspector General announced a new research study in November 2023. Scheduled to be issued in 2025, the research study will audit the PBJ reporting of staffi...

Read More

Sep 30, 2023

Nursing Home Capabilities and Collaboration to Ensure Resident Care During Emergencies

PUBLISHED: September 2023 Related News Coverage Although most nursing homes met Federal emergency preparedness requirements, an estimated 77 percent reported challenges with p...

Read More

Sep 30, 2023

Staffing Mandate Analysis In-Depth Analysis on Minimum Nurse Staffing Levels & Local Impact

Updated September 2023 | Updated December 2022 | Published July, 2022 Related News Coverage On April 11, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a ...

Read More

jama network

Jul 27, 2023

Examination of Staffing Shortages at US Nursing Homes During the COVID-19 Pandemic

PUBLISHED: July 27, 2023 Related News Coverage Staffing shortages have been widely reported in US nursing homes during the COVID-19 pandemic, but traditional quantitative rese...

Read More

jama network

Jul 27, 2023

Association of Receipt of Paycheck Protection Program Loans With Staffing Patterns Among US Nursing Homes

PUBLISHED: July 27, 2023 Related News Coverage Did staffing hours change among nursing homes that received forgivable loans through the Paycheck Protection Program (PPP), whic...

Read More

Jul 27, 2023

New Dimensions of Staffing Patterns in Nursing Homes and Nursing Home Quality: Comparing Staffing Instability to Staffing Turnover

PUBLISHED: July 27, 2023 Related News Coverage This study examines how measures of staffing—turnover and instability—are associated with one another and how they independently...

Read More

Jun 30, 2023

Nursing Home Staffing Study: Comprehensive Report

PUBLISHED: June 2023 Related News Coverage A comprehensive report prepared under contract to CMS by ABT Associates summarizes results from a Nursing Home Staffing Study includ...

Read More

May 8, 2023

Staffing Shortages, Staffing Hours, and Resident Deaths in U.S. Nursing Homes During the COVID-19 Pandemic

PUBLISHED: May 08, 2023 Related News Coverage Staffing shortages at nursing homes during the COVID-19 pandemic may have impacted care providers’ staffing hours and affected re...

Read More

health affairs journal

Feb 28, 2023

Understanding Nursing Home Spending And Staff Levels In The Context Of Recent Nursing Staff Recommendations

PUBLISHED: February 2023 Related News Coverage This study examined the proportion of facility revenues spent on nursing staff, as well as nursing staff levels in hours worked ...

Read More

Jan 30, 2023

Assessment of CMS’s Early Use of Payroll-Based Journal Data To Improve Enforcement of Nursing Home Staffing Standards

Expected Issue Date 2024 Announced January 2023 October 2022, CMS began to provide State Survey Agency surveyors (State surveyors) with extracts of Payroll-Based Journal (PBJ)...

Read More

Jan 30, 2023

More Than a Thousand Nursing Homes Reached Infection Rates of 75 Percent or More in the First Year of the COVID-19 Pandemic

PUBLISHED: January 2023 Related News Coverage This is the second report in the series and builds on the first OIG report by focusing on nursing homes themselves. It looks at t...

Read More

health affairs journal

Jan 25, 2023

The Role Of Real Estate Investment Trusts In Staffing US Nursing Homes

PUBLISHED: January 25, 2023 Related News Coverage REIT investment was associated with average relative staffing increases of 2.15 percent and 1.55 percent for licensed practic...

Read More

jama network

Jan 10, 2023

Association of Staffing Instability With Quality of Nursing Home Care

Published: January 10, 2023 Related News Coverage This study examined whether staffing instability, defined as the percentage of days below average staffing levels, is associa...

Read More

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