CMS Use of Staffing Data for Nursing Home Oversight

This technical report evaluates the use of the Centers for Medicare & Medicaid Services (CMS) Payroll Based Journal (PBJ) data by State survey agencies to oversee nursing home staffing compliance. The report outlines the necessity of sufficient staffing in nursing homes to meet the needs of residents, emphasizing the requirement for at least eight hours of registered nurse (RN) services daily. It assesses the early experiences of States in utilizing PBJ data and guidance from CMS to identify staffing deficiencies. The findings indicate that while States find the PBJ data beneficial, CMS does not provide comprehensive information necessary for effective oversight. Specifically, CMS fails to identify nursing homes with fewer than eight RN hours, which limits States' ability to target their oversight effectively. The report also includes recommendations for CMS to enhance the data and guidance provided to States, aiming to improve the identification of nursing homes that do not meet staffing requirements.