This document is a guide detailing the PBJ quarterly check-in process and the implications of new state staffing regulations. It outlines the agenda for the quarterly meeting, which includes updates on staffing calculations, best practices, and a live Q&A session. The document highlights recent developments in state staffing regulations, noting that several states have introduced or amended staff reporting requirements, which vary by state and may impose higher staffing minimums than those defined by CMS. It discusses the impact of these regulations on PBJ reporting, including specific definitions of direct care staff and the penalties for non-compliance. Additionally, the document addresses current updates regarding the COVID-19 Public Health Emergency and its implications for nurse aides, including waivers for training and certification. The guide also explains the Five-Star Staffing Calculation methodology and provides clarity on meal breaks and training hours in relation to PBJ reporting requirements.