Take 5: October 2026
Staffing ratings, payroll data and pay
Five things worth your time this month.
1 · CMS
Staffing holds many buildings back from CMS’s new icon.
In September, CMS began using a shorter standard survey nationwide for nursing homes that meet its bar for high performance, and said Care Compare would mark them with an icon starting October 8. To qualify, a building needs a five-star overall rating and at least three stars for staffing, among other criteria, and CMS expects about 12% of nursing homes to qualify. How the staffing rating works is in Turnover and your star rating.
“Among facilities that do not currently qualify, the most common reason, beyond the five-star rating requirement, is due to a low staffing rating …”
2 · CMS
Staffing data now goes through iQIES.
CMS moved Payroll-Based Journal submissions to iQIES on August 17 and retired PBJ in the old QIES system on September 15, reports included. You must register for PBJ roles in iQIES before you can submit, and iQIES now rejects more than 22.5 hours a day for one employee ID. The next quarter, July through September, is due November 14.
“These updates do not include any changes to PBJ policies.”
3 · Research
Better pay went with lower turnover for support staff.
A study of 418 Iowa nursing homes from 2011 to 2022 found that each extra dollar an hour went with lower turnover among dietary, housekeeping, laundry and maintenance staff, by 3.83 percentage points for housekeeping and 3.50 for dietary. Larger teams went with lower turnover too, for dietary, housekeeping and laundry staff. It’s one state, and the study shows a link rather than proof of cause.
“Our findings suggest that improving wages and staffing levels may be effective strategies for reducing turnover among nursing home support staff …”
4 · Data
Nursing home jobs dipped slightly in September.
Skilled nursing facilities had about 1,587,400 jobs in September, seasonally adjusted and preliminary: 1,600 fewer than in August and about 30,100 more than a year earlier. Health care as a whole added 17,000 jobs, below its average of 33,000 a month over the prior year. It’s a monthly read on the job market you hire from.
“… nursing and residential care facilities lost jobs (-9,000).”
5 · Policy
Minnesota’s wage floors for nursing home workers took effect.
Minimum wages set by Minnesota’s Nursing Home Workforce Standards Board took effect September 10: $22.50 an hour for CNAs, $23.50 for trained medication aides, $27.00 for LPNs and $19.00 for other nursing home workers. Another $1.50 increase takes effect January 1, 2027, and the state pays for the wages through nursing home reimbursement rates, after CMS approved the change in August. If you run buildings in Minnesota, these are now the floor for your pay scales.
“This first-of-its-kind board is helping Minnesota confront longstanding staffing shortages and low pay in nursing home care.”
Sources
- Centers for Medicare & Medicaid Services (CMS). QSO-26-14-NH REVISED: Nursing Home Risk-Based Survey National Implementation. Memo, September 29, 2026.
- CMS. Staffing Data Submission Payroll Based Journal (PBJ). Updates of August 17 and September 11, 2026.
- Sharma H. Effect of staffing and wages on turnover of nonclinical support staff in nursing homes. Journal of the American Medical Directors Association 27(10), 2026.
- US Bureau of Labor Statistics. The Employment Situation, September 2026, including Table B-1. Released October 2, 2026.
- Minnesota Department of Labor and Industry. Minnesota’s minimum wage standards for nursing home workers in effect Sept. 10. September 10, 2026.