Evidence record
Four States Implemented Different Nursing Home Minimum Spending Requirements Related to Resident Care, and Three of These States and Some Nursing Homes Experienced Challenges
- Jurisdiction
- MassachusettsNew JerseyNew YorkPennsylvania
- Publication date
- October 28, 2026
- Report identifier
- REPORT-0214
Findings
2
Recommendations
1
Overall conclusion
The four states implemented their own nursing home minimum spending requirements related to resident care and faced challenges in data collection and reporting, suggesting CMS should factor these findings into future Medicaid payment transparency efforts and potential rulemaking.
Scope
Scope includes evaluating four states (Massachusetts, New Jersey, New York, Pennsylvania) that had established minimum spending requirements related to resident care in nursing homes as of January 2026, across multiple nursing homes in each state; focus on whether spending requirements were implemented and challenges encountered in data collection and reporting.
Findings (2)
Each finding has a stable link.
- F-1454
Each State implemented its own nursing home minimum spending requirements related to resident care, with variations in how the spending threshold was calculated using different financial figures.
- F-1455
Three of the four States identified challenges in implementing minimum spending requirements, such as difficulties collecting data from nursing homes and lack of audited data to calculate the minimum spending percentages; some selected nursing homes experienced challenges in complying with the requirements, including staffing shortages and difficulties gathering and reporting required data within time constraints.
Recommendations (1)
- R-1298
CMS should consider the information in this report as it implements Federal Medicaid payment transparency reporting requirements for nursing homes and in any future rulemaking regarding minimum spending requirements.
Related finding F-1455