An analysis of a year’s worth of payroll data has revealed that as many as 75% of U.S. nursing homes do not meet federal expectations for registered nurse staffing.

Investigators from Harvard and Vanderbilt also said that 7 out of every 10 facilities self-reported higher total direct staffing levels than could be verified in the now-standard Payroll-Based Journal.

Study co-author David Grabowski, Ph.D., Department of Health Care Policy at Harvard, said he found the RN data “‘staggering,” and that study results could have broader implications for other self-reported quality measures, such as pressure ulcers and pain. He encouraged CMS to step up audits of self-reported quality measures.

Researchers examined records from 15,399 facilities to reach their findings. Health Affairs published the results.