February’s announcement of adjustments to the Five Star Rating included the announcement that payroll-based staffing would be implemented in the next year or two for nursing homes, and CMS announced yesterday the release of its staffing submission data Payroll-Based Journal (PBJ) system. Section 6106 of the ACA mandated that nursing facilities electronically submit direct care staffing information, including agency and contract staff, to CMS using payroll or other auditable data.
CMS will require that staffing and census data be collected on a quarterly basis, and that the submitted data is both timely and accurate. The data will be collected for each fiscal quarter. Staffing data includes the number of hours worked by each staff member each day within the quarter, and includes entries for administration, physician services, nursing services, pharmacy services, dietary services, therapeutic services, dental services, podiatry services, mental health services, vocational services, clinical laboratory services, diagnostic x-ray services, administration & storage of blood, housekeeping services, and a generic “other services” category for staff not included in one of the previous categories. Census data is the facility’s census on the last day of the quarter.
Strict guidelines for the timeliness of submission have been provided in the PBJ Version 1.0 Policy Manual. CMS notes that it will be auditing the accuracy of staffing information to ensure compliance with this requirement. Facilities that are found out of compliance will be subject to enforcement actions that have not yet been defined based on available documentation.
The new PBJ system can be used on a voluntary basis starting October 1, 2016. Use of PBJ will be required for all nursing facilities starting on July 1, 2016. Facilities that wish to participate in the voluntary program can start registering this summer, in August.
View the CMS website for Staffing Submission PBJ system information.