Timely and Accurate PBJ Data is More Important Than Ever

Posted on August 7, 2018 by Jonathan Lips

The Centers for Medicare & Medicaid Services (CMS) reminds all nursing facilities that the deadline for submission of Payroll Based Journal (PBJ) data for the period April 1 –June 30, 2018, is Aug. 14. Timely and accurate submission of data is especially important, because CMS now uses PBJ data to calculate staffing measures in Nursing Home Compare and the Five-Star Quality Rating System.  

CMS has made clear that it will only use data that is submitted and accepted by each quarterly deadline for these calculations.  Data submitted or corrected after the deadline has passed is not used by CMS. 

As of July 2018 the Five-Star Quality Rating System Technical User’s Guide indicates that the following exceptions apply to the scoring rules for assigning the staffing rating and RN staffing rating:

• Providers that fail to submit any staffing data by the required deadline will receive a one-star rating for overall staffing and RN staffing for the quarter.
• Providers that submit staffing data indicating that there were seven or more days in the quarter with no RN staffing (job codes 5-7) but on which there were one or more residents in the facility will receive a one-star rating for overall staffing and RN staffing for the quarter.

CMS conducts audits of nursing homes to verify the data submitted and to ensure accuracy. Facilities that fail to respond to these audits and those for which the audit identifies significant discrepancies between the hours reported and the hours verified will receive a one-star rating for overall staffing and RN staffing for three months from the time at which the deadline to respond to audit requests passes or discrepancies are identified. 

In late July CMS updated staffing calculations using PBJ data from the period Jan. 1 – March 31, and a number of facilities found their staffing domain rating lowered to one-star as a result. The next update will occur in October 2018, and it will rely on data for the period April 1 –June 30, 2018. 

CMS encourages providers to submit data early so they can correct errors if needed. CMS has previously noted that it may take up to 24 hours for a facility to receive a validation report, and the agency urges facilities to allow time for this and check CASPER for the validation. 

For questions related to software or technical requirements, email NursingHomePBJTechIssues@cms.hhs.gov; for questions related to PBJ policies, email NHstaffing@cms.hhs.gov.