Harmony Healthcare Blog

Payroll-Based Journal (PBJ) Data Collection: Top 10 Things You Need to Know

Posted by Kris Mastrangelo on Thu, Apr 19, 2018


Edited by Kris Mastrangelo

C.A.R.E.

Compliance • Audits/Analysis • Reimbursement/Regulatory • Education/Efficiency


Are you ready hand writing with a black mark on a transparent boardPayroll-Based Journaling goes live next week (4.23.18) on the Nursing Home Compare Five Star! 

  1. Staffing Information Collected for Quality Interpretation

    The Centers for Medicaid and Medicare Services (CMS) collects, tracks and analyzes Skilled Nursing Facility (SNF) staffing data.  The purpose of this metric is to gauge quality of care as this information not only depicts the staffing levels, but, it may be an indicator of staffing turnover which correlate to the quality of care rendered. The information is posted publicly on the Nursing Home Compare website.The AHCA Quality Cabinet Committee inquired to CMS the intent of posting the “expected” staffing information.  CMS responded that the underlying implications are that “not all Skilled Nursing Facilities require the same level of staffing.” 
  1. CMS Form-671 (Staffing Portion) Not Required June 1, 2018

    While the CMS Form-671 data has always been present, the PBJ data source replaces the CMS Form-671.  Effective on June 1st, 2018 CMS will stop requiring providers to complete the staffing portion (page 2) of CMS Form-671. SNF’s will still be required to complete parts of the form unrelated to staffing (e.g., address, ownership type, etc.) 
  1. Case Mix Concerns

    There are concerns regarding the Case Mix Adjustment Factor and the unintended consequence that MDS coding may imply that a facility staffing levels are inadequate.  
  1. History

    The Affordable Care Act initiated the mandate for all SNF’s to electronically submit direct care staffing which is based on payroll and auditable data. The first mandatory reporting period began July 1, 2016.

    Below are the deadlines for each reporting period: 

Fiscal Quarter

Reporting Period

Due Date

1

October 1 – December 31

February 14

2

January 1 – March 31

May 15

3

April 1 – June 30

August 14

4

July 1 – September 30

November 14

 

  1. The 4 Measures posted on Nursing Home Compare include 
  • RN Hours Per Resident Day.
  • Total Nursing Hours Per Resident Day (HPRD).
  • Physical Therapist Hours Per Resident Day (HPRD).
  • Average Daily Census. 
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  1. The 2 Measures used in Ratings 
  • Risk Adjusted RN Hours Per Resident Day (HPRD).
  • Risk Adjusted Total Nursing Hours Per Resident Day (HPRD). 
  1. The Steps to Calculate Measures 
  1. Sum hours paid over quarter.
  2. Sum daily census over quarter.
  3. Calculate Hours Per Resident Day (HPRD) by dividing hours over average daily census.
  4. Calculate expected Hours Per Resident Day (HPRD) using RUG-66 (details pending).
  5. Risk adjust measures by comparing to expected staffing. 
  1. Staffing Cut Points Table March 2018
    As seen in the below table, the staffing domain cut points are shifting and this may impact the overall rating. 

RN Ratings 

  1. Submission Deadlines
    The below table provides the staffing data quarter, submission date and when it will be made public.

PBJ Submission Table

Data Submitted for Calendar Quarter

Submission Date

Used in Five-Star

Approximate Date Posted on Nursing Home Compare

2017 Q1

5.15.17

No

-

2017 Q2

8.14.17

No

-

2017 Q3

11.14.17

No

-

2017 Q4

2.14.18

Yes

4.26.18

2018 Q1

5.15.18

Yes

7.25.18

2018 Q2

8.14.18

Yes

10.24.18

2018 Q3

11.14.18

Yes

1.23.19

2018 Q4

2.14.19

Yes

4.24.19

 

  1. Penalties
    Skilled Nursing Facilities will be penalized for missing and or erroneous PBJ Data Submission. The Staffing Star Domain rating being set to 1-star when:

    Missing
  • Reporting no RN hours for 7 or more days.
  • Auditing shows inconstancies in submitted data.
  • Late submission of PBJ data.
  • Exclude meal times.
  • Provide a unique ID for each employee.
  • Submit MDS discharge assessments on a timely manner.
  • Exclude hours for staff that provide care to non-certified areas.

 Erroneous

  • Total nurse staffing < 1.5 hours per resident per day.
  • Total nurse staffing > 12 hours per resident per day.
  • Nurse aide staffing > 5.25 hours per resident per day.

Harmony Healthcare International (HHI) is available to assist with any questions or concerns that you may have. You can contact us by clicking here.  Looking to train your staff?  Join us in person at one of our our upcoming Competency/Certification Courses.  Click here to see the dates and locations. 


Join us November 1st & 2nd, 2018 at Mohegan Sun Resort for harmony18
7th Annual LTPAC Symposium
Click Here to Register
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