PBJ Reporting Requirement Resumes
Aug. 14th marks the deadline for nursing homes to finalize Payroll-Based Journal (PBJ) data submissions for the quarter covering April 1st through June 30th with the Centers for Medicare and Medicaid Services (CMS). PBJ submissions are used to calculate quarterly staffing ratings used in the Five-Star Quality Rating System. Only data that are successfully submitted by the deadline are used in determining ratings, and inaccurate submissions can result in a home being assigned a single star for the staffing domain. Providers may overwrite previously submitted data for that quarter until the deadline date.
During the Public Health Emergency (PHE), CMS waived the requirement for nursing homes to submit staffing data through the PBJ system for the quarter covering Jan. 1st through March 31st. Because of the waiver, staffing data that would have been used to update the staffing domain for the July 2020 quarterly refresh of the Five-Star rating system was incomplete. Therefore, the staffing measures and star ratings are not updated for most homes and will be held constant based on data from the prior quarter (i.e., Oct. 1st through Dec. 31, 2019). However, for homes that were assigned a one-star rating as a PBJ reporting penalty during the April 2020 Five-Star update, CMS is removing the rating downgrade and temporarily suppressing their staffing measures and star rating.
Members should be certain that their reporting accurately reflects the requirement for a registered nurse (RN) to be on site for at least eight consecutive hours, seven days per week. The latest version of the PBJ policy manual (November 2018) and related resources are available for download at the bottom of the dedicated CMS PBJ web page here. The user manual for uploading data through the CMSNet Secure Access Service is available here.
CMS recommends that providers take advantage of the verification resources after uploading their data to ensure a successful submission. Once the data is uploaded, the system will remind the user to:
- Check the My Submissions page. This feature will show the status of the zip file.
- Check the Certification and Survey Provider Enhanced Reporting (CASPER) application for a system-generated PBJ Final File Validation Report (FFVR) within 24 hours. If no FFVR appears, run a PBJ Submitter FFVR to check your file for errors.
- Run the PBJ 1702D (by Employer) or 1703D (by Job Type) Reports to verify that the submitted quarterly PBJ data accurately reflects your records.
Please note that accurate and timely reporting has implications for the facility's federal star ratings as well as state Nursing Home Quality Initiative (NHQI) score calculation. Tips to avoid some other common reporting pitfalls are discussed here.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841