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New PBJ Data Shows Slight Improvement

On Oct. 26th, the Centers for Medicare and Medicaid Services (CMS) released nursing home Payroll-Based Journal (PBJ) data for the second quarter of calendar year 2022. Facilities use the PBJ system to report detailed staffing information. The State had indicated that Q2 data would be used as the basis for inaugural penalties assessed on nursing homes that were unable to meet required State nursing staffing levels. This despite the fact that the Governor last week renewed Executive Order 4 (for the 14th time), which declares a statewide disaster emergency due to health care staffing shortages.

The PBJ data confirms the emergency: of the 600 nursing homes with data, 75 percent were unable to meet the requisite staffing levels, despite the risk of penalties. This marks a slight improvement; in the prior quarter, the percentage was closer to 80. And although the Department of Health (DOH) has signaled that the regulations are under discussion at the highest levels, they have not yet been finalized, making it unclear when and how the State might assess penalties. In the absence of clarity, we recommend that providers be aware of their compliance levels and be prepared to argue for mitigation if necessary.

We have developed two resources that members may find helpful. The first is a data tool that presents facility-specific PBJ staffing and compares it to the State requirements (both on a quarterly and daily basis). It provides an easy way to review what the Department sees for your facility when it looks at the CMS data release. Members can access the download links for current and past quarters here.

The other is a form that should be helpful in documenting the case for mitigation of any potential staffing penalties. Because the regulations suggest an opportunity for providers to request a waiver of the requirements and mitigation of penalties based on certain circumstances, LeadingAge NY has drafted a Sample Mitigation Data Form for members to use to demonstrate their efforts to comply with the minimum staffing requirements.

We will keep members informed of any developments on this issue. An article with links to the latest version of the proposed regulations as well as our comments is available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, or Karen Lipson, klipson@leadingageny.org. Both can be reached at 518-867-8383.