The Centers for Medicare & Medicaid Services (CMS) is committed to enhancing the quality of care in nursing homes. A critical aspect of quality care is adequate and well-managed staffing. To better understand and monitor staffing levels in nursing homes, CMS introduced the Payroll Based Journal (PBJ) system. This system mandates that nursing homes electronically submit direct care staffing information, a significant step initiated under Section 6106 of the Affordable Care Act (ACA).
This article delves into the PBJ system, its requirements, reporting periods, and resources available, offering crucial information for aged care facilities in 2016 and beyond. While not directly a “Daa Menu Audit Tool For Aged Care Homes 2016,” the PBJ system itself serves as a vital audit and transparency tool for staffing data within the aged care sector. Understanding PBJ is essential for compliance and for demonstrating a commitment to quality resident care.
The Importance of Staffing Data in Nursing Homes
CMS has long recognized the direct link between nursing home staffing and the quality of care provided to residents. Staffing data is used extensively by CMS to assess and improve care quality. This data is publicly available on the CMS Nursing Home Compare website and is a key component of the Nursing Home Five Star Quality Rating System. This system helps consumers make informed decisions about nursing home care by understanding staffing levels and variations across different facilities.
The PBJ system was developed to collect more accurate and frequent staffing data. By requiring electronic submission of payroll-based staffing information, including agency and contract staff, CMS gains a clearer picture of staffing levels, employee turnover, and tenure. These factors are directly linked to the quality of care residents receive.
Payroll Based Journal (PBJ) System: A Detailed Overview
The PBJ system is a free, secure electronic method for long-term care facilities to submit staffing data to CMS. This system ensures regular and auditable data collection, enhancing the accuracy and reliability of staffing information.
Key Features of the PBJ System:
- Mandatory Reporting: As of July 1, 2016, all long-term care facilities are required to submit staffing data through the PBJ system.
- Electronic Submission: Facilities must submit data electronically, ensuring efficiency and standardization.
- Payroll-Based Data: The data must be derived from payroll and other auditable sources, guaranteeing accuracy and verifiability.
- Regular Submissions: Data is required quarterly, providing a more frequent and up-to-date view of staffing levels.
- No Cost Access: Facilities can access and use the PBJ system at no charge.
Image showing the CMS Provider Data Catalog, highlighting resources for accessing and downloading publicly reported healthcare data. The catalog enhances transparency and data accessibility for stakeholders in aged care and healthcare.
PBJ Reporting Periods and Deadlines
Adhering to the reporting deadlines is crucial for compliance with the PBJ system. Submissions must be received by 11:59 PM Eastern Standard Time on the 45th calendar day after the end of each fiscal quarter.
PBJ Reporting Deadlines for Each Fiscal Quarter:
| 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 |
Facilities must ensure timely submissions to avoid any compliance issues and to contribute to the accuracy of national nursing home data.
Accessing PBJ Policy and Technical Information
CMS provides comprehensive resources to assist facilities with PBJ reporting. These resources are available in the “Downloads” section of the CMS website dedicated to PBJ.
Policy Information Resources:
- PBJ Policy Manual: This manual offers a comprehensive overview of the PBJ system, including submission requirements, sample screens, deadlines, and definitions of job categories.
- PBJ Policy Manual Frequently Asked Questions (FAQs): This document addresses common questions and provides clarifications on policy-related aspects of PBJ.
- PBJ Summary Presentation: A presentation summarizing key points of the PBJ system, useful for training and understanding the system at a glance.
Technical Information Resources:
- PBJ Errata: Updates and corrections to the PBJ Data Submission Specifications.
- PBJ Data Submission Specifications: Detailed technical specifications for data submission, crucial for software developers and vendors.
- NHPBJ XSD File: The XML schema definition file for submitting employee and staffing data.
- PBJ Admin Excel to XML Template: A template to convert Excel data into the required XML format for submission.
- PBJ Excel to XML Template: Another Excel template option for data conversion.
- PBJ Data Specs (PDF, Access Database, CSV, HTML files): A collection of files providing full data specifications in various formats for different user needs.
Image from the PBJ Policy Manual download section, illustrating the availability of key documents and resources for nursing homes to understand and comply with PBJ reporting requirements. Accessing these resources is crucial for accurate data submission.
Publicly Available PBJ Staffing Data
Since November 1, 2017, CMS has made PBJ staffing data publicly available through a public use file. This file includes daily hours paid to nursing staff in each facility, categorized by roles such as director of nursing, registered nurses, licensed practical nurses, certified nurse aides, and medication aides. It also includes daily census data calculated using Minimum Data Set (MDS) submissions.
This public data enhances transparency and allows for greater scrutiny of staffing levels in nursing homes. The PBJ public use file is accessible at https://data.cms.gov/. Further details are available in Survey and Certification memorandum SC 17-45.
Staying Updated with PBJ System Changes
The PBJ system is subject to updates and changes. CMS regularly communicates updates through the “Updates” section of the PBJ website and via Open Door Forums, training sessions, and vendor calls.
Key Updates from 2019 and 2020:
- April 16, 2020: Delay in rejecting older fileSpecVersions (2.00.0 and 2.00.3), allowing continued use alongside version 4.00.0 until further notice.
- January 9, 2020: Release of revised PBJ Data Specifications (Version 4.00.0) with changes to file layout and removal of census tags. Encouragement for users to transition to version 4.00.0.
- April 18, 2019: Revised versions of PBJ Data Specifications (Version 3.01.0), PBJ User Guide, and PBJ CASPER Reports User Guide released. Census data no longer uploaded via XML files.
- March 3, 2019: PBJ Census Page for Manual Data Entry no longer available as census data is derived from MDS assessments.
- December 7, 2018: Updates to the PBJ Policy Manual and FAQ to clarify meal break policy and reporting hours for “Universal Care Workers.” Introduction of new CASPER reports (1704S and 1704D) for census data verification.
Facilities should periodically check the CMS PBJ website and participate in CMS communication channels to stay informed about the latest updates and ensure ongoing compliance.
Conclusion
The Payroll Based Journal (PBJ) system is a cornerstone of CMS’s efforts to improve nursing home quality through better staffing data management and transparency. While not a “daa menu audit tool for aged care homes 2016” in name, PBJ functions as a critical audit mechanism for staffing within these facilities. By mandating electronic, payroll-based data submission, CMS ensures more accurate, reliable, and frequent insights into staffing levels. For aged care homes, understanding and diligently participating in the PBJ system is not just about compliance; it’s about contributing to a higher standard of resident care and demonstrating accountability in staffing practices. Utilizing the provided resources and staying updated with CMS communications are essential steps for every nursing home to effectively navigate and leverage the PBJ system.
