CMS Expects PBJ Data To Soon Impact Five-Star Ratings

According to a recent memo, the Centers for Medicare & Medicaid Services (CMS) will be releasing the Payroll-Based Journal (PBJ) data for the third quarter of the calendar year 2017 to the public through a Public Use File (PUF) later this month.

Like prior quarters, these PUFs will contain preliminary data submitted by skilled nursing providers for the third quarter of calendar year 2017. In prior quarters the files have reported information on approximately 89% of providers nationwide. The missing providers either failed to report their information prior to the submission deadline or had a submission that failed to meet certain quality checks. These providers are flagged as being non-compliant on Nursing Home Compare (NHP).

The information contained in the PUF can be reviewed by anyone including family members, managed care organizations and the media—which may result in you being questioned about direct care hours being delivered by different positions (RN, LPN, CNA) on a cumulative, average or even daily basis.

PBJ Data Will Soon Impact Your Five-Star Rating

In addition, CMS is expected to soon use PBJ data to calculate risk adjusted measures on the average hours per patient day by different job categories (e.g. RNs), which will be incorporated into your Five-Star Ratings. Since this rating is a key driver of business for providers – the implications are huge. A negative reputation, particularly a low star rating, can be detrimental to an organization.

CMS has made it crystal clear that submitting PBJ data—and doing so on time and accurately—will become increasingly important over time. To ensure that all hours are being captured and reported accurately, providers should use PBJ software that makes that possible and simplifies the reporting process.

OnShift will continue to monitor and keep you apprised of PBJ developments as they occur. We are experts in this area and are here to assist you in any way that we can.