Long-Term Care

Verifiable staffing data based on payroll will be submitted by LTC providers beginning 10/1/2015

MDS 3.0 Insider, April 10, 2015

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CMS has long identified staffing as one of the vital components of a nursing home’s ability to provide quality care.  Over time, CMS has utilized staffing data for a myriad of purposes in an effort to more accurately and effectively gauge its impact on quality of care in nursing homes.  We also post staffing information on the CMS Nursing Home Compare website, and it is used in the Nursing Home Five Star Quality Rating System to help consumers understand the level and differences of staffing in nursing homes.  
Section 6106 of the Affordable Care Act requires facilities to electronically submit direct care staffing information (including agency and contract staff) based on payroll and other auditable data.  The data, when combined with census information, can then be used to not only report on the level of staff in each nursing home, but also to report on employee turnover and tenure, which can impact the quality of care delivered.
Therefore, CMS has developed a system for facilities to submit staffing and census information – Payroll-Based Journal (PBJ).  This system will allow staffing and census information to be collected on a regular and more frequent basis than currently collected. It will also be auditable to ensure accuracy.    All long term care facilities will have access to this system at no cost to facilities.
CMS intends to collect staffing and census data through the PBJ system on a voluntary basis beginning on October 1, 2015, and on a mandatory basis beginning on July 1, 2016.  Registration for voluntary submission will begin in August 2015, and CMS will communicate more information at that time. Training will also be provided on registration and for both voluntary and mandatory submissions.
This webpage provides information on how data will be collected and who to contact for questions.
PBJ Policy Information:
The following files contain technical information related to the PBJ and are now available under the Downloads section of this page:
·           PBJ Policy Manual DRAFT – Provides general background and information about the submission requirements, such as sample submission screens, submission deadlines, and definitions of job categories.      
Questions regarding the PBJ Policy Manual should be directed to nhstaffing@cms.hhs.gov.
PBJ Technical Information:
The following files contain technical information related to PBJ and are now available under the Downloads section of this page:
·         PBJ 1.0 Submission Specs V1.00.0 for the October 1, 2015 Release
1.      PBJ data specs PDF files ZIP – Full data spec report and the unduplicated edits report, as well as the Overview document.
2.      PBJ data dictionary ZIP – The Access database used to maintain the items and edits, as well as generate the reports.
3.      PBJ data specs CSV files ZIP – Comma-separated value (CSV) files of the items and item values.
4.      PBJ data specs HTML files ZIP – Set of HTML files that can be used to navigate the items and edits in a browser.
5.      PBJ data specs XML and XSD files ZIP – Sample PBJ XML submission file and its associated XSD file for performing some of the validations in the specs.
Questions regarding the PBJ Data Specifications should be directed to NursingHomePBJTechIssues@cms.hhs.gov.  Software developers or vendors that provide services such as automated payroll or time and attendance systems that will support electronic submissions should use this address.  In an effort to serve you better, we are offering voluntary vendor registration at https://www.qtso.com/vendor/post.php. This information will be used to contact you with important PBJ news, updates, and conference call information.
Please note that CMS may not provide an individualized response to each inquiry; however, CMS will address all applicable issues and comments through Open Door Forums, training sessions, vendor calls, or updates to
CMS will communicate any changes to these materials on this page, as well as through Open Door Forums hosted by CMS.
To read more, click here. 



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