The Centers for Medicare and Medicaid Services, alias CMS, identified staffing as a crucial element in quality care provided by nursing homes. The staffing is then used in the quality rating for these nursing homes. Under the Affordable Care Act (ACA) Section 6106, health care facilities are obligated to submit direct care staffing electronically. Direct care staff includes agency and contract staff. The facilities should also submit their census information each quarter of every year.
The reporting system used by CMS to submit this information is referred to as the Payroll-Based Journal, PBJ, hence the term PBJ reporting. PBJ reporting has strict requirements, and the involved organizations must track any additional information about staffing, hours in which every individual work, their position, and pay.
The Information Recorded in the PBJ Report
PBJ reporting for nursing homes requires the facilities to report the following employees’ information:
- Employee ID: All the direct care staff is assigned a unique Employee ID. The ID contains the information that can be used to identify an employee
- Working days and hours: The days and hours in which an employee is obligated to deliver services
- Job title code: The role performed by each employee during the assigned working hours, CMS only allows 40 PBJ Job Title Codes
- Pay type code: The pay classification for each employee during the working hours, either exempt, non-exempt, or contract
PBJ Report Information Recording Specifications
- Night shifts:The CMS requires the employees’ working hours to be recorded against their actual dates. In the case of a night shift, starting from 2200HRS to 0600HRS the next day, there will be two entries. I.e., two hours for completing the first day and six hours for the next day
- Multi-tasking: When an employee has various duties to execute in a single day, CMS allows the recording and submission of this data. However, this only applies if the system can record the change in duties
- Salaried Staff: Nursing homes are only allowed to record forty working hours for exempt employees. If the employee has worked for fifty hours, only forty hours are recorded under PBJ, and the employee is paid for the forty hours only. For non-exempt employees, overtime for extra work can be registered under the PBJ report, and they are payable
- Census Data: The PBJ systems record some Census Data at the end of every month. Each nursing home must submit the number of paid employees primarily by Medicaid, Medicare, or any other paying institution
Challenges Faced by Nursing Homes When Submitting PBJ Reports
Timekeeping
Timekeeping is vital in PBJ reporting. The submitted data’s reliability depends on how reliable a nursing home’s timekeeping system is. Thus, the nursing homes are obligated to record every hour spent by each employee to work.
Flexibility
Recording the activities of non-standard staff is one of the most challenging tasks in PBJ reporting. As earlier mentioned, night shifts are recorded in two different entries. Similarly, if an employee executes two various tasks in one day, they are recorded under different job categories and title codes.
Conclusion
PBJ reporting is exceptionally vital for every nursing home. It gives a star rating to the nursing homes according to their performances. The involved nursing homes should always comply with the PBJ reporting Labor laws to submit their PBJ reports accordingly.
