Electronic submission of staffing data through the Payroll-Based Journal (PBJ) is required of all Long Term Care Facilities starting in 2016. Section 6106 of the Affordable Care Act (ACA) 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.
ALL nursing homes are encouraged to register to submit data to prepare to meet this requirement and maintain compliance.
- Obtain a CMSNet User ID for PBJ Individual, Corporate and Third Party users, if you don’t already have one for other QIES applications. (https://www.qtso.com/cmsnet.html)
- Obtain a PBJ QIES Provider ID for CASPER Reporting and PBJ system access. (https://mds.qiesnet.org/mds_home.html)
- PBJ Corporate and Third-Parties must use the current form based process to register for a QIES ID. Registration forms are available under the Access Request Information / Forms section on the right side of the page. (https://www.qtso.com/)
- Exported file (XML) from automated system (e.g. payroll, timekeeping) or
- Manual entry directly though PBJ system, or
- Combination of XML and manual entry ( merging data) Yearly Submission Deadlines
Yearly Submission Deadlines
Reporting Medical Director Hours
AMDA - The Society for Post-Acute and Long-Term Care Medicine met with the Centers for Medicare & Medicaid Services (CMS) and argued that the original “on site” requirement for reporting Medical Director hours could have lead to inaccurate reporting. In March of 2016, CMS amended this requirement to changes made to the final PBJ manual, which includes the removal of “on site” when describing the way Medical Directors hours are to be reported.
The Medical Director section of the PBJ manual now reads:
“For medical directors, CMS understands it may be difficult to identify the exact hours a physician spends performing medical director activities versus primary care activities. Data reported should be auditable and able to be verified through either payroll, invoices, and/or tied back to a contract. Facilities must use a reasonable methodology for calculating and reporting the number of hours spent on-site conducting primary responsibilities. For example, if a medical director is contracted for a certain fee (e.g., per month) to participate in Quality Improvement meetings and review a certain number of medical records each month, the facility should have a reasonable methodology for converting those activities into the number of hours paid to work.”
PBJ Version 2.0 Policy Manual: Labor Codes and Descriptions
- FAQs from CMS
- Slide Overview of PBJ with tracking examples
- News articles about PBJ
- PBJ Training Modules for an introduction to the PBJ system and step by step registration instruction are available on QTSO e-University, select the PBJ option
- More information is available on the CMS PBJ website
- Questions regarding PBJ policy issues should be directed to NHStaffing@cms.hhs.gov
- 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.)