Mandatory changes to CMS reporting measures are fast approaching long term care facilities. These changes are designed to promote greater accountability while enabling a means to quantify the value return of the service provided.

As of July 1st 2016, facilities will be required to use the Payroll-Based Journal (PBJ) for quarterly reporting – a standardized electronic system for submitting staffing and census information.

These new changes will be reported here on the RA Blog, in a simplified, resourceful 3-part series:

  • PART 1 (this post): Important essentials, present and future differences, biggest challenges facing providers, resources.
  • PART 2: Direct staff list and codes, what data to report, when and how to report.
  • PART 3: Questions, considerations, list of helpful resources.

In the near future, the new CMS values-based outcomes will also be covered in a series of posts.

Important Essentials of the PBJ

Moving forward into the future, skilled nursing facilities (SNFs) wanting to participate in the Medicare and Medicaid programs will be required to meet the amended reporting requirements.

A few important things to note are:

  1. It is mandatory therefore, there will be penalties for non-compliance
  2. The information may be audited for accuracy and verification
  3. Information must be sent quarterly in a timely matter

Present and Future Differences

CMS-present-and-future CMS Payroll-Based Journal (PBJ) Reporting (Part 1)

Featured Image Credit: Long-Term Living Magazine

Shaking Things Up versus Benefits?

CMS-reporting-1 CMS Payroll-Based Journal (PBJ) Reporting (Part 1)

While the changes are bound to shake things up, they are designed to bring about positive changes.

For instance, in the long term care industry, related cost of labor is the largest operating cost. With the new changes, related cost of labor, staffing and scheduling will be key points of focus for providers.

Therefore, in the long term, this will likely result in more streamlined processes, outcomes, and even cost savings for both CMS and facilities alike.


Biggest Challenges Ahead

According to Pamela J. Skrzynski and Jodie Carleton, published in Long-Term Living Magazine, the following things will likely be the biggest challenges for providers:

  • The administrative burden and organization involved in acquiring, processing and systematizing these new changes will likely hit most healthcare facilities hard, at least in the beginning.
  • As hours worked will need to be recorded for every employee, every single day, and aligned with unique identifiers in the PBJ system, identifying more accurate methods to document staff while they are in the building may prove challenging.
  • In addition to employees, the hours worked will monitor agency staff and contractors, therefore, non payroll staff will need to be manually added on a daily basis (an administrative consideration), or additional time clocks/ ID scanning systems may need to be implemented for all direct staff to ensure accurate reporting.
  • Implementing high quality processes and systems that can produce an auditable document trail and be presented to CMS if required is also a big challenge – discuss these with your current software/ systems IT consultant. There could also be additional costs involved in purchasing new software for scheduling, timekeeping and payroll to ensure it is PBJ ready.


  • CMS PBJ website – Includes basic policy information, technical details for providers and third parties, and is updated regularly with new information.
  • QIES PBJ website – Includes training, FAQs and information for third-party vendors/developers.