The new changes for CMS PBJ Reporting are being reported in a 3-part series, here on the RA Blog, and include:
- PART 1: Important essentials, present and future differences, biggest challenges facing providers, resources.
- PART 2 (this post): Direct staff list and codes, what data to report, when and how to report.
- PART 3: Questions, considerations, list of helpful resources.
Which Staff Will Facilities Need To Report?
Reporting is required for the following direct care staff (including agency and contract staff).
The occupations are each given unique identifying numbers for ‘labor code’ and ‘job title code’, which must be aligned to the PBJ system.
- Medical Director
- Physician Assistant
- Registered Nurse Director of Nursing
- Registered Nurse with Administrative Duties
- Registered Nurse
- Licensed Practical/Vocational Nurse with Administrative Duties
- Licensed Practical/Vocational Nurse
- Certified Nurse Aide
- Nurse Aide in Training
- Medication Aide/Technician
- Nurse Practitioner
- Clinical Nurse Specialist
- Occupational Therapist
- Occupational Therapy Assistant
- Occupational Therapy Aide
- Physical Therapist
- Physical Therapy Assistant
- Physical Therapy Aide
- Respiratory Therapist
- Respiratory Therapy Technician
- Speech-Language Pathologist
View the direct staff list/ codes and description of services on page 12 of this pdf.
What Data to Report
Both census and staffing data must be reported together.
Data reporting must include:
- Category of work performed, e.g., RN, LPN, CNA or therapist
- Census data
- Resident case mix
- Staff turnover and tenure information
- Hours of care provided per resident per day (CMS interprets this to mean hours worked)
Individual employees (agency and contractors included), are given a unique ID in the PBJ system, with:
- Hire date
- Termination date
- Full-time or part-time status
- Pay type—exempt, non-exempt or contract
- Labor category (time must be split if multiple roles are performed)
- Hours worked per day
Find more information on data required here.
When to Report
Facilities will be required to report each fiscal quarter:
Quarter 1: October 1 – December 31
Quarter 2: January 1 – March 31
Quarter 3: April 1 – June 30
Quarter 4: July 1 – September 30
To maintain compliance, all data must be received in a timely and accurate manner.
“To be recognized as timely, provider submissions of staffing and resident census data must be received by CMS by the end of the day (11:59 p.m. EST) on the 45th calendar day following the last day of the fiscal quarter. For example: Quarter 1 begins on October 1 and ends on December 31. For staffing and census data to be considered timely by CMS, providers have until 11:59 p.m. EST on February 14 to submit the data. Providers have the option of submitting data to CMS at any frequency during the fiscal quarter. However, the accepted submission will be the last submission accepted into the system prior to the deadline (as described previously). Submissions will be accepted after the deadline by CMS but will not be considered timely and will not be included in facility staffing data for any of the reported items, such as the Five-Star Quality Rating System. The staffing data reports can be reviewed by providers by opening the CASPER site for reports,” reports Sophie Campbell, for the American Association of Nurse Assessment Coordination.
How to Report
CMS have a standardized electronic QIES system (the PBJ) where all staffing and census data are to be submitted.
Providers are required to register to submit and the QIES university has extensive training materials to guide key personnel – payroll officer, administrators, etc – to use the system correctly.
There are 2 modes for submission into the electronic system:
- Manual data submission – enter data directly into the PBJ User Interface guided by sample screens and the manual.
- Direct upload – derived from automated payroll or time and attendance sheet systems. But first there are very specific technical requirements that must be met before direct upload is allowed.
- 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.