Ask the payment expert …. about the total nurse staffing measure

Nov 11, 2022 | Five Star Staffing Ratings, Rules for PBJ Reporting

Ask the payment expert …. about the total nurse staffing measure

Q: What is the Skilled Nursing Facility Value-Based Payment Total Nurse Staffing Measure?

A: The Total Nursing Hours Per Resident Day Measure uses auditable electronic data reported to the Payroll-Based Journal system to calculate total nursing hours per resident day. It is one of two new measures that will begin affecting payments in the FY 2026 SNF VBP program year, the other being SNF Healthcare Associated Infections Requiring Hospitalization.

The numerator for this measure is the total nursing hours derived from PBJ data. Total nursing hours include RN, LPN and CNA hours per resident day. The denominator is a count of daily resident census derived from MDS assessments. The daily MDS census is summed across all days in the quarter.

FROM

McKnights

PUBLISHED

November 11, 2022

SOURCE

Wilkes, Eleisha R. “Ask The Payment Expert …. About the Total Nurse Staffing Measure.” McKnight’s Long-Term Care News, 11 Nov. 2022, www.mcknights.com/print-news/ask-the-payment-expert-about-the-total-nurse-staffing-measure.

More News in this PBJ Topic

CMS Updates Staffing & Turnover Measures

the Centers for Medicare & Medicaid Services (CMS) issued updates to guidance on minimum health and safety standards that Long-Term Care (LTC) facilities (often called “nursing homes”) must meet to participate in Medicare and Medicaid.

CMS also updated and developed new guidance in the State Operations Manual (SOM) to address issues that significantly affect residents of LTC facilities.

read more

States get needed nurse aide waiver relief but workers’ fates uncertain

Skilled nursing providers in at least 15 states averted the loss of thousands of frontline workers Thursday, when the Centers for Medicare & Medicaid Services let expire a blanket national waiver allowing the use of non-certified nurse aides. Those states had been awarded new waivers through an application process, meaning they demonstrated testing backlogs or other delays that kept providers from converting a large share of temporary nurse aides into permanent certified nurse assistants.

read more

Thousands of nursing homes face lower Five-Star ratings

New Five-Star scoring metrics could penalize an estimated 10% to 16% of providers who have relied on staffing strengths to drive their overall ratings.

The Centers for Medicare & Medicaid Services on Thursday published new guidance for calculating staffing stars in the public-facing rating system. It incorporates total nurse staffing on weekends; annual RN and total nurse turnover; and administrator turnover.

read more

CMS offers leniency to Kronos users impacted by ransomware attack

Ultimate Kronos Group (UKG), a software used by SNFs for PBJ submission, was the victim of a ransomware attack on December 11, 2021. CMS announced it will not downgrade affected facilities that miss the February 14, 2022 PBJ submission deadline or submit incomplete information.

Impacted Kronos users need to contact CMS by March 1, 2022 with specific requested information as noted in the CMS memo below.

read more

How to Boost Your Nursing Home Star Rating

For the administrator looking to improve an overall quality score quickly, the staffing score is a good place to start.

The staffing score will boost a facility’s overall score by one star if it: exceeds the health inspection score, and is either four or five stars.

read more

Importance of the human touch

Everyone falls into auto-mode now and then. While SimplePBJ continues to discover and add new verification checks for potential issues, the human touch is still needed to confirm the PBJ data you’re submitting is accurate.

Don’t get lulled into thinking the data from your payroll or timekeeping system is 100% PBJ ready. Many times that ends up not being the case.

read more

Staffing Rating Under 4 Stars? Review PBJ Data; Set and Monitor Goals

Staffing is difficult—that was a defining truth for nursing homes before the COVID-19 public health emergency created a full-blown staffing crisis that still is harming providers throughout healthcare. So, it may seem like the wrong time for directors of nursing services (DNSs) to pay much attention to the staffing domain in the Five-Star Quality Rating System.

“However, all of the Five-Star data—the staffing, health inspections, and quality measures domains—funnels into multiple parts of a facility’s life,” says Shelly Maffia, RN, MSN, MBA, NHA, QCP, CHC, director of regulatory services for Proactive Medical Review and Consulting in Evansville, IN.

read more

5 Star, QMs, and PBJ Data Updates

5 Star, QM’s and PBJ data updates have been released. Last week, we shared that QRP’s were released for review. All are critical reporting which impacts our 2022 FY reimbursement and our publicly displayed information on Care Compare. There are a few small windows of time for review and correction if needed.

read more

Tips for the PBJ pro — Top 5 PBJ Mistakes

We’re often asked, “What are the biggest mistakes facilities make when completing their PBJ reports?”

Here are the top 5 — based on thousands of facility implementations, consultations, and audit reviews.

read more