News Digest: More Changes to Staffing Five Star and Reporting Requirements during the COVID Pandemic
To address the lack of PBJ data reporting during the pandemic, CMS announced it was holding Staffing Five Star ratings constant. In addition, CMS recognized that this suspension may harm some facilities – those who were downgraded to a 1 star rating will instead display “Not Available” rather than the 1 star rating.
Also, CMS ended an earlier reporting waiver and informed nursing homes they must submit data for Calendar Quarter 2 by August 14, 2020.
PBJ reporting is back on track
After a bumpy three-month ride, PBJ reporting is back on track for the quarter. In late March, CMS issued a staffing data submission waiver due to the COVID-19 public health emergency. On June 25, that waiver ended – which means PBJ reporting requirements for the quarter are back in effect.
What do I need to report?
In the published memo, CMS announced that the end of the waiver means: Facilities must submit their April-June data by the normal August 14 deadline. Facilities do not need to submit their January-March data, although they are still encouraged to do so.
Feige, Jenn. “Tips for the PBJ pro: PBJ Reporting Is Back on Track.” SimpleLTC, 21 July 2020, www.simpleltc.com/pbj-reporting-is-back-on-track.
CMS ends Blanket Waiver of Nursing Home Staffing Data Submission Requirement
The Centers for Medicare & Medicaid Services (CMS) announced that it is ending its waiver of the requirement for nursing homes to submit staffing data through CMS’s Payroll-Based Journal (PBJ) system, effective immediately.
The original waiver, issued with a retroactive date of March 1, 2020, waived the PBJ reporting requirements set forth under 42 C.F.R. 483.70(q). Absent this waiver, providers would have been required to submit staffing data through CMS’s PBJ system for CMS’s second fiscal quarter reporting period, from January 1 through March 31, with a due date of May 15
“CMS ENDS BLANKET WAIVER OF NURSING HOME STAFFING DATA SUBMISSION REQUIREMENT, REQUIRES DATA SUBMISSION BY AUGUST 14, 2020.” Hancock Daniel, 6 July 2020, hancockdaniel.com/2020/07/cms-ends-blanket-waiver-of-nursing-home-staffing-data-submission-requirement-requires-data-submission-by-august-14-2020
CMS Memo Confirms PBJ Submission Deadline and Provides Five-Star Updates
On June 25, CMS released a QSO memo updating changes to the staffing and quality domains of Five-Star due to COVID-19.
With this memo, CMS immediately ends the blanket emergency waiver of 42 CFR 483.70(q), which requires nursing home providers to submit staffing data through the Payroll-Based Journal (PBJ) system.
“CMS Memo Confirms PBJ Submission Deadline and Provides Five-Star Updates.” WHCA/WiCAL, 2 July 2020, www.whcawical.org/ill_pubs_articles/cms-memo-confirms-pbj-submission-deadline-and-provides-five-star-updates.
CMS announces end of emergency blanket data waiver for nursing homes
Federal officials said Friday that they are ending an emergency blanket waiver intended to reduce administrative burden on nursing homes amid the continuing COVID-19 pandemic.
The Centers for Medicare & Medicare Services (CMS) said that effective August 14, nursing homes nationwide will again be required to submit staffing data through the Payroll-Based Journal (PBJ) system, which allows the agency to collect “staffing information which impacts the quality of care residents receive,” CMS said in a press release.
The first initial submission to PBJ must cover the second quarter of the current calendar year.
Spivey, Mark. “CMS Announces End of Emergency Blanket Data Waiver for Nursing Homes.” ICD10monitor, 29 June 2020, icd10monitor.com/cms-announces-end-of-emergency-blanket-data-waiver-for-nursing-homes.
Payroll Based Journal Waiver Ended and Other Five-Star Updates
In the CMS memo dated June 25, 2020, CMS addressed changes to staffing information and quality measures posted on the Nursing Home Compare Website and Five Star Quality Rating System due to the COVID-19 Public Health Emergency.
CMS ended the PBJ emergency blanket waiver of staffing data submission requirement. All nursing homes will be required to resume submission of staffing data for Calendar Quarter 2 (April – June) 2020 through the PBJ system by August 14, 2020. Five-star staffing measures and ratings will be updated in October 2020 based on data submitted by August 14, 2020.
Lehmann, Sarah. “Payroll Based Journal Waiver Ended and Other Five-Star Updates.” HW&Co. CPAs & Advisors, 22 July 2020, hwco.cpa/payroll-based-journal-waiver-ended-and-other-five-star-updates
PBJ reporting waiver ends
CMS has ended the PBJ staffing data submission waiver included in the COVID-19 emergency blanket waiver.
In a letter released June 25, CMS announced that facilities are once again required to submit their April–June PBJ data by the normal August 14 deadline.
CMS also decided NOT to require the submission of January–March 2020 staffing data for PBJ reporting, a change from earlier statements.
Feige, Jenn. “PBJ Reporting Waiver Ends.” SimpleLTC, 26 June 2020, www.simpleltc.com/pbj-reporting-waiver-ends
CMS Announces Changes to 5-Star Rating System; End of Staffing Submission Waiver
In a policy memo on June 25, CMS announced temporary changes to the 5-star rating system on Nursing Home Compare. These changes include freezing pieces of the staffing and quality measures domains, as well as the immediate end to the PBJ staffing submission waiver. These changes are discussed in greater detail below.
In March 2020, CMS waived requirements at 42 CFR 483.70(q) related to submissions of staffing data through the payroll-based journal system. This data is used to calculate the staffing domain rating on Nursing Home Compare and updates on a quarterly basis. The staffing ratings currently reflected on Nursing Home Compare are based on data from calendar quarter 4 2019 (October – December). The next scheduled update for this domain, July 2020, would rely on data collected for calendar quarter 1 2020 (January – March), the submission of which was waived. As a result, the staffing domain measures and ratings for the July update will be held constant.
CMS notes that holding this domain constant denies providers the resolution of penalties, such as the automatic downgrade to a one-star rating that a provider receives when they fail to submit data or when they report more than 4 days in a quarter with no RN on site. For providers in this circumstance, the measures and ratings for the staffing domain will be suppressed with the July update.
“CMS Announces Changes to 5-Star Rating System; End of Staffing Submission Waiver.” LeadingAge, 26 June 2020, https://leadingage.org/cms-announces-changes-to-5-star-rating-system-end-of-staffing-submission-waiver/
CMS Orders Nursing Homes to Resume Reporting Staffing Data as COVID-19 Waiver Expires
Nursing homes must resume the submission of staffing data to the federal government later this summer after the Centers for Medicare & Medicaid Services (CMS) allowed an emergency COVID-19 waiver to expire.
CMS on Thursday announced that facilities must report their payroll-based journal (PBJ) staffing data for the second quarter of 2020 by August 14, ending a temporary suspension of the requirement that the agency implemented as part of broader COVID-19 paperwork waivers.
Spanko, Alex. “CMS Orders Nursing Homes to Resume Reporting Staffing Data as COVID-19 Waiver Expires.” Skilled Nursing News, 25 June 2020, skillednursingnews.com/2020/06/cms-orders-nursing-homes-to-resume-reporting-staffing-data-as-covid-19-waiver-expires.
Related CMS and PBJ Resources
To learn more about the details, policies and information in these articles, please review these CMS and PBJ publications.
QSO Memo 20-34-NH
Technical Users' Guide
July 2020
