PBJ Policy Manual Archives
📖 See exactly how CMS instructs senior care facilities to fulfill the staff reporting of PBJ data
What is the PBJ Policy Manual?
The Payroll-Based Journal (PBJ) Policy Manual describes how facilities must fulfill the requirement to report quarterly staffing levels with these data points:
- Employee ID: a unique, anonymous and unduplicated identifier to evaluate when staff start and stop working in a facility over time
- Date: When reported hours were worked, calculated from midnight to midnight
- Hours Worked and Paid: The number of hours each staff member both works and is paid to provide direct care to residents in the nursing home
- Job Title Code: The role performed by staff in one of 40 standardized PBJ Job Title Codes defined by CMS
- Pay Type Code: How staff are paid – either exempt, non-exempt or contract
As described in the Payroll-Based Journal (PBJ) Policy Manual, the Centers for Medicare and Medicaid Services (CMS) has long identified staffing as a vital component of a nursing home’s ability to provide quality care. Section 6106 of the Affordable Care Act requires facilities to submit direct care staffing data (including agency and contract staff) based on payroll and other auditable data. The reporting system is called the Payroll-Based Journal (PBJ) system.
Where is PBJ Used
PBJ-reported staffing data is combined with resident census counts to report Hours Per Resident Day (HPRD) levels of nursing staff in each facility and categorize nursing homes into a Five Star rating system. In 2022, CMS added staff turnover and tenure measures to the staffing Five Star calculation as added ways to for consumers to assess the quality of care delivered.
Staffing levels and turnover measures are posted on the CMS Care Compare website (formerly Nursing Home Compare), and used in the Nursing Home Five Star Quality Rating System to help consumers understand the level and differences of staffing in nursing homes.
Version 2.6 (the most recent version)
Published June, 2022
Archives of PBJ Policy Manuals & FAQs
(Get a free Access Pass to download individual manuals & FAQs)
CURRENT - Payroll Based Journal Policy Manual version 2.6 - June 2022
After almost four years with no changes, the CMS Policy Manual was updated in June 2022 to version 2.6. This is the current PBJ Policy Manual in effect.
Updates to the payroll based journal policy included:
- Reminded facilities to run CASPER reports to verify accuracy and completeness of their submissions.
- Provided extensive details on the Employee ID linking process, upload file and technical specifications to ensure accurate tenure and turnover metrics.
- Clarified the definition of Medical Directors and Administrators
In parallel activity, CMS added staff turnover and tenure metrics to the Care Compare Five Star rating system. As such, this policy manual detailed ways in which providers could ensure accurate employee ID linking to ensure the turnover and tenure metrics are not articially higher than reality.
CURRENT - FAQs for PBJ Policy Manual – November 2018
The still most recent PBJ FAQ document was published in October 2018. While the PDF file says it was updated in October, 2018, the file itself says it was posted November 19, 2018.
This FAQ added two one questions, removed one and modified two previously answered questions. New concepts included:
- Detailed the requirement on removing 30 minutes for lunch breaks whether the break is paid or unpaid
- Add explanation on how to report time for Universal Care Workers who work in multiple PBJ roles
- Updated posting schedule of staffing information and star rating to the Nursing Home Compare provider listings
- Removed the previously answered question on Hire and Termination dates as that data became optional, not required.
Payroll Based Journal Policy Manual v 2.5 - October 2018
After a full calendar year with no changes, the CMS Policy Manual was updated in October 2018 to version 2.5. Version 2.5 lasted almost four years before the next update to 2.6 in 2022. Updates in this version included:
- Reminder that the PBJ system will not accept submissions after the deadline.
- Created a definition of required Meal times deductions based on hours worked and staff type.
- Add rules for Universal Care Workers that provide both CNA and non-CNA services.
- Further defined the job roles of Medical Director, Paid Feeding Assistant and Qualified Activities Professional.
A substantially long description of required meal breaks was included in this version to eliminate confusion and any arbitrariness in the removal of meal breaks time from reported paid and worked hours.
FAQs for PBJ Policy Manual – September 2017
The fifth version of the PBJ FAQ document was published September 26, 2017 after four quarters (one year) of PBJ data submission by facilities.
This FAQ added two new questions and modified just one previously answered question. New concepts included:
- Introduced a new ability to link Employee ID numbers when changing tracking systems
- Provided extensive detail on the method CMS is using to automatically calculate resident census for facilities using MDS assessment data
- Provided details on the timing of changes to the Nursing Home Compare provider listings after the most recent PBJ reporting period
Payroll Based Journal Policy Manual v 2.4 - September 2017
With a full 4 quarters of reporting complete, the CMS Policy Manual was updated in September 2017 to version 2.4. Updates included:
- Introduction of an Employee ID linking process and upload file.
- Add clarification that Meal times shall be deducted for all staff whether it is paid or unpaid
- Made reporting of Resident Census optional instead of required
A small but significant change in this policy update required the removal of meal times from reported hours – even if the meal break was paid. This represented another adjustment to standard payroll hours requirement to stay PBJ compliant.
To providers’ benefit, this update removed the requirement to report resident census. Instead CMS developed an automated method to calculate census based on MDS data.
FAQs for PBJ Policy Manual – April 2017
The fourth PBJ FAQ document was published April 17, 2017 after the second required data submission by facilities.
This FAQ added zero new questions, removed two, and modified just one previously answered question. New concepts included:
- Changed the requirement to report Hire and Termination dates to optional from required
- Removed a prior answered question on optional reporting of Laboratory and Radiology staff
- Removed a prior answered question on Hire and Termination dates as that requirement was made optional
Payroll Based Journal Policy Manual v 2.3 - April 2017
With two quarterly reporting periods completed, CMS released version 2.3 of the CMS Policy Manual in April 2017. Updates included:
- Directions to check the Final Validation Report in CASPER to ensure a submission was successful.
- Introduced a significant change making Hire Date and Termination Date for each staff Optional.
- Made Job Titles 32 (Dental Services), 33 (Podiatry Services) and 35 (Vocational Service Worker) optional to report, not required
This update marked the abandonment of hire and termination data collection. Over five years later, CMS published its automated method of calculating turnover and tenure metrics in the June 2022 Technical Users Guide.
FAQs for PBJ Policy Manual – December 2016
The next PBJ FAQ document was published December 21, 2016 just a month after the first required data submission by facilities.
This FAQ added four new questions, removed one, modified four previously answered questions and rearranged their order. New concepts included:
- Further clarified corporate staff hours that can be reported
- Included Respiratory therapists in a prior question about therapy hours
- Added more detail on reporting Hire and Termination dates
- Recommended maintaining of Employee IDs regardless of reporting system changes
- Clarified that the midnight split rule does not require a change in payroll techniques used to pay staff
- Introduced a method to convert minutes to fractions for manually entering hours in the PBJ system
- Clarified how to confirm successful submission of data in the PBJ system
Payroll Based Journal Policy Manual v 2.2 - December 2016
Following the first required submission deadline in November 2016, CMS published version 2.2 of the CMS Policy Manual. Updates included:
- Reinforcement of the need to maintain employee ID’s when switching contract vendors to avoid issues with turnover and tenure.
- Clarification of hire dates when staff transfer to new facilities.
- For users who manually submit data, a conversion table to convert minutes to fractions.
- Added clarification that corporate staff can only be reported when paid to work on site at a facility.
Of note, the continued clarification on proper methods to report hire and termination dates correctly were a sign of the challenges involved in collecting that data.
FAQs for PBJ Policy Manual – April 2016
The second PBJ FAQ document was published April 27, 2016 just two months before the new PBJ reporting requirement began July 1, 2016.
This FAQ added five new questions, removed one and modified four previously answered questions. New concepts included:
- Removal of lunch hours from reported paid and worked hours
- Confirmation of which providers are required to comply with PBJ rules and that it does not apply to swing beds
- Added flexibility in reporting on staff who perform multiple roles
- Clarified that practioner hours billed to Medicare directly or other payers cannot be reported in PBJ
- Introduced methods to report Therapist hours for different scenarios
- Removed requirement to report Laboratory and Radiology staff, making it optional
- Created a method to report extra hours worked by salaried staff beyond their salaried duties
- Defined how to report hours for shifts occuring in two calendar days (crossing midnight).
- Removed the part-time vs full-time guidance from the prior FAQ document
Payroll Based Journal Policy Manual v 2.1 - April 2016
With many questions coming from the industry, a new version was quickly released when CMS delivered PBJ Policy Manual version 2.1 in April, 2016, just two months before the official start of the PBJ program on July 1, 2016. Updates included:
- Direction to use unique Employee ID’s for contract and agency staff
- Introduction of the “midnight split” defining the reporting time for hours worked to be midnight to midnight each day
- Clarification of when to report additional paid hours for salaried staff working more than the standard 8 hours they are paid
- More specific instructions on reporting hours for Medical Directors, Physical Therapists, Occupational Therapists and Speech Therapists, Corporate staff, staff in training and staff at hospital-based SNFs.
- Made Job Titles 36 (Clinical Laboratory Services) and 37 (Diagnostic X-ray Services) optional to report, not required
The “midnight split” rule and requirement for contact staff further separated payroll-based journal data from the norms of timekeeping data used in payroll systems.
Payroll Based Journal Policy Manual v 2.0 - March 2016
The transition from Version 1 to Version 2 occurred in March, 2016, three months before the official start of the PBJ program on July 1, 2016. Updates included:
- Clarification of which long-term care facilities are subject to PBJ – specifically excluding swing beds.
- Clarification on the handling of staff performing duties fitting multiple job descriptions
- Updated definition of the Administrator job description
A small but significant change clarified that reporting of administrative staff is limited to just licensed nursing home administrators versus all non-clinical staff (office, front desk, etc.).
Administrative staff responsible for facility management as required under 483.75(d) such as the administrator and the assistant administrator.
FAQs for PBJ Policy Manual – August 2015
The initial PBJ FAQ document was published August 25, 2015 to accompany DRAFT PBJ Policy Manual version 1.1 during the voluntary testing period to be used be the early testers of the payroll-based journal system.
This FAQ posed and answered 14 questions covering concepts including:
- Reporting Hours PAID versus Hours WORKED
- Defining Direct Care Staff
- Reporting on staff who perform multiple roles
- Compiling hours for Medical Directors who get paid by the facility AND as an attending physician
- Determining hours paid and worked by contract staff and specialist contractors
- Separating hours of staff who work in both an acute-care hospital and co-located skilled nursing facility
- Providing methods to capture and report hours for contract staff
- Illustrating how to report Hire and Termination dates for contract staff
- Validating the reporting of the sampling method used to report census
- Clarifying which hours of corporate staff can be reported at a facility level
- Explaining how to report training hours for staff attending training
- Confirming the removal of the requirement to report part or full-time status
- Instructing facilities how to register and submit data during the voluntary period
- Explaining how data submitted during the voluntary period will be used
DRAFT Payroll Based Journal Policy Manual v 1.1 - August 2015
The second draft PBJ policy manual updated the PBJ policy to incorporate the final rule that was published August 4, 2015. Updates included:
- Definition of Direct Care Staff
- Submission requirements of work category (job types). resident census data and information on turnover and tenure
- Delineation of agency vs. contract vs. employed staff
- Definition of a uniform electronic data format
- Quarterly schedule of submission
The definition of Direct Care staff is a core PBJ concept introduced in this version.
Direct Care Staff are those individuals who, through interpersonal contact with residents or resident care management, provide care and services to allow residents to attain or maintain the highest practicable physical, mental, and psychosocial well-being. Direct care staff does not include individuals whose primary duty is maintaining the physical environment of the long term care facility (for example, housekeeping).
DRAFT Payroll Based Journal Policy Manual v 1.0 - April 2015
The draft PBJ policy manual was initially published during the voluntary testing period to be used be the early testers of the payroll-based journal system.
CMS developed a system for facilities to submit staffing and census information and named it the Payroll-Based Journal (PBJ) system. The PBJ system collects staffing information on a regular quarterly basis – which is more frequent than previously used.
The PBJ system is auditable to ensure accuracy. The PBJ Policy Manual provides basic information to be used for submitting staffing and census information through the PBJ system
Registration for the PBJ system through QIES will begin in August 2015 for facilities that will submit data on a voluntary basis starting October 1, 2015 only. CMS will communicate more information at that time. Facilities that will not be submitting data voluntarily should not register at this time.
There are additional materials that provide technical specifications and instructions on how to submit data manually or upload automatically from a payroll or time and attendance system.