Category: CMS’ PBJ Policies

More PBJ Topics

  • Minimum Staffing
  • State Mandates & Medicaid
  • Survey & FTags for Staffing
  • Five Star Staffing Ratings
  • Nursing HPRD & Turnover
  • PBJ Audits by CMS

Nursing homes sue over minimum staffing ratios, mandatory spending levels

Nonprofit New York nursing homes are taking action against the state in a push to overturn “illegal and unconstitutional” policies that establish a minimum staffing requirement and spending mandates for providers. LeadingAge New York, leading a group of 80 nonprofit and public nursing homes, on Monday filed a lawsuit against the state over the two statutes being enacted during the COVID-19 public health emergency.

CMS Strengthens Nursing Home Oversight and Safety to Ensure Adequate Staffing

Centers for Medicare & Medicaid Services (CMS) announced actions that will bolster nursing home oversight and improve transparency in order to ensure that facilities are staffed adequately to provide high-quality care. These actions include sharing data with states when potential issues arise regarding staffing levels and the availability of onsite registered nurses; clarifying how facilities should report hours and deduct time for staff meal breaks; and providing facilities with new tools to help ensure their resident census is accurate.

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.

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.

  • CMS' PBJ Policies
  • Rules for PBJ Reporting
  • Studies & Research of PBJ Data

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.