As part of the federal government’s effort to verify staffing levels at skilled nursing facilities, skilled nursing facilities are rated on their nursing and caretaking personnel based on payroll records. How the government assesses those records has raised questions among providers, and the Centers for Medicare & Medicaid Services (CMS) recently gave Skilled Nursing News a glimpse into the audit process.

The goal is to have every facility submitting verifiable, auditable data, using the payroll-based journal (PBJ) staffing information. It’s the audit aspect that has led to some uncertainty. At the American Health Care Association (AHCA) conference and expo in San Diego in October, several speakers on a PBJ panel wanted to know more about what might trigger an audit by CMS.

“It’s the million-dollar question, right?” Don Feige, the founder and former owner of SNF-focused software firm ezPBJ, told Skilled Nursing News.