Changes and Results from First PBJ Submission

Mar 30, 2017 | Rules for PBJ Reporting, Five Star Staffing Ratings

News Digest: Changes and Results After First PBJ Submission

With the first full PBJ reporting period over, and 90%+ facilities successfully submitting a PBJ report – CMS identified data and technical issues to clean up.  Those changes came through in a new Policy Manual and FAQ.  Meanwhile the industry found some areas of PBJ reporting that could merit a change.


CMS urges more provider diligence on PBJ data

Skilled nursing providers should submit their next round of payroll based journaling data well ahead of the May 15 deadline in order to catch errors, Centers for Medicare & Medicaid Services officials said Thursday.

CMS staff told attendees of the Skilled Nursing Facility Open Door Forum call to not hold out until the deadline in order to see if there are “errors and issues” and leave time for corrections if needed.


Mongan, Emily. “CMS Urges More Provider Diligence on PBJ Data; Notes Nursing Home Compare Update.” McKnight’s Long-Term Care News, 24 Mar. 2017,


Providers get an ‘A’ for submitting PBJ data, officials say

Around 90% of long-term care providers have submitted electronic staffing data, officials said Thursday.

The Payroll-Based Journal submissions were due Nov. 14 to reflect staffing data from July 1 to Sept. 30. However, the Centers for Medicare & Medicaid Services will accept submissions until Dec. 1 as long as providers are making a “good faith effort,” according to sources on a CMS Skilled Nursing Facilities/Long-Term Care Open Door Forum call Thursday.


Newman, Elizabeth Leis. “Providers Get an ‘A’ for Submitting PBJ Data, Officials Say.” McKnight’s Long-Term Care News, 18 Nov. 2016,


PBJ updates make it easier for providers to submit hire, termination, and rehire information

On February 17, 2017, the Centers for Medicare & Medicaid Services (CMS) released two updates to the Payroll-Based Journal, making it easier for providers to submit hire, termination, and rehire information for employees without receiving errors.

These updates, detailed below, are considered a “step in the right direction” by the American Health Care Association (AHCA) in their pursuit, joined by other providers and organizations, to “create efficiencies in the collection of staffing data.”

Hurlburt, Amanda. “PBJ Updates Make It Easier for Providers to Submit Hire, Termination, and Rehire Information.” The Post-Acute Advisor, 23 Feb. 2017. No longer available.


Don’t punish SNFs for training

The Centers for Medicare & Medicaid Services have made information technology and staff competency a priority for the past five years. In response, skilled nursing facility educators expanded training programs to keep up with increased needs. For example, a Certified Nursing Assistant early detection training program was focused on decreasing re-hospitalizations.

Then in July 2016, the Payroll Based Journal system became mandated. It requires a SNF to deduct the hours CNAs participate in in-service training so that staffing levels will be accurately reflected for the Nursing Compare Five Star Rating reporting. Consequently, SNFs are be penalized for training their staff. That’s despite saving the CMS money by avoiding unnecessary hospital readmissions and improving quality of care.


Marcus, Jeff R. “Don’t Punish SNFs for Training.” McKnight’s Long-Term Care News, 30 Dec. 2016,


CMS Staff Tracking System Promises More Accuracy

The new payroll-based journal (PBJ) system developed by the Centers for Medicare & Medicaid Services to determine the staffing component ratings in the Five-Star Quality Rating System will likely be “a huge change, [resulting in] a more comprehensive and more accurate” look at a facility’s staffing, Ashkan Javaheri, MD, CMD, said at the AMDA – the Society for Post-Acute and Long-Term Care Annual Conference.

Medical directors’ hours are part and parcel of the new system, and “it’s important to understand that the hours you [record and] submit should be based on your medical directorship duties — on what the facility is paying you to do,” said Dr. Javaheri, assistant professor at the University of California–Davis School of Medicine and head of the geriatric division at Mercy Medical Group–Dignity Health Medical Foundation in Sacramento. “Hours for your patient care are not reportable in PBJ.”


Kilgore, Christine. “CMS Staff Tracking System Promises More Accuracy.” Caring for the Ages, 1 June 2017,

Related CMS and PBJ Resources

To learn more about the details, policies and information in these articles, please review these CMS and PBJ publications.

Cms qso memorandum for pbj
QSO Memo 17-25-NH
Payroll based journal policy manual
PBJ Policy Manual v2.2
Faqs for pbj policy manual
PBJ Policy FAQs Dec '16

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