Category: State Mandates & Medicaid

State Mandates & Medicaid


Next Quarterly Payroll-Based Journal Data Submission Due

We remind nursing home members that Payroll-Based Journal (PBJ) data submissions covering Jan. 1st through March 31st must be finalized with the Centers for Medicare and Medicaid Services (CMS) by May 15th. PBJ submissions have been the basis for calculating the staffing domain of the Five-Star Quality Rating System for several years, and they are now being used to compute staff turnover and weekend staffing rates currently being displayed on Nursing Home Compare. As of July of this year, CMS expects to incorporate these measures into the Five-Star calculation.

More PBJ Topics

  • Minimum Staffing
  • Five Star Staffing Ratings
  • Research & Studies of PBJ Data
  • Survey & FTags for Staffing
  • PBJ Audits by CMS

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.

‘Powerful Data’ Could Inform CMS’ Nursing Home Minimum Staffing Standards

As federal minimum staffing requirements loom for skilled nursing providers, analysts with the Medicare Payment Advisory Commission (MedPAC) unveiled crucial data detailing the effects of state-level standards on the industry. While research found state minimum staffing requirements increased staffing levels and in some cases improved quality measures, there were some unintended consequences: a decrease in indirect staffing and skill mix, or the number of registered nurses (RNs) and licensed practical nurses (LPNs) relative to certified nursing assistants (CNAs).

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 Staff, Hours & Census
  • PBJ Report Submission
  • State Mandates & Medicaid
  • Nursing Turnover & Hours

Studies PBJ Data

Read the studies & media coverage of PBJ based research

Provider PBJ Hub

Links to key PBJ resources for skilled nursing facilities


Memos to states with CMS' PBJ guidance and policies

Tech Users Guide

How to calculate the Five Star ratings on Care Compare

PBJ Policy Manual

CMS' rules & requirements for quarterly PBJ submissions

Get Access to the PBJ Library

Get a free Library Pass to the archives of key PBJ manuals, research, communications and web tools.