According to the Centers for Medicare and Medicaid Services (CMS), keeping track of staffing information in long-term care facilities is critical to quality care assurance. The CMS uses the data tracking of staff at care facilities and nursing homes for various purposes. Primarily, it is used to help consumers understand the staffing situation in nursing homes and have greater confidence in the facilities they choose.
A payroll-based journal (PBJ) mandate was enacted under Section 6106 of the Affordable Care Act (ACA) to improve the accuracy of staff data reporting at nursing homes and long-term care facilities. PBJ submissions became a requirement on July 1st, 2016, and long-term care facilities are given 45 days to file their quarterly report to the agency. Employers must be meticulous when documenting every staff member’s time, date, and hours under the correct job title code and labor category to ensure compliance with the Act.
Throughout this article, we will explain what PBJ reporting is and what types of data must be submitted. We will also discuss which medical facilities must provide PBJ reporting, the required job codes, and payroll based journal due dates.
What is PBJ Reporting?
The Center for Medicare and Medicaid Services adheres to strict rules for reporting direct care staffing, including utilizing agencies and contract workers. The CMS developed the Payroll Based Journal (PBJ) system to facilitate the submission of staffing information. The CMS can collect staffing information more frequently and regularly. The Payroll Based Journal system is free of charge for long-term care facilities to use and helps facilities meet PBJ reporting deadlines.
By combining this data with census information, nursing homes can then be assessed to determine their staffing levels, employee turnover, and tenure. This assessment can impact the quality of care they deliver. Information about nursing home staffing is posted on the CMS Nursing Home Compare website. It is used in the 5-star nursing home quality rating system to help consumers better understand how homes are staffed.
Facilities Required to Submit Payroll Based Journal Data
In line with the CMS PBJ reporting requirements, all long-term care facilities must submit accurate and detailed quarterly information on how many hours staff members work in specific job categories. Here are the types of facilities that must adhere to payroll based journal reporting requirements:
PBJ Reporting for Nursing Homes
A nursing home provides long-term residential care to the elderly or disabled. Nursing homes have many names, including skilled nursing facilities (SNF), long-term care facilities, older people’s homes, rest homes, and convalescent homes.
Residents of nursing homes interact with many facility employees on any given day. Regardless of the frequency of interaction, these employees make up the team that runs the nursing home and provides care to the residents and patients.
PBJ Reporting for Alzheimer’s Facilities
Patients with Alzheimer’s disease need a lot of assistance in their daily lives and are usually unable to live independently.
Care services for Alzheimer’s patients are under the following three categories:
1. Respite Care
This type of care consists of two categories:
- In-home care assists with exercising, bathing, dressing, and even medical care.
- Adult day services are interactive programs like dance classes, support groups, or musical activities offered in community centers. These programs, as well as meals and transportation, are led by professional staff.
2. Residential Care
- Retirement housing is where patients are supervised but can still have some independence. Those with early-onset Alzheimer’s can benefit from this type of care.
- Basic assisted living is a step between living independently and being in a nursing home. They provide health care services, meals, housing, and even help with bathing and household chores.
- Nursing homes are a good choice when someone needs long-term medical treatment. Some long-term care facilities provide special assistance to patients with Alzheimer’s, ensuring that your loved one is secure and receiving the proper care and attention. These facilities offer lockdown rooms for Alzheimer's patients who tend to wander.
- Continuum care retirement communities provide different levels of care in one location. Care can include assisted living, independent living, and nursing home services. The upside to this type of care facility is residents whose needs change can quickly move to get different services.
3. Hospice Care
is commonly used for end-of-life treatment, which can offer comfort to those with late-stage Alzheimer’s. Medicaid, Medicare, and leading private insurance plans typically cover hospice care costs.
PBJ Reporting for In-Home Nursing Agencies
In-home nursing is provided to patients who prefer to stay at home but need professional support for their physical or chronic conditions. In-home nursing agencies can provide qualified professional nurses to care for patients at home and enable them to recover peacefully and comfortably.
This approach allows patients to receive care and attention without the hassle of traveling and waiting in line. Many services are provided, including medication administration, nursing care, and wound care procedures.
PBJ Reporting for Residential Care Home Facilities
Residential care home facilities or group homes are usually shared by 20 or fewer residents, where rooms may be private or shared. Many long-term care services in residential facilities are offered to people who need full-time assistance.
Staff is available around the clock to provide personal care and meals. However, not all residential care home facilities offer skilled nursing. The services offered vary from home to home.
PBJ Reporting for Other Skilled Nursing Facilities
Skilled nursing facilities share similarities to nursing homes, and there are times when the terms and descriptions are used interchangeably. However, actual skilled nursing facilities may offer more medical expertise and services. Registered nurses deliver skilled nursing care in a medical setting under the supervision of a doctor.
As far as nursing care goes, it’s the same level and quality of care you would receive at a hospital. These skilled nursing facilities also need to adhere to the payroll based journal reporting requirements.
What Data Must be Submitted?
First, medical facilities must register in the PBJ system. Then, they must enter several different data points for each employee to satisfy payroll based journal requirements:
- Employee Unique ID
- Hire Date
- Termination date (if any)
- Pay type code (non-exempt, exempt, contact)
- Work day and date
- Job title code
- Job category code
- Hours worked per day and date
There are several things to note about data entry for CMS’ payroll-based journal reporting:
1. Each employee’s duties and responsibilities must be described in as much detail as possible. Employees who perform different tasks during the course of a day need to be categorized with different job codes for each change of shift. For example, an employee worked as an occupational therapist for the first half of the day and in advisory services for the second half. The employee would need to have the occupational therapy job code applied for those hours worked, and the advisory services job code applied for work performed under that role. The CMS system allows you to record and submit this data.
2. As dictated by CMS, hours worked must be attributed to the specific date they were performed. For example, a shift that starts at 9:00 on one evening and ends at 5:00 the following morning requires separate entries. Three hours would be recorded for the first day and 5 hours for the second day.
3. Following PBJ reporting guidelines, a total of 40 hours is the maximum that can be recorded for exempt, salaried employees. PBJ can be used to report overtime hours claimed by non-exempt employees.
4. If you work with contractors or individuals paid directly by Medicare, you don’t have to include them in your PBJ submission.
Payroll Based Journal Job Codes
CMS has specified 40 job descriptions, each with its own Labor Category Code and Job Title Code. Reporting is done based on the employee’s primary role and official title. However, job codes are essential because staff members often switch job functions daily. The hours of every individual staff member must be reported daily under the correct job title code and labor category.
For example, a nurse may start one shift as a unit manager, then change function to floor nurse in the second shift. In this situation, the facility would have to report a change in the designated title and document four hours as a nurse with administrative duties, and four hours without administrative duties.
You can find the complete list of job titles and staffing categories here.
PBJ Reporting Deadlines
The PBJ reporting schedule requires that submissions be received by 11:59 p.m. Eastern Standard Time on the 45th calendar day after the last day of the quarter. The following table explains the reporting period and PBJ reporting due dates:
Fiscal Quarter | Reporting Period | Due Date |
|---|---|---|
1 | October 1 – December 31 | February 14 |
2 | January 1 – March 31 | May 15 |
3 | April 1 – June 30 | August 14 |
4 | July 1 – September 30 | November 14 |
How to Submit PBJ Reporting Data
- Manually, by entering data for each employee line by line into the CMS system via its website.
- Automatically, via a pre-filled XML file with a maximum size of 5MB. The data must meet technical requirements, which can be found here.
- A combination of both methods allows for information not included in your XML file to be manually added into the CMS system even after you’ve submitted the XML file.
How APS Can Help
Now that you know what payroll based journal reporting is, you’ll see that it is essentially a practice in reliable timekeeping. The more diligent you are with your time tracking, the more accurate and verifiable your data will be when submitted to the CMS. APS can help with your PBJ reporting requirements in the following ways:
Dimensions Time Tracking
Our employee time tracking software allows medical facilities to track time by category, including department and location. Employees can allocate their time more granularly for accurate PBJ reporting of time.
Special Income Types
Our time and attendance tracking software allows medical facilities to create complex attendance rules. Track and manage shift differentials, on-call pay, call-back pay, and more.
PBJ Reporting
APS has partnered with Prime Care Technologies to assist healthcare organizations required to submit CMS PBJ reporting. APS provides payroll data to Prime Care Tech, which is combined with facility data to produce a complete PBJ reporting file. This file is then submitted to the CMS to satisfy the payroll based journal reporting requirements.
Schedule a demo with us today to see how APS can help with your PBJ reporting requirements.
