After last year’s staffing rating calculation overhaul, CMS has confirmed that they are making some adjustments to their methodology. One of the changes is to accommodate the updates we saw to the MDS assessment earlier this month, while the other change is to further penalize providers who do not successfully submit PBJ data accurately. We seem to say it every quarter, but submitting PBJ data with confidence and accuracy is more paramount than ever!

Coming April 2024: Harsher staffing penalties

CMS has announced that they will no longer allow providers to be excluded from turnover measures for failing to submit accurate PBJ data.

Six quarters of PBJ data are needed for CMS to calculate turnover. Since July 2022, CMS has excluded the three turnover measures (Total Nurse Turnover, RN Turnover, and Administrator Turnover) if providers did not timely submit their PBJ data for any of the six prior quarters. Most instances of this resulted in a neutral impact to the provider’s overall staffing score.

Starting in April 2024, however, providers that do not submit PBJ data, or submit erroneous data for one or more of the six prior quarters, will no longer be excluded. Instead, providers will receive the lowest possible score on their staffing turnover measures.

The lowest possible score for all three turnover measures combined is 20 points out of 130. This penalty will stain Five-Star and Care Compare reports for a year and a half, remaining on the staffing score until the quarter(s) of no data submission drop off from the 6-quarter look-back period.

Accurate and timely PBJ data submission is more important than ever.

CMS to freeze HRD measures

To calculate the three Adjusted Hours per Resident Day (HRD) staffing measures, CMS has relied on clinical data from Section G of the MDS assessment. On Oct. 1 2023, a significant change was made to the MDS and Section G was replaced by Section GG.

In July 2024, CMS will update their methodology to calculate the HRD measures to a model based on the PDPM.

In the meantime, CMS will use the existing methodology once more to calculate HRD measures for the January 2024 Five-Star and Care Compare refresh. That refresh will be comprised of staffing and Case-Mix data from July 2023 – September 2023. In April 2024, the January measures will be held constant (frozen) until the new methodology is released in July 2024.

The three HRD staffing measures are:

• Total Nurse HRD
• RN HRD
• Weekend Nurse HRD

Thorough and accurate PBJ submission for the October 2023 – December 2023 timeframe is still required and will be critical for upcoming turnover calculations.

Time marches on: Updated look-back period

Five-Star Reports for September, October, and November 2023 will use the look-back period of April 2022 – March 2023 for PBJ turnover calculations.