Last September, CMS announced that the year 2024 would come with some adjustments to the Staffing Rating calculations. CMS is also updating the methodology used to calculate Hours per Resident Day (HRD) measures. In a staffing landscape where PBJ audits are anything but scarce, facilities that fail to submit PBJ data accurately can expect more severe punishment.

The challenges may be more rigid, but there is opportunity for success. A renewed focus on above-and-beyond staffing and accurate, timely PBJ data submission can lead to increased scores (and improved resident care).

CMS will no longer exclude turnover measures for providers that fail to submit accurate PBJ data.

Six quarters of PBJ data are used 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 on the provider’s overall staffing score.

Starting in April, 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.

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 when Section G was replaced by Section GG.

In July, 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, the HRD measures calculated for the January refresh will be held constant (frozen) until the new methodology is released in July.

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 and Five Star staffing scores.

On Dec 14, Simple launched a new, HIPAA-compliant user portal for submitting support requests called NetsmartCONNECT. Please note: Simple’s PBJ support team can only be contacted through NetsmartCONNECT or via phone. 

Important! If you have not created a NetsmartCONNECT account yet, check out the training video and other resources here: NetsmartCONNECT for Simple clients. This user portal is the only way to see support case updates, so creating an account ahead of the PBJ deadline can help you save time. We will also review this new process in our quarterly PBJ webinar (register below).

Five-Star Reports for January, February, and March 2024 will use the look-back period of July 2022 – June 2023 for PBJ turnover calculations.