CMS kicked off the new year with more PBJ reporting disclosures. In a letter released January 7, CMS announced that it will begin posting new PBJ metrics to the Medicare.gov Care Compare website:

• Weekend staffing — the level of total nurse and registered nurse (RN) staffing on weekends over a quarter
• Staff turnover — the percent of nursing staff and number of administrators that stopped working at the nursing home over a 12-month period
• Detailed staffing data — employee-level staffing data

These additions are not unexpected after several high-profile reports published last year. However, news that CMS would immediately begin posting this data to the Care Compare website in January 2022 — and incorporate the measures into the Five-Star Staffing rating in July 2022 — caught many by surprise.

Timeline of events

• January 7 — CMS announces the upcoming posting of weekend staffing and staff turnover metrics
• January 14 — CMS releases the revised Five-Star Rating System Technical Users’ Guide, which will detail the staff turnover formula and the updated Staffing Five-Star calculation
• January 26 — weekend staffing and staff turnover metrics post to Care Compare and the Provider Data Catalog, and employee-level data posts to the PBJ section of data.cms.gov
• July 2022 — Five-Star Staffing ratings incorporate weekend staffing and staff turnover for the PBJ submission period of January 1 - March 31

What can I do?

Although CMS won’t release the new Technical Specifications until January 14, there are some best practices you can implement now:

• Verify Employee ID consistency in your PBJ submissions. If you changed timekeeping and/or payroll systems and did not maintain the same Employee IDs, employees with the old IDs will be considered by CMS as having ended their work at your facility. To fix this, you need to submit an Employee ID Linking file to connect the old and new Employee IDs together. Failing to connect the Employee IDs will artificially increase your staff turnover measures.
• Audit your weekend staffing hours to confirm that nursing hours provided Saturday and Sunday do not vary significantly from those provided Monday through Friday. If you discover noticeable variations in weekend versus weekday hours, you will want to adjust hours accordingly.

Food for thought

Including data on weekend staffing and staff turnover were just two of the recommendations from previous OIG and GAO reports. A third underscored the importance of non-nurse staffing data. CMS' inclusion of administrators in staffing turnover is a likely nod to this, and facilities should take note of the other non-nurse staff mentioned:

• Medical directors
• Dietitians
• Pharmacists
• Social workers
• Activity staff

As CMS continues its desire to "further enhance the information available to consumers, residents and families" through data transparency, those other non-nurse staff may eventually find a seat at the PBJ table.

Quarterly reminder

Your Q1 2022 (October 1 – December 31, 2021) PBJ staffing data is due Monday, February 14 and will post to Care Compare the end of April 2022. Last quarter's Staffing Five-Star (July 1 – September 30, 2021 data) will post to Care Compare the end of January.

Have more questions?

SimplePBJ will host its PBJ Quarterly Check-In on January 26. This free webinar is your opportunity to get all your PBJ questions answered before the upcoming February 14 submission deadline. You can ask your questions live during the webinar, or click the button below to submit your questions now so we can prioritize them.

In December, Kronos experienced a ransomware attack that affected some cloud-based services, including payroll and timekeeping systems. We reached out to CMS on behalf of our customers and received this response:

“We are aware of the situation with Kronos and working with them on how best to handle it. Kronos will be contacting all of their clients to advise on how this quarter’s submissions will be handled as soon as a decision has been made.”

A reminder to anyone impacted by the attack — SimplePBJ provides the ability to manually add hours, combine data from multiple sources, scrub data, and produce XML files to submit to CMS. Email info@simplepbj.com if you'd like to learn more.

SimplePBJ will incorporate the new January 14 staffing metrics on weekend staffing and staff turnover as quickly as we can. In the interim, you can use our existing tools found on the Quarterly Totals and Visualize Staffing pages to analyze weekday versus weekend staffing hours.

Wed, Jan. 26, 2022 | 11:30 am CT

SimplePBJ will host its quarterly PBJ check-in webinar on Jan. 26. Learn the latest CMS updates and ask your PBJ questions. You can also submit questions in advance to be sure they get answered during the webinar, or ask them during the live Q&A.