Since 2016, skilled nursing providers have been required to submit Payroll-Based Journal (PBJ) data to the Centers for Medicare and Medicaid Services (CMS) as a way to drive industry standards and ensure high quality care for patients.
CMS has been very clear from the start that PBJ data would eventually affect a providers’ Five Star Quality Rating, but it was never certain when that date would be, or how PBJ data would replace the current method of data capture.
On April 6, 2018, CMS released an announcement that many providers have been anxiously waiting and preparing for- PBJ data will now be used to determine Five Star Quality Ratings.
How will the Five Star Rating be Calculated?
- Five Star Ratings will be calculated based on Q4, 2017 data that was submitted before the February 14, 2018 deadline.
- Beginning in April 2018, CMS will begin to use the RUG-IV system to calculate adjusted staffing levels.
- The Staffing Rating will continue to be calculated by combining a total nurse staffing rating with an RN rating.
- New ratings’ thresholds will be created based on the existing distribution of ratings among nursing homes.
- On June 1, 2018, the 671 will go away.
The CMS plans to update the Technical Users Guide on May 1, 2018. You can access it here: https://www.medicare.gov/NursingHomeCompare/Data/About.html
The next PBJ submission deadline is May 15.