AHCA: Payroll-Based Journal Updates

Lisa Volk in Clinical & Quality

The Centers for Medicare & Medicaid Services (CMS) has announced that they are taking steps to ensure that skilled nursing facilities are adequately staffed through three actions detailed below. 

First, CMS will utilize Payroll-Based Journal (PBJ) data to identify providers that have a significant drop in staffing levels on weekends or have several days in a quarter without a registered nurse (RN) working. The names of these providers will be shared with state survey agencies so that some weekend surveys can be conducted. If the surveys find insufficient nursing levels, facilities will be cited for non-compliance. 

Second, CMS has published a new update to the PBJ Policy Manual and FAQs, which are available here. Key updates include a more thorough explanation of the Meal Break Policy, reiterating that 30 minutes for every 8 hours worked need to be deducted for a meal break for every shift that exempt, non-exempt, or contract employees work regardless of whether the break is paid. If staff takes a meal break that is longer than 30 minutes, the actual time of the break should be excluded. The updates also include instructions for reporting hours for "universal care workers." 

Last, CMS announced the launch of two new PBJ reports. Both reports focus on MDS based resident census. Report 1704S Daily MDS Census Summary displays the daily MDS-based resident census for each day in the quarter. Report 1704D Daily MDS Census Detail displays a list of the residents that the MDS-based census is comprised of in a given timeframe. Detailed information on accessing the reports can be found here . Providers can submit questions on these reports to the QTSO Help Desk at help@qtso.com

In the coming days, AHCA will provide members with resources to help prepare for the above-mentioned actions. Additionally, AHCA will continue to provide updates on PBJ as they become available. If you have any questions, please contact the AHCA PBJ team here

This message contains confidential information and is intended only for AHCA/NCAL membership. Dissemination, distribution or copying the contents of this email beyond this group is strictly prohibited. 


Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15