What You Need to Know to Prepare for PBJ

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Long-term care facilities mandatory Payroll Based Journal (PBJ) reporting is fast approaching. So, you only have one more quarter to get your ducks in a row, so to speak.

July 1, 2016 is the first quarter that PBJ reporting will be mandatory, meaning the period for data to be submitted will be from July 1, 2016, to September 30, 2016, with the first mandatory submission to the PBJ system due by no later than 45-days after the quarter ends which is November 14, 2016.

So now is the time to get everything in place to test your reporting methodology and identify any gaps in your process so that you can correct them as needed.

Here’s a list of items that you will need to include to meet the PBJ reporting requirements:

– a unique employee ID for each direct staff care provider (no SSN’s allowed)
– a complete, accurate record for each facility that identifies their direct care staff (includes agency and contractors too)
– include medical personnel as defined by CMS (RN, PT, LPN, etc.)
– residence census data (Medicare, Medicaid, other)
– direct care staff turnover and tenure (start and term dates)
– hours of care provided by each category of staff per resident per day including start and end date and the hours worked per individual

Just to clarify, because I know this is a common question asked, how to identify Direct Care Staff are those individuals who, through interpersonal contact with residents or resident care management, provide care and services to allow residents to attain or maintain the highest practicable physical, mental, and psychosocial well-being.

Direct care staff does not include individuals whose primary duty is maintaining the physical environment of the long-term care facility (for example, housekeeping). Nor does it include care providers who bill direct.

Did you know…?

– The name of the PBJ reporting system is Quality Improvement and Evaluation System (QIES), and you must register your facility to obtain user ID’s at https://www.qtso.com/cmsnet.html
– QIES allows only two logins per facility (they time out after a period-of-time, so you must work fast).
– While in the QIES system you will NOT be able to access the internet, so no copy and pasting your data… if you do not have a file to upload, then it is truly manual data entry.
– You will need to have a way of generating unique IDs for your direct care staff, agency, and contractors. You can reuse IDs for the same individual, but not for others (ex. employee leaves employment and returns then you can reuse the ID they had previously).
– You will need to map job titles to the CMS defined codes to ensure they are in sync for reporting purposes.
– You will need to have a record of all the hours of your direct care staff, agency, and contractors work in order to back up your reporting in case of an audit.
– You have three options for submitting your PBJ data: manually enter it into the QIES system, file submission (XML zip file format only) or upload a file and then enter in the remaining or missing data manually.
– There is not a “test” period, but you can use the voluntary submission period to submit files and check for errors, etc. (this is strongly recommended)

Feeling Overwhelmed?

Well, you’re not alone. But don’t worry SwipeClock’s Workforce Management Suite solution can help make this process easier.


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