CMS Peels Back Curtain on Why Providers Receive PBJ Audits
As part of the federal government’s effort to verify staffing levels at skilled nursing facilities, skilled nursing facilities are rated on their nursing and caretaking personnel based on payroll records. How the government assesses those records has raised questions among providers, and the Centers for Medicare & Medicaid Services (CMS) recently gave Skilled Nursing News a glimpse into the audit process.
Audits of PBJ data were introduced in the shift to PBJ from the prior staffing data collection method. With triggered or random audits, CMS verifies reported data is consistent with payroll records and have higher confidence in PBJ accuracy.
CMS Peels Back Curtain on Why Providers Receive PBJ Audits
The goal is to have every facility submitting verifiable, auditable data, using the payroll-based journal (PBJ) staffing information. It’s the audit aspect that has led to some uncertainty. At the American Health Care Association (AHCA) conference and expo in San Diego in October, several speakers on a PBJ panel wanted to know more about what might trigger an audit by CMS.
“It’s the million-dollar question, right?” Don Feige, the founder and former owner of SNF-focused software firm ezPBJ, told Skilled Nursing News.
November 29, 2018
Gotchas to watch for in PBJ audits
PBJ Audits are a key part of the Staffing Five Star methodology going forward based on the details shared by CMS with State Survey Agency Directors on how they will use Payroll-Based Journal data for Staffing Five Star measures.
Here’s what to watch for in preparing your PBJ submissions so that when you are audited, your report can meet the demands of auditors.
May 4, 2018
Preliminary Testing Audits of PBJ Data
The Centers for Medicare & Medicaid Services (CMS) has begun a pilot testing program to audit Payroll-Based Journal (PBJ) data.
Granite Dolphin and Myers and Stauffer audit teams are focused on examining payroll records and other auditable data to identify if staffing is accurately reported based on paid hours. As such, information requested may include information from payroll, timekeeping systems, invoices or contracts for contracted staff and interviews with staff responsible for PBJ data entry and submission.
“Preliminary Testing Audits of PBJ Data.” FORVIS, 22 June 2017, Link no longer available.
CMS to conduct pilot audit process for PBJ
CMS has announced in a letter addressed to skilled nursing facility administration that their PBJ staffing audit team will begin conducting audits of PBJ data submitted to CMS.
The letter states that the PBJ audit team will examine payroll records and other auditable data along with PBJ submission data to identify if staffing is being reported accurately based on hours staff are paid to work.
Hurlburt, Amanda. “CMS to Conduct Pilot Audit Process for PBJ.” The Post-Acute Advisor, 15 June 2017. No longer available.
