The use of Payroll-Based Journal (PBJ) data in surveys provides clues about an impending federal staffing mandate.

The article discusses how the Centers for Medicare & Medicaid Services (CMS) has updated its guidance on nursing home staffing, which is expected to result in more citations and penalties for facilities that fail to meet minimum staffing requirements.

Key points:

• The CMS update requires surveyors to ask direct care staff and directors of nursing about staffing levels and how they are determined.
• Facilities will be cited if they fail to submit staffing data through the Payroll-Based Journal (PBJ) system.
• The updated guidance aims to reduce inconsistency in how surveyors apply staffing standards, with some states having much higher or lower citation rates than others.
• Industry experts expect the new guidance to result in more citations and penalties for facilities that do not meet minimum staffing requirements.

Experts quoted in the article:

• Steven Littlehale, executive vice president of Zimmet Healthcare Services Group: "When you push a little bit, facilities will often say that they staff based on their budget, and not on their casemix... That's a significant problem."
• Mark Morton, NASL's Director of Government Relations: "It's another breadcrumb, the administration is definitely telling us operators, staffing matters significantly to us and so we're going to measure you on that any way we can."

The article suggests that the CMS update is part of a broader effort by the Biden administration to prioritize staffing in nursing homes.