Select Page

A Payroll-Based Journal (PBJ) report is an official report that nursing homes and other long-term care facilities submit quarterly to the Centers for Medicare and Medicaid Services (CMS). It tracks staffing levels to ensure they meet CMS standards and documents the hours worked by all direct care staff in nursing homes, such as licensed nurses, nursing assistants, and therapists. Additionally, a PBJ report includes the number of residents in the facility and the hours of care provided to each resident. 

A facility’s Human Resources or payroll staff will use the PBJ report internally to track staffing levels and enter the relevant data into the PBJ reports. This allows facilities to identify understaffed areas, adjust staffing levels accordingly, and make informed decisions about employee scheduling. For this reason, the PBJ report is a vital tool for nursing homes to ensure they are adequately staffed to provide quality care to their residents. 

What is included in a payroll-based journal report?

While payroll processing is essential for every nursing home and long-term care facility, it can be tedious and time-consuming. One reason is that nursing homes have many employees to manage and hours to track accurately. 

The CMS requires facilities to track all hours for direct care staff, including agency staff who attend to residents. This does not apply to others, like housekeeping or maintenance, who do not count as direct care staff, even though they directly impact the facility’s environment. 

The PBJ report also must categorize the direct care staff members’ types of work, including job roles, responsibilities, and hours of care spent with each resident per day.

How to submit a payroll-based journal report? 

There are three options for submitting a PBJ report:

A physician is checking that the documented hours in the quarterly PBJ report are accurate and correct.
A PBJ report tracks staffing levels to ensure they meet CMS standards.
  • Option one: Facilities can submit their data manually, which can be overwhelming because it requires HR staff to manage and track employee hours, leading to a high risk of errors, often resulting in delays and employee dissatisfaction. 
  • Option two: Facilities can upload their PBJ report data via an automated system, such as payroll-based journal software. Advanced PBJ software will have specific features, such as automating the time and attendance of care staff, exporting data, and electronically submitting quarterly PBJ reports, making the process significantly quicker, more accurate, and efficient, saving facilities time and money. Furthermore, using an automated software program minimizes human errors and data entry mistakes, saving the team time and energy while allowing them to focus on providing better care to the residents.
  • Option three: Facilities can use a combination of options one and two.

Due to the high level of detail and accuracy needed to submit PBJ reports, many nursing facilities face challenges when submitting PBJ reports to the CMS. We will discuss some of these common challenges next.

CMS PBJ Reporting Challenges for Nursing Homes 

As mentioned earlier, CMS PBJ reporting is essential for every nursing home and long-term care facility. However, nursing homes often face challenges that can negatively impact employee morale.

Below, we will highlight some common challenges nursing homes face when submitting a PBJ report while staying compliant with the CMS’ requirements:

A member of HR reviews the facility's quarterly CMS PBJ report before submitting it to the CMS.
Nursing homes often face challenges when submitting CMS PBJ reporting that can negatively impact employee morale.
  • Not adhering to the “Midnight Split” rule: This rule requires that all direct care hours, including those worked during overnight shifts, be recorded on the day they occurred. This can make it difficult for nursing homes to accurately report staffing hours, especially when recording overnight shifts spanning two calendar days. In such cases, nursing homes must split and report these hours by calendar day to avoid errors in PBJ submissions. Failure to submit accurate payroll or timekeeping systems results in inaccurate staffing data, negatively impacting the facility’s overall quality rating and Medicare reimbursements.
  • Reporting the wrong PBJ data specifications: PBJ specifications require that Pay Type (exempt, non-exempt, or contract) and Job Title (PBJ job title codes) are included in staffing hour reports instead of the employee’s details. This makes it more difficult for nursing homes to accurately track staff hours, especially for employees with multiple roles, pay types, and job titles. 
  • Incorrect reporting of all direct care hours: The CMS specifies that all direct care hours—including internal employees, agency, and contract staff whose primary duty is to provide care and services to the residents—are accurately reported. In addition, nursing homes must report partial direct care paid hours for staff who provide some direct care, even if their primary role is not in direct care. This creates the problem of identifying which employee hours are reported as partial direct care hours, often leading to inaccurate direct care hours reporting and, ultimately, impacting the facility’s overall CMS quality rating.
  • Failure to meet compliance deadlines: Facilities must submit quarterly PBJ reports to the CMS. Failure to meet the CMS’ deadlines can result in non-compliance penalties, leading to an automatic one-star rating in the staffing category for the quarter. The submission deadlines are:
    • Quarter 1 (January-March): May 15th
    • Quarter 2 (April-June): August 14th
    • Quarter 3 (July-September): November 14th
    • Quarter 4 (October-December): February 14th

The CMS uses the PBJ reporting data to determine a nursing home’s staffing levels and quality of care. If a nursing home fails to submit accurate staffing data or does not meet the PBJ reporting requirements, its overall quality rating will be impacted on the Medicare Compare website. This will ultimately affect the facility’s reputation and ability to attract new residents, leading to financial instability and low census numbers. 

Next, we will look at effective ways a nursing home can ensure they meet the CMS’s PBJ reporting regulations while providing high-quality care to residents. 

Contact us here to see how our payroll-based journal software can improve your PBJ reporting.

4 Ways Payroll-Based Journal Software Streamlines PBJ Reporting in Nursing Homes

There are several strategies nursing homes can employ to improve their PBJ reporting process and meet the CMS’ compliance requirements: 

  1. Invest in payroll-based journal software 

Simplify and streamline the PBJ report process by investing in payroll-based journal (PBJ) software that automates data collection and reporting, reducing the risk of errors and providing real-time access to staffing data. This can help nursing homes make informed decisions about staffing levels and employee scheduling.

Effective PBJ software will automatically collect and organize direct care staff hours, pay rates, and job titles from the payroll system. This eliminates the need for time-consuming manual data entry that is prone to errors.

  1. Train staff on payroll processing 

Adequate staff training ensures accuracy in payroll-based journal (PBJ) mandatory reporting and processing. Therefore, nursing homes should look for effective training programs that teach staff how to properly use the facility’s PBJ software, so they can track and report employee hours accurately and meet the CMS’ regulations.

  1. Implement time clocks 

Advance PBJ software programs will have a built-in time clock function that eliminates the need for third-party punch clock applications, streamlining the process for nursing homes. Furthermore, payroll systems will have an automation feature that allows nursing homes to import and export direct care hours to Excel rather than manually submitting them, saving time and money.

  1. Automated electronic PBJ reports

As mentioned, nursing homes and other long-term care facilities must submit the CMS PBJ report quarterly. This means that either HR or payroll staff must keep tabs on the PBJ deadlines to ensure they are not missed. Using a robust PBJ software system that can automatically submit PBJ reports will ensure that facilities do not miss the CMS’ PBJ due dates. 

Nursing homes can ensure accurate and efficient payroll management by implementing these strategies. Whether it’s training staff on payroll processing or implementing time clocks, nursing homes have tools at their disposal to ensure PBJ reporting is done accurately, efficiently, and—most importantly—in compliance with the CMS’ requirements.

Achieving an Accurate PBJ Report Using PBJ Software

If nursing homes and other long-term care facilities want to ensure they submit an accurate PBJ report every quarter, a practical solution is to invest in a powerful payroll-based software that can improve the accuracy, efficiency, and staffing management of payroll processing. 

The benefits of using PBJ software for PBJ reporting are clear, especially with automated data entry and reporting processes. Payroll processing becomes much faster and more accurate, reducing the risk of human error and saving valuable time. 

Furthermore, advanced payroll systems will have payroll-specific features, such as:

Staff members use the facility's payroll-based journal software to ensure all documented hours are accurate.
Payroll-based journal software simplifies and streamlines the PBJ reporting process.
  • An in-house payroll system rather than a third-party punch clock app saves the facility time, money, and effort, so they do not need to invest in a third-party app
  • An automated calendar that submits PBJ reports electronically every quarter ensures facilities will not miss PBJ deadlines
  • A built-in application to import time or clocked-in hours from third-party vendors ensures all data is transferred accurately and efficiently
  • An automated payroll-tracking device ensures all hours are recorded accurately

For more on recent trends in long-term care, read our blog and subscribe to the LTC Heroes podcast