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Date ArticleType
6/4/2019 Regulatory
Mealtime’s Flagging Providers on PBJ Audits Could Result in a One-star for the Staffing Domain

Accuracy in reporting PBJ staffing data is necessary and requires providers to follow the CMS PBJ Technical Manual related to all aspects of PBJ. Not reporting mealtimes accurately can result in a one-star for overall staffing and RN staffing for the quarter.  Use the information below to ensure your facility in in compliance:

  • Nursing home workers providing direct care could easily end up working through the time allotted to them for a break. Even when this happens, meal breaks still need t be removed from the PBJ hours prior to submission.
  • CMS expects providers to reduce total hours worked by .50 hours for each shift of 8 hours or more and 1.0 hours for shifts of 16 hours or more to account for mealtimes.
  • Time allotted for meals should be removed according to the PBJ Technical Manual whether the employee takes the meal breaks and whether the employee is paid for the time spent on a meal break.

Recommended action:

  • Establish policy and procedures related to meal breaks.
  • When using a third party(s) for PBJ submission, ensure that all parties understand the mealtime exclusion. Establish who will ensure meal breaks are reduced accurately for all employee’s time that is reported to CMS.
  • Establish accurate reporting with agency employees as well as therapy employees to ensure accuracy.
  • Designate individuals to coordinate and respond to a PBJ audit prior to an audit notice. Providers must respond usually within 5 days of notice. 
  • Inspect what you expect by establishing auditing of PBJ data prior to submission.

Kindly forward PBJ questions to ldavenport@ihca.org