Changes to PBJ & Five-Star Reporting due to the COVID-19 Public Health Emergency

Thoughtware Alert Published: Jul 16, 2020
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QSO 20-34-NH

CMS issued Memorandum QSO 20-34-NH on June 25, 2020. This memo updates COVID-19 public health emergency waivers affecting data reported to Nursing Home Compare and Five-Star Reporting. Changes to the Payroll-Based Journal (PBJ) reporting, five-star staffing, and quality measure (QM) ratings will begin July 29, 2020.

PBJ Reporting & Five-Star Staffing Rating Updates

CMS is ending the current waiver of PBJ staffing data submission beginning with the 2020 quarter 2 data.

  • Quarter 2 (April 1 to June 30) staffing data must be submitted by August 14, 2020.
  • Current Five-Star Reports will remain frozen with the December 31, 2019, staffing data.
  • Quarter 1 (January 1 to March 31) data won’t be used to calculate staffing star ratings.
  • Providers with the automatic downgrade penalty to one star for staffing will have staffing data suppressed. Staffing data won’t be reported for those providers and won’t be downgraded to one star. 
  • The October 2020 Five-Star Report staffing measure will be updated with quarter 2 data submitted by August 14, 2020.

QM Rating Updates

  • The QM star rating will be held constant and won’t be updated with underlying data after December 31, 2019.
  • Most QM measures included on the Five-Star Report have already reached the December 31, 2019, limit and won’t be updated on future reports.
  • Individual QM ratings will continue to change until the underlying data reporting period reaches December 31, 2019, for the following measures:
    • Short-stay rehospitalization
    • Short-stay outpatient emergency department visits
    • Short-stay successful return to home and community
    • Long-stay hospitalizations
    • Long-stay outpatient emergency department visits

Health inspection ratings will continue to be frozen until further notice.

If you have questions regarding Nursing Home Compare, PBJ reporting, or the five-star rating system, please reach out to your BKD Trusted Advisor™ or use the Contact Us form below.

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