PBJ is an abbreviation for Payroll-Based Journal, a reporting requirement under Section 6106 of the Affordable Care Act, ACA, as from 1st Oct. 2015 in the USA. ACA, also known as the Obamacare or the Patient Protection and Affordable Care Act, requires long-term health care facilities to submit information regarding the staff working in the patient’s direct care.
Direct care staff refers to people who use interpersonal contact or are involved in residential care management to assist the recipients in attaining or maintaining the highest level of physical, mental, and psychological health and well-being. This does not include anyone responsible for the upkeep of the various facilities’ physical environments. THUS, the PBJ system was created by CMS (Center for Medicare and Medicaid Services) to cater to this reporting.
The PBJ system assists the participating companies to electronically upload an XML file (at most 5MB) to submit their data. The system also helps these companies to enter the data manually into the CMS system. This data can similarly be entered using both, and the PBJ system supports this. Initially, PBJ reporting was optional only to become mandatory from 1st July 2016.
PBJ reporting is much strict and complex since it requires detailed data that is very accurate. This reporting has impacted the stakeholders positively by giving birth to a new level of transparency in long-term health care facilities. However, its submissions are strict, and the consequences impact both the employees and the patient care.
The CMS has assigned a Labor Category Code and a Job Title Code to forty job descriptions required for PBJ reporting. The staffing hours are reported daily for each staff member under their respective labor category and job title code. Data collected by the PBJ system is used to create a rating for the individual direct care provider. The reviews are extracted from the data regarding the;
- physical inspections of the facility
- PBJ data input into the CMS system
- Measures set for the clinical data
An overall star rating is then given to the facility according to the reviews from the data above. A company that fails to meet the submission deadline may be at risk of losing its overall and staffing star ratings.
Information Recorded in the PBJ System
The following data is required for each registered employee after completing the registration process to facilitate PBJ filing.
- Employee’s ID
- Date of starting the contract
- Contract termination date
- Type of pay code, either exempt, non-exempt, or contract
A registered company has 45 days as a new year-quarter starts to submit the previous quarter’s payroll data. In addition, the direct care workers are required to give out information regarding their working days and dates, the hours they work per day, and respective job categories and titles. However, the working hours paid directly by Medicare are not submitted within the PBJ reporting.
The PBJ reporting has increased accuracy, transparency, and validation in the direct care industry. Similarly, the rating has brought about stiff competition among the long-term health care facilities as each company strives to offer the best services. More information concerning the PBJ submission requirements can be traced to the CMS website.