2016PAYROLL-BASED JOURNALCOMPLIANCE GUIDE(A.K.A. YOU WISH PBJ MEANT PEANUT BUTTER & JELLY)

2 0 1 6 P B J C O M P L I A N C E G U I D E

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L E G A L D I S C L A I M E RPBJ Compliance, Publications and Content

The 2016 PBJ Compliance Guide is intended to be used as a handbook for the reader to reference in conjunction with, but

not exclusive of, official regulatory information. The laws, regulations, rulings and other material contained herein may

change over time, and the reader should seek out the most current materials. This guide does not include everything that

you need to know. We strongly encourage you to read and understand all laws and regulations that are applicable for PBJ

compliance and to follow them closely.

We present this guide for informational purposes only. The information in the 2016 PBJ Compliance Guide should not be

relied upon or construed as legal advice or legal opinion. It is not an offer to represent you, nor is it intended to create an

attorney-client or other confidential, advisory relationship. The content of any Internet e-mail sent to us or any of our

personnel at e-mail addresses listed within this guide will not create an attorney-client relationship or other confidential,

advisory relationship, and will not be treated as confidential. You should not rely upon the information presented in the

2016 PBJ Compliance Guide to make legal or other professional decisions without seeking personal advice from an attorney

or other professional.

We are not responsible for the content of any third-party website or information referenced within the guide. If any such

third party site violates any laws or ethical rules of your jurisdiction, we are not available to represent you. End users may

view and use the content of this guide for personal use. All other uses are prohibited. The 2016 PBJ Compliance Guide does

not offer any guaranteed compliance with any law. By using the 2016 PBJ Compliance Guide as a point of reference, the user

takes full responsibility for meeting the requirements of PBJ and indemnifies us from any claims that arise from its use.

C O N T E N T S

PBJ

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First Things First — Mandatory Compliance Features 4

Payroll-Based Journals — What You Need to Know 5

The Goal of PBJ 6

PBJ Data Reporting 7

Direct Care Staff 8

Did You Know? 9

PBJ Impact 11

Important Dates for PBJ Reporting 12

Payroll-Based Journal Timeline 13

Help with Meeting PBJ Requirements 14

Workforce Management Suite PBJ Solutions 15

Protecting Your Business 16

Contact Us Today 17

2 0 1 6 P B J C O M P L I A N C E G U I D Eswipeclock

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O U R W O R K F O R C E M A N A G E M E N T S U I T EF E AT UR E S T H AT SUPP O R T PAY RO L L- B A SED J O UR N A L R EP O R T IN G

PBJ

Employee data (title, gender,

date of hire, term date, EE ID, etc.)

Track hours worked

Job code tracking

Auditable reporting

Employee status (FT, PT)

Staffing and schedule management

Communication/collaboration via

email & text

Mobile access (punch IN/OUT,

tracking hours for offsite employees)

Dashboard— accrued & total

overtime hours

Timekeeping data records

Hours’ threshold indicator and alerts

Time card approvals

Finalized pay period (lock-down data)

FIRST THINGS FIRST

Below is a list of all the features that showcase our Workforce Management Suite

and how its powerful components will help you become and remain compliant.

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PBJ Employee groups

Time card audit

Manageable, editable time cards (with

audit trail)

Certification tracking/expiration (RN,

PT, LPN, etc.)

Alert indicators (overtime, max hours, etc.)

Daily Auto Email report (view OT,

missing punches, total hours)

Schedule Preferences

Proactive Time Management

Forecasting of hours

PAY R O L L- B A S E D J O U R N A L S —

W H AT YO U N E E D T O K N O W

PAY R O L L- B A S E D J O U R N A L ( P B J ) R E P O R T I N G I S

R E Q U I R E D B Y T H E C E N T E R S F O R M E D I C A R E &

M E D I C A I D S E R V I C E S (C M S ) S Y S T E M T H AT W I L L

R E G U L A R LY CO L L E C T M A N D AT E D S TA F F I N G A N D

C E N S U S D ATA F R O M A L L L O N G -T E R M N U R S I N G

F A C I L I T Y P R O V I D E R S . C M S H A S L O N G B E E N

U R G I N G P R O V I D E R S T O S U P P LY D ATA T H AT

I S A CC U R AT E , C A N B E A U D I T E D, A N D I S

CO L L E C T E D M O R E O F T E N T H A N T H E

C U R R E N T O N E T I M E P E R Y E A R .

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T H E G O A L O F P B J

The goals of the PBJ Staffing Data Submission Program are

to 1) standardize reporting requirements and 2) collect

information related to direct care staffing (including agency

and contract staff) and facility census on a more frequent

basis, in an electronic format. These mandatory compliance

measures are being undertaken in connection with Section

6106 of The Affordable Care Act.

—Pamela J. Skrzynski

A S C U R R E N T LY

S T R U C T U R E D ,

R E P O R T I N G W I L L B E

M A N D AT O R Y E F F E C T I V E

J U LY 1 , 2 0 1 6

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P B J D ATA R E P O R T I N G

H E R E I S A L I S T O F

I T E M S T H AT YO U

W I L L N E E D T O

I N C L U D E T O M E E T

T H E P B J R E P O R T I N G

R E Q U I R E M E N T S :

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A unique employee ID for each direct staff

care provider (no SSN’s allowed)

A complete, accurate record for each facility

that identifies their direct care staff

Medical personnel as defined by CMS (RN,

PT, LPN, etc.)

Residence census data (Medicare, Medic-

aid, other)

Direct care staff turnover and tenure (start

and term dates)

Hours of care provided by category per direct

staff member, per day

Start and end date and the hours worked

per individual

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D I R E C T C A R E S TA F F

Just to clarify, because we know this is a common question asked, how to identify

Direct Care Staff. They are those individuals who, through interpersonal contact

with residents or resident care management, provide care and services to allow

residents to attain or maintain the highest practicable physical, mental, and

psychosocial well-being.

Direct Care Staff does not include individuals whose primary duty is maintaining

the physical environment of the long-term care facility (for example, housekeeping).

Nor does it include care providers who bill direct.

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D I D YO U K N O W ?

T H E N A M E O F T H E P B J

R E P O R T I N G S Y S T E M I S

Q U A L I T Y I M P R O V E M E N T

A N D E VA L U AT I O N

S Y S T E M ( Q I E S ) , A N D

YO U M U S T R E G I S T E R

YO U R FA C I L I T Y T O

O B TA I N U S E R I D s H E R E

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• QIES allows only two logins per facility (they

time out after 15 minutes of inactivity).

• While in QIES you will NOT be able to copy and

paste your data from other resources if you

do not have a file to upload, then it is truly

going to be manual data entry.

• You will need to have a way of generating

unique IDs for your direct care staff, agency,

and contractors. You can reuse IDs for the

same individual, but not for others (ex.

employee leaves employment and returns

then you can reuse the ID they had previously).

C L I C K T O R E G I S T E R

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D I D YO U K N O W ? ( C O N T.)

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• You will need to map job titles to the CMS defined codes to ensure

they are in sync for reporting purposes.

• In the case of an audit, you will need to have a record of all the

reported hours of your direct care staff, agency, and contractors so

that you can verify your PBJ reporting.

• You have three options for submitting your PBJ data: manually enter

it into the QIES system, file submission (XML zip file format only) or

upload a file and then enter in the remaining or missing data manually.

• There is not a “test” period, but you can use the voluntary submission

period to submit files and check for errors, etc. (this is strongly

recommended).

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P B J I M PA C T

PBJ will affect staffing, operational

costs, and your projected revenue

goals. Unfortunately, you cannot

eliminate the cost, but you can

control how you proactively

manage the reporting process

that will ultimately minimize the

overall cost involved.

By putting in place the solutions that will ensure you meet the reporting

requirements that show your facility is providing quality of care you minimize

the risk of delayed reporting, penalties, etc.

I M P O R TA N T D AT E S F O R P B J R E P O R T I N G

J U LY 1, 2 016 I S T H E F I R S T Q U A R T E R T H AT

P B J R E P O R T I N G W I L L B E M A N D AT O R Y,

M E A N I N G T H E P E R I O D F O R D ATA T O B E

S U B M I T T E D W I L L B E F R O M J U LY 1, 2 016 , T O

S E P T E M B E R 3 0 , 2 016 , W I T H T H E F I R S T

M A N D AT O R Y S U B M I S S I O N T O T H E P B J S Y S T E M

D U E B Y N O L AT E R T H A N 4 5 - D AY S A F T E R T H E

Q U A R T E R E N D S W H I C H I S N O V E M B E R 14 , 2 016 .

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Optional Reportingby Feb. 14, 2016

OCT NOV DECJ AN MAR APR MAY JUNO CT NOV DEC JAN FEB MAR APRM AY JUNJULA UG SEP OCT NOVJULA UG SEP

OCT 1 - DEC 31 ‘15

FISCAL 2016 Q1OCT 1 - DEC 31 ‘16

FISCAL 2017 Q1

Optional Reportingby Aug. 14, 2016

APR 1 - JUN 30 ‘16

FISCAL 2016 Q3

Mandatory Reportingby Aug. 14, 2017

APR 1 - JUN 30 ‘17

FISCAL 2017 Q3

Optional Reportingby May 15, 2016

JAN 1 - MAR 31 ‘16

FISCAL 2016 Q2

Mandatory Reportingby May 15, 2017

JAN 1 - MAR 31 ‘17

FISCAL 2017 Q2

Mandatory Reportingby Nov. 14, 2016

JUL 1 - SEP 30 ‘16

FISCAL 2016 Q4MANDATORY START

NOV. 14, LAST DAY TO SUBMIT

FEB

Mandatory Reportingby Nov. 14, 2017

PENTALTIES WILL INCUR

JUL 1 - SEP 30 ‘17

FISCAL 2017 Q4

2015 20172016

Payroll-Based Journal Timeline (PBJ)

Mandatory Reportingby Feb. 14, 2017

H E L P W I T H M E E T I N G

T H E P B J R E Q U I R E M E N T S

W E K N O W T H I S M U S T S O U N D L I K E A D A U N T I N G

TA S K T O TA C K L E . W E L L , YO U A R E N O T A L O N E . B U T

D O N ’ T W O R R Y, O U R W O R K F O R C E M A N A G E M E N T

S U I T E S O L U T I O N C A N H E L P M A K E T H I S

P R O C E S S E A S I E R F O R YO U.

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O U R W O R K F O R C E M A N A G E M E N T S U I T EF E AT U R E S T H AT S U P P O R T P B J I N C L U D E :

PBJ

Employee data (title, gender, date of hire, term date, EE ID, etc.)

Track hours worked

Job code tracking

Auditable reporting

Employee status (FT, PT)

Staffing and schedule management

Communication/collaboration via email & text

Mobile access (Punch IN/OUT, tracking hours for off-site employees)

Dashboard— accrued & total overtime hours

Timekeeping data records

Hours’ threshold indicator and alerts

Time card approvals

Finalized pay period (lock-down data)

Employee groups

Time card audit

Manageable, editable time cards (with audit trail)

Certification tracking/expiration (RN, PT, LPN, etc.)

Alert indicators (overtime, max hours, etc.)

Daily Auto Email report (view OT, missing punches, total hours)

Schedule Preferences

Proactive Time Management

Forecasting of hours

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P R O T E C T YO U R B U S I N E S SP L A N , P R E PA R E & E X E C U T E

Operations is a vital component of your continued success. You need to

ensure that continued education, training & support occurs regularly to

ensure you’re able to remain compliant with ongoing reporting requirements

and to stay current with any updates that will impact your ability to meet

future reporting requirements.

Understanding what’s coming and putting a plan in place to meet

the overall objective requires knowing your level of responsibility,

implementing the necessary tools, validating the data is accurate

and submitting it within the required deadline.

Preparation is crucial to your ability to meet the ACA and PBJ

compliance requirements successfully. This means identifying

the solutions you need and investing in operational systems,

resources, and providing the training your staff needs.

Implementation can make or break the execution of

your solutions, and ultimately your ability to satisfy

your compliance obligations. So you need to have

the right tools in place and ensure the right people

are managing them.

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L E T U S H E L P YO U I M P L E M E N T O U R

W O R K F O R C E M A N A G E M E N T S U I T E

We’re ready to help you get the peace of mind you’re looking for and deserve.

Call your payroll provider today!

Disclaimer: The PBJ reporting requirements provided are subject to change. See page 2.

For more information follow these links:

http://go.cms.gov/1V7bz6F

http://1.usa.gov/1Vu6NPC

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