PBJ audits are beginning

Ken BellSkilled NursingLeave a Comment

PBJ “gotchas”

ezPBJ Audit Manager
ezPBJ is working hard to make your PBJ audits as pain-free as possible!  ezPBJ already holds much of the information requested by CMS and will make that information easily downloadable. In addition we are adding a new audit section where you can upload the requested PBJ audit documents and create the PBJ audit files to deliver to the CMS auditors.

PBJ audits are beginning!

CMS has announced the pilot of its new PBJ audit process. In a letter to Skilled Nursing Facilities, CMS described the audit process and focus area. PBJ staffing audit teams will “examine payroll records and other auditable data along with PBJ submission data to identify if staffing is being reported accurately based on hours staff are paid to work.”

CMS noted that the PBJ audit process may include, but is not limited to, information from:

  • Payroll systems
  • Timekeeping systems
  • Invoices for contracted staff
  • Interviews with staff responsible for PBJ data entry

Because CMS is piloting the audit process, findings from the audits “will not result in sanctions or negative actions against the facility.” CMS has not provided a time frame for when the pilot audit process concludes and the formal PBJ auditing begins.

CMS will begin the pilot process with offsite audits. An Offsite Request Template illustrates what information facilities are expected to provide. Offsite audits ask for the data to be submitted via a secure FTP site.

Requested information in a PBJ audit

PBJ audits request this information in electronic format (Excel or Access) if possible, otherwise in scanned documents:

  • Contact information
  • Daily census summary number of residents by payer source PER DAY
  • Crosswalk between employee IDs used for PBJ submission and employees on payroll records and contracted employees
  • Crosswalk between job title code/labor category code per the PBJ submission to job titles per the payroll/time keeping systems
  • Daily time system reports, timecards or punch detail reports with quarterly totals
  • Payroll records and reports
  • Nursing Staffing Assignment and sign-in sheets
  • Description of payroll job code/department listings used in payroll system
  • Invoices to support all contracted personnel reported on PBJ submission
  • Documentation and methodology used to support any employee for whom a portion of total hours worked are included on the PBJ submission
  • Payroll records for corporate employees included on PBJ submission and not included on the nursing home’s payroll
  • Medical Director documentation (e.g., contract, invoices paid) and the methodology used to support the hours worked

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