Healthcare is one of the most regulated industries in the U.S. economy. For long-term care facilities, it’s a double-whammy as they must comply with both federal and state regulations. This is why it’s crucial that LTC facilities not only have accurate data across the entire organization, but have access to that data and analytics as well.
The Centers for Medicare & Medicaid Services (CMS), the chief federal regulating body for nursing homes, is a stickler for accurate and timely data. CMS oversees the Payroll-Based Journal (PBJ) reporting requirements. Let’s take a quick look at where we’ve been and where we’re going in terms of PBJ and data.
Payroll-Based Journal Timeline
- CMS introduced the concept of PBJ Reporting in April 2015.
- Voluntary reporting began in October 2015.
- The CMS allowed voluntary participation for three quarters (fiscal quarters 1, 2, and 3 of 2016).
- The first mandatory reporting period began July 1, 2016.
- CMS was very forgiving to facilities in the early stages of mandatory reporting.
- Now, on the CMS Nursing Home Compare site, LTC facilities that fail to submit their PBJ data literally receive a black mark next to their name.
- In addition, facilities that miss two consecutive reporting periods will have their all-important Five-Star Rating suppressed altogether.
- Next up came PBJ audits.
- And, most recently, CMS is making PBJ data available to the public.
It’s safe to say that PBJ reporting is not going away. Those who think so are deluding themselves and ignoring industry trends.
The reason CMS instituted PBJ reporting in the first place is to improve quality of care. This will only prove more important in coming years as the ever-growing, ever-demanding Baby Boomer generation ages and becomes dependent on long-term care facilities.
As the ongoing tragedies at the 27 LTC facilities in Ottawa, Canada attest to — 163 reported cases of abuse and 2,033 instances of noncompliance since 2012 — careful oversight is a must for the long-term care industry. In fact, the number of complaints and so-called “critical incidents” in long-term care has been steadily rising in the province: 1,300 in December 2013; 2,800 in March 2015; and 3,370 in April 2017. A recent editorial noted that, unlike the Nursing Home Compare Site in the U.S., “There is no single, accessible portal to let members of the public compare data…”
It Takes a Village
Resident care and resident satisfaction go hand in hand. At Greek American Rehabilitation & Care Centre in Illinois, every employee, every department, every level is actively invested and engaged in resident satisfaction.
Take, for example, fall prevention and infection control. It’s a total facility effort. Maintenance and therapy staff look for potential fall hazards and equipment failures, like faulty wheelchairs. The housekeeping staff work in tandem with nursing on infection control, and on maintaining safe and quality living conditions.
According to Mordechai Finkel, director of Human Resources at Greek American, this is why having a one-stop dashboard is so vital to organizational success. “It really takes a full community to make everything work,” he says.
A Deep Dive into Data
Which brings us back to Payroll-Based Journal reporting. With PBJ, it’s all about the data. It’s important to have current, accurate, and complete data at your fingertips. CMS Five-Star Ratings cover a number of areas, so you need all your data in one place. Census, employee staffing, and agency utilization — these benchmarks cut across departments, underscoring the need to eliminate silos.
Organizations with integrated systems that talk to one another, vs. disparate modules and different vendors’ products, will find PBJ compliance much easier. A fully integrated system will also eliminate headaches in the event of a PBJ audit.
Beyond Regulatory Compliance
Highly regulated businesses find it increasingly difficult to excel in the marketplace. But it’s a mistake to use compliance as an excuse for mediocrity. An article in Forbes gives three suggestions on how to excel in the face of regulations:
- Nurture a Culture of Care — In the long-term care industry, this is extremely important. When you truly care for your employees, they will pay it forward and exhibit true care for their patients.
- Integrate the Customer into Your Core Values — This is a more direct approach to ensuring customer care. Our webinar on Disney best practices illustrates why Disney’s customer-centric approach is so successful.
- Embrace Change — As a whole, the LTC industry is somewhat slower to embrace change than other verticals. This is particularly evident in terms of technology.
Think of data beyond its regulatory applications, too. Organizations need access to real-time data in order to make better business decisions and, ultimately, provide better care. Smarter business decisions give organizations a competitive advantage, which is sorely needed in today’s LTC space.
About the Author
As Compliance Expert at SmartLinx, Tom Jegou oversees SmartLinx innovations in our payroll and compliance systems. Tom is focused on transforming client needs into leading-edge products. Tom leads cross-functional teams from a product's conception through to its launch. Tom led the design of the 1095-C and Payroll-Based Journal reporting features in the WorkLinxTM suite. Since 1996, Tom has worked with every aspect of Human Capital Management Systems. He has defined, supported, implemented and managed Payroll, Time and Labor and HR systems. Tom is a Certified Payroll Professional through American Payroll Association.More Content by Tom Jegou