Transition to Payroll-Based Journal (PBJ) Staffing Measures on the Nursing Home Compare tool on Medicare.gov and the Five
Star Quality Rating System
• Transition to Payroll-Based Journal (PBJ) Data – Starting in April, 2018, CMS will use PBJ data to determine each facility’s
staffing measure on the Nursing Home Compare tool on Medicare.gov website, and calculate the staffing rating used in the Nursing
Home Five Star Quality Rating System.
• Staffing data audits - We are providing lessons-learned from audits conducted, and guidance to facilities for improving
their accuracy. Nursing homes whose audit identifies significant inaccuracies between the hours reported and the hours verified,
or facilities who fail to submit any data by the required deadline will be presumed to have low levels of staff. This will
result in a one-star rating in the staffing domain, which will drop their overall (composite) star rating by one star for
• Requirement for registered nurse (RN) staffing – We are reminding nursing homes of the importance of RN staffing and the
requirement to have an RN onsite 8 hours a day, 7 days a week. Nursing homes reporting 7 or more days in a quarter with no
RN hours will receive a one-star rating in the staffing domain, which will drop their overall (composite) star rating by one
star for a quarter. This action will be implemented in July 2018, after the May 15, 2018 submission deadline for data for
2018 Calendar Quarter 1, 2018 (January – March, 2018) data.
• Technical assistance – CMS is continuing its efforts to help nursing homes submit accurate data, and there are a variety
of ways described below in which facilities can seek support.
• Future Actions – As of June 1, 2018, we will no longer collect facility staffing data through the CMS-671 form, and we will
announce other future activities.