staffing & five-star - simpleltc...healthcare staffing, scheduling and reporting challenges. don...
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Staffing & Five-StarHow the MDS affects your PBJ
Don FeigeDirector of Business Development, ezPBJ
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About our Speaker
• ezPBJ provides easy-to-use software to manage all aspects of Payroll-Based Journal reporting
• ezPBJ assembles, validates and submits Payroll-Based Journal reports for facilities in 49 states
• ezPBJ provides a FREE PBJ benchmarking tool ezPBJ Essentials
• Don Feige is a software entrepreneur specializing in workforce solutions that solve healthcare staffing, scheduling and reporting challenges. Don has helped hundreds of skilled nursing facilities understand PBJ policy, design PBJ data capture processes, and improve PBJ reporting.
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Staffing Five-Star Fundamentals
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What’s New in the Staffing Five-Star
What WasThe 671
What IsPBJ
FrequencyEvery 9 to 15 months,
during Survey(2 weeks of data)
Every 3 months(Every day of the quarter)
Methods Unaudited worked hours
Auditable worked AND paid hoursNew LPN w/ Admin category
Overtime hours for Salaried Staff no longer includable
Case-Mix Adjustment
RUGS-III (53)
1995-1997 time study
RUGS-IV (66)
STRIVE time study
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The New PBJ Staffing Five-Star Calculation
Nursing Hours
Paid/worked nursing hours (risk-adjusted) still drive the Five-Star rating:
• RN Hours Per Resident Day (except LPN with Admin. Duties removed)
• Total Nursing Hours Per Resident Day (RN + LPN + Aide)
Reported to Adjusted
Staffing Five-Star Ratings continue to be risk adjusted to account for differences in resident acuity.
Resident RUG-IV data based on most recent MDS and “drawn” on last business day of the last month of the reported quarter.
Five-Star formula
The Staffing Five-Star formula is unchanged:
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Timing of PBJ & Staffing Five-Star Ratings
PBJ Reporting QuarterPBJ
Deadline
Approx. Five-Star Posting to NHC(4th Wednesday)
Oct 1 – Dec 31 2017 2/14/18 4/25/2018
Jan 1 – Mar 31 2018 5/15/18 7/25/18
Apr 1 – Jun 30 2018 8/14/18 10/24/18
Jul 1 – Sep 30 2018 11/14/18 1/23/19
Oct 1 – Dec 31 2018 2/14/19 4/24/19
Jan 1 – Mar 31 2019 5/15/19 7/24/19
Apr 1 – Jun 30 2019 8/14/19 10/23/19
First PBJ Five-Star rating
Live on NHC
Staffing Five-Star ratings adjust quarterly
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Staffing Five-Star Cut Points Table –RN Focus
Staffing Points and Rating (updated April 2019)
↓ Total nurse staffing rating and hours (RN, LPN and nurse aide) ↓
1 2 3 4 5
Old 671-based < 3.262 3.262 -3.660 3.661 -4.172 4.173 -4.417 ≥ 4.418
RN rating and hours New PBJ < 3.107 3.107 -
3.5733.574 -4.037
4.038 -4.403 ≥ 4.404
1 < 0.283 < 0.316
2 0.283 -0.378 0.316 – 0.500
3 0.379 -0.512 0.501 – 0.723
4 0.513 -0.709 0.724 – 1.041
5 ≥ 0.710 ≥ 1.042
Add 1 StarLose 1 Star
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Seeing the MDS in PBJ
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The Formula − PBJ-Based Staffing Five-Star
Hours (Reported)
Hours (Expected)
Hours(NatlAvg)
Hours (Adjusted)
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The Details − PBJ-Based Staffing Five-Star
Hours(NatlAvg)
Hours (Adjusted)
Payroll Hours / Daily Avg Census
Strive* Hours / Daily Avg
Census
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Data Sources − PBJ-Based Staffing Five-Star
CMS CMS
Payroll + Vendors / MDS Census
MDS RUGS /MDS Census
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Our Tools: PBJ-Based Staffing Five-Star
/
/Updated
Daily
Updated Quarterly
LIVE Five-StarPROJECTIONS
Updated Daily
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Real-Life Example
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Essentials: Free PBJ Benchmarking Tool
• www.ezPBJ.com/Essentials
• Analyze your PBJ metrics & run competitive comparisons of your facility’s Public PBJ data and NHC Five-Star metrics
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Q&A
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Thanks for attending!Find all our Learning Lab handouts at
simpleltc.com/learninglab