Why the MDS Will Impact Your PBJ Five Star

A little-noticed PBJ policy update last September will play an important role in your Staffing Five Star rating once CMS begins using PBJ data in 2018.  PBJ Census calculations are now based on your MDS.

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PBJ rules no longer require the submission of Resident Census.  Instead, CMS released a new method they will use to automatically calculate a Daily Census from your MDS submissions.  For the details, see question 19 on page 6 of CMS' PBJ Policy Manual FAQ.

OK, so CMS is calculating your census.  What does that mean?

Five Star ratings currently use on an Hours Per Resident Per Day metric.  So this ratio goes up when you have more reported hours (a bigger numerator).  And the ratio goes down when you have more reported residents (a bigger denominator).

Discharge Assessments Matter

Why?  If your facility doesn't submit an MDS Discharge assessment, CMS will assume the resident was discharged only after 150 days without an MDS assessment.

If CMS assumes the resident is still in your facility after they've already left, your Hours Per Resident Per Day goes down for PBJ staffing!

Timely filing of your MDS Discharge assessments ensures your resident count isn't inflated for PBJ calculations.

Steps to Take

PBJ data is NOT YET being used to calculate Staffing Five Star ratings.  ezPBJ will let you know as soon as the new methodology comes out.  CMS has told us to expect this in April 2018.

Let your leadership and MDS Coordinator know about the changes happening, and emphasize the added importance of keeping MDS submissions and discharge assessments up to date.

As always, give ezPBJ a call at (585) 210-9780 or send us an email if you want to learn more.