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Effective March 23, 2012, directs the Secretary of HHS, following consultation with state long-term care ombudsman programs and others, to require facilities to electronically submit direct care staffing information based on payroll and other verifiable and auditable data in a prescribed uniform format.
Prior to January 2013, it does not appear that HHS has released guidance pursuant to this provision.
On a related note, on June 18, CMS issued guidance to state Medicaid directors clarifying the availability of Medicaid funding for certain administrative costs incurred by state long-term care ombudsman programs. Also, on June 14, the Administration on Aging (AoA) issued a proposed rule regarding the State Long-Term Care Ombudsman program under the Older Americans Act, replacing a 1994 proposed rule that had never been finalized. Comments are due August 19, 2013.
On August 21, 2014, Reps. Doris Matsui (D-CA) and Jan Schakowsky (D-IL), Co-Chairs of the Congressional Seniors Task Force, along with other House colleagues, wrote to CMS urging the agency to implement sections 6103 and 6106 of the ACA requiring that “nursing home staffing information be obtained through a payroll data collection system.”
On Apr. 4, 2015 CMS issued a letter to state survey agency directors providing “information such as the timing of submissions, sample entry screens, and how we expect facilities to electronically submit their staffing data.”
On Apr. 15, CMS issued a proposed rule (fact sheet) updating Fiscal Year (FY) 2016 payments under the Skilled Nursing Facility (SNF) Prospective Payment System (PPS). According to the proposals delineated in the rule, Medicare payments to SNFs are expected to increase by 1.4%, or $500 million, over FY 2015 rates. The regulation addressed this provision of the ACA.
On July 16, CMS released a proposed rule that revises the requirements that long-term care facilities must meet to participate in the Medicare and Medicaid programs. The rule addressed this provision of the ACA. Comments are due Sept. 14.
On July 30, CMS released a final rule (fact sheet) updating the fiscal year (FY) 2016 SNF PPS. Under the final rule, Medicare payments to SNFs are expected to increase by 1.2% (versus 1.4% under the proposed rule), with aggregate FY16 payments rising by $430M compared with FY 2015. The rule addressed this provision of the ACA.
On Dec. 10, 2015, CMS issued a reminder to all long-term care facilities regarding their respective obligation to submit staffing data through the Payroll-Based Journal (PBJ) beginning July 1, 2016. CMS outlines the steps nursing homes should take to meet this requirement and ensure compliance, as well as provides key training materials.
On Sept. 29, CMS issued a final rule delineating major reforms to Medicare and Medicaid conditions of participation (CoPs) impacting long-term care (LTC) facilities. In particular, the rule stipulates new prohibitions on the use of pre-dispute binding arbitration agreements as a condition of admission to the facility, among other reforms. The rule addresses these provisions of the ACA.
SEC. 6106. ENSURING STAFFING ACCOUNTABILITY. Section 1128I of the Social Security Act, as added and amended by this Act, is amended by adding at the end the following new subsection: ‘‘(g) SUBMISSION OF STAFFING INFORMATION BASED ON PAYROLL DATA IN A UNIFORM FORMAT.—Beginning not later than 2 years after the date of the enactment of this subsection, and after consulting with State long-term care ombudsman programs, consumer advocacy groups, provider stakeholder groups, employees and their representatives, and other parties the Secretary deems appropriate, the Secretary shall require a facility to electronically submit to the Secretary direct care staffing information (including information with respect to agency and contract staff) based on payroll and other verifiable and auditable data in a uniform format (according to specifications established by the Secretary in consultation with such programs, groups, and parties). Such specifications shall require that the information submitted under the preceding sentence— ‘‘(1) specify the category of work a certified employee performs (such as whether the employee is a registered nurse, licensed practical nurse, licensed vocational nurse, certified nursing assistant, therapist, or other medical personnel); ‘‘(2) include resident census data and information on resident case mix; ‘‘(3) include a regular reporting schedule; and ‘‘(4) include information on employee turnover and tenure and on the hours of care provided by each category of certified employees referenced in paragraph (1) per resident per day. Nothing in this subsection shall be construed as preventing the Secretary from requiring submission of such information with respect to specific categories, such as nursing staff, before other categories of certified employees. Information under this subsection with respect to agency and contract staff shall be kept separate from information on employee staffing.’’.
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