The Centers for Medicare & Medicaid Services announced plans today to end the emergency waiver and resume requirements for all nursing homes to submit staffing data through the Payroll-Based Journal (PBJ) system by Aug. 14.  

In addition, on July 29, staffing measures and star ratings will be held constant, and be based on data submitted by Dec. 31, 2019. The systems are used for the consumer-facing Nursing Home Compare website and the Five-Star Quality Rating System.

Today’s announcement also means that CMS will remove the automatic one-star staffing rating downgrade that many facilities experienced. Instead, those facilities will have their measures and ratings temporarily suppressed.

Facilities may have received an automatic star downgrade to 1 star due to missing a submission deadline or for having four or more days in a quarter with no registered nurse. Now, they will not be able to correct and improve their rating in this domain since the ratings will be held constant, CMS explained.

“We continue to emphasize the importance of staffing based on its relationship to quality,” said the memo sent by the Center for Clinical Standards and Quality/Quality, Safety, and Oversight Group.

“Therefore, this memorandum serves as notice that, effective immediately, CMS is ending the blanket emergency waiver of 42 CFR 483.70(q), and all nursing homes are required to resume submission of staffing data through the PBJ system as required by the regulation. Specifically, facilities must submit the requisite staffing data for Calendar Quarter 2 (April – June) 2020 through the PBJ system by August 14, 2020.

The blanket waiver was meant to allow regulators to concentrate efforts on dealing with COVID-19 and lessen administrative burdens on providers, CMS said.

The agency emphasized that it is “not holding quality measure ratings constant” because a facility’s quality measure rating can still be updated by a quality measure with underlying data that is earlier than Dec. 31, 2019.

In addition, regulators said they are continuing to monitor events and will restart the inspection ratings “as soon as possible.” They also said they would inform stakeholders of any subsequent changes before they are made to Nursing Home Compare. 

Today’s directive about the shift of focus was sent to states and nursing home stakeholders.

The CMS memorandum can be found here.