PBJ Question and Answers 

  1. If a nurse is working 8 hours and the center reports 7.5 hours (due to the 30-minute meal time exclusion) will the provider be penalized for not having an RN on staff for 8 hours?  

a.  CMS auditors are aware of this situation and as long as the facility can provide proof that the RN was onsite for 8 consecutive hours, reporting time for 7.5 is not going to be an issue.

2.  Do meal times need to be excluded even if the staff eats with the residents or works through lunch?  

a.  Per the PBJ Policy Manual, facilities must deduct the time allotted for meals from each employee’s daily hours. A 30-minute meal break must be deducted from an employee’s shift whether or not the employee actually takes a meal break. We realize that this policy is frustrating for members and AHCA continues to advocate for changes to be made to it. However, until such time that a policy change is made providers must exclude meal times to avoid being penalized. 

b.  Providers may consider having two separate timekeeping systems to comply with both CMS’s PBJ requirements and the Department of Labor’s (DOL) Fair Labor Standard Act. Manually editing the data to reflect the needs for both PBJ reporting and payroll runs the risk of human error and documentation challenges during an audit by either CMS or DOL. If separate timekeeping systems is not possible, as a best practice, providers should have a system that preserves the original record before any edits are made. 

3.  Which residents do we need to report hours for?  

a.  Hours should be reported for SNF/NF residents, essentially, those that have an MDS assessment submitted for them.