The Centers for Medicare and Medicaid Services (CMS) recently published updates to the Payroll-Based Journal (PBJ) Manual and associated Frequently Asked Questions (FAQs). Below is a summary of the key updates.
PBJ Manual
Version 2.7 updated June 2025 is the most recent version of the PBJ Manual. Key updates include:
- Facilities are reminded to run their census reports and verify the accuracy of their resident census data prior to the submission deadline.
- No single individual can have more than 22.5 hours of work reported for any one day. This is to comply with the requirement that for every eight hours of work, a minimum of 30 minutes must be deducted for a meal break regardless of whether a break was taken or not. If a longer break is taken, that total time must be deducted.
- The manual also clarifies that for nursing hours to be counted, work must be completed on-site.
FAQs
The FAQs have been updated to include several new questions that provide additional clarity on existing policy requirements. Below is a summary of some of these items.
- Surveyors are aware of the PBJ meal break policy, and a facility should not be cited if they can prove that there were 8 consecutive hours of RN on-site coverage 7 days a week. If a facility has an RN waiver for having an RN onsite 8 hours a day for 7 days a week, they should provide that information to CMS to avoid a downgrade to 1 star.
- If an employee’s salary and contract are based on a work week exceeding 40 hours and the total hours are specified, all hours worked – excluding meal breaks – may be reported.
- Three new FAQs were added regarding PBJ audits, including information on appeal reconsideration requests, triggers for a failed PBJ audit, and clarity on audit communications from CMS vs. audit contractors.
Providers are encouraged to view both updated resources in detail.
AHCA has several resources to support providers with PBJ, including: