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Nursing Shortage Brings Serious Staffing Challenges


Posted on Thursday, May 02, 2019


PBJ Reporting: RN Shortages Add to Time & Attendance Difficulty

With the Bureau of Labor Statistics projecting that 203,700 new registered nurses will be needed annually through 2026 and nursing colleges struggling to grow their programs, an expected nursing shortage will leave nursing homes managing an aging population on two fronts: more patients and more nurses retiring.

A fact sheet created by the American Association of Colleges of Nursing describes some of the challenges:

  • A 2018 survey by the National Council of State Boards of Nursing and the Forum of State Nursing Workforce Centers found that more than 50% of the RN workforce is at least 50 years old
  • The number of U.S. residents over the age of 65 is projected to reach 83.7 million by 2050
  • The resulting staffing shortages raise the stress level for nursing – leading many of them to quit the profession
  • A lack of capacity in U.S. nursing programs suffering from budget constraints and a shortage of faculty, classroom space and clinical sites

A nursing shortage has significant consequences for both health care quality and patient outcomes with numerous studies demonstrating the relationship between inadequate RN staffing levels and increased rates of infection, hospital readmission and patient mortality. Moreover, declining workforce numbers mean potential staffing challenges for nursing homes; unlike many other industries, nursing homes operate under stringent staffing regulations.

Nursing Home Staffing Challenges and PBJ Reporting Requirements

In nursing homes, staffing levels are subject to federal oversight and reporting requirements under the Affordable Care Act. Staffing reports are used to verify staffing levels of a variety of positions, and to enforce a Medicare requirement that each facility have a registered nurse working a minimum of eight hours a day. Staffing levels also affect a facility's published rating.

The data, submitted quarterly under a system known as "payroll-based journaling" (PBJ), can add an extra layer of difficulty to staffing efforts. Inaccurate or incomplete reporting can expose a facility to fines and increased regulatory scrutiny, in addition to a lowered rating.

Last year Medicare reduced the ratings of nearly 1,400 nursing homes for failure to provide adequate staffing or failure to provide the required payroll data, according to U.S. News & World Report. Careful and accurate PBJ reporting is a critical component of facility staffing efforts.

A Crucial Task Made Simple Right Out of the Box

Payroll-based journaling requires a detailed hourly census that must be submitted to the Center for Medicare & Medicaid Services (CMS) in XML format at the end of every quarter. The next deadline is May 15.

Time Rack time and attendance software has PBJ reporting capability built in, with features that allow you to track and report detailed hourly staffing levels, accounting for meals, breaks and overtime and accurately capturing the data needed to produce a quarterly XML file for upload to the CMS website with a few clicks.

Time Rack software interfaces with a huge variety of payroll platforms – and customized bridges can be created for any others.

Don't risk errors or waste time trying to manually track and format your PBJ report. That's time you don't have and aggravation you don't need.

To set up a demonstration or to learn more about what our state-of-the-art, fully customizable time and attendance software can do, give us a call or click on the link below.

Contact us to learn more about PBJ-enabled Time and Attendance tracking