News for MDS Experts

On August 17, 2026, the Centers for Medicare & Medicaid Services (CMS) will launch the Internet Quality Improvement and Evaluation System (iQIES) functionality for Payroll-Based Journal (PBJ) data submission and reports. 𝗛𝗲𝗿𝗲’𝘀 𝘄𝗵𝗮𝘁 𝘆𝗼𝘂 𝗻𝗲𝗲𝗱 𝘁𝗼 𝗸𝗻𝗼𝘄 𝗮𝗯𝗼𝘂𝘁 𝘁𝗵𝗲 𝘁𝗿𝗮𝗻𝘀𝗶𝘁𝗶𝗼𝗻.
-You must register for PBJ roles in iQIES before you can submit data.
-PBJ submissions for Fiscal Quarter 3 must be submitted in QIES only through August 14, 2026. After August 14, 2026, at 11:59 PM ET, QIES will no longer accept PBJ records.
-PBJ submissions for Fiscal Quarter 4 start August 17, 2026, and must be submitted only in iQIES. Fiscal Quarter 4 submissions will not be accepted between July 1, 2026 and August 16, 2026, in QIES or iQIES.
-Beginning August 17, 2026, users will be allowed to access and run PBJ reports in iQIES. See the list of reports including the CASPER and iQIES reports for comparison.
qtso.cms.gov/news-and-updates/what-expect-pbj-data-submission-and-reporting-iqies ... See MoreSee Less

CMS is implementing an increase to the Quality Measure (QM) rating thresholds, increasing each rating threshold by one-half of the average improvement in QM scores (QSO 19-08-NH). For the July 2026 refresh, the average improvement was determined from the period of January 2025 – April 2026.
𝘕𝘰𝘵𝘦 𝘵𝘩𝘦 𝘱𝘰𝘪𝘯𝘵 𝘵𝘩𝘳𝘦𝘴𝘩𝘰𝘭𝘥𝘴 𝘧𝘰𝘳 𝘪𝘯𝘥𝘪𝘷𝘪𝘥𝘶𝘢𝘭 𝘘𝘔𝘴 𝘥𝘪𝘥 𝘯𝘰𝘵 𝘤𝘩𝘢𝘯𝘨𝘦.
www.cms.gov/medicare/health-safety-standards/certification-compliance/five-star-quality-rating-sy...
www.cms.gov/medicare/provider-enrollment-and-certification/certificationandcomplianc/downloads/us... ... See MoreSee Less

The June update of Appendix B to the MDS 3.0 RAI User’s Manual contains changes to the list of State RAI Coordinators, MDS Automation Coordinators, and CMS locations and contacts.
www.cms.gov/files/document/appendix-b-june-2026-pdf.pdf
www.cms.gov/files/document/changes-appendix-b-june-2026-pdf.pdf ... See MoreSee Less

Facilities may need MDS support before there is a crisis.

Common signs include assessment backlogs, MDS Coordinator vacancy or turnover, PDPM coding concerns, Triple Check inconsistencies, care plans not matching MDS coding, Quality Measure concerns, or new and overwhelmed MDS staff.

A second set of eyes can help identify gaps before they become harder to fix.

#MDS #skillednursing #longtermcare #PDPM #Compliance #QualityMeasures #MDSCONSULTANTS ... See MoreSee Less

Happy Fourth of July!

Today, we celebrate the freedoms we enjoy and honor those who have served and continue to serve our country.
From all of us at MDS Consultants, we wish you, your families, and your residents a safe, happy, and relaxing Independence Day.

Thank you to the healthcare professionals working through the holiday to provide exceptional care. Your dedication does not go unnoticed.

Have a wonderful Fourth of July!
❤️🤍💙

#FourthOfJuly #IndependenceDay #longtermcare #skillednursing #HealthcareHeroes #MDSCONSULTANTS #ThankYouHealthcareProfessionals ... See MoreSee Less

The CMS iQIES Survey and Certification User Manuals have been updated. qtso.cms.gov/software/iqies/reference-manuals ... See MoreSee Less

The Instructions for the Interim LTCSP Initial Survey and Certification Process have been edited effective 6/23/2026 related to the iQIES updates.
www.cms.gov/medicare/provider-enrollment-and-certification/guidanceforlawsandregulations/nursing-...
www.cms.gov/files/zip/initial-surveys.zip
www.cms.gov/files/document/revision-history-ltc-survey-process-documents-files-06-23-2026.pdf ... See MoreSee Less

OIG's objective was to determine whether nursing homes’ RN staffing hours reported in CMS’s PBJ were supported in accordance with Federal requirements. Nursing homes participating in the Medicare or Medicaid programs are required to electronically submit complete and accurate direct care staffing information to the Centers for Medicare & Medicaid Services’ (CMS’s) Payroll-Based Journal (PBJ) system. Direct care staff include nurse staff (e.g., registered nurses [RNs] and nurse aides) and non-nurse staff (e.g., therapists and social workers). The information that nursing homes report for each direct care staff member includes, among other things, the category of work (e.g., director of nursing, RN with administrative duties, or RN) and the number of hours paid to deliver services for each day worked.
𝗪𝗵𝗮𝘁 𝗢𝗜𝗚 𝗙𝗼𝘂𝗻𝗱
Not all nursing homes’ RN staffing hours reported in CMS’s PBJ were supported in accordance with Federal requirements.
For 45 of 100 sampled items, nursing homes reported a net of 748.5 hours that were not supported.
For 2 of 100 sampled items, nursing homes reported 336 hours that could not be verified because the nursing homes did not provide supporting documentation.
𝗪𝗵𝗮𝘁 𝗢𝗜𝗚 𝗥𝗲𝗰𝗼𝗺𝗺𝗲𝗻𝗱𝘀
We made four recommendations to CMS, including that CMS educate nursing homes on updated guidance for submitting staffing information and communicate to nursing homes on trends in CMS PBJ audit findings. The full recommendations are in the report. CMS concurred with two recommendations and did not concur with one recommendation. CMS did not indicate concurrence or nonconcurrence with the remaining recommendation.
oig.hhs.gov/reports/all/2026/cmss-processes-were-not-effective-in-ensuring-the-accuracy-of-staffi... ... See MoreSee Less

📢 Industry Update

According to reporting by McKnight's Long-Term Care News, a recent HHS OIG audit identified a 5% error rate in Payroll-Based Journal (PBJ) registered nurse staffing data and recommended that CMS strengthen audit oversight, improve follow-up on reporting errors, and share common findings with providers.

The audit identified both overreported and underreported RN hours, along with documentation issues involving meal breaks, unpaid hours, and reporting inaccuracies.

As PBJ data continues to impact Care Compare, Five-Star ratings, and regulatory oversight, this serves as a reminder that accurate staffing documentation, payroll records, and PBJ reporting continue to play an important role in compliance and quality monitoring.

Source: cstu.io/fecb6c

What are your thoughts? Do you think additional education and feedback will improve PBJ reporting accuracy, or are stronger audit requirements needed?

#LongTermCare #PBJ #FiveStar #CareCompare #HealthcareCompliance #MDS #SkilledNursing #QualityImprovement ... See MoreSee Less