PBJ Staffing Data Reconciliation Audit

Quarterly inspection template for reconciling Payroll-Based Journal (PBJ) staffing submissions against payroll time records, approved schedules, and contract invoices before CMS submission.

Audit Scope and Submission Readiness

• Quarterly reporting period matches the intended CMS submission window
  Record the start and end dates for the quarter under review and confirm they match the submission period.
• Facility CCN and legal entity information match source records
  Verify the CMS Certification Number and facility legal name are consistent across PBJ, payroll, and contract documentation.
• PBJ submission file version and export date documented
  Capture the file version, export date, and preparer name for traceability.
• Supporting source documents available for the full quarter
  Confirm availability of payroll registers, timecards, approved schedules, agency invoices, and prior correction logs.

Payroll Time Record Reconciliation

• Total reported hours reconcile to payroll time records
  Enter the variance between PBJ reported hours and payroll/timekeeping hours for the quarter.
• Direct care staff hours are supported by time records
  Verify nursing, therapy, and other direct care hours are traceable to approved time records.
• Overtime, shift differentials, and missed punches reviewed for accuracy
  Confirm payroll adjustments were reviewed and reflected correctly in the PBJ export.
• Unworked paid time excluded from PBJ submission
  Verify PTO, holiday pay, bereavement, and other non-worked paid time were excluded where required.
• Time record exceptions documented and resolved
  List unresolved exceptions such as missing punches, duplicate shifts, or manual edits and note the resolution status.

Contract Labor and Agency Invoice Validation

• Agency hours reconcile to approved invoices
  Enter the variance between PBJ contract labor hours and invoiced hours for the quarter.
• Contract labor staff have valid vendor and assignment documentation
  Verify each agency worker included in PBJ has supporting vendor records, assignment dates, and role documentation.
• Invoice dates and service periods align to the reporting quarter
  Confirm invoices and service periods fall within the quarter being submitted or are properly allocated.
• Duplicate agency entries identified and removed
  Check for duplicate hours, duplicate invoices, or repeated staff identifiers in the PBJ file.
• Contract labor exceptions documented with corrective action
  Document any invoice mismatches, missing vendor support, or disputed hours and the corrective action taken.

Role Mapping and Staffing Category Accuracy

• Staff job titles map correctly to PBJ reporting categories
  Confirm each employee and contractor is assigned to the correct PBJ category for the hours reported.
• Licensed staff credentials verified for reported role
  Confirm licenses, certifications, and expiration dates support the role reported in PBJ.
• Administrative and support hours excluded from clinical categories
  Verify non-clinical hours were not misclassified as nursing or therapy hours.
• Staffing category exceptions reviewed with department leadership
  Document any disputed role mappings, reclassifications, or approval decisions.

Submission Controls, Corrections, and Approval

• All identified variances corrected or formally explained
  Verify all material discrepancies have been corrected in the source data or documented with justification.
• Correction log includes issue, owner, due date, and resolution status
  Confirm a complete log exists for all findings and corrective actions.
• Final PBJ submission reviewed and approved by authorized leader
  Authorized approver signs off on the reconciled PBJ submission prior to CMS filing.
• Submission readiness status
  Select the final readiness status for CMS submission.