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SNF Operators – Know Your PBJ Staffing Star Ratings… before they post

SNF Operators – Know Your PBJ Staffing Star Ratings… before they post

What would it mean to your organization if you could watch the trend of your CMS PBJ staffing star ratings … daily?

Payroll-Based Journal (PBJ) is the report used by the Centers for Medicare and Medicaid Services (CMS) to evaluate levels of staffing in a skilled nursing facility as it relates to quality measures. To determine the quarterly PBJ staffing star rating, the intricate formula calculates RN and overall staffing against census and complexity of the patients.

The formula, while intricate, can be a useful tool for SNF operators who wish to make a positive impact on their quarterly ratings. However, doing the calculations manually would be an onerous task. Filling out the quarterly report for CMS based on time clock data is complex enough without trying to manually figure the calculations.

At Prone 2 Dream, we believe there’s a better way – a prospective approach. By viewing timeclock data and census together on a daily basis, a SNF operator and their Director of Nursing can make evidence-based decisions when scheduling. Dream CORE Dashboards is a business intelligence solution that provides daily tracking of your time clock data, as well as Overtime Analysis, Earnings Reports, Wage Analysis, Labor Distribution and more.

By watching your DreamCORE Dashboards on a daily basis, you have actionable information to positively impact your PBJ staffing star ratings.

Missing an RN one day? Set your DreamCORE to alert you – so you can correct the situation before it becomes part of your permanent CMS record.

When you have access to your daily PBJ staffing star ratings and make data-driven decisions on a daily basis, you can:

> Optimize clinical staffing dollars

> Equip your team to stay ahead of timeclock data

> Gain insight on CMS adjustment trends

Daily visibility of PBJ star trends brings stability, and ultimately enables you to project what each quarter’s stars will be. DreamCORE takes the mystery out of PBJ reporting.

Contact us for a Live Demo.



PBJ Staffing Star Ratings Infographic

Role Based Access Control for Skilled Nursing Business Intelligence

Role Based Access Control for Skilled Nursing Business Intelligence

Data drives decisions, evidence-based decisions.


Yet, in the world of breathtakingly fast data analytics, how can you be certain that only the right people are seeing sensitive data? This is the purpose of Role-Based Control Access (RBAC) also known as Role-Based Security (RBS).


What is Role-Based Access Control (RBAC)?


Each person in an organization has a position or a role. RBAC sets a framework whereby each employee only has access to data that is pertinent to that role. If the individual has responsibility for budget decisions for a specific department, he/she has access to that data only and no access to other departments.


Prone 2 Dream Technologies deploys RBAC for its DreamCORE Dashboards. Skilled Nursing business intelligence is delivered in drillable dashboards with a focus on Census, Overtime, Receivables, and Expenses. These are the CORE of the business and where frontline department leaders are making decisions about how to spend the company’s revenue.


These leaders are expected to contribute to the overall profitability of the company. However, they typically have to wade through data overload by signing into multiple platforms or shuffling multiple spreadsheets to find what they need to make decisions.


DreamCORE Dashboards presents the plethora of skilled nursing data in a logical, relevant format, with infinite views. RBAC narrows the scope to each individual’s frame of reference – he or she only sees the data for areas where they can make an impact. They get the data they need… and ONLY the data they need.


Here’s the RBAC framework for DreamCORE Dashboards:


RBAC Framework



Examples of Role-Based Access Control


Culinary Manager – Sees payroll, overtime, and department budget adjusted daily per fluctuating census only for the facility’s culinary department


Director of Nursing – Sees payroll, overtime, and department budget adjusted daily per fluctuating census only for the facility’s nursing department. Plus, she sees a daily tracking of her CMS PBJ star rating – data only relevant to her role.


Facility Administrator – Sees all the data relevant to that specific property/location.

Regional Director – Sees all the data for the facilities he oversees.


Executive Team – All the data for all the facilities, as well as corporate financials, P&L, forecasts, Payroll Analysis, and more.


As a result, sensitive data remains secure, and each individual is aware that their focus is different from another within the company. Yet DreamCORE Dashboards provide one version of the truth, updated daily.


Two individuals in different roles, but who have access to the same dashboard page are both seeing the same data. For example, a regional director has a virtual meeting with a facility administrator. They are both seeing that facility’s “green data” – one version of the truth, updated daily.


Benefits of RBAC in DreamCORE Dashboards


  1. Protects sensitive payroll data. Most department leaders need to control schedules and overtime expense, yet need to keep wage rates secure. DreamCORE Dashboards provides that security while allowing leaders to make data-driven decisions.
  2. Protects patient data. DreamCORE Dashboards focus on the financial data of a patient’s stay and it’s only available to certain roles, as defined by executive leadership.
  3. Eliminates data overload at the front line. Narrowing the focus is the first step towards positive outcomes – DreamCORE Dashboards are a tool for front line success.
  4. Ease of change. Individuals’ roles change – whether they are adding responsibilities, moving to a different facility, or getting a promotion, changing access is as easy as contacting our support team.

Role-Based Security

Learn more about Prone 2 Dream’s Role-Based Security.


The Ease of Single Sign-on


Nobody needs yet another set of login credentials to gain access to their data. Prone 2 Dream is a Microsoft Partner, so with your current Microsoft account, your team simply logs in to their email account and access to their dashboards is a click away.


Our single sign-on feature mitigates the risk in accessing third-party sites, reduces time spent accessing multiple accounts, lowers the total cost of ownership of IT with fewer help desk / support ticket requests, and creates happy users.


Empower your front line leaders


Data drives decisions. If your facilities are wading in data overload or simply don’t have the time to shuffle through their various papers and platforms, book a demo of DreamCORE Dashboards today.


We understand that data can be intimidating, especially to department managers who were hired for their acumen in distinctly different areas. We take pride in providing onboarding and training for your teams and helping them learn to love their numbers.


SNF Operators – How to Manage HPPD

SNF Operators – How to Manage HPPD

SNF Operators can manage their HPPD by using a tool that integrates the company time clock with its EHR and book of record – Dream CORE Dashboards.

Prone 2 Dream’s innovative technology assembles the critical data you need to manage HPPD to meet both regulatory and financial obligations.

With Role-Based Security, all sensitive employee information remains restricted. It is impossible for users to see data outside their role.

Your nursing schedule is a labyrinth. The Director of Nursing needs to balance patient needs with compliance issues and staff scheduling. Often this results in paying Premium Overtime – the dollars in excess of payroll budgets. Yet, nursing schedulers can make better decisions by having historical data and predictive analytics.

With Dream CORE‘s user-friendly dashboards, SNF Operators have a clear view of HPPD, a rolling punch analysis, and a drill down to individuals on the time clock.

Integrating these data sets also enables a SNF Operator to manage their CMS staffing rating. A simple formula projects the next quarter’s rating, and a desired rating is achievable by managing the HPPD.

Overtime is the “O” in CORE – one of the controllables within a SNF’s financial management [Census, Overtime, Receivable, Expenses]. See the benefits and features in the infographic below.

Book a live demo – Grab a spot on our calendar here.


SNF Operators – Effective Admissions for Better Client Experiences

SNF Operators – Effective Admissions for Better Client Experiences

Skilled Nursing Facility operators – Does your current Admissions process provide a comfortable transition for the new patient arrival?

Are you capturing the required verifications and authorizations?

Is ICD-10 coding a breeze for your MDS nurse?

Do you know the theoretical reimbursement benchmark? Do you know if you’re getting paid what you’ve earned or do you suspect you’re leaving money on the table?

Prone 2 Dream Technologies processes Admissions through 2 user-friendly apps. The Admissions app speeds the process of approving a new referral and communicating the start of the new patient’s journey to your team. The PDPM app calculates the theoretical reimbursement, and memorializes the patient’s journey in your center.

Check out the process in this easy infographic. Then contact us to see these steps in action.


Thinking About A Major Systems Update? Here’s How To Make The Transition Smoothly

Thinking About A Major Systems Update? Here’s How To Make The Transition Smoothly

How many software applications does it take to run your company?

You depend on each of these programs to perform at their highest level, and subsequently rely on the developers to continually upgrade their product. Upgrades have to be seamless and user-friendly so that your teams (the users) don’t skip a beat.

Periodically, a major systems upgrade is necessary within your own company. You may have decided a different EHR will better serve you. Or perhaps it’s a financial system that’s become outdated. Plus, you need your various software programs to be integrated … in a way that benefits your unique needs.

Making a decision about a major systems update is exciting! But thinking about how to pull it off can send you quickly into a state of overwhelm:

  • Where do we start?
  • How long will it take?
  • How will we accomplish the project?
  • How will we find the right experts to enlist?
  • Is it worth the disruption?

Let’s take a look at how to make it happen…

What does a major systems update look like?

Here’s the best news about taking on a major systems update: If you have not yet transitioned to cloud technology, now is the time! All the software programs you use are cloud-based, and by transitioning away from traditional hardware systems, you lower your total cost of ownership.

The purpose of deploying a major systems update goes beyond needing to update one or two of the programs you’re currently using. You’ll be integrating ALL your existing systems and programs, feeding them into your financial book of record.

Integration is the coding of the subsidiary ledgers to bring that data to the right general ledger line. The EHR is one of the largest subsidiary ledgers (census, payers). Your update migrates health information records by cross-mapping – integrating the clinical data with the financial data. 

First steps – Creating the Topography

Setting up the general ledger codes initiates your system. This is the topography of your system update as your financial book of record is the anchor. All subsidiary ledgers have to feed into the book of record. Your topography is the backbone or what’s known as the System Standup.

The topography is a structural technological document that shows how the systems will talk to each other. This becomes a template for all units. As you expand to add any new skilled nursing facilities, they will conform to this template. The goal is that all the software systems join into the topography in the same way, across multiple locations.

Continuity Planning and Disaster Recovery Plan

Continuity planning is the roadmap for setting the system up to work in integration with the subsidiary ledgers. When each relevant software is speaking to each other, you’re able to better track your financials, submit better reports to stakeholders, CMS, and other authorities, have successful audits, and ultimately, have the confidence that your numbers are accurate. 

Within every successful topography, you’ll need a formal structure of how to recover if/when something inevitably goes awry. Planning ahead for unforeseen events will keep the disruption to a minimum. 

Setting up migration teams for success

Then the work really begins. Once the topography is finalized, you need the humans who will write the upload utilities for data migration, database management, and all connectivity. This takes teams of experienced data managers, and many of your software providers will supply this support. They can migrate their program into your topography, but you will want integration experts to connect various programs together. 

Expanding and utilizing your existing technology

Is your company currently using Microsoft365? It’s a huge, powerful product that almost all companies all buy, but then only use the basic features. In reality, Microsoft 365 has the ability to provide the platform for the integrations. You may have been reading about all the ways Microsoft is entering the healthcare industry and empowering their users.

Microsoft for healthcare

How we help with a major system update

A major systems change is exciting! But we know how much work is involved.

We understand and have written successful topography, continuity planning, and connectivity systems. We have extensive experience in data migration and database management. We onboard your teams and provide ongoing training for their success.

Prone 2 Dream Technologies has been a Microsoft partner since 2016. MS wants the end user to be empowered, not restricted. That’s where P2D comes in – we’ve seen the underutilization of MS365 and want to show our clients how to maximize that investment.

Thinking about a major systems update? Call us for a complimentary consultation today.


Calculate Theoretical PDPM Reimbursements to Collect What You’ve Earned

Calculate Theoretical PDPM Reimbursements to Collect What You’ve Earned

It’s been a year since the inception of CMS’ new regulation – PDPM. As an industry, have we benefited? Hmmm… many are scratching their heads and wondering “Did we leave money on the table?”

That’s a fair question. Because at the end of the day all that’s changed, for the most part, is the way the reimbursements are calculated. There has been some re-stratification of therapy utilization, and a new central focus on nursing.

When you distill it further, it shifted the elusive chase of “720”, COD, and partner delivery models to “getting it right at admission” and delivering the nursing holistically, but isn’t that what “Skilled Nursing” implies in the first place?

What hasn’t changed is the process by which SNFs are arriving at the billing for their reimbursements and the laborious interdisciplinary Triple Check and data scrubbing. The October 2019 shift to PDPM was not near as painful as acclimating to the MDS/OASIS in 1996, as technology has eased the labyrinth of cross-checking the claims.  Many software vendors are laser focused on the retrospective “scrub” to ensure the digits meet the rigorous standards of submission.

We have acclimated quite nicely as an industry to the prevalence of data management, allowing our EHR to reflect our story of commitment to care and service, though the nemesis of coding the delivery of care remains intricate – digitizing clinical logic has never been an exact science.

Inevitably, the existing processes still cause strife between clinicians, admissions and billing as these shifts are playing out in real-time. It’s no wonder we’re not certain if our reimbursements will meet the level of service that we’ve earned – primarily because we continue looking in the rearview mirror.  Now is the time to put a “stake in the ground” with prospective logic.

There’s a better way – calculating a theoretical reimbursement at the point of admission.

The PPS (Prospective Payment System) has never really been “Prospective” has it?  Prone 2 Dreams still thinks it should be, just as CMS prepared us for the crossover to PDPM. Using this methodology, why not set your team up for success at the onset, instead of wondering why your reimbursement is lower than expectation – in hindsight?

It must be acknowledged that the first three days of the patient’s SNF stay are hectic, clinicians distill assessments, evaluate conditions, comorbidities, edge of bed visits, and liaison communications.  Admissions sets up the demographics, prepares for transportation, reception, and mobilize the support service teams. The business office pulls the CWF, verifies insurance, and gets initial auth… it is in this narrow window that we must get things right!

Take a look at Dream PDPM – a tool that calculates a theoretical reimbursement and memorializes each patient upon admission, allowing you to assess gaps in your EHR and billing system to capture the inconsistency inherent to digitizing clinical logic.

How does it work?

First, we open our virtual team environment for our customers. Get everyone together!

Dream PDPM  app is secure, protecting sensitive data …mobile, any device anywhere…collaborative, everyone contributes in one place.

Second, we are set to manage change.  So, go ahead…we understand that things change…conditions, additions, accidental omissions…

Dream PDPM  app memorializes every change, creating a brand new “Theo” pdf for tracking so that the whole team is on the same page while preserving the history.

Finally, for many RNs who are preparing the care plans, focusing on healing, preparing the success journey for the patient, getting all the appropriate boxes checked in this scramble may be a challenge.

Dream PDPM  app is simple and only takes a few minutes to complete.

While Dream PDPM is a tangible tool, here are a few intangible results:

  • Dream of your IDT team spending less time on Triple Check.
  • Dream of a comparative story – Actual vs Theoretical – promoting the interdisciplinary dialogue in a learning environment.
  • Dream of organically creating your reference library as the growth of the team memorializes these meetings.

We did – and the result is Dream PDPM.

Dream PDPM provides the benchmark to achieve maximum reimbursement and allows your team to develop and enhance their skills in identifying and correcting gaps.

The critical 3-day admission window lends to expand our learning the finer points of a Skilled Nursing Admission. Each step of the patient’s journey toward a successful outcome is measured on this prospective standard – enabling any disparities in payment to be identified and recorded giving your team an edge.

Prone 2 Dream Technologies can transition your company to a prospective approach to PDPM with a trackable system. We create the learning environment that helps your team perform better in their admissions process, thereby enabling better reimbursements. Please contact us for a complimentary consultation today.

Our Dream is always grounded in collecting the data, formulating powerful real-time analytics, and presenting results to your team in dynamic dashboards.

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