Administrator flags new 'next of kin' admissions rule and pending PBJ audit

Carmen Meyer, administrator of the Neighbors, informed the committee that a state legislative change effective June 1 allows nursing homes to accept hospital discharges under a "next of kin" representative in some cases rather than waiting for a court guardianship. Meyer cautioned the rule raises practical questions about financial authority, Medicaid processing and banks accepting next‑of‑kin arrangements.

"Technically speaking, nursing homes can accept someone that is considered next of kin as long as the guardianship has started," Meyer said, but she added there remain questions about what the representative can legally do, whether financial institutions will accept it and how Medicaid applications will proceed.

Meyer also reported the county received a PBJ (payroll‑based journaling) audit notice covering all three county facilities on June 1 and that staff submitted requested payroll and supporting documentation. She explained PBJ data feeds CMS's staffing component of the five‑star rating and that a failed PBJ audit can reduce the staffing star rating to one star for three months though it has no direct financial penalty.

"Payroll‑based journaling is completed quarterly ... we have not heard back yet on if we have passed or failed the PBJ audit," Meyer said, describing the narrow tolerance for reporting differences and the administrative burden of producing proof for audited staff hours.

The committee asked procedural questions and discussed how often audits occur; Meyer said PBJ audits are uncommon but can occur randomly and that staff are monitoring the response. No committee action was taken; staff will report results when the audit outcome is known.