Case Study — Healthcare / Compliance Operations
A Nursing Home Payroll Company Moved from Quarterly Reporting to Real-Time Star Rating Intelligence
Client
ProPayHR
Industry
Healthcare / Long-Term Care / Payroll Services
Focus
CMS Compliance · Star Rating Optimization · Staffing Analytics
Time-to-Compliance Insight
Real-time
Star rating visibility cut from a 3-month government lag to a live daily view — every single quarter.
Missed Submission Deadlines
Zero
Automated deadline tracking eliminates the single most preventable cause of an automatic 1-star rating.
Target Reporting Accuracy
99%+
Agency, therapy, and consultant hours fully integrated and validated in every CMS submission — automatically.
The Opportunity

A proactive operator ready to turn compliance data into a strategic advantage

ProPayHR serves long-term care facilities where CMS star ratings directly influence admissions, occupancy, and revenue. Already a strong operator in payroll services, ProPayHR recognized an opportunity to give clients something the industry lacked: a forward-looking view of compliance performance rather than waiting on government feedback cycles to close.

The CMS reporting structure is inherently retrospective — a facility submits quarterly staffing data and receives a star rating weeks later, after the quarter has already ended. ProPayHR saw this structural gap as an opportunity to differentiate by building real-time predictive visibility into the process, while also capturing the full breadth of hours worked — agency nurses, therapy staff, and corporate consultants — so every submission reflects each facility’s true staffing investment.

Faster compliance insight

The CMS feedback cycle delivers star ratings weeks after a quarter closes. ProPayHR wanted clients to have that same insight in real time — so they could act on it, not just receive it.

Complete hours reporting

Agency nurses, therapy staff, and corporate consultants represent a meaningful share of hours worked. Integrating these into CMS submissions would more accurately reflect each facility’s true staffing investment.

Proactive deadline management

Quarterly CMS deadlines carry significant consequences. ProPayHR wanted an automated system to keep every facility submission-ready well in advance, removing any reliance on manual calendar tracking.

Portfolio-wide visibility

Multi-facility operators needed a single view across their portfolio — aggregated star ratings, staffing trends, and compliance status — to identify optimization opportunities before they surfaced in government reports.

The Solution

PBJ Navigator — real-time compliance intelligence, built for operators not auditors

We designed and built PBJ Navigator, a cloud-based platform that connects directly to ProPayHR clients’ time and attendance systems (Infotronics) and census data (PointClickCare). Every day, staffing hours and resident census are pulled automatically, CMS calculations run in the background, and a live predicted star rating surfaces on the dashboard — weeks or months before any government feedback arrives.

Agency, consultant, and therapy hours can be uploaded via spreadsheet or entered directly, ensuring every hour worked flows into the CMS submission. Automated alerts fire the moment staffing drops below safe thresholds, RN hours go missing, or a submission deadline is approaching. Corporate and regional leaders see every facility they oversee in one view.

Live star rating engine

Replicates the CMS calculation methodology in real time using actual staffing and census data — giving facilities a predicted score today rather than waiting on the quarterly government cycle.

Complete hours integration

CSV upload and manual entry tools ensure agency, therapy, and consultant hours flow into every CMS submission, so each facility’s reported staffing ratio reflects the full scope of care delivered.

Automated submission management

Countdown timers, submission status tracking, and configurable alerts keep every facility submission-ready well ahead of each quarterly CMS deadline.

From Reactive Reporting to Predictive Compliance
Time elapsed from quarter end to actionable star rating insight
BEFORE — Standard CMS cycle
45 days to submit
Government processing
Result arrives (reactive)
Correction period (months)
AFTER — PBJ Navigator
Live predicted star rating — updated daily from day 1 of every quarter
Quarter end
Day 45
Day 90
Day 135Day 180+
Shifting from reactive to predictive — The standard CMS cycle delivers star ratings 90 to 180 days after a quarter ends. PBJ Navigator surfaces a live predicted score from day one of every quarter, giving ProPayHR clients the insight and runway to optimize staffing decisions in real time.
Corporate Visibility

One dashboard. Every facility. Full portfolio intelligence.

For ProPayHR’s multi-facility clients, PBJ Navigator delivers a corporate-level view aggregating predicted star ratings, submission status, compliance indicators, and staffing trends across every building in a portfolio. Regional managers receive automated reports without logging in daily. Real-time alerts surface emerging issues — staffing thresholds, data sync confirmations, approaching deadlines — the moment they appear.

Corporate Dashboard — Portfolio Star Rating Overview
Live predicted ratings across facilities · Q3 2026 · Next deadline: Aug 14
Facility Predicted Stars Last Submission RN Hours Status
Meadowbrook Care — NJ ★★★★☆ May 15, 2026 On track ✓ Good
Sunrise Gardens — FL ★★★☆☆ May 15, 2026 Watch ⚠ Low
Lakeview Rehab — IL ★★★★★ May 15, 2026 On track ✓ Good
Heritage Pines — TX ★☆☆☆☆ Missing ⚠ Alert ⚠ Critical
4 facilities shown · 1 critical alert requires action · Next CMS deadline: Aug 14, 2026 (44 days)
Corporate portfolio dashboard — Each facility shows its live predicted star rating, last submission date, RN hour status, and a compliance indicator. Heritage Pines has a pending data upload — surfaced in real time so leadership can act immediately, well ahead of the quarterly deadline.

“You have a real-time view into where you’re holding. You’re not surprised 3 months after you make a submission that you thought you were providing care on one level — and all of a sudden you get a one-star rating.”

ProPayHR — PBJ Navigator kick-off session, July 2025
The Business Case

For nursing homes, stars are not vanity metrics — they are an occupancy and revenue lever

CMS star ratings are published publicly and drive where families place loved ones. Moving from 3 stars to 4 stars does not just improve standing — it drives admissions. For an operator running a 100-bed facility at $250 per bed per day, even a modest improvement in occupancy translates to hundreds of thousands in additional annual revenue. ProPayHR recognized that giving clients real-time visibility into their predicted star rating was not just a compliance upgrade — it was a revenue strategy.

Real-time
Compliance insight
Predicted star rating updated daily throughout every quarter
95%
Staffing accuracy target
Automated data integration and validation across all staff categories
100%
Hours coverage
Agency, therapy, and consultant hours fully integrated into every CMS submission
Healthcare
Finance & Compliance
Operations
Long-Term Care