Case Mix Regulations Adopted
Regulations were published in today’s State Register authorizing DOH to change the Case Mix acuity process for all nursing homes. DOH will utilize a rolling MDS collection period (October 2020 – March 2021) for the upcoming Case Mix adjustment to the July 1, 2021 rates that will capture all MDS assessments completed during that six-month period. This replaces the historical 92-day lookback snapshot methodology. In addition, the regulations specify the following:- Going forward, October – March will be the collection period utilized for the July Case Mix Adjustment, and April – September will be the collection period utilized for the January Case Mix adjustment.
- The temporary 5% CMI Cap provision will be repealed. That provision had limited any upward or downward CMI adjustments to 5% pending an audit but now DOH acknowledges that this had caused delays of more than three years before rates were finalized. (Note: this does not eliminate or reduce OMIG’s authority to audit MDS data).
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