Important Time for MDS Assessments
We remind nursing home members that the Medicaid case mix "picture date" was Jan. 25, 2017. It is important that homes ensure that an MDS assessment is submitted for each resident listed on their Jan. 25th census roster. This roster will be uploaded to the Department of Health (DOH) in April, and the resulting data will be used to calculate the Case Mix Index (CMI) used to adjust the Medicaid rate for resident acuity for the six-month period beginning on July 1, 2017.
Residents listed on the roster who do not match to an MDS will be presumed to be Medicaid residents, assigned the lowest RUG score, and included in the facility's Medicaid Case Mix Index (CMI) calculation. Until now, DOH has tried to minimize such defaults by working with individual homes to help ensure an MDS match for each resident, a process that is cumbersome and time-consuming. In an attempt to improve the timeliness of Medicaid rate updates, DOH is considering strategies that may impose penalties or result in delayed rate updates for homes that continue to require intervention in matching residents on the roster to the appropriate MDS.
Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841