Nursing Home Members: Please Share Your Case Mix Information

LeadingAge NY thanks all of the nursing home members who promptly responded to our request for case mix information and encourages those who have not yet done so to share their July 2023 and projected January 2024 Medicaid case mix index (CMI) figures with us at their earliest convenience. This information will allow us to gauge the financial impact on members of the State budget proposal to freeze the July 2023, rather than the January 2024, CMI while the State implements a replacement acuity adjustment methodology (more information here).

Please note that the CMI is shown on schedule 4 of the Medicaid rate sheet packet as the “Facility Specific Case Mix” and is not the same as the “Facility Case Mix Adjustment.” As is the usual practice, the initial January 2024 rate sheets contain the same case mix as the July 2023 rates as a placeholder, meaning that members would have to project their January 2024 case mix based on their own assessment data (i.e., Medicaid assessment count by Resource Utilization Group (RUG)-III category for assessments with assessment reference dates spanning April through September 2023).

As we fight this proposal, we are also discussing with the Department of Health (DOH) whether and how the State would adjust 2024 rates using the new case mix methodology once it is developed. This would have a significant bearing on the financial impact of the freeze.

Please send case mix information to Eric Dumas (edumas@leadingageny.org). We thank you for your partnership in this important effort.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841 or Eric Dumas, edumas@leadingageny.org