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Nursing Home Census Rosters Due

We remind members that based on the return to a picture date-based case mix index (CMI) calculation for July 2019 rates, nursing homes are required to upload their Jan. 30, 2019 resident census roster to the Health Commerce System (HCS) by Dec. 26th. Certifications are due Dec. 30th. The Dear Administrator Letter (DAL) from the Department of Health (DOH) that outlines the process is available here. Members should take care to ensure accuracy to minimize the possibility of “defaults” – cases where an inability to match a resident with a Minimum Data Set (MDS) assessment results in the resident being assigned the lowest possible score.

Members encountering issues should notify DOH staff via primail@health.ny.gov. Please be sure to send any messages containing resident information via secure transfer.

The process is in response to an injunction issued by the State Supreme Court that prohibits DOH from implementing the July 2019 rates it initially issued, which were calculated using an alternative case mix calculation method. The State is reverting to January 2019 rates while the July rates are being recalculated. More information on how the State is making retroactive payments is available here. Once new July 2019 rates based on a January 2019 picture date CMI are calculated, DOH will use them to reconcile payments for the July 1, 2019 through Dec. 31, 2019 time frame.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841