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Nursing Home Case Mix Data Collection Entering Second Stage

The streamlined approach that the Department of Health (DOH) is using to gather data to adjust nursing home January 2020 Medicaid rates for acuity is occurring as scheduled. After the 10-day period during which providers had the opportunity to submit additional or corrected MDS information to the Centers for Medicare and Medicaid Services (CMS), DOH will be downloading the updated federal file and using it to update the MDS data reflected on the Health Commerce System (HCS). The Dear Administrator Letter (DAL) that lays out the schedule is available here, and the slides used by DOH to outline the new process are here.

Providers will have two weeks starting July 3rd to verify that the appropriate MDS is being matched to each resident and to contact DOH to request corrections if discrepancies are identified. While the process should minimize the number of instances where DOH staff intervention is required, providers should reach out to DOH for Assessment Reference Date (ARD) changes, to add or remove a resident after matching is completed, or to make changes to a finalized file. For assistance, please contact MDSBRHCR@health.ny.gov. Please be sure to use secure transfer if sending any resident-identifying information. Instructions for using the secure transfer function of the HCS are provided on page 22 of the webinar slides.

We remind members that this new process has no impact on how the case mix index (CMI) is calculated or on the MDS assessments that are used for the calculation. It simply provides a more efficient way for DOH to compile, and for providers to verify, the data that is customarily used for calculating CMI.

We urge members to carefully review their data for accuracy and to let us know if they encounter any difficulties with the process. Providers should complete the matching process and finalize their data by July 17th. The required certification is due by July 24th.

Contact: Darius Kirstein, dkirstein@leadingageny.org