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Nursing Home Census Roster Collection Approaching

Recognizing that clinical staff have been busy with other priorities, the Department of Health (DOH) has delayed the census roster collection process needed to calculate case mix index (CMI) adjustments for Jan. 1, 2020 rates. At this point, DOH does need to move forward and reports that a Dear Administrator Letter (DAL) instructing nursing homes of when and how to provide and verify their data is being prepared, although the timing is not yet known. We expect that the case mix used to adjust January rates will be based on a July 31, 2019 picture date. LeadingAge NY and other associations have requested that, if needed, additional response time be granted for those providers showing good cause. DOH has indicated a willingness to work with providers facing difficulties.

Encouragingly, DOH rate setting staff have been working with programmers to streamline the roster submission/verification/correction process. The Department is hopeful that the new process will help reduce the time and effort required to address correction requests. We expect that instead of the process starting with providers submitting a census roster to DOH, the first step for providers will be to review a list that DOH will compile and post on the Health Commerce System (HCS) showing the residents that DOH believes were in house on the picture date, along with the most proximate assessment. DOH will be presenting a webinar (that will be repeated and likely posted for on-demand viewing) to discuss the new process. As soon as we have insights on timing, we will let members know. After this process is completed, we anticipate DOH to repeat it promptly to establish the CMIs for July 2020 rates, which are likely to be based on a Jan. 29th picture date.

Contact: Darius Kirstein, dkirstein@leadingageny.org