Nursing Home Acuity Workgroup
- Meeting 3 is also available in Portable Document Foramt (PDF)
Nursing Home Acuity Workgroup
Meeting #3
June 27, 2019
Agenda
- Welcome
- Final Nursing Home Acuity Workgroup Meeting
- Today´s Workgroup Discussion: Recommendations
- Next Steps
- Reference: Statutory Nursing Home Acuity Workgroup Requirements
Final Nursing Home Acuity Workgroup Meeting
Schedule of Nursing Home Acuity Workgroup Meetings
| Meeting | Purpose | Date |
|---|---|---|
| Meeting #3 (today) | Final review of Workgroup Recommendations for report due June 30, 2019. | June 27, 2019 11:00 a.m. – 1:00 p.m. |
Today´s Workgroup Discussion: Recommendations
Workgroup Discussion Themes
- Comparisons Against Other States and Federal Changes.
- Improve Future Practice Regarding Accuracy in MDS Collection Process.
- Reduce or Eliminate Abusive Practices to Ensure Appropriate Acuity for Residential Health Care Residents.
Recommendation #1
Research how Other States use Acuity in Rate Setting– Reach out to other states to discuss how acuity is used for setting rates.
Things to consider:
- How is acuity captured/measured?
- How often is acuity modified in the rates?
- What, if any, is the authorization for acuity?
Recommendation #2
Research the Proposed Federal Patient Driven Payment Model– Reach out to industry experts to gain an understanding on what the proposed PDPM entails and how it will affect NYS´s acuity collection and rate setting processes.
Things to consider:
- How does the proposed PDPM compare to the current MDS?
- How often will the PDPM be updated?
- What is the timeline for implementation of PDPM?
Recommendation #3
Modify RUG Grouper– Change the current RUG grouper from RUGS III to RUG IV or some other advanced grouper to capture patient acuity more accurately.
Things to consider:
- Should cost data be rebased?
- What data is needed to calculate new weights?
- Should the number of RUG categories be reduced?
- What statutory, regulatory, and Federal changes will be needed to implement this proposal?
Recommendation #4
Implement Day Weighting– Apply / incorporate the number of days to each assessment to achieve a case mix index that is a more precise measure of patient acuity.
Things to consider:
- What additional information on type and duration of service in accordance with each assessment will be needed?
- How will the additional information be collected?
- Is the information reported in the Optional State Assessment (OSA) helpful?
Recommendation #5
Quarterly MDS Rate Adjustments – Expand case mix rate adjustments from semi–annually to quarterly.
Things to consider:
- What additional data will be required for collection?
- Should day weighting be considered?
- What statutory, regulatory, and Federal changes will be needed to implement this proposal?
Next Steps
Next Steps
- Draft Workgroup Report and share with workgroup members.
- Finalize and Distribute Workgroup Report.
Reference: Statutory Nursing Home Acuity Workgroup Requirements
Nursing Home Acuity Workgroup
(Chapter 57, Laws of 2019)
The Workgroup shall review:
- Recent case mix data and related analyses conducted by the Department with respect to the Department´s implementation of the July 1, 2019 change in methodology;
- The Department´s minimum data set collection process; and
- Case mix adjustments authorized under subparagraph (ii) of paragraph (b) of subdivision 2–b of section 2808 of the Public Health Law.
Such review shall seek to promote a higher degree of accuracy in the minimum data set data, and target abuses.
The Workgroup may offer recommendations on how to:
- Improve future practice regarding accuracy in the minimum data set collection process; and
- Reduce or eliminate abusive practices.
In developing such recommendations, the Workgroup shall ensure that the collection process and case mix adjustment recognizes the appropriate acuity for residential health care residents.
The Workgroup may provide recommendations regarding the:
- Proposed Federal Patient Driven Payment Model; and
- Administrative complexity in revising the minimum data set collection and rate promulgation processes.
Notwithstanding any changes in Federal law or regulation relating to nursing home acuity reimbursement, the Workgroup shall report its recommendations no later than June 30, 2019.
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