Case Mix

Talino · Apr 6, 2011

know when the collection period is for cmis for the year.

example: collection period ends 7/27/11. all obra assm’ts w/ ard between 4/27 – 7/27 will be included.

between 4/27 – 7/27, be a hawk! know the residents condition on a daily basis. attending the daily report or reading the daily report (each single day) is very beneficial. have nurses notify you w/ minute changes – e.g., a resident (usually coded transfers =3/2) required 2-person assist going back to bed on one day (even just that one instance).

familiarize yourself (if not, the entire staff) w/ the rug categories (see sample attached) and the value of each rug in dollars. identify residents whose status fall in any of the higher categories (as opposed to the previous rug score). then, schedule the upcoming obra mds sooner than originally scheduled.

scenario (based on the collection period above):

resident’s 1st quarter mds ard was 3/11 w/ a rug score of pc1 (her previous mdss were consistent at this level). her 2nd quarter mds is due 6/11.
on 4/20, resident was started on ivf due to poor p.o. intake. she was also being treated for uti. she also exhibited s/s of depression on a daily basis (no pleasure doing things, feeling tired, no appetite, trouble concentrating).
on 4/27, she completed the ab rx, her p.o. intake improved and the ivf was d/c’d. she was more upbeat and now resuming her usual functions. do the 2nd quarter mds now to capture the ivf and s/s of depression w/ a severity score of 10 or more. the rug score will likely be hd2, that is, $150 more than pc1.
had you stuck w/ the orig. 2nd qtr mds on 6/11 and attained a rug pc1, you would have lost $13,500.00 in revenue ($150 x 90 days).
her 3rd qtr mds is now due 7/28.

most overlooked money-maker –> the adl index. an additional sum of 1 can bumped the rug value one level higher.

RUGIV_CATEGORIES_(SHARED)[1].pdf

michmommylala · Dec 31, 2012

Great post Talino

Does anyone have any information, cheat sheets, tips they are willing to share in regards to monitoring and increasing CMI.
Anything would be greatly appreciated
Thanks
Donna

nursesoto82 · Feb 20, 2013

I've always been under the impression that you can only readjust an ARD by 14 days (between days 79-92 from the previous assessment's ARD) unless its a sig change. It wouldn't cause a scheduling conflict to do a quarterly in April if its originally set for June?

andy3k · Feb 20, 2013

The RAI Manual says early assessments are allowed and does not define how early. Therefore, one day after an admission assessment, you could perform a quarterly or annual. The next day you could do yet another quarterly or annual, if you so chose. There is no 14 day requirement as mentioned in the previous post.