10 ways to Increase your Case Mix Index
There are numerous ways a facility can increase their Case Mix Index. Facilities must monitor the follow criteria to ensure proper Medicaid Reimbursement and increase your Case Mix Index.
- Emergency Room Visits: IV medications, IV fluids, oxygen and blood transfusions may have been administered to patients while in the Emergency Room.
- Hospital Stays of Less Than Three Days: IV fluids, IV medications, surgical wounds, blood transfusions, IV contrast material for testing purposes may have been administered while in the hospital.
- Flu Symptoms: Patients frequently require additional physician visits, may have additional physician orders, may have a fever and vomiting and may require oxygen. Patients will often have a diagnosis of pneumonia with fever or weight loss with a fever during these illnesses.
- Podiatry Visits: Foot lesions are defined as any cuts, ulcers or fissures. These may occur after being seen by the podiatrist or may be the reason for a podiatry visit. Remember that ankle problems are not considered foot problems and should not be coded in this section.
- Skin Issues: Any skin issues that occur should be followed by a chart audit by the MDS Coordinator to determine if these skin issues are as a result of pressure, venous stasis or excoriations due to incontinence. Early identification and coding of skin issues on the MDS assures that these issues are being care planned and treated.
- Rehabilitation: The Rehabilitation department should alert the MDS Coordinator whenever a patient is placed on their case load for Medicare Part B services. The MDS Coordinator in collaboration with the rehab staff can determine if an early MDS Assessment is warranted to capture the rehab services to increase the case mix.
- Tracking of Physician Visits: It is beneficial an easier to track physician visits in comparison to days of physician order changes. When a patient has had two physician visits in a 14 day window, the MDS coordinator can then review the chart to determine if there have been two days of order changes in order to capture a Clinically Complex category.
- Review of Daily Census: This will alert the MDS Coordinator regarding hospitalizations and ER visits.
- Review of Daily Shift Communications: Reviewing the communication between shifts may alert the MDS Coordinator to symptoms of flu, pneumonia, fevers, vomiting, oxygen use or other medical conditions that may require additional nursing services.
- Respiratory Therapy: Patients who have orders for nebulizer treatments should become a focus for review to determine if they will have 7 days of respiratory therapy services which may include breathing exercises, evaluation of lung sounds, oxygen saturation in addition to the nebulizer treatments.