Harmony Healthcare Blog

Case Mix Assessments

Posted by Kris Mastrangelo, OTR/L, LNHA, MBA on Fri, Jun 18, 2010

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Edited by Kris Mastrangelo

Case Mix Assessments:  There is significant opportunity to increase the case mix index with the intervention of rehabilitation during the appropriate assessment windows.  Increased communication between the rehabilitation staff and the MDS Coordinator regarding patients receiving Medicare Part B services has the potential to increase the case mix index in two ways. 

Using the OBRA assessment schedule, the rehabilitation staff should be routinely screening patients who may benefit from Part B services.  Harmony recommends that all patients be screened on a quarterly basis, made possible with an accurate level of rehabilitation staffing.  However, use of the OBRA assessment schedule can lead to discussion regarding patients' needs during the morning staff meeting and in discussions with nursing staff. 

Secondly, the rehabilitation staff should alert the MDS coordinator when initiating therapy for a Medicare Part B beneficiary regardless of the OBRA assessment schedule.  It may be possible to complete an assessment early or to complete an extra assessment to capture a higher RUG category with the provision of rehab services.  Harmony recommends that when a patient is not best served using a rehab low program with 15 minute visits by the therapist to assess the patients' progress with Restorative Nursing Rehab Programs, therapy should provide at least 150 minutes of direct skilled rehabilitation to that patient.

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Tags: Case Mix, OBRA, ARD

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