Washington Case Mix Scores Update

DSHS released its promised update of the 2023 quarter 4 case mix scores.  Each provider should have already received these revised reports.  The Department changed the report to address several issues.  First, they parsed the HIPPS code into separate categories for PT, OT. Nursing, SLP and Non Therapy Ancillaries.   Second, the Department is now using the correct case mix indexes as published in the most recent Federal Register and effective October 1, 2023.

We do now know if the Department is now pulling the corrected MDS given all the technical issues in October and November 2023.  Providers should review these revised reports for the following:

• Are the corrected MDSs reflected on this report?
• Are there Defaults?

Both the above issues should be resolved.

In addition, providers should analyze the revised report to understand utilize of depression and restorative end splits as well as functional coding for both Medicaid and total days.  I have attached a summary report using a sample data set.

The Department will release a preliminary care mix index detail report the week of April 8, 2024.  This report will include MDS assessments for the six month period October 1, 2023 through March 31, 2024 and transmitted by April 4, 2024.