2013 Revised Code of Washington
Title 74 - PUBLIC ASSISTANCE
74.46 Nursing facility medicaid payment system.
74.46.485 Case mix classification methodology -- Notice of implementation.

RCW 74.46.485 Case mix classification methodology — Notice of implementation.

(1) The department shall:

     (a) Employ the resource utilization group III case mix classification methodology. The department shall use the forty-four group index maximizing model for the resource utilization group III grouper version 5.10, but the department may revise or update the classification methodology to reflect advances or refinements in resident assessment or classification, subject to federal requirements. The department may adjust the case mix index for any of the lowest ten resource utilization group categories beginning with PA1 through PE2 to any case mix index that aids in achieving the purpose and intent of RCW 74.39A.007 and cost-efficient care; and

     (b) Implement minimum data set 3.0 under the authority of this section and RCW 74.46.431(3). The department must notify nursing home contractors twenty-eight days in advance the date of implementation of the minimum data set 3.0. In the notification, the department must identify for all semiannual rate settings following the date of minimum data set 3.0 implementation a previously established semiannual case mix adjustment established for the semiannual rate settings that will be used for semiannual case mix calculations in direct care until minimum data set 3.0 is fully implemented.

     (2) A default case mix group shall be established for cases in which the resident dies or is discharged for any purpose prior to completion of the resident's initial assessment. The default case mix group and case mix weight for these cases shall be designated by the department.

     (3) A default case mix group may also be established for cases in which there is an untimely assessment for the resident. The default case mix group and case mix weight for these cases shall be designated by the department.

[2011 1st sp.s. c 7 § 4; 2010 1st sp.s. c 34 § 9; 2009 c 570 § 2; 1998 c 322 § 22.]

Notes:

Purpose -- Findings -- Intent -- Severability -- Effective date -- 2011 1st sp.s. c 7: See RCW 74.48.005, 74.48.900, and 74.48.901.      Analysis -- 2011 1st sp.s. c 7: See note following RCW 74.46.431.      Effective date -- 2010 1st sp.s. c 34: See note following RCW 74.46.010.      Effective date -- 2009 c 570: See note following RCW 74.46.431.