NYS Nursing Home CMI Project –

Due to recent federal changes to the MDS 3.0, Resource Utilization Group (RUG) based case mix adjustment is no longer feasible. The NYS Department of Health (NYSDOH) held an initial briefing on October 30, 2024 to discuss that change.

The consulting firm, Myers and Stauffer has been contracted by DOH to develop a replacement methodology for adjusting Medicaid rates. The consulting firm is working on an alternative, a case mix index (CMI) methodology that will adapt the Patient-Driven Payment Model (PDPM) approach currently used in determining Medicare Part A rates. Although NYSDOH has not made this official yet, it appears to be the direction the state is leaning.

While development is in its early stages, now is the time to prepare for this change anticipated to take place during the second half of 2025. As SNF consultants, we highly recommend you and your staff become familiar with the “Nursing Component” we believe DOH plans to implement.

To ensure facilities are prepared to accurately code the nursing component, Coretactics is encouraging SNFs to educate staff now. Our experts are here to assist in your facility’s preparation or you have questions.

Give Coretactics experts a call at 518-280-1343 or Email Us!