The New York State Department of Health has announced its intention to switch from a RUGs based system to a PDPM based system for its Case Mix methodology.

A time frame for implementation of the new methodology has not been announced.

The change is being triggered because of the updates to the MDS that are going into effect on 10/1/23, version 1.18.11 v5.

Therefore, it is likely that DOH will be freezing CMI scores based on MDS collections between April 1, 2023, and September 30, 2023.

These CMI scores are expected to be included in the January 2024 rate updates.

DOH has also not announced how long the potentially frozen CMI scores could be in place.

A thorough review of all MDS collected during the 6-month period is highly recommended, especially those who are yet to be transmitted.

These scores could impact for some time.

DOH has also not given any specifics on what a potential PDPM based system will look like, including which components will be or will not be included.

It is expected that OMIG MDS audits will continue, as they are currently working on 2018 CMI.

It is also unclear if MDS submissions collected AFTER 10/1/203 will be used in future rate calculations.

If you have any questions about how these changes can impact your SNF or how your speech therapy department can help, please contact us.