Case Mix describes differences in residents within a population in terms of their physical and mental conditions and the resources that are used in their care. Case Mix reimbursement systems measure the intensity of care and services required for each resident and translate those measures into groupings. Those groupings are used in the calculation of facility payment.
Case Mix Weights
Documents
- Case Mix Accuracy Review (CMAR) Summary July 2020
- Declaring Pending Medicaid Eligibility in the MDS
- MDS-WA Listserve Sign Up/Mange Subscriptions
- 2025 WA State CMID Report Run Schedule Word | PDF
State Law and WA Admin Code
- RCW 74.46.485 - Case mix classification methodology.
- RCW 74.46.501 - Quarterly Average case mix indexes – Facility and Medicaid
- WAC 388-96 – NH Medicaid payment system
- WAC 388-96-738 - Default case mix group and weight when there is no MDS assessment
- WAC 388-96-905 - Case mix accuracy review of MDS nursing facility resident assessments
- WAC 388-96-904 - Administrative Review
- WAC 388-96-901 - Disputes
State of Washington Contacts
- Analyst, Technical Rates Section: Bobbie Howard, 360-725-2474, bobbie.howard@dshs.wa.gov
- RAI Coordinator and Case Mix Accuracy Review Program Manager: Tara Hawks, 360-999-7634, tara.hawks@dshs.wa.gov
- MDS Automation Coordinator: Betty Metz, 360-725-3432, betty.metz@dshs.wa.gov
- MDSHelpdesk@dshs.wa.gov