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VI. HOW TO ARRIVE AT A CASE MIX CLASSIFICATION

Introduction

The case mix classification is determined by applying criteria to each completed CMR assessment form. The Minnesota Department of Health will assign the final classification by computer to ensure consistency in classification. However, facility staff, Preadmission Screening teams, residents and families may wish to know how to apply the criteria themselves.

The completed assessment form includes many items of information about a resident's care, but only a few of these items are used in determining the case mix payment classification. All items on the form, as well as many other items, were taken into consideration in the case mix research project. However, the specific items used for the classification are those that the case mix research project identified as the best indicators of differences in costliness of care. The remaining items provide supporting documentation for the items used in the classification determination.

Step-1

Review scores on the eight key Activities of Daily Living (ADL's) to determine the total number of key ADL's in which the resident is considered dependent. Key ADL's and dependency scores are as follows:

CMR Form Item, ADL Not Dependent Dependent
Dressing 0-1 2-4
Grooming 0-1 2-3
Bathing 0-3 4-5
Eating 0-1 2-4
Bed Mobility 0-1 2-3
Transferring 0-1 2-4
Walking 0-1 2-4
Toileting 0 1-6
Case Mix Classification

___________
Step-2 Determine the ADL Category as follows:

Low ADL = Dependent in 0-3 key Activities of Daily Living
Medium ADL = Dependent in 4-6 key Activities of Daily Living
High ADL = Dependent in 7-8 key Activities of Daily Living

  
Step-3 Refer to the Resident Classification Decision Tree on page 24. Choose the branch of the tree which matches the residents ADL Category above, Low, Medium or High.  

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Updated Tuesday, 16-Nov-2010 08:51:38 CST