Minnesota Case Mix Review Program
Minnesota Case Mix is a system that classifies residents into distinct groups, called Resource Utilization Groups (RUGs), based on the resident’s condition and the care the resident receives. These groups determine the daily rate the facility charges for the resident’s care. DHS assigns a value to each classification, which they use to calculate the daily rate of payment for private pay and Medicaid stays.
The 2014 Minnesota Session Law amended Minnesota Statutes 2012, section 144.0724. Click on the yellow bar above the statute for more info. (New 08/2014)
Primary changes to the stature were to remove outdated language regarding MDS 2.0 and RUG-III and to simplify statute language
A change to Facility Initiated Request for Reconsideration; facilities will be given 14 days to provide additional information if requested from Case Mix Review as described in Minnesota Statute 144.0724 Sub. 8. Also under the Request for Reconsideration process, notwithstanding any law to the contrary, the facility may not charge a fee for providing copies of the requested documentation to the resident or resident’s representative.
Case Mix Manual (PDF: 921KB/43 pages) (Last updated 02/2014)
Information for Residents, their Families, and Responsible Parties (Last updated 08/2014)
Information to help residents and families better understand the Case Mix System.
Case Mix Information for Providers (Last updated 02/2014)
Information designed for providers including the Case Mix Classification Manual for Nursing Facilities.
MDS and RAI Information (Last updated 09/2014)
Information about the MDS assessment instrument and the RAI manual including links to pertinent CMS web pages.
Training and Education (Last updated 12/01/2012)
Information related to upcoming training opportunities, handouts from past training sessions and links to online training.
Case Mix Vendor Page (Last Updated 12/01/2012)
Minnesota-specific MDS and Case Mix criteria.
History (Last Updated 8/2014)
History includes historical documents that may be valuable for research but are no longer current.