Nursing Home Casemix 2026

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  1. Click ‘Get Form’ to open the Nursing Home Casemix document in the editor.
  2. Begin by filling out the resident's information in Section 1, including name, date of birth, and admission date. Ensure accuracy as this data is crucial for classification.
  3. Proceed to Section 2, where you will assess the resident's functional status using the Minimum Data Set (MDS) criteria. This includes evaluating Activities of Daily Living (ADLs) such as bathing and dressing.
  4. In Section 3, classify the resident according to their care needs using the Resource Utilization Groups (RUG-III) system. Select the appropriate category based on therapy requirements and complexity of care.
  5. Review all entered information for completeness and accuracy before submitting. Utilize our platform’s features to save your progress or share with colleagues for collaborative input.

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Case mix groups are designed to aggregate acute care inpatients that are similar clinically and in terms of resource use. Acute care inpatients are assigned to groups based on clinical and administrative data collected via the Discharge Abstract Database (DAD).
The Case Mix Index (CMI) is the average relative DRG weight of a hospitals inpatient discharges, calculated by summing the Medicare Severity-Diagnosis Related Group (MS-DRG) weight for each discharge and dividing the total by the number of discharges.
Case mix index is a metric that reflects the diversity, complexity, and severity of the patients treated at a healthcare facility, such as a hospital. Case mix index is used by the Centers for Medicare and Medicaid Services (CMS) to determine hospital reimbursement rates for Medicare and Medicaid beneficiaries.