04/01/1998 CMI512A.TXT CASE MIX INDEX SETS FOR USE WITH VERSION 5.12 of M3PI The following 4 Case Mix Index (CMI) Sets are appropriate for use with version 5.12 of M3PI. The 4 sets are designated by CMI Set Control Codes (A01, A02, B01, and B02). CMI Set Codes starting with an "A" are Medicare PPS sets, and these sets are based on nursing time, rehabilitation time, and ancillary costs. CMI Set Codes starting with a "B" are Medicaid or Research Sets, and these sets are based on nursing time only. ---------------------------------------------------------------- SET CODE: A01 SET NAME: Medicare PPS Rural--07/01/98 SET DATE: 03/29/1998 Description: Set A01 is appropriate for RUG-III classification of Medicare residents in Rural facilities. This set is a provisional set for use with the Medicare Prospective Payment System (PPS) to be implemented nationally on 07/01/1998. Set A01 is based on provisional Medicare PPS payment rates that include nursing time, rehabilitation time, and selected ancillary costs. This set is based on calculations for a large representative sample of Medicare residents. Set A01 gives the ordinal position of each group rather than the actual numeric index. At this time, the underlying numeric indices are still under review and subject to change before PPS implementation on 07/01/1998. A future set will provide the actual numeric indices when available. CAUTION: Set A01 is a provisional Medicare PPS set and the ordinal positions of the groups and the resulting Medicare PPS RUG-III classifications may change before actual PPS implementation. Array Ver. 5.12 CMI for Element # M3PI Group Group --------- ------------- ------- 44 group model rehabilitation groups: 1 RUC 44.000 2 RUB 43.000 3 RUA 42.000 4 RVC 41.000 5 RVB 40.000 6 RVA 38.000 7 RHC 39.000 8 RHB 36.000 9 RHA 33.000 10 RMC 37.000 11 RMB 34.000 12 RMA 32.000 13 RLB 31.000 14 RLA 26.000 Groups used in both 44 and 34 group models: 15 SE3 35.000 16 SE2 30.000 17 SE1 29.000 18 SSC 28.000 19 SSB 25.000 20 SSA 24.000 21 CC2 27.000 22 CC1 23.000 23 CB2 22.000 24 CB1 21.000 25 CA2 20.000 26 CA1 17.000 27 IB2 14.000 28 IB1 12.000 29 IA2 8.000 30 IA1 6.000 31 BB2 13.000 32 BB1 11.000 33 BA2 7.000 34 BA1 2.000 35 PE2 19.000 36 PE1 18.000 37 PD2 16.000 38 PD1 15.000 39 PC2 10.000 40 PC1 9.000 41 PB2 5.000 42 PB1 4.000 43 PA2 3.000 44 PA1 1.000 45 BCI 1.000 34 group model rehabilitation groups: 46 RAD 0.000 NOT ACTIVE IN THIS CMI SET 47 RAC 0.000 NOT ACTIVE IN THIS CMI SET 48 RAB 0.000 NOT ACTIVE IN THIS CMI SET 49 RAA 0.000 NOT ACTIVE IN THIS CMI SET ---------------------------------------------------------------- SET CODE: A02 SET NAME: Medicare PPS Urban--07/01/98 SET DATE: 03/29/1998 Description: Set A02 is appropriate for RUG-III classification of Medicare residents in Urban facilities. This set is a provisional set for use with the Medicare Prospective Payment System (PPS) to be implemented nationally on 07/01/1998. Set A02 is based on provisional Medicare PPS payment rates that include nursing time, rehabilitation time, and selected ancillary costs. This set is based on calculations for a large representative sample of Medicare residents. Set A02 gives the ordinal position of each group rather than the actual numeric index. At this time, the underlying numeric indices are still under review and subject to change before PPS implementation on 07/01/1998. A future set will provide the actual numeric indices when available. CAUTION: Set A02 is a provisional Medicare PPS set and the ordinal positions of the groups and the resulting Medicare PPS RUG-III classifications may change before actual PPS implementation. Array Ver. 5.12 CMI for Element # M3PI Group Group --------- ------------- ------- 44 group model rehabilitation groups: 1 RUC 44.000 2 RUB 43.000 3 RUA 42.000 4 RVC 41.000 5 RVB 40.000 6 RVA 37.000 7 RHC 39.000 8 RHB 35.000 9 RHA 33.000 10 RMC 38.000 11 RMB 34.000 12 RMA 32.000 13 RLB 30.000 14 RLA 25.000 Groups used in both 44 and 34 group models: 15 SE3 36.000 16 SE2 31.000 17 SE1 29.000 18 SSC 28.000 19 SSB 26.000 20 SSA 24.000 21 CC2 27.000 22 CC1 23.000 23 CB2 22.000 24 CB1 21.000 25 CA2 20.000 26 CA1 17.000 27 IB2 14.000 28 IB1 12.000 29 IA2 8.000 30 IA1 6.000 31 BB2 13.000 32 BB1 11.000 33 BA2 7.000 34 BA1 2.000 35 PE2 19.000 36 PE1 18.000 37 PD2 16.000 38 PD1 15.000 39 PC2 10.000 40 PC1 9.000 41 PB2 5.000 42 PB1 4.000 43 PA2 3.000 44 PA1 1.000 45 BCI 1.000 34 group model rehabilitation groups: 46 RAD 0.000 NOT ACTIVE IN THIS CMI SET 47 RAC 0.000 NOT ACTIVE IN THIS CMI SET 48 RAB 0.000 NOT ACTIVE IN THIS CMI SET 49 RAA 0.000 NOT ACTIVE IN THIS CMI SET ---------------------------------------------------------------- SET CODE: B01 SET NAME: Medicaid 34 group--Nurs. only SET DATE: 03/29/1998 Description: Set B01 is appropriate for 34 group RUG-III classification for State Medicaid payment, acuity tracking by facility, or other research purposes. Set B01 is based on nursing staff times found in large multistate research studies conducted in 1995 and 1997. This set has been adjusted for a July 1995 sample of all nursing home residents in several states. Array Ver. 5.12 CMI for Element # M3PI Group Group --------- ------------- ------- 44 group model rehabilitation groups: 1 RUC 0.000 NOT ACTIVE IN THIS CMI SET 2 RUB 0.000 NOT ACTIVE IN THIS CMI SET 3 RUA 0.000 NOT ACTIVE IN THIS CMI SET 4 RVC 0.000 NOT ACTIVE IN THIS CMI SET 5 RVB 0.000 NOT ACTIVE IN THIS CMI SET 6 RVA 0.000 NOT ACTIVE IN THIS CMI SET 7 RHC 0.000 NOT ACTIVE IN THIS CMI SET 8 RHB 0.000 NOT ACTIVE IN THIS CMI SET 9 RHA 0.000 NOT ACTIVE IN THIS CMI SET 10 RMC 0.000 NOT ACTIVE IN THIS CMI SET 11 RMB 0.000 NOT ACTIVE IN THIS CMI SET 12 RMA 0.000 NOT ACTIVE IN THIS CMI SET 13 RLB 0.000 NOT ACTIVE IN THIS CMI SET 14 RLA 0.000 NOT ACTIVE IN THIS CMI SET Groups used in both 44 and 34 group models: 15 SE3 2.100 16 SE2 1.790 17 SE1 1.540 18 SSC 1.440 19 SSB 1.330 20 SSA 1.280 21 CC2 1.420 22 CC1 1.250 23 CB2 1.150 24 CB1 1.070 25 CA2 1.060 26 CA1 0.950 27 IB2 0.880 28 IB1 0.850 29 IA2 0.720 30 IA1 0.670 31 BB2 0.860 32 BB1 0.820 33 BA2 0.710 34 BA1 0.600 35 PE2 1.000 36 PE1 0.970 37 PD2 0.910 38 PD1 0.890 39 PC2 0.830 40 PC1 0.810 41 PB2 0.650 42 PB1 0.630 43 PA2 0.620 44 PA1 0.590 45 BCI 0.590 34 group model rehabilitation groups: 46 RAD 1.660 47 RAC 1.310 48 RAB 1.240 49 RAA 1.070 ---------------------------------------------------------------- SET CODE: B02 SET NAME: Research 44 group--Nurs. only SET DATE: 03/29/1998 Description: Set B02 is appropriate for 44 group RUG-III classification for acuity tracking by facility or other research purposes. This set and the 44 group model of version 5.12 are NOT appropriate for Medicaid payment purposes. Set B02 is based on nursing staff times found in large multistate research studies conducted in 1995 and 1997. This set is based on a Medicare-oriented sample of residents in selected Skilled Nursing Facilities in several states in 1995 and 1997. Array Ver. 5.12 CMI for Element # M3PI Group Group --------- ------------- ------- 44 group model rehabilitation groups: 1 RUC 1.430 2 RUB 1.050 3 RUA 0.850 4 RVC 1.240 5 RVB 1.140 6 RVA 0.890 7 RHC 1.300 8 RHB 1.160 9 RHA 0.960 10 RMC 1.480 11 RMB 1.200 12 RMA 1.060 13 RLB 1.220 14 RLA 0.870 Groups used in both 44 and 34 group models: 15 SE3 1.860 16 SE2 1.520 17 SE1 1.280 18 SSC 1.240 19 SSB 1.150 20 SSA 1.110 21 CC2 1.230 22 CC1 1.080 23 CB2 1.000 24 CB1 0.920 25 CA2 0.910 26 CA1 0.820 27 IB2 0.760 28 IB1 0.730 29 IA2 0.630 30 IA1 0.580 31 BB2 0.750 32 BB1 0.710 33 BA2 0.610 34 BA1 0.520 35 PE2 0.860 36 PE1 0.840 37 PD2 0.780 38 PD1 0.730 39 PC2 0.720 40 PC1 0.700 41 PB2 0.560 42 PB1 0.550 43 PA2 0.530 44 PA1 0.510 45 BCI 0.510 34 group model rehabilitation groups: 46 RAD 0.000 47 RAC 0.000 48 RAB 0.000 49 RAA 0.000