Case Mix Reporting

The System uses Medicare Regions tables, RUG rates and Medicaid Case Mix Rates for specific states.

Each time you edit and exit an MDS record, the System calculates the ADL, Medicaid and Medicare PPS RUG scores for that record. This information is:

• Included on the printed MDS.
• Submitted with the electronic copy.
• Used for internal reporting.
• Shared with the Hi-Tech Resident Accounting System to include in claims.

Other Case Mix Reporting

• Print Case Mix Worksheets to gather responses used to calculate case mix.
• Use the Case Mix Calculator to preview a potential resident’s Case Mix score and how it will affect the facility average.
• Use the Case Mix Calculator to view how changes in MDS responses will affect the resident's case mix score.
• For states that use a Case Mix facility average to determine Medicaid reimbursement, view and compare scores and averages for current and prior quarters.
• If you use our Therapy module, print the Medicare Scheduled Assessments to learn the Optimal MDS Start Date to capture the most therapy time in an MDS record.
• Print Medicare Completed Assessments to review the RUG scores that will be submitted for Medicare and commercial PPS billing. If you integrate Clinical Records with Resident Billing, this information passes directly into the resident’s billing record.