Long-Term Care Resources (NFs and ICFs/ID)
If you submit corrections to your MDS data, please submit them through the normal process – do not send them to the Reimbursement Unit.
The Minimum Data Set (MDS) Case Mix Preview Report provides detailed information relating to the case mix for your facility’s next quarter’s rate calculation. You will be able to see what records will be included in the calculation and adjust errors as needed. If received in time, the corrected assessment records will be included in the final case mix calculation.
Note: MDS corrections, accepted by CMS, are reported back to Medicaid with an approximate three-day lag. For example: The April 1 case mix is calculated using data that was extracted on, or about, the last business day of February. MDS corrections submitted within the three-day reporting lag are unlikely to arrive to Medicaid in time to be included in the calculation.
When to request the MDS Case Mix Preview Report
The report will be available approximately two months prior to the rate effective date.
Jan. 1 Rate | Apr. 1 Rate | Jul. 1 Rate | Oct. 1 Rate | |
MDS Period of Interest | July 1 to | October 1 to | January 1 to | April 1 to |
When should you request the report? | Around November 1** | Around February 1** | Around May1** | Around August 1** |
When should you submit corrections to the MDS data? | Within 14-days of identifying the error, or as stated in the RAI Manual. |
* Or as stated in the Utah State Plan or Rule
** Requests submitted before the data is available, will be held until the data is available.
Calendar Month | State Quarter | |
7 | Jul | Q1 |
8 | Aug | |
9 | Sep | |
10 | Oct | Q2 |
11 | Nov | |
12 | Dec | |
1 | Jan | Q3 |
2 | Feb | |
3 | Mar | |
4 | Apr | Q4 |
5 | May | |
6 | Jun |
MDS Case Mix Request
The MDS Case Mix Preview request process requires users to certify their understanding and compliance with the requirements for viewing, sharing, and destroying MDS Case Mix Preview Reports.
Please use the MDS Case Mix Preview Request Form opens in a new tab to request a report.
Additionally, individuals using MDS Case Mix information should understand the following:
- Requests must include the current, and correct, facility 12-digit Medicaid ID.
- The preview report contains confidential health information that is legally privileged.
- The preview report is intended only for the use of the individual(s) specified in the report header.
- Unauthorized re-disclosure or failure to maintain confidentiality could subject you to penalties described in federal and state law (i.e., $10,000 per record - not report,but each line of the report).
- Case mix requests with missing or incorrect information will be returned. The requestor will need to submit a new request.
Long-Term Care Resources (NFs and ICFs/ID) | |
Please click on one of the following links to be directed to specific resources available for that category: Nursing Facilities - MDS Case Mix Preview Report - UPL Program |
General Information | Via U.S. Post Office | Via UPS or FedEx |
801-538-6122 | DHHS, Division of Integrated Healthcare ORCA/Reimbursement PO Box 143325 Salt Lake City, UT 84114-3325 | DHHS, Division of Integrated Healthcare |