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
September 30*

October 1 to
December 31*

January 1 to
March 31*

April 1 to
June 30*

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.

Record Selection and MDS Case Mix Calculation opens in a new tab (July 2007)

Long-Term Care Resources (NFs and ICFs/ID)

Reimbursement Resources Training - Nursing Facilities

Please click on one of the following links to be directed to specific resources available for that category:

Nursing Facilities
     - Rates

             - Historical Rates
     - FRV Calculator

     - MDS Case Mix Preview Report
     - QI Incentive Programs
     - Non-state Government Owned (NSGO)

          - UPL Program
          - Quality Improvement Program
     - Swing Bed Rates
     - Moratorium and Transfer of NF Beds
     - Additional Resources
ICF/ID
     - Rates
     - Incentive Programs
FCP and FRV Forms

Bed Assessment Rates

General Information

Via U.S. Post Office

Via UPS or FedEx

DHHS, Division of Integrated Healthcare

ORCA/Reimbursement

PO Box 143325

Salt Lake City, UT  84114-3325

DHHS, Division of Integrated Healthcare
ORCA/Reimbursement
288 North 1460 West
Salt Lake City, UT 84116-3231