Nursing Facility Providers
This section contains information for Medical Assistance providers regarding Long-Term Care and Case Mix. Most of the information in this section was previously on the Long-Term Care Bulletin Board System.
In addition to the items listed below, please look under the "Related Topics" for information that you may find helpful.
Advance Public Notices for New Nursing Facility Rate Setting
Payment for County Nursing Facility Services
Payment for Nursing Facility Services Provided by General Nursing Facilities
Schedule of Regional Meetings
County CMI's in Pennsylvania
The Case-Mix Index (CMI) statewide averages in Pennsylvania MA nursing facilities using RUG-III Pennsylvania-normalized "nursing only" CMIs. Only non-defaulted assessments for facilities with valid CMI Reports are used in the average. The total facility Average CMI for County Facilities and the average MA CMI for county facilities is shown below:
CMI – County Only
|Picture Date||Total Facility||Average|
The Interpretative Guidelines * are to assist nursing facilities with understanding interpretations of the 1187 Nursing Facility regulations used during audits of the MA-11 Cost Reports. These Guidelines are intended to be a continuous work in progress between the Department and the industry.
*This document is in Adobe PDF format. You must have a copy of Adobe Acrobat Reader installed on your system to view them.
PA MSA Designations
The MSA is a statistical standard classification designated and defined by the Federal Office of Management and Budget (OMB). Pennsylvania uses MSA designations as defined in OMB Bulletin No. 99-04 in the rate setting process for nonpublic nursing facilities. See § 1187.94 (relating to peer grouping for price setting). In addition, MSAs are used in defining a bed transfer request. See § 1187.162 (relating to definitions).
PA MSA Designations List
PA MSA Designations MAP