(1) Each case mix classification group shall be assigned a case
mix weight. The case mix weight for each resident of a nursing
facility for each calendar quarter or six-month period during a
calendar year shall be based on data from resident assessment
instruments completed for the resident and weighted by the number
of days the resident was in each case mix classification group.
Days shall be counted as provided in this section.
(2) The case mix weights shall be based on the average
minutes per registered nurse, licensed practical nurse, and
certified nurse aide, for each case mix group, and using the
United States department of health and human services nursing
facility staff time measurement study. Those minutes shall be
weighted by statewide ratios of registered nurse to certified
nurse aide, and licensed practical nurse to certified nurse aide,
wages, including salaries and benefits, which shall be based on
cost report data for this state.
(3) The case mix weights shall be determined as follows:
(a) Set the certified nurse aide wage weight at 1.000 and
calculate wage weights for registered nurse and licensed
practical nurse average wages by dividing the certified nurse
aide average wage into the registered nurse average wage and
licensed practical nurse average wage;
(b) Calculate the total weighted minutes for each case mix
group in the resource utilization group classification system by
multiplying the wage weight for each worker classification by the
average number of minutes that classification of worker spends
caring for a resident in that resource utilization group
classification group, and summing the products;
(c) Assign the lowest case mix weight to the resource
utilization group with the lowest total weighted minutes and
calculate case mix weights by dividing the lowest group's total
weighted minutes into each group's total weighted minutes and
rounding weight calculations to the third decimal place.
(4) The case mix weights in this state may be revised if the
United States department of health and human services updates its
nursing facility staff time measurement studies. The case mix
weights shall be revised, but only when direct care component
rates are cost-rebased as provided in subsection (5) of this
section, to be effective on the July 1st effective date of each
cost-rebased direct care component rate. However, the department
may revise case mix weights more frequently if, and only if,
significant variances in wage ratios occur among direct care
staff in the different caregiver classifications identified in
this section.
(5) Case mix weights shall be revised when direct care
component rates are cost-rebased as provided in RCW 74.46.431(4).
[2011 1st sp.s. c 7 § 5; 2010 1st sp.s. c 34 § 10; 2006 c 258 § 4; 1998 c 322 § 23.]
NOTES:
Purpose -- Findings -- Intent -- Severability -- Effective date -- 2011 1st sp.s. c 7: See RCW 74.48.005, 74.48.900, and 74.48.901.
Analysis -- 2011 1st sp.s. c 7: See note following RCW 74.46.431.
Effective date -- 2010 1st sp.s. c 34: See note following RCW 74.46.010.
Effective date -- 2006 c 258: See note following RCW 74.46.020.