(1) The department will prepare and distribute resident listings to facilities by the 15th day of the third month of each quarter (cut off date) . The listings will identify current assessments for residents in the nursing facility on the first day of the second month of each quarter as reflected in the database maintained by the department. The listings will identify resident social security numbers, names, assessment reference date, the calculated RUG-III category and the payor source. Resident listings shall be signed and returned to the department by the 15th day of the first month of the following calendar quarter. Facilities who do not return this corrected resident listing by the due date will use the database information on file in their case mix calculation.
(2) If data reported on the resident listings is in error or if there is missing data, facilities will have until the 15th day of the first month of each calendar quarter to correct data submissions.
(a) Errors or missing data on the resident listings due to untimely submissions to the CMS database maintained by the Department of Public Health and Human Services (DPHHS) are corrected by transmitting the appropriate assessments or tracking documents to DPHHS in accordance with CMS requirements.
(b) Errors in key field items are corrected following the CMS key field specifications through DPHHS.
(c) Errors on the current payor source should be noted on the resident listings prior to signing and returning to DPHHS.
(3) The department may also use Medicaid paid claim data to determine the Medicaid residents in each facility when determining the Medicaid average case mix index for each facility.