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Analytic Resources on DAVE

Analytic Resources on DAVE. People: Technical Expert Panel Analytic Workgroup Statistical and infrastructure support within the DAVE team Expertise from prior contractors Data: SNF Stay File 36 months of all MDS assessments from national warehouse

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Analytic Resources on DAVE

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  1. Analytic Resources on DAVE • People: • Technical Expert Panel • Analytic Workgroup • Statistical and infrastructure support within the DAVE team • Expertise from prior contractors • Data: • SNF Stay File • 36 months of all MDS assessments from national warehouse • 18 months of national Medicare claims data (parts A & B) • Other CMS data on providers and chains

  2. Patterns and Trends in SNF Care RH is the most common RUG on 5-Day MDS Assessments Understanding how providers respond to payment changes is a goal

  3. Patterns and Trends in SNF Care Changes in the Percent of Assessments within Rehab Categories from 1999 to 2001 • The percentage of RH cases has dropped for hospital based units but increased for freestanding ones. • The increase in RH in freestanding units is due to a decline in the percent of cases in RU and RV. • Outcomes and processes in freestanding and hospital based units are so different that we are examining them as separate groups.

  4. Patterns and Trends in SNF Care Percent of RH Therapy at 5 Day Assessment Based on Provided rather than Ordered Therapy Both the GAO and CMS are closely monitoring the use of ordered therapy.

  5. Patterns and Trends in SNF Care Average LOS for RH Residents in Freestanding SNF Units (CY 2000) Resident population, access to home health, and Medicaid coverage may account for differences

  6. Patterns and Trends in SNF Care Length of Stay Varies Across Site & Ownership Type (CY2000) Ownership Type Differences Facility Type Differences Review activity will allow DAVE to determine whether facilities with longer lengths of stay tend to have more days denied because medical necessity was lacking.

  7. Patterns and Trends in SNF Care State Differences in the Percent of Medicare Residents who Remain in SNF after Medicare coverage ends (CY 2000) Differences reflect substantial variation in the percentage of residents receiving skilled care who already resided in a Nursing Facility

  8. Preliminary Review Result Findings Common Discrepancies in Offsite Review:

  9. Preliminary Review Result Findings Common Discrepancies in Onsite Retrospective Reviews of Medicaid:

  10. Preliminary Review Result Findings Common Discrepancies in Onsite Two Staged Reviews of Medicare:

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