AN ACT Relating to nursing facility case mix classification methodology; and amending RCW 74.46.485.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:

Sec. 1.  RCW 74.46.485 and 2011 1st sp.s. c 7 s 4 are each amended to read as follows:

(1) The department shall:

(a) Employ the resource utilization group ((III)) IV case mix classification methodology. The department shall use the ((forty-four)) fifty-seven group index maximizing model for the resource utilization group ((III)) IV grouper version ((5.10)), but the department may revise or update the classification methodology to reflect advances or refinements in resident assessment or classification, subject to federal requirements. The department may not adjust ((the)) any resource utilization group case mix index ((for any of the lowest ten resource utilization group categories beginning with PA1 through PE2 to any case mix index that aids)) with the exception of the ten lowest case mix indices, based on the assigned numeric weights, and the categories of PC1 and PC2 when no behavior code is associated with the individual resident's assessment. Resource utilization groups may only be adjusted by the department if necessary to aid in achieving the purpose and intent of RCW 74.39A.007 and cost-efficient care; and

(b) Implement minimum data set 3.0 under the authority of this section ((and RCW 74.46.431(3))). The department must notify nursing home contractors twenty-eight days in advance the date of implementation of the minimum data set 3.0. In the notification, the department must identify for all semiannual rate settings following the date of minimum data set 3.0 implementation a previously established semiannual case mix adjustment established for the semiannual rate settings that will be used for semiannual case mix calculations in direct care until minimum data set 3.0 is fully implemented.

(2) A default case mix group shall be established for cases in which the resident dies or is discharged for any purpose prior to completion of the resident's initial assessment. The default case mix group and case mix weight for these cases shall be designated by the department.

(3) A default case mix group may also be established for cases in which there is an untimely assessment for the resident. The default case mix group and case mix weight for these cases shall be designated by the department.

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