Schedule 3 Committee of the Whole CCW of 5

Transcription

1 Schedule 3 Committee of the Whole CCW of 5 Mem o Electronic Delivery Only To: Jane Sinclair, General Manager Sunset Manor Home for the Aged From: Jeff Kwan, Vice President, Financial Health and Accountability North Simcoe Muskoka Local Health Integration Network (NSM LHIN) Date: January 23, 2018 Re: Long-Term Care (LTC) Case Mix Index (CMI) Results This memo serves as notice of your Case Mix Index (CMI) results that will be used to adjust your Nursing and Personal Care (NPC) funding in. For the year commencing April 1, 2018, the Ministry of Health and Long-Term Care has worked with the Long-Term Care (LTC) CMI Working Group which includes representation from Local Health Integration Networks (LHINs), LTC associations, and LTC homes to confirm the following decisions for CMI adjustment. These are designed to achieve a balance between maintaining funding stability in the sector while recognizing changes in relative home acuity as follows: Continue maintaining the 5% home level limit on Special Rehabilitation (SR) which means that a maximum of 5% of a home s assessed days will be assigned to the SR category in the calculation of the. Continue applying the negative 5% CMI funding floor, which ensures that no home will have a greater than 5% decrease in the CMI.

2 Schedule 3 Committee of the Whole CCW of 5 In the attached CMI spreadsheet, we are providing you with three important numbers. Home Level CMI This is the raw CMI value calculated from your MDS 2.0 assessments completed between April 2016 March 2017 SR Limited CMI This is the CMI value once the assessed days are limited to 5% in the SR case mix category. Any assessed days over 5% are assigned to the next highest non-sr case mix group This is the final CMI value that will be used to adjust NPC funding. It is determined by applying the re-indexing factor (which ensures fiscal neutrality across the province) to the SR Limited CMI and applying the funding floor if necessary In addition to the CMI spreadsheet showing the data used to calculate the numbers for your home, a home level Special Rehabilitation Limited CMI Calculator and a Funding Impact Calculator have also been provided. The Frequently Asked Question (FAQ) document attached provides details about the methodology used to calculate the various CMI numbers and additional information to help you interpret these numbers. The decision on any funding increases in the NPC envelope for the fiscal year will be made in Spring Additional information can be found on the ministry website ( and Ontario LTC Homes portal ( and questions may be sent to our HSFR Helpline via (HSF@ontario.ca). Thank you for your dedication to creating an equitably funded Long-Term Care system that will continue to deliver quality care for the people of Ontario.

3 Schedule 3 Committee of the Whole CCW of 5 Case Mix Index (CMI) Results for Long Term Care (LTC) Homes with Classified Beds Re-indexing Factor Assessment Period April 1, 2016 to March 31, Highlights for There were no methodological changes for CMI Calculation Continued application of 5% funding stabilization floor, no home would lose more than 5% in Funding CMI Notes: * Classified Bed Numbers are shown as they will appear in the April 2018 payment notice ** Special Rehabilitation (SR) Limited CMI is the facility level CMI when calculated with a maximum of 5% of assessed days assigned to the Special Rehab RUG category *** Funding CMI is the facility s SR Limited CMI multiplied by the re-indexing factor (unless the home was identified as an exception), limiting to a 5% decrease from Funding CMI ****1% per diem increment is a medeling assumption. Actual per diem change will be confirmed in Spring 2018 Facility Code LTC_ID NH_ID Home Name LHIN Name Classified Beds* % Assessed Days in Special Rehab Home Level CMI SR Limited CMI** *** % Change in from to ESTIMATED % funding impact change with 1% per diem increment**** H11839 Sunset Manor Home for Senior Citizens -The County of Simcoe North Simcoe Muskoka % % 9.6% Totals/Averages 77, % % 1.0%

4 Schedule 3 Committee of the Whole CCW of 5 Special Rehabilitation (SR) Limited Calculator Home Name : Sunset Manor Home for Senior Citizens -The County of Simcoe Facility Code : Assessment Period : April 1, 2016 to March 31, 2017 As Reported After Applying 5% Special Rehab Limit Provincial Values RUG III (34 Group) Assessed Days % Assessed Days % Weight (2009) RUG Weighted Patient Days (RWPD) (1) (2) (1) x (2) Assessed Days After Applying 5% Special Rehab Limit % 1 SE % % , , % 2 SE % % , , % 3 SE % 0 0.0% , % 4 RAD 3, % 2, % , , % 5 RAC % % , % 6 RAB % 0 0.0% , % 7 RAA 0 0.0% 0 0.0% , % 8 SSC 8, % 8, % , ,501, % 9 SSB % % , % 10 SSA 1, % 1, % , , % 11 CC2 4, % 4, % , ,045, % 12 CC1 1, % 1, % , , % 13 CB % % ,329, % 14 CB % % ,210, % 15 CA2 1, % 1, % , , % 16 CA % % , % 17 IB % % , % 18 IB1 8, % 8, % , ,143, % 19 IA % 0 0.0% , % 20 IA % % , % 21 BB % 0 0.0% , % 22 BB % % , % 23 BA % 0 0.0% , % 24 BA % 0 0.0% , % 25 PE % 1, % , , % 26 PE1 16, % 16, % , ,355, % 27 PD % % , % 28 PD1 1, % 1, % , ,861, % 29 PC % 0 0.0% , % 30 PC % 0 0.0% , % 31 PB % 0 0.0% , % 32 PB % % , % 33 PA % 0 0.0% , % 34 PA % % ,400, % Total Assessed Days (A) 53, % 53, % 27,731, % Total RUG Weighted Patient Days (B) 63, SR Limited Case Mix Index (CMI) (C) = B/A

5 Schedule 3 Committee of the Whole CCW of 5 Financial Impact Calculator Home Name: Sunset Manor Home for Senior Citizens -The County of Simcoe Facility Code: Calculation of Special Rehabilitiation (SR) Limited Case Mix Index (CMI) Re-Indexing Factor* Before Mitigation After Mitigation (If Applicable) Reference C D E =C x D Funding CMI values are limited to a 5% decrease from the previous Funding CMI Estimated Funding Impact Fiscal Year Reference Fiscal Year Estimated Annual NPC Funding Increment for Fiscal Year ** Nursing and Personal Care Base Per Diem Number of Classified Beds Calendar Days Estimated Approved Nursing and Personal Care Expenditures: F 1.00% G H I J 365 5,447,828 G x H x I x J 5,968,842 % Change from Prior Year $ Change from Prior Year $ per diem Change from Prior Year 9.56% 521, Notes: * The Re-indexing Factor = sum of previous weighted patient days divided by sum of current weighted patients days for all Ontario long-term care homes with classified beds. This factor is applied to all homes to ensure fiscal neutrality. ** 1% is a hypothetical number used for modeling purposes. Actual funding increments are subject to Ministry budget processes. Disclaimer: The estimated funding impact only considers the effect of CMI on the Nursing and Personal Care envelope for homes with classified beds. This funding estimator does not provide a complete picture for homes that have changed classifed bed numbers from