CSC Proprietary 1 Analytic Resources on DAVE People: Technical Expert Panel Analytic Workgroup Statistical and infrastructure support within the DAVE team.

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CSC Proprietary 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

CSC Proprietary 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

CSC Proprietary 3 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. Patterns and Trends in SNF Care

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

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

CSC Proprietary 6 Length of Stay Varies Across Site & Ownership Type (CY2000) Patterns and Trends in SNF Care 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. Facility Type Differences Ownership Type Differences

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

CSC Proprietary 8 Preliminary Review Result Findings Common Discrepancies in Offsite Review:

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

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

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