2023 Ohio Revised Code › Title 51 | Public Welfare › Chapter 5124 | Intermediate Care Facility for Individuals With Intellectual Disabilities Services › Section 5124.192 | Acuity Groups for Purpose of Assigning Case-Mix Scores.

Effective:
July 1, 2018
Latest Legislation:
House Bill 24 - 132nd General Assembly
(A) The department of developmental disabilities shall establish six acuity groups for the purpose of assigning case-mix scores to ICF/IID residents. An ICF/IID resident's case-mix score shall be the score of the resident's acuity group as specified in rules authorized by this section.
(B) The department shall place each ICF/IID resident into one of the acuity groups. In determining which acuity group an ICF/IID resident is to be placed into, the department shall do all of the following:
(1) In accordance with rules authorized by this section and using the most recent resident assessment data for the ICF/IID resident available to the department, calculate for the resident an assessment score for each of the medical, behavioral, and adaptive skills domains on the resident assessment instrument used to compile or revise assessment data for ICF/IID residents under section 5124.191 of the Revised Code;
(2) For each of the ICF/IID resident's domain assessment scores and using values specified in rules authorized by this section, assign the following points:
(a) If the resident's assessment score for the domain is more than one standard deviation above the mean assessment score for the domain for all ICF/IID residents as of December 31, 2017, one point;
(b) If the resident's assessment score for the domain is more than one-half standard deviation above the mean assessment score for the domain for all ICF/IID residents as of December 31, 2017, and not more than one standard deviation above that mean, two points;
(c) If the resident's assessment score for the domain is more than the mean assessment score for the domain for all ICF/IID residents as of December 31, 2017, and not more than one-half standard deviation above that mean, three points;
(d) If the resident's assessment score for the domain is not more than the mean assessment score for the domain for all ICF/IID residents as of December 31, 2017, and not more than one-half standard deviation below that mean, four points;
(e) If the resident's assessment score for the domain is more than one-half standard deviation below the mean assessment score for the domain for all ICF/IID residents as of December 31, 2017, and not more than one standard deviation below that mean, five points;
(f) If the resident's assessment score for the domain is more than one standard deviation below the mean assessment score for the domain for all ICF/IID residents as of December 31, 2017, six points.
(3) Using the following weights, determine the weighted sum of the points assigned under division (B)(2) of this section to each of the ICF/IID resident's domain assessment scores and round the weighted sum to the nearest whole number:
(a) Points assigned to the resident's assessment score for the medical domain shall be weighted at thirty-five per cent.
(b) Points assigned to the resident's assessment score for the behavioral domain shall be weighted at thirty per cent.
(c) Points assigned to the resident's assessment score for the adaptive skills domain shall be weighted at thirty-five per cent.
(4) Place the ICF/IID resident into the following acuity group:
(a) If the resident's weighted sum of points is five or lower, group one;
(b) If the resident's weighted sum of points is at least six and not more than eight, group two;
(c) If the resident's weighted sum of points is nine or ten, group three;
(d) If the resident's weighted sum of points is eleven or twelve, group four;
(e) If the resident's weighted sum of points is at least thirteen and not more than fifteen, group five;
(f) If the resident's weighted sum of points is sixteen or higher, group six.
(C)(1) The director of developmental disabilities shall adopt rules under section 5124.03 of the Revised Code as necessary to implement this section, including rules that do all of the following:
(a) Subject to division (C)(2) of this section, specify case-mix scores for each acuity group established under this section;
(b) Prescribe a methodology for calculating assessment scores for the medical, behavioral, and adaptive skills domains on the resident assessment instrument used to compile or revise assessment data of ICF/IID residents under section 5124.191 of the Revised Code;
(c) Specify values to be used in assigning points to domain assessment scores.
(2) The case-mix score specified for an acuity group shall be based on relative resource use by ICF/IID residents who are placed in the group and were included in a time study of ICF/IID residents performed by the department.