Trends in North Carolina Medicaid

Based on the latest data from the state of North Carolina, we can look at trends for Medicaid in skilled nursing in the state. Overall, average case-mix is up significantly, continuing a long term climbing trend. Keep in mind that in North Carolina, if the mean case-mix is increasing while your facility case-mix stays constant, your pay can go down. In other words, if the case-mix at your building is flat, your pay could be going down.


As you probably know, there are two main drivers for case-mix under the 34 grouper: therapy and ADL scores. We’ll take a look at both.


After a couple of flat quarters, the percentage of residents in therapy has risen by one percentage point. This would certainly drive the case-mix index up.


ADL Scores

Over this same time period, average ADL scores declined slightly. In North Carolina average ADL scores tend not to move much. 


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