Q4 2018 North Carolina Medicaid Data


The data used to set rates for skilled nursing facilities in North Carolina for the final quarter of 2018 is here. We mine this data every quarter for not only trends but to also identify opportunities for us and our clients. I’ll summarize the major points here.

Overall case-mix index continues to climb. No surprise here. In each state that implements case-mix, the index tends to rise over time. North Carolina is no exception. (In states under case-mix for a very long time I’ve seen rehab as high as 70% for Medicaid.) As you can see in the image to the right (click to enlarge), the latest increase of 0.0088 is not the highest we’ve seen but is significant.

ADL scores continue to fall. This one is more surprising given how important ADL scores are. I don’t know what exactly drives this trend but I do have a suspicion. (click to enlarge) Don’t let this happen to you. ADL scores are important. Contact us for help training!

click to enlarge

Rehab continues to dominate the Medicaid categories. This quarter continues a trend of rehab taking more patients from Reduced Physical Function and others. What makes this quarter more interesting than most is for the first time in a while we have a reduction in extensive services. The Rehab category picked up an unusually high 4%. This is what is driving the increase in overall case-mix, especially in light of the overall reduction in average ADL scores.

The number of people on Medicaid in skilled nursing facilities remains largely unchanged. It’s been higher. It’s been lower. It’s only about 70 people lower than the average for the past 6 quarters.


We have data for your facility as well if you’d like to see how you building looks compared to averages or your nearby peers. Contact me for more information!