Nursing facilities across the country were left scrambling when CMS updated their Case-Mix HRD calculation last year. It was a brand-new way to calculate the Case-Mix HRD with no predictable baseline. This change was significant – the shockwaves of the new calculation method are still being felt across the industry today, almost a year later.

In fact, the change brought over a 20% increase of the National Average of Total Nursing Case-Mix HRD from 2023 to 2024, and a whopping 70% increase for the National Average of RN Case-Mix HRD for the same time period.

Knowing the impact this would bring to the industry, SimplePBJ™ was the first PBJ solution to provide a live Case-Mix prediction early in 2024. We combined tools from our SimpleAnalyzer™ and SimplePBJ™ products to calculate the PDPM Case-Mix using real-time MDS data.

The disruption has been felt outside of nursing homes as well – from technical solutions to state entities both struggling to accurately capture the new calculation method. In fact, the Simple team identified a key error in how one state was calculating some PDPM values.

As part of our ongoing effort to offer valuable data tools, Simple has been developing updates to improve our Case-Mix prediction accuracy. After working closely with CMS and PDPM experts, Live Case-Mix calculations from Simple are now more accurate than ever.

Where can I see my updated predictions?

If you are a SimplePBJ™ user who also subscribes to our SimpleAnalyzer™ (MDS analytics) product, be sure to check out your Five-Star Prediction in SimplePBJ™. If you have already submitted your PBJ file for the quarter (congrats!) you’ll also want to revisit your Predict Five-Star to see the latest and most accurate prediction of your Five-Star staffing score.

What is the benefit of this calculation?

Measuring Case-Mix data in real time means SimplePBJ™ customers will not have to wait 3-6 months to see updated Case-Mix values from CMS.

How much does it cost?

This feature is included with the existing subscription costs of SimplePBJ™ Pro and SimpleAnalyzer™.

How do I access the PDPM Case-Mix predictor?

If your organization uses both SimplePBJ™ and SimpleAnalyzer™, this tool is now available to you in SimplePBJ™ on the Predict Five-Star page.