# RCW 74.46.485: RCW 74.46.485: Case mix method implementation

> Washington · Statutes · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S485

## Section

- **Citation:** RCW 74.46.485
- **Heading:** RCW 74.46.485: Case mix method implementation
- **Jurisdiction:** Washington
- **Kind:** Statutes
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Washington Code / Title 74 / Chapter 46 / Section 485

## Text

(1) The legislature recognizes that staff and resources needed to adequately care for individuals with cognitive or behavioral impairments is not limited to support for activities of daily living. Therefore, the department shall: (a) Beginning July 1, 2024, implement a method for applying case mix to the rate. This method should be informed by the minimum data set collected by the centers for medicare and medicaid services; (b) Subject to the availability of amounts appropriated for this specific purpose, employ the case mix adjustment method to adjust rates of individual facilities for case mix changes; (c) Upon the discontinuation of resource utilization group's scores, and in collaboration with appropriate stakeholders, create a new case mix adjustment method for adjusting direct care rates based on changes in case mix using the patient-driven payment method; (d) By December 1, 2024, provide an initial report to the governor and appropriate legislative committees outlining a phased implementation plan; and (e) By December 1, 2026, provide a final report to the appropriate legislative committees. These reports must include the following information: (i) An analysis of the potential impact of the new case mix classification methodology on nursing facility payment rates; (ii) Proposed payment adjustments for capturing specific client needs that may not be clearly captured in the data available from the centers for medicare and medicaid services; and (iii) A plan to continuously monitor the effects of the new methodologies on each facility to ensure certain client populations or needs are not unintentionally negatively impacted. (2) A default case mix group shall be established for cases in which the resident dies or is discharged for any purpose prior to completion of the resident's initial assessment. The default case mix group and case mix weight for these cases shall be designated by the department. (3) A default case mix group may also be established for cases in which there is an untimely assessment for the resident. The default case mix group and case mix weight for these cases shall be designated by the department.

## Nearby sections

- [RCW 74.46.010 RCW 74.46.010: Short title—Purpose—Finding.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S010.md)
- [RCW 74.46.020 RCW 74.46.020: Definitions.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S020.md)
- [RCW 74.46.022 RCW 74.46.022: Nursing facility medicaid payment system—Establishing procedures, principles, and conditions.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S022.md)
- [RCW 74.46.024 RCW 74.46.024: Pay-for-performance supplemental payment structure—Establishing procedures, principles, and conditions.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S024.md)
- [RCW 74.46.421 RCW 74.46.421: Purpose of part E—Nursing facility medicaid payment rates.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S421.md)
- [RCW 74.46.441 RCW 74.46.441: Public disclosure of rate-setting information.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S441.md)
- [RCW 74.46.475 RCW 74.46.475: Submitted cost report—Analysis and adjustment by department.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S475.md)
- [RCW 74.46.485 RCW 74.46.485: Case mix method implementation.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S485.md)
- [RCW 74.46.496 RCW 74.46.496: Case mix weights—Determination.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S496.md)
- [RCW 74.46.501 RCW 74.46.501: Average case mix indexes determined quarterly—Facility average case mix index—Medicaid average case mix index.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S501.md)
- [RCW 74.46.531 RCW 74.46.531: Department may adjust component rates—Contractor may request—Errors or omissions.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S531.md)
- [RCW 74.46.541 RCW 74.46.541: Skilled nursing facility safety net assessment—Reimbursement of medicaid share.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S541.md)
- [RCW 74.46.551 RCW 74.46.551: Facility-based payment rates—Comparative analysis—Rate add-ons.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S551.md)
- [RCW 74.46.561 RCW 74.46.561: Nursing home payment rates—System components—Quality incentive—Reimbursement of safety net assessment—Rate reductions or increases limited.](https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S561.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_WA_T74_C46_S485. Check the current official text before relying on it. Not legal advice.