Case Mix Certification Rule for Inpatient Rehabilitation Facilities

by Grace M. Carter, Orla Hayden, Susan M. Paddock, Barbara O. Wynn

Download eBook for Free

FormatFile SizeNotes
PDF file 0.2 MB

Use Adobe Acrobat Reader version 10 or higher for the best experience.

To be classified as an inpatient rehabilitation facility (IRF), a hospital or unit must show that during its most recent 12-month cost reporting period, it served an inpatient population of whom at least 75 percent required intensive rehabilitation services for one of ten specified conditions. For the sake of brevity we denote this rule as the “75% rule.” The purpose of this 75% rule is to ensure that IRFs are primarily involved in providing intensive rehabilitation services. In early 2002, Medicare and Medicaid Services (CMS) instituted a comprehensive review of this policy with the intent of understanding whether potential policy or administrative changes are needed. This report provides a description of case mix at IRFs as input to that review.

This report is part of the RAND Corporation draft series. The unrestricted draft was a product of the RAND Corporation from 1993 to 2003 that represented preliminary or prepublication versions of other more formal RAND products for distribution to appropriate external audiences. The draft could be considered similar to an academic discussion paper. Although unrestricted drafts had been approved for circulation, they were not usually formally edited or peer reviewed.

Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.