Medicaid RUG and Medicaid Case Mix Professional CHHI-RUG (1-Day) - March 28th

Medicaid RUG and Medicaid Case Mix Professional CHHI-RUG (1-Day) - March 28th

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Service and Performance Requirements

A Competent Harmony Healthcare Medicaid RUG and Medicaid Case Mix Professional (CHHI-RUG) is an interdisciplinary team member who successfully completes this 3 Day intensive, clinically founded training, geared towards providing and documenting outstanding patient care while understanding regulatory requirements and reimbursement related to Medicaid RUG and Medicaid Case Mix in a Skilled Nursing Facility (SNF) setting. This program is interactive with a focus on practical application for the clinical staff and interdisciplinary team. 

This 8 hour course will provide a general overview of all 50 states and delineate which states utilize an MDS RUG Based Medicaid Reimbursement System, identify the basic method of reimbursement, as well as whether the state incorporates Value-Based Purchasing Quality Incentive Measures into the model.  The session will focus on the below listed states:

  1. Alabama (not a CMI state)
  2. Alaska (not a CMI state)
  3. Arizona (not a CMI state)
  4. Arkansas (not a CMI state)
  5. California RUG-III 34 and Add-On
  6. Colorado RUG-III 34
  7. Connecticut RUG-IV 48 CMI and Add-On
  8. Delaware (not a CMI state)
  9. District of Columbia RUG-IV 48 (refresher) and Add-On
  10. Florida Add-On (not a CMI State)
  11. Georgia RUG-III 34
  12. Hawaii RUG-III 34
  13. Idaho RUG-IV 48
  14. Illinois RUG-IV 48
  15. Indiana RUG-IV 48
  16. Iowa RUG-III 34
  17. Kansas RUG-III 34Texas RUG-III 34, QUIPP-4 measures, Add-On: (QAPI, RN, IP, QM)
  18. Kentucky RUG-III 34 and Add-On
  19. Louisiana RUG-III 34
  20. Maine RUG-III 44
  21. Maryland RUG-IV 48
  22. Massachusetts Add-On MMQ (not a CMI State)
  23. Michigan (not a CMI State)
  24. Minnesota RUG-IV 48
  25. Missouri Add-On (not a CMI state)
  26. Montana RUG-III 34
  27. Nebraska RUG-III 34
  28. Nevada RUG-III 34
  29. New Hampshire RUG-IV 48
  30. New Jersey (not a CMI state)
  31. New Mexico (not a CMI state)
  32. North Carolina RUG-III 34 and Add-On
  33. North Dakota RUG-III 34 
  34. Ohio RUG-IV 57, Ventilator and Pneumonia and Add-On
  35. Oklahoma (not a CMI state)
  36. Oregon (not a CMI state)
  37. Pennsylvania RUG-III 44 
  38. Puerto Rico (not a CMI state)
  39. Rhode Island RUG-IV 48
  40. South Carolina Add-On (not a CMI state)
  41. South Dakota RUG-III 34 
  42. Tennessee RUG-IV 48, QuiLTS and Add-On
  43. Texas RUG-III 34
  44. Utah RUG-III 34
  45. Vermont RUG-IV 48
  46. Virginia RUG-IV 48 (refresher) and Add-On
  47. Washington RUG-IV 57
  48. West Virginia RUG-III 34
  49. Wisconsin RUG-IV 48
  50. Wyoming (not a CMI state)

The HHI Medicaid RUG and Medicaid Case Mix 1 day course offers participants a comprehensive understanding of Medicaid Reimbursement in the context of:

Overview                                                       Medicaid RUG:  Day 1

RUG Levels/Strategies and Documentation    Medicaid RUG:  Day 1

Recommended Audience

CEOs, COOs, Administrators, MDS Coordinators, Nurse Managers, Rehabilitation Managers, Nurses, Occupational Therapists, Physical Therapists, Speech Language Pathologists, Business Office Managers, Admissions Directors, and Social Services.


This program will enable healthcare providers to enhance quality of care through an improved understanding of the state specific Medicaid and Value-Based Purchasing reimbursement system.

Learning Outcomes

  1. Learner to identify whether the state Medicaid reimbursement system is Case Mix, MDS Based.
  2. Learner to identify whether the state Medicaid reimbursement system is based on Quality Incentive Program.
  3. Learner to identify the state-specific, Medicaid Case Mix and Quality Incentive reimbursementnuances.


Day 1 Agenda
8:30 a.m. to 11:45 a.m.

8:30 a.m. – 10:30 a.m.

  • Overview/Case Mix and Quality Incentives
  • RUG-III 34
  • California, Colorado, Georgia, Hawaii, Iowa, Kansas, Kentucky, Louisiana, Montana, Nebraska, Nevada, North Carolina, North Dakota, South Dakota, Texas, Utah, West Virginia

10:30 a.m. – 10:45 a.m.


10:45 a.m. – 11:45 a.m.

  • RUG-III 44
    • Maine, Pennsylvania

11:45 a.m. – 12:15 p.m.


Day 1 Agenda
12:15 p. m. to 5:45 p.m.

12:15 p.m. – 2:15 p.m. 

  • RUG-IV 48
    • Connecticut, District of Columbia, Idaho, Illinois, Indiana, Maryland, Minnesota, New Hampshire, Rhode Island, Tennessee, Vermont, Virginia, Wisconsin
  • RUG-IV-57
  • Ohio, Washington

2:15 p.m. – 2:30 p.m. 


2:30 p.m. – 4:30 p.m.

  • Non-CMI States
    • Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Michigan, Missouri, New Jersey, New Mexico, Oklahoma, Oregon, Puerto Rico, South Carolina, Wyoming
  • MMQ
    • Massachusetts

4:30 p.m. – 4:45 p.m.


4:45 p.m. – 5:45 p.m. 

  • Strategies and Documentation

    Contact Hours

    NAB: 8
    ANCC: 8