Disclosures: Sterling Haring, DO, MPH: Nothing to disclose

Objective: To test hypothesis that a targeted intervention aimed at capturing specific comorbidities among patients admitted to inpatient rehabilitation would increase Case Mix Index (CMI) as a measure of patient acuity.

Design: Single-site trial.

Setting: 80-bed academic inpatient rehabilitation hospital affiliated with a large quaternary academic medical center

Participants: Thirteen rehabilitation physicians and nurse practitioners.

Interventions: A single resident conducted independent review of the acute care charts of all patients admitted to the inpatient rehabilitation hospital at the time of admission. Screening was conducted for a list of specific comorbidities identified by CMS as Tiered Comorbidities for FY 2019. When diagnoses were identified, the screener communicated the finding to the admitting team and hospital coding staff. Targeted re-visitation

Main Outcome Measures: Case Mix Index

Results: In the 3 months prior to the intervention, CMI was an average of 142.3 (range 140-143, annual mean 143). In the first 4 weeks of the intervention, mean CMI rose to 1.65; at time of writing, in-house CMI is 1.80.

Conclusions: Review of acute care records at time of admission by a clinician familiar with IRFPAI Tiered Comorbidities can increase the capture rate of relevant comorbidities, thereby increasing the accuracy of medical acuity measurement.

Level of Evidence: Level IV

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/improving-case-mix-index-and-accuracy-of-acuity-measurement-in-the-inpatient-setting/