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Hospitals Should Start Preparing Occupational Mix Data Now to Make the July 2017 Survey Deadline

by Glenn Bunting, Director, Health Care Practice

Short-term, acute-care hospitals participating in Medicare are required to collect and submit their data on occupational mix of employees to the Medicare Administrative Contractor (MAC) by July 1, 2017.

This survey applies to all pay periods ending between January 1, 2016, and December 31, 2016, and will be applied to the fiscal year 2019 wage index data. The estimated time to collect and complete these surveys is approximately 480 hours, or 12 weeks.

Failure to meet the deadline or reporting inaccurate information could cost an organization hundreds of thousands to millions of dollars in lost Medicare inpatient and outpatient reimbursement over a three-year period.

The Centers for Medicare & Medicaid Services (CMS) is required to collect this data every three years, according to Section 304(c) of Public Law 106-554 amended section 1886(d)(3)(E) of the Social Security Act. The law also requires the application of the occupational mix adjustment to each hospital’s wage index data.

Who's Affected

The survey is applicable to any hospital subject to the Inpatient Prospective Payment System (IPPS). The survey results will be applied to each hospital’s annual wage index information covering a three-year period.

Those that aren’t required to complete the survey include:

  • Critical access hospitals
  • No or low Medicare utilization providers
  • Hospitals that terminate participation in the Medicare program before January 1, 2016

What's Involved

CMS requires hospitals to summarize and submit employee payroll salary and paid hours information to their MAC. The payroll information must be identified by non-nursing personnel as well as nursing personnel, which includes RN, LPN, surgical techs, nursing aides, orderlies, attendants, and medical assistants, among others.

CMS also requires the inclusion of a proportionate share of home office and related organization payroll data; however, employees working in areas excluded from inpatient prospective payment systems aren’t reported. Additionally, contracted professional fee and hours information pertaining to outsourced services must also be reported by nursing and non-nursing categories.

We're Here to Help

Contact your Moss Adams professional if you’d like to understand more details about this survey and how your short-term, acute-care hospitals might prepare. Moss Adams Health Care Consulting has a dedicated team of Medicare reimbursement professionals who focus exclusively on wage index and occupational mix improvement.


Glenn Bunting has over 25 years of experience in the health care finance industry. He specializes in Medicare and Medicaid reimbursement issues, including wage index improvement and occupational mix survey reporting. He can be reached at (916) 503-8195 or glenn.bunting@mossadams.com.


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