CMI-case mix index is a relative value assigned to a DRG group of patients in a medical care environment. The value is used in determining the allocation of resources for the residents.

It is a metric that is typically driven by the MDS nurse or the MDS resource. My hypothesis is that if the DORs are the owners of the process that there will be an increase in building CMI.


I began by sending a spreadsheet with all of the buildings in my cluster to the EDs and the DORs. I tracked the CMI of each building daily as well as the CMI of another cluster for comparison.  There was also in-depth analysis of each building’s RUGs during the course of the month to engage dialogue amongst the DORs and the EDs to problem-solve ways in which we can improve the process.


The findings in May indicated 10.4 percent growth of the Cluster CMI over the 2017 cluster average and increased the adjusted Medicaid revenue by $74,000 over the prior month.

Results were promising, so it was rolled out in another cluster.

Early findings are promising in that with rehab being the driving force behind the building’s CMI, there will be an increase. By nature, therapists are problem solvers and DORs are number analyzers. The management of CMI combines two of the greatest strengths of a rehab department, plus you add in our passion to enhance the quality of life of our residents, and everyone ends up winning.

View poster: CMI: The New DOR Metric (PDF format)

By Andy Cisneros, TPM/PTA, Legend West San Antonio, San Antonio, TX