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Occupational Mix Survey: What You Need to Know

Every three years, the Centers for Medicare and Medicaid Services (CMS) requires any Hospital that is subject to the Inpatient Prospective Payment System (IPPS) to complete an Occupational Mix Survey (OMS).

This data is then used to calculate an Occupational Mix Adjustment Factor (OMAF). The occupational mix adjustment impacts a hospital’s average hourly wage and even the smallest change can have a significant reimbursement impact.

What is an Occupational Mix Adjustment?

The purpose of the occupational mix adjustment is to account for the regional differences in cost of wages and control the effect of hospitals’ employment choices on the wage index. Typically, rural hospitals have a less-skilled labor mix resulting in a smaller average hourly wage compared to hospitals in larger markets. CMS developed the OMAF to account for the disparity in labor mix.

What is an Occupational Mix Survey?

The Occupational Mix Survey calculates average hourly wages for occupational categories determined by CMS using paid salaries and hours data from the hospital’s payroll system. Payroll data is summarized on the OMS using the occupational categories below.

The CMS instructions for the OMS include descriptions for each category to assist hospitals when analyzing each job function:

  • Registered Nurses (RNs)
  • Licensed Practical Nurses (LPNs), Licensed Vocational Nurses (LVNs), and Surgical Technologists
  • Nursing Assistant and Orderlies
  • Medical Assistants
  • All Other Occupations (non-nursing employees)

Distinguishing between categories is essential and can oftentimes be difficult for hospitals which leads to errors or filing an inaccurate survey. Submitting the occupational mix survey as accurately as possible is imperative for developing a hospital’s wage index and can significantly impact reimbursement.

Take the Stress Out of Completing the Occupational Mix Survey

Blue & Co.’s experience with the occupational mix survey and assisting our hospital clients over the years allows us to bring a unique approach to completing the survey.

We believe the combination of our knowledge of the survey instructions, along with working alongside multiple members of departments within the Hospital, we can ensure proper category assignments, especially if your hospital has employees working in various roles.

Although we are still waiting on formal guidance from CMS, we anticipate the occupational mix surveys will be due in early July of 2023 and will need to be completed using 2022 calendar year information.

If your hospital needs assistance completing the occupational mix survey or is looking for education on how the survey impacts your reimbursement, our team is here to help.

Contact Us

For questions related to the 2022 Occupational Mix Survey or if assistance is needed to complete the survey, please reach out to your local Blue & Co. Advisor or a member of our reimbursement team below.

Kyle Smith, CPA, 340B ACE, Director
317-713-7957 | kcsmith@blueandco.com

Carolyn Chaplin, CPA, Senior Reimbursement Manager
317-713-7919 | cchaplin@blueandco.com

Austin Fisher, CPA, Senior Reimbursement Manager
317-275-7438 | afisher@blueandco.com

Clint Brill, CPA, Senior Reimbursement Manager
502-992-3512 | cbrill@blueandco.com

Jacob Wethington, CPA, Reimbursement Manager
614-222-4770 | jwethington@blueandco.com

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