2016 Occupational Mix Survey Hospital Reporting Form CMS-10079 for the Wage Index Beginning FY 2019

Section 304(c) of Public Law 106-554 amended section 1886(d)(3)(E) of the Social Security Act and requires CMS to collect data every 3 years on occupational mix of employees for each short-term, acute care hospital participating in the Medicare program. The zip file in the downloads section below contains two files. One is a PDF document which contains Form CMS-10079 (2016) and includes the 2016 Occupational Mix survey HOSPITAL form and instructions and definitions. The second file is an excel spreadsheet that has two tabs: One is the 2016 Occupational Mix survey form that HOSPITALS MUST complete and submit to their Medicare Administrative Contractor. The second tab contains the 2016 Occupational Mix survey hospital instructions and definitions. CMS requires that hospitals use the excel spreadsheet when hospitals submit their 2016 Occupational Mix survey data to their Medicare Administrative Contractor. Also included in this zip file are the relevant text files in order to meet 508 compliance.