Rug 66 Classification System

Cms updates federal rates annually.

Rug 66 classification system.

Texas medicaid adjusts the rug 34 relative risk weights to reflect local practice to establish person level payments. Rug iv classification system 66 group with medicare case mix indices for 10 1 2010. Use the hierarchical classification worksheet in chapter 6 of the rai manual. Rug iii version 5 2 calculator worksheet 34 group model.

The aim of the rug refinement is to improve the ability of the existing rug iii classification system to explain non therapy ancillary nta costs. The simplified rehabilitation classification in the 48 group model is better suited for long term care. Rug iv is a patient classification system for skilled nursing patients used by the federal government to determine reimbursement levels. Determine all of the rug iv groups for which a resident qualifies not just the first group for which the resident qualifies.

Rug iv classification system 66 group with medicare case mix indices for 10 1 2010 instructions. In the rug iv 48 group model compared to the rug iv 66 medicare group model the rehabilitation groups have been collapsed from 23 to 5 groups and the different levels of rehabilitation service are only distinguishable by the adl range. Mds 3 0 rug iv 66 category table urban adls end splits rug cmi rate 042 aids 15 16 signs of depression le2 45 412 73 941 02 15 16 no signs le1 33 345 26 787 19 11 14 signs of depression ld2 42 396 66 904 38 11 14 no signs ld1 27 332 42 757 92. If the resident qualifies in the extensive services group and a special care high group always choose the extensive services classification because it is higher in the hierarchy.

Payment is determined by categorizing patients into groups based on their care and resource needs. Logic version 1 03 and code version 1 03 0 july 18 2013. This method is stemming from the snf pps fy2012 final rule and was previously rug iii. To reflect snf care inflation in the cost of goods and services.

Assessment process using a new patient classification system called the patient driven payment model pdpm pdpm beginning october 1 2019 you must use the pdpm patient classification model. There is no transition period from rug iv to the pdpm. This system primarily. Brant fries 2003 using data from our 2001 analysis files and replicated and validated the research.

Rug assignments weights are applied at the individual level but the average relative risk of a facility s residents is typically used to adjust the nursing components of state medicaid payment systems one exception. Rug iv categories and characteristics 1 major rug iv category rug iv score characteristics associated with major rug iv category rehabilitation plus extensive services rux rul rvx rvl rhx rhl rmx rml rlx residents satisfying all of the following three conditions.