Rug Scores In Nursing Homes

Rug resource utilization groups is a patient classification system for nursing home patients used by the federal government to determine reimbursement levels for skilled nursing home facilities.

Rug scores in nursing homes.

Minimum data set supportive documentation guidelines rug iii version 5 12 34 grouper june 1 2012. Mds 3 rug 53 groups. Rug iv vs pdpm under the rug iv model both patients would be classified into the same payment group because they received the same number of therapy minutes and. With rug iii it was the upper 35 rug scores and under rug iv it will be the upper 52 rug scores.

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. A week minimum at least 2 disciplines 1 discipline 5 days. Texas medicaid adjusts the rug 34 relative risk weights to reflect local practice to establish person level payments. This distribution was used to calculate the nursing case mix indices.

Utilizes the same nursing classification structure as rug iv except there are some modifications. Rug iv classification system 66 group with medicare case mix indices for 10 1 2010. Understanding mds 3 0 and rug iv reimbursement for nursing homes. If you believe a loved one is suffering abuse neglect at a nursing home or that the facility is acting fraudulently call the experienced attorney s at senior justice law firm today at 561 717.

However the use of section. This system categorizes residents into a payment group based upon their care and resource needs. Having a minimum activity of daily living adl dependency score of 2 or more. Rug iii version 5 2 calculator worksheet 34 group model.

Mds 3 rug iii version 5 12 44 grouper. Updated 2001 distribution of days for the rug 44 and rug 53 models. Senior justice law firm understands medical records and rug scores and how nursing homes can adjust these numbers to illegally to increase profits. Rug iii v5 12 descriptors for sb mds 2 0 category adl index end splits rug codes 16 18 ruc 9 15 rub rehabilitation ultra high rx 720 mins.

Mds 3 0 rug iv 66 category table urban adls end splits rug cmi rate 042 aids 2 5 2 or more restorative nursing on 6 days wk bb2 11 253 71 578 46 2 5 none or fewer restorative nursing than required bb1 10 242 47 552 83 0 1 2 or more restorative nursing on 6 days wk ba2 4 210 34 479 58 0 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. Health care consulting inc.