Rug Classification System

Determine all of the rug iv groups for which a resident qualifies not just the first group for which the resident qualifies.

Rug classification system.

This method is stemming from the snf pps fy2012 final rule and was previously rug iii. Rug iv classification system 66 group with medicare case mix indices for 10 1 2010 instructions. 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 urban institute re examined prior efforts by abt associates 2000 and dr.

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. There were two changes to the rug iii classification logic with version 5 12 from version 5 11. Rug iv is a patient classification system for skilled nursing patients used by the federal government to determine reimbursement levels. 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.

Rug iv classification system 66 group with medicare case mix indices for 10 1 2010. When you find the first of the 66 individual rug iv groups for which the resident qualifies assign that group as the rug iv classification. Logic version 1 03 and code version 1 03 0 july 18 2013. The rug iii version 5 20 grouper package includes the 53 group rug iii model that will be used for billing medicare part a snf pps days of service starting january 1 2006.

These revised worksheets replace earlier worksheets that were dated 12 11 98. Version 5 12 classification worksheets dated 8 16 00 the rug iii classification worksheets located in the downloads section are revised versions dated 8 16 00. Revisions include one logic change in each worksheet and several wording clarifications in each worksheet. These changes are 1 mds item j5c end stage disease has been dropped as a qualifier for the clinically complex groups and 2 the adl break point between the 34 group model raa and rab rehabilitation groups has been modified to an upper value.

Resource utilization groups rugs rugs are mutually exclusive categories that reflect levels of resource need in long term care settings primarily to facilitate medicare and medicaid payment they are assigned to individuals based on data elements derived from the ltc minimum data set mds there is a standard order or hierarchy and each rug. Payment is determined by categorizing patients into groups based on their care and resource needs. This system primarily. Use the hierarchical classification worksheet in chapter 6 of the rai manual.

Rug iii version 5 2 calculator worksheet 34 group model.