Rug iv classification include all minutes in individual therapy one half of the minutes in concurrent therapy although total minutes received are documented on each resident s mds and all minutes in group therapy.
What is rug iv.
Determine all of the rug iv groups for which a resident qualifies not just the first group for which the resident qualifies.
This monetary shift is accomplished by adjusting therapy group payments.
This method is stemming from the snf pps fy2012 final rule and was previously rug iii.
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.
Rug iv essentially recalibrates the rug iii in order to put more money into complex patient cases that require intensive nursing services.
Rug iv classification system 66 group with medicare case mix indices for 10 1 2010 instructions.
Rehabilitation plus extensive services rux rul rvx rvl rhx rhl rmx rml rlx residents satisfying all of the following three conditions.
What is case mix who to call for case mix information case mix questions and answers requesting a reconsideration what is rehabilitation.
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 is associated with relative weighting factors rug assignments can be made on a hierarchical or an index maximization basis.
14 key concepts 2 must know rugs payment rates for the resident in order to make decisions that will optimize reimbursement o rug iii group associated payment mds 2 0 and mds 3 0.
Having a minimum activity of daily living adl dependency score of 2 or more.
Use the hierarchical classification worksheet in chapter 6 of the rai manual.
Ultra u 720 minutes very high v 500 719 minutes.
Rug iv is a patient classification system for skilled nursing patients used by the federal government to determine reimbursement levels.
In other words payments for intensive nursing care will rise while total payment for therapy groups will remain fairly constant.
Major rug iv category rug iv score characteristics associated with major rug iv category.
The fact sheets are designed around individual topics and rug categories and can be provided individually or as a package of several based on the needs of individual resident.
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.
Having a minimum activity of daily living adl dependency score of 2 or more.
As an example a new admission with a case mix classification of rab might be provided with a package of fact sheets that include.
Rug iv directory of fact sheets.
