Rug Scores For Nursing Homes

Nursing homes are notorious for scheming to avoid detection of negligence fraud or abuse but analyzing a loved one s rug score could help signal whether a facility is committing medicare fraud.

Rug scores for nursing homes.

Score on mds 2 0 cognitive performance scale 3. Rug iv classification system 66 group with medicare case mix indices for 10 1 2010. Rug iii v5 12 descriptors for sb mds 2 0 category adl index end splits rug codes 16 18 ruc. Mds 3 rug iii version 5 12 44 grouper.

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. This distribution was used to calculate the nursing case mix indices. 100 203 title iv subtitle c 101 stat 1330 1987 obra 87. 4 5.

Having a minimum activity of daily living adl dependency score of 2 or more. Understanding mds 3 0 and rug iv reimbursement for nursing homes. Nursing reh l itation activties 2 at least 6 days a week passive or active rom amputation care splint care training in dressing or grooming eating or. With rug iii it was the upper 35 rug scores and under rug iv it will be the upper 52 rug scores.

In calculating the distribution 861 unclassifiable records bc1 were deleted from the file. The rug score really matters. 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. Cms to comply with certain nursing home related reforms required by the omnibus budget reconciliation act of 1987 public law pub.

Mds 3 rug 53 groups. Rug iii version 5 2 calculator worksheet 34 group model. Health care consulting inc. 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 44 rug 53 distribution chart based on cy 2006 data is available for download from the downloads section below. For instance if a loved one is highly dehydrated and rarely leaves her bed she should not have a rug score at an ultra intensity level because. Texas medicaid adjusts the rug 34 relative risk weights to reflect local practice to establish person level payments. Updated 2001 distribution of days for the rug 44 and rug 53 models.

And in addition if the patient needs complex nursing care such as respiratory care or communicable disease isolation that too increases the rug score significantly. This system categorizes residents into a payment group based upon their care and resource needs. However the use of section.