Rug Classification System

These revised worksheets replace earlier worksheets that were dated 12 11 98.

Rug classification system.

There were two changes to the rug iii classification logic with version 5 12 from version 5 11. Minimum data set supportive documentation guidelines rug iii version 5 12 34 grouper june 1 2012. Determine all of the rug iv groups for which a resident qualifies not just the first group for which the resident qualifies. For detailed information concerning this update see the fy2010 snf pps rug iii classification case mix indices v1 pdf document in the download zip file for the update.

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. 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. 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. 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.

Rug iv classification system 66 group with medicare case mix indices for 10 1 2010 instructions. The urban institute re examined prior efforts by abt associates 2000 and dr. Logic version 1 03 and code version 1 03 0 july 18 2013. Payment is determined by categorizing patients into groups based on their care and resource needs.

Revisions include one logic change in each worksheet and several wording clarifications in each worksheet. 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. Rug iv is a patient classification system for skilled nursing patients used by the federal government to determine reimbursement levels. 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.

Use the hierarchical classification worksheet in chapter 6 of the rai manual. This system primarily. Rug iii version 5 2 calculator worksheet 34 group model. 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.

This method is stemming from the snf pps fy2012 final rule and was previously rug iii.