Rug Iii Vs Rug Iv

Reserve funds for the inevitable adjustment of your mds rug iv payments and reduction to hybrid rug iii rates in the spring of 2011.

Rug iii vs rug iv. Mds 3 0 rug iv decision tree 48 grouper minnesota case mix system. Rug iii m3pi version 5 12b is located in the downloads section. Minimum data set supportive documentation guidelines rug iii version 5 12 34 grouper june 1 2012. 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.

Rugs iv a provider needs to essentially map their current historic medicare case mix as determined under mds 2 0 paid under rugs iii to rugs iv. Mds 3 rug 53 groups. Contents include 1 a dos grouper program that will update rug iii classifications in an mds 2 0 submission file in standard cms format. Assessing the impact of rugs iii to rugs iv.

Special care 3 categories at least one of the following conditions must be present. Cms has decided that medicare part a payments during this transition period will be at the rug iv rate. To date there are two ways to do this and neither are easy. Rug iii version 5 2 calculator worksheet 34 group model.

Rug iv classification system 66. Special care adl ssc ssb ssa 7 14 15 16 17 18. Rug iv is a patient classification system for skilled nursing patients used by the federal government to determine reimbursement levels. Mds 3 rug iii version 5 12 44 grouper.

This system primarily. Most residents who were once classified under the extensive service category under rug iii will be re classified under the special care and clinically complex. In order to assess the financial impact or revenue impact of payment under rugs iii vs. Iv medication and iv feeding are no longer qualifiers for extensive service.

Cp ms quadriplegia each must have an adl. Only 1 04 of the residents can classify under extensive services. Rug iv categories and characteristics 1 major rug iv category rug iv score characteristics associated with major rug iv category. This method is stemming from the snf pps fy2012 final rule and was previously rug iii.

Payment is determined by categorizing patients into groups based on their care and resource needs. Treatment with any stage iii or iv pressure ulcer foot infections or wounds with application of dressing radiation therapy while a resident or dialysis while a resident. Rug iii can be calculated from mds 2 0 and mds 3 0 rug iv can t be calculated from mds 2 0 o require mds 3 0 to calculate rug iv assessments will be rejected o mds 2 0 ard 10 01 10 or later o mds 3 0 ard 09 30 10 or earlier. Hybrid rug iii payments.