Rug Iv Categories

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 categories. Rug iv 66 group model calculation worksheet for snfs page 1 of 29 october 12 2010 the purpose of this rug iv version 1 00 calculation worksheet for the 66 group model is to provide a step by step walk through to manually determine the appropriate rug iv classification based on the data from an mds assessment. Having a minimum activity of daily living adl dependency score of 2 or more. The extensive services category shows substantial increases in payment from rug iii to rug iv. Use the hierarchical classification worksheet in chapter 6 of the rai manual.

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. 10 clinical categories. Pdpm reclassified the rug iv categories into 16 possible cmgs broken down into two components. The worksheet takes the grouper logic.

The special care category is now split into high and low for more accurate case mix indexes cmis the impaired cognition and behavior categories are combined into one category. Rug iv is a patient classification system for skilled nursing patients used by the federal government to determine reimbursement levels. Rug iv background 1 strive staff time and resource intensity verification why o 1990 1995 1997 studies o practice changes resident mix changes and technology. Rapid rug iv guide 48 group classification the rapid rug iv guide is intended to be an at a glance reference providing the mds 3 0 items and criteria for each rug category.

This method is stemming from the snf pps fy2012 final rule and was previously rug iii. The guide also includes the calculation to determine the resident s late loss adl score. 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. Differences between rug iii and rug iv.

Category i extensive services while a resident adl 2 16 adl 0rug iv. Used as an end split for most categories many categories have minimum or maximum score requirement some conditions have a minimum score requirement.