Nursing Home Rug Levels

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Nursing home rug levels.

Rug scores consist primarily of the levels of occupational physical and speech therapy a patient receives along with the intensity of nursing services. 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. This rug level will impact the amount medicare will reimburse the facility. There is a concurrent expansion of the level of care presumption.

Updated october 3 2018. A week minimum at least 2 disciplines 1 discipline 5 days. Rug iii v5 12 descriptors for sb mds 2 0 category adl index end splits rug codes 16 18 ruc 9 15 rub rehabilitation ultra high rx 720 mins. Nursing homes increasingly push patients into rehab at end of life.

The nursing facility must provide for the total medical social and psychological needs of each client including room and board social services over the counter drugs medical supplies and equipment and personal needs items. 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. Report to congress on patient classification under medicare s prospective payment system for skilled nursing facilities 2006 dr. Brant fries presentation 2003 these are slides from the may 2003 presentation by dr.

However the use of section t to predict the amount of therapy that is anticipated to be provided during the initial period on the five day. Rug level 1 rehab 2 extensive service maryland medicaid nursing home level of care medicaid paid light moderate heavy 15 0 10 20 30 40 50 60 light moderate heavy heavy special percent of residents rehab extsrvc special care clinically complex impr. With rug iii it was the upper 35 rug scores and under rug iv it will be the upper 52 rug scores. This system categorizes residents into a payment group based upon their care and resource needs.

Overview the nursing facility program provides institutional care to medicaid recipients whose medical condition regularly requires the skills of licensed nurses. The rug score shows the type and quantity of care required for each individual resident. This level is set within three days of the fifth 14 th 30 th 60 th and 90 th days of a patient s stay at the sub acute facility. Skilled nursing facilities snfs that provide services including audiology and speech language pathology services to medicare beneficiaries are paid under a prospective payment system pps through part a of the medicare benefit.