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MDS 3.0 RUGIV Decision Tree – 48 Grouper

www.dhs.wisconsin.gov

MDS 3.0 RUGIV Decision Tree – 48 Grouper. Select the RUGIV Group with the
highest Case Mix Index(CMI) for which the resident meets the required conditions
. Domain. ADL. Score. End Splits or Special. Requirements. RUGIV. Group. CMI.
(CMS Set. F01). Extensive Services (At least one of the following ♢.).

Resource Utilization Group (RUG) – IV, Grouper 48 – DMAS

www.dmas.virginia.gov

RUG Category. RUG Description. ADL Range. RUG Weight Effective. 7/1/2017.
AAA. Default Group. 0 to 16. 0.45. BA1. Behavioral/Cognitive with No Restorative
Nursing. 0 to 1. 0.53. BA2. Behavioral/Cognitive with Restorative Nursing. 2 to 5.
0.58. BB1. Behavioral/Cognitive with No Restorative Nursing. 0 to 1. 0.75. BB2.

RUG IV Classification Manual

www.nd.gov

Oct 1, 2013 ASSIGNING A CLASSIFICATION. FOR RUG IV. Published By: Medical Services
Division. North Dakota Department of Human Services. 600 E Boulevard Ave
Dept 325. Bismarck, ND 58505-0250. October … through all of the 48
classification groups, noting each classification for which the resident qualifies.

MDS 3.0 and RUGIV Updates and Current Status – CMS.gov

www.cms.gov

Nov 9, 2010 November 9, 2010. MDS 3.0 & RUGIV. 2. Agenda. • Resource Sites. • MDS 3.0
Submission and Validation. • Survey & Certification. • SNF Part A. • MDS 3.0 …..
MDS 3.0 & RUGIV. 48. Quality Measures. 1. • MDS 2.0 QMs are basically
mapped to MDS 3.0. • NQF voting on NH measures ends November 16.

SNF Payment Models Research Technical Report – CMS.gov

www.cms.gov

classification under RUGIV, a large majority of SNF residents receive therapy,
and their case- mix group is determined primarily by the …. Similar to the current
RUGIV model, per-diem payment under RCS-I would be determined by two
primary factors: base …… Table 48: Recommended Resident Groups for SLP
Payment .

Medicare-Required SNF PPS Assessments – CMS.gov

www.cms.gov

The MDS 3.0 classifies residents into a Resource Utilization Group Version IV (
RUGIV) based on the average resources needed to care for someone with
similar care needs. RUGIV classifications help Medicare determine the Part A
SNF PPS payment. The RUGIV classification system includes eight major
classification …

Resident Roster User Guide – Maryland Medicaid

mmcp.health.maryland.gov

The Case Mix Index (CMI) set is the standard nursing-only CMI set published by
CMS for RUGIV 1.03, 48-Groups identified as F01. The days attributable to
inactive/expired assessments or tracking forms are categorized as BC1. Index
maximization is used to assign each resident to the final RUGIV classification.
RUGIV …

RUG – eohhs

www.eohhs.ri.gov

Effective June 1, 2013, the Rhode Island Office of Health and Human Services (
OHHS) is adopting a new Medicaid method of paying for Nursing Home and
Hospice room and board services based on the Minimum Data Set (MDS) 3.0
format with the CMS RUG IV V1.02. Grouper version containing 48 RUG
categories.

Provider Requirements for Minimum Data Set (MDS) 3.0 – Texas …

apps.hhs.texas.gov

Jun 29, 2016 DADS will collect RUGIV 48 group version 1.03, index maximizing, in item
Z0250 using the default CMI set established by CMS. DADS will not use this RUG
IV group for Medicaid payment purposes at this time. Chapter 5, Section 5.1
Transmitting MDS Data. All Medicare and Medicaid-certified nursing …

A Review of Nursing Facility Resource Utilization … – OIG .HHS .gov

oig.hhs.gov

To determine the extent to which Resource Utilization Groups (RUGs) … RUG
based on 108 items on an assessment of the resident known as the …. be used
as evidence to show that MDS accuracy has improved over time. OEI-02-02-
00830. A REVIEW OF NURSING FACILITY RESOURCE UTILIZATION GROUPS
iv …

F245-392-000 Resource Utilization Group (RUG) – Washington …

www.lni.wa.gov

2. Limited assistance. 3. Parental/IV or total dependence or tube feeding with 26
% to 75% calorie intake. Eating: Step #3. Total ADL Score. RUG Calculation.
Category 1 (of 6) – Rehabilitation … Rehab Low – 48 to 149 minutes total therapy
per week AND at least 3 days of any combination of 3 disciplines. Bill REHAB
LOW …

Rapid RUG Guide for MDS 3.0 RUG-III, Version 5.12 44-grouper

www.dhs.pa.gov

RAPID RUG GUIDE MDS 3.0. RUGIII, VERSION 5.12 44GROUPER.
Rehabilitation – ADLs = 4 – 18. ADL Score. RUG-III. Special Care – ADLs >= 7 (
continued). Ultra High Intensity Criteria. 6. 2 or more …. Points awarded for
Parenteral/IV, IV medications and qualifying for Special Care, of dressing. (
M1200I) 4 – 11. No. CA1.

R42401, Medicare's Skilled Nursing Facility Primer: Benefit Basics …

greenbook-waysandmeans.house.gov

Aug 8, 2012 observation services of more than 48 hours increased by 70%. The increase in ….
classification system—Resource Utilization Group (RUG)—and the wage index
that is used to adjust payments …. The most recent version of the RUG
classification system is RUGIV, which replaced the RUG-. 53 system on …

HOUSE ENROLLED ACT No. 1493 – Indiana General Assembly

iga.in.gov

therapy reclassification methodology in the RUGIV, 48-Group model for payment
of nursing facility services. (c) Before the office changes a health facility service
reimbursement that results in a reduction in reimbursement, the office shall
provide public notice of at least one (1) year. The public notice under this
subsection:.

Minimum Data Set 3 0 Coding and Minimum Data Set 3.0 Coding …

chfs.ky.gov

Aug 8, 2013 Changes effective October 2013. • More substantial changes. • Anticipated
changes include: – Therapy. 3. – ADL clarification. – RUG Classification ….. IDT
review and/or revision of care plan. • Referral for PASRR Level II: 48. • Referral
for PASRR Level II: – Required by law when SCSA is completed for an.

MDS 3.0 Section G Training for Swing- Bed Facilities – Alabama …

www.alabamapublichealth.gov

Feb 17, 2015 … Assessment Instrument). 2. Understand why it is important to be familiar with
each component of each. ADL, the definitions described in Section. G and the
Rule of 3. 3. Understand how accurate coding of Section. G impact the
calculation for placing a resident in a Resource Utilization Group. (RUG) – IV …

South Carolina Department of Health and Human … – SCDHHS.gov

www.scdhhs.gov

Jan 1, 2013 Our Government Solutions team has proven Medicaid experts who have
delivered exceptional results across the country in moving Medicaid to
sustainable growth paths, while at the same time improving the quality of care.
Our staff is committed to producing strategies that meet our clients' needs to …

Nursing Home Assessment Fee Legislation – TennCare Topics

www.tn.gov

Jul 1, 2014 Group-Version 4 (RUGIV), 48-Grouper model; and. (4) To pay nursing home
covered services covered for medicaid beneficiaries within medicare upper
payment limits, as negotiated with the bureau. The upper payment limit of all
nursing homes shall be calculated by the bureau using the higher of the cost …







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