Definition Of Rug In Mds

Mds 3 0 rug iv decision tree 48 grouper.

Definition of rug in mds.

Domain adl score end splits or special requirements rug iv group cmi cms set f01 extensive services at least one of the following tracheostomy care while a resident o0100e2. Minimum data set supportive documentation guidelines rug iii version 5 12 34 grouper june 1 2012. The minutes that define a rug level are a. The worksheet takes the grouper logic.

The minimum data set mds is part of the u s. Mds 3 0 rug iv decision tree 48 grouper minnesota case mix system. Mds 3 rug 53 groups. The grouper outputs the rug iv code which is combined with an assessment indicator to create the hipps.

Hipps codes are based on assessments made using the minimum data set mds. Federally mandated process for clinical assessment of all residents in medicare or medicaid certified nursing homes and non critical access hospitals with medicare swing bed agreements. 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. Coding isolation on the minimum data set mds is new territory for many mds coordinators.

During the passage of the patient protection and affordable care act aca congress delayed the implementation of rug iv until oct. Instrument mds 3 0 is scheduled for oct. The minimum data set mds the mds assessment tool is a comprehensive summary of the patient s mental and physical issues completed by the fifth day after admission to a snf. Rug iii mds 3 0 mapping specifications v1 00 5 this document presents logic that can be used to produce rug iii classifications using assessment items contained on mds 3 0 and accommodates item set changes for assessments on or after october 1 2013 as well as earlier assessments.

Originally the corresponding updated resource utilization group rug iv reimbursement methodology was supposed to be implemented the same day. Mds 3 0 rug iv decision tree 48 grouper select the rug iv group with the highest case mix index cmi for which the resident meets the required conditions. While there have been no changes to the resident assessment instrument rai manual instructions for coding isolation many mds nurses are wondering if current isolation due to the sars. Grouper software run at a skilled nursing facility or swing bed hospital uses specific data elements from the mds to assign beneficiaries to a rug iv code.

Mds 3 rug iii version 5 12 44 grouper. The term swing bed refers to the social security act s authorizing small rural hospitals to use their beds in both an acute care and skilled nursing facility. It is typically completed by a nurse and triggers are provided for assessment of mds elements by other professionals.