HCFA has implemented the first phase of the Prospective Payment System for Nursing Facilities. The reimbursement rate for care of the geriatric patient does not contain product costs in the RUGS III classification rates. Based on this many cost reimbursement firms are recommending that facilities discontinue IV services. I believe that care delivery should be based on patient assessment and goals of therapy. If you work in long term care infusion and encounter similar situations please let me know. I am attempting to pull together some data to support a HCFA reply and an interim action plan for Nursing FAcilities. Thank you. Glenn Ross, VP Infusion Therapy.