case mix

Specialties MDS

Published

Specializes in mnagement, LTC, geriatrics.

Again, new to this job. Is there a minimum amount of days that rehab/restorative items need to be done during the window to impact the case mix score?

Any response would be appreciated.

Thanks

Up Vote Up Vote ×

For us in Ohio it is needs to be 5 days at 150 minutes a Medium is a higher case mix than a High is.

Up Vote Up Vote ×
Specializes in ER CCU MICU SICU LTC/SNF.

to qualify in the rehab low intensity criteria (rla or rlb)

in the last 7 days (section p1b [a,b,c] and p3):

rehab therapy (can be across 3 disciplines - ot, pt, and/or st)

= 45 minutes or more (total)

= 3 or more days / week

plus

nursing rehabilitation services = 2 or more, received for at least 15 minutes/day, administered for 6 or more days:

  • h3a,b** any scheduled toileting program and/or bladder retraining program
  • p3a,b** passive and/or active rom
  • p3c splint or brace assistance
  • p3d,f** bed mobility and/or walking training
  • p3e transfer training
  • p3g dressing or grooming training
  • p3h eating or swallowing training
  • p3i amputation/prosthesis care
  • p3j communication training

**count as one service even if both provided

this info is also located in the rai p6-16

Up Vote Up Vote ×

nice to know...I do have question re: a resident who is readmitted as MedA. On Peg feeding,but may eat puree as tolerated wound care for stage II. Has ST order, but ST only comes 2x/week. Do you know how to increase RUG score?Thank you...

Up Vote Up Vote ×
Specializes in ER CCU MICU SICU LTC/SNF.

Assuming the PEG meets the calorie/fluid requirements, the RUG score will be in the Clinically Complex category.

  • PEG + Dx: Aphasia will bump the RUG one level higher = Special Care.

  • (1) Stage II ulcer w/ rx has no weight. But if there is another site, even a stage I, RUG = Special Care.

  • Less than 3 days of therapy AND less than 45 mins/week will not bring the score any higher despite the Rehab. nursing programs.

  • Did resident receive IVFs, IV meds, suctioning while in hospital? Check out more in the RUG III quick guide attached.

This is a decent online PPS RUGS Calculator based on your MDS data. Since it is outdated, it does not calculate Rehab + Extensive Services category. Albeit, all the other RUG scores seem accurate. Ignore the rates. You must click the "accept terms of use" button.

Looking at your other thread, you'll need a lot of support. The RAI contains practically most of the info, but, never hesitate to ask!

Good luck!

RUG III.PDF

Up Vote Up Vote ×

Thank you so much Talino...i really appreciate your help:)

Up Vote Up Vote ×

Yes, it does matter. This is how you make the money and if you understand nothing else about the MDS/PPS, learn this. Do you have a RUG crosswalk? If not, ask your corporate MDS nurse, she or he should have one. Think of this as the bookmark for your RAI bible.

Up Vote Up Vote ×
+ Add a Comment