Mds-rugs

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Help! Does anyone know where I can get a book on RUGS? I need to know What triggers what RUG score. Thanks:confused:

The 53-RUG-III applies to ALL 50 States. CMS added one major RUG (the Rehab plus Extensive Services) with 9 new sub-RUGs (RUX, RUL, RVX, RVL, RHX, RHL, RMX, RML, RLX). The new RUG combines the qualifiers for the current Rehab RUGs with the Extensive Services RUGs qualifiers. To classify into one of the nine new categories a resident needs THREE essential requirements: 1. have an ADL score of 7 or higher AND 2. meet criteria for Extensive Services RUG-III groups AND 3. meet criteria for Rehab RUG-III groups. So while this new system does not change how we complete the MDS we all now more than ever, will be needing: more accurate, readily accessible (late-loss) ADL documentation to capture for example that one instance of two person assist or 3 instances of weight-bearing support; better pre-admission screening for and/or recording of extensive services qualifiers w/ their important dates; and increased and close communication w/ skilled Rehab to obtain the right ARD for optimal reimbursement.

So what else are THEY waiting for? Bring on DAVE2 :chair:, MDS 3.0 :rolland the results of STRIVE ! May the PPS Force be with US ALL!

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Specializes in MDS coordinator, hospice, ortho/ neuro.
Here is another question. I had a patient who came in for 6 days of IV antibiotics. Well on day six it was decided he was to weak to go home and the Doctor ordered physical therapy. I had already done his 5 day MDS so I don't know exactly what to do. Can anyone help?

Your options are:

  1. capture all that on the 14 day assessment;
  2. if you don't expect that patient to still be there on day 14 you can re-do your 5 day assessment using up to day 8 for your ARD. It is legal to use grace days......although if you've already submitted that 5 day assessment you'd either have to inactivate it or re-do it as a correction.

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I agree with the above^^^^

Go to day 8, see if therapy can project a high or medium and go for the RMX or RML score which will pay higher then the original 5 day you did which was probably an SE2 or SE3.

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RondaS, I agree with the above. If you have not submitted the 5-day MDS, use day 8, project a RMX or an RML. If the patient is going to still be there on day 15, do the PPS 14-day assessment and capture the therapy and the IV abx.

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Specializes in LTC, Hospice, Case Management.

Hey here's another tip for you all in case you haven't come across this yet. Had a resident with ADL score of 15, an IV med and 500 min therapy. I determined this to be an RVL. My facility software uses an automatic RUG calculation and it kept coming up with an RMX. Racked my brain for 2 days, calling software vendor, cooperate support, etc... finally figured out that at least in my area RMX actually has a higher reimbursement rate than RVL and thats why I got that score. I know this is NOT true in all areas, because my cooperate support is several states away and according to their reimbursement rates for that area this was not true, but it was for mine.

Just wanted to give ya'll a tip of the day to maybe save someone a headache.

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Thanks for all the help. I have another problem.

I had an admission and the next day the patient had to be discharged due to a sudden death in her family. Therapy was her skill. Therapy did not have time to do an eval. So when I did the MDS in section T where it ask if therapy is ordered I put yes it was ordered. Then thru day 15 how many days would they get therapy and second est. minutes. If I do this I get a therapy RUG score but if I answer no to if therapy was ordered that is not the truth. Can anyone help me here?

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RondaS, it sounds like you will only have one day billed to Medicare. You can project a rehab medium even with zero actual minutes of rehab achieved. If you can take any IV's in the lookback period, then you have a RML or an RMX. You did have eval orders, sounds correct.

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RondaS, I agree with the above. If you have not submitted the 5-day MDS, use day 8, project a RMX or an RML. If the patient is going to still be there on day 15, do the PPS 14-day assessment and capture the therapy and the IV abx.

I didn't think that you could project past a rehab high?

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You can project a rehab medium or a rehab high, not a very or ultra.

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thanks for the input great help and greatly apreciated

looking4 help

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I think we need a forum just for MDS/PPS. There are so many times when I would love to bounce info off another coordinator and there is noone else in my facility who knows anything about it. There are so many knowledgable MDS people in this forum!!!

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I would love to have someone to bounce things off of. I am the only one in my facility that knows this stuff. So its lonely and fustrating.

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