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The index maximizing classification approach is used in the Medicaid payment system. There is a designated Case Mix Index (CMI), a numeric value that represents the relative resource utilization associated with each of the 48 RUG-IV classifications.
Resource Utilization Groups, or RUGs, flow from the Minimum Data Set (MDS) and drive Medicare reimbursement to nursing homes under the Prospective Payment System (PPS). A resident is initially assigned to one of the seven major categories of RUGs based on their clinical characteristics and functional abilities.
The Michigan Department of Health and Human Services (MDHHS) will utilize the PDPM classifications used under the Medicare skilled nursing facility (SNF) prospective payment system (PPS) as calculated by the MDS 3.0. PDPM consists of four case-mix categories and six rate components.
There are seven major RUG categories: Rehabilitation, Extensive Services, Special Care, Clinically Complex, Impaired Cognition, Behavior Problems, and Reduced Physical Function.
CMS has proposed to replace RUGs with PDPM effective October 1, 2019. The proposal's timing is not surprising given CMS' assurances that it would give adequate lead time for providers and vendors to implement the operational changes necessary under the new payment model.
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The RUG score shows the type and quantity of care required for each individual resident. RUG scores consist primarily of the levels of occupational, physical and speech therapy a patient receives along with the intensity of nursing services the patient requires.
The RUG score shows the type and quantity of care required for each individual resident. RUG scores consist primarily of the levels of occupational, physical and speech therapy a patient receives along with the intensity of nursing services the patient requires.
The index maximizing classification approach is used in the Medicaid payment system. There is a designated Case Mix Index (CMI), a numeric value that represents the relative resource utilization associated with each of the 48 RUG-IV classifications.
Resource Utilization Groups, or RUGs, flow from the Minimum Data Set (MDS) and drive Medicare reimbursement to nursing homes under the Prospective Payment System (PPS). A resident is initially assigned to one of the seven major categories of RUGs based on their clinical characteristics and functional abilities.
Resource Utilization Groups, or RUGs, flow from the Minimum Data Set (MDS) and drive Medicare reimbursement to nursing homes under the Prospective Payment System (PPS). A resident is initially assigned to one of the seven major categories of RUGs based on their clinical characteristics and functional abilities.

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