Providers Concerned About How CMS' SNF Changes Will Affect Them

MacKenzie Kimball, for HealthLeaders Media , August 24, 2009

In the SNF final rule, CMS also calls to revise the reporting the rehab RUG classification process for short-stay residents, which are defined as residents who are discharged on day 8 of the SNF stay or earlier. This revised process will calculate the rehab RUG for short-stay resident by using items from the MDS 3.0, including the number of therapy minutes provided, date of admission, date therapy started, ADL level, and the ARD. According to the final rule, classification into rehab RUGs for short-stay residents "will be based on the average daily minutes of therapy provided," which are as follows:

  • Average daily therapy minutes are between 15-29 minutes = Rehabilitation Low category (RLx).

  • Average daily therapy minutes are between 30-64 minutes = Rehabilitation Medium category (RMx)

  • Average daily therapy minutes are between 65-99 minutes = Rehabilitation High category (RHx)

  • Average daily therapy minutes are between 100-143 minutes = Rehabilitation Very High category (RVx)

  • Average daily therapy minutes are 144 or greater =  Rehabilitation Ultra High category (RUx)

Even though CMS does not believe that these changes will produce financial pressures and have taken steps to ensure they do not result in an increased workload, these components of the final rule will modify many facility processes related to therapy services and SNFs should ensure their staff are well trained and prepared to adapt.

To view the FY 2010 SNF final rule, visit the Resources page on MDSCentral.

MacKenzie Kimball is an associate editor in the long-term care market at HCPro. She writes PPS Alert for Long-term Care and manages MDSCentral.

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