Therapy Component Rug

Above is a picture of what life is like under rug iv vs.

Therapy component rug.

The resident s rug was either a therapy rug or non therapy nursing rug. Texas medicaid adjusts the rug 34 relative risk. A therapy component reflecting the amount of therapy services provided or expected to be provided. Utilizes the same nursing classification structure as rug iv except there are some modifications.

And a non case mix adjusted component reflecting the costs of room and board linens and administrative services. The therapy component is case mix adjusted for. Under rug iv the number of pt ot and slp therapy treatment minutes are combined for a total number of treatment minutes that is used to classify a given patient into a given therapy rug under pdpm patient characteristics will be used to predict the therapy costs associated with a given patient rather than rely on service use. Ultra high very high high medium low and therapy non case mix.

Cms provides nursing and therapy weights that are used along with other component factors to establish person level per diem. Under rug iv you have two case mix categories nursing which includes non therapy ancillary services and therapy which includes physical occupational and speech therapy. Lynda jennings otr tota mcc 2019 11 3 18 4 key elements of pdpm. Of the resident and a case mix adjusted non therapy ancillary component.

Adjust the nursing components of state medicaid payment systems one exception. Rug non case mix therapy component non case mix component nursing base rate nta nursing 43 57. An initial set of rugs developed primarily to. 8 tep focused on the therapy component was held in february 2015 nursing index rug session 1 introductions and project overview therapy base rate therapy index rug or rehab non rehab payment rug non case mix therapy.

One of the basic abcs of pdpm will be the change in case mix components. Rug iv includes six therapy payment levels. The nursing component is case mix adjusted for all rugs. Therapy rugs are used to bill over 90 of part a days pdpm moves away from intensity driven model of payment to characteristic need driven model of payment.

Both pt and ot components will have individual cmis for payment whether therapy is provided or not since therapy days and minutes do not play a role in payment calculations under pdpm as it does in the current rug iv pps payment system. Since 1998 snfs have been paid under the resource utilization group prospective payment system rug iv pps.