Medicare Rug-53 That Went Into Term Paper

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It notes that these nine new categories only apply to "MDS assessments that meet the criteria for the rehabilitation category and the Extensive Services category" (Field and Kazmer, 2006). These cases must also have an ADL rating of 7 or higher to qualify, and it talks about grouper software that facilities can use to assess whether these criteria are met or not. The article notes that a good case mix of patients can help a facility become a "winner" with RUG-53.

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Finally, it lists several processes facilities should utilize to make sure cases have the right qualifications. These include timing the Assessment Reference Date, obtaining all medical records, and following RAI guidelines in coding. All of these things should help assure RUG-53 works for all facilities......

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