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Case mix for nursing home payment: resource utilization groups, version II.

Schneider DP, Fries BE, Foley WJ, Desmond M, Gormley WJ - Health Care Financ Rev (1988)

Bottom Line: A study of 3,427 nursing home residents in New York State, measuring both resources used and resident characteristics, was used to develop a resident classification system for payment purposes.The system balances clinical, statistical, and administrative criteria, making it useful both for the New York State Medicaid payment system and for quality of care and facility management.

View Article: PubMed Central - PubMed

ABSTRACT
A study of 3,427 nursing home residents in New York State, measuring both resources used and resident characteristics, was used to develop a resident classification system for payment purposes. The system balances clinical, statistical, and administrative criteria, making it useful both for the New York State Medicaid payment system and for quality of care and facility management.

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Resource utilization groups, version II (RUG-II) classification system
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f1-hcfr-88-supp-039: Resource utilization groups, version II (RUG-II) classification system

Mentions: The RUG-II classification system integrates the two basic approaches described previously. Groups are determined by first locating residents within the clinical hierarchy, then placing them into individual RUG's within that category by using ranges of the ADL index. In total, the system consists of 16 mutually exclusive groups, shown in Figure 1. The first two RUG-II groups consist of residents in the heavy rehabilitation category. The first RUG-II group, denoted “RA” (heavy rehabilitation-A), contains all residents who receive significant rehabilitation services (with a restorative goal) and a RUG-II ADL index value of either 3 or 4. A second group, denoted “RB” (heavy rehabilitation-B), consists of the remainder of the residents in the heavy rehabilitation category, those with ADL index scores from 5 to 10. The other groups are similarly specified. The 16 RUG-II groups and their abbreviations are shown in Table 5. A resident falls into one and only one group.


Case mix for nursing home payment: resource utilization groups, version II.

Schneider DP, Fries BE, Foley WJ, Desmond M, Gormley WJ - Health Care Financ Rev (1988)

Resource utilization groups, version II (RUG-II) classification system
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4195112&req=5

f1-hcfr-88-supp-039: Resource utilization groups, version II (RUG-II) classification system
Mentions: The RUG-II classification system integrates the two basic approaches described previously. Groups are determined by first locating residents within the clinical hierarchy, then placing them into individual RUG's within that category by using ranges of the ADL index. In total, the system consists of 16 mutually exclusive groups, shown in Figure 1. The first two RUG-II groups consist of residents in the heavy rehabilitation category. The first RUG-II group, denoted “RA” (heavy rehabilitation-A), contains all residents who receive significant rehabilitation services (with a restorative goal) and a RUG-II ADL index value of either 3 or 4. A second group, denoted “RB” (heavy rehabilitation-B), consists of the remainder of the residents in the heavy rehabilitation category, those with ADL index scores from 5 to 10. The other groups are similarly specified. The 16 RUG-II groups and their abbreviations are shown in Table 5. A resident falls into one and only one group.

Bottom Line: A study of 3,427 nursing home residents in New York State, measuring both resources used and resident characteristics, was used to develop a resident classification system for payment purposes.The system balances clinical, statistical, and administrative criteria, making it useful both for the New York State Medicaid payment system and for quality of care and facility management.

View Article: PubMed Central - PubMed

ABSTRACT
A study of 3,427 nursing home residents in New York State, measuring both resources used and resident characteristics, was used to develop a resident classification system for payment purposes. The system balances clinical, statistical, and administrative criteria, making it useful both for the New York State Medicaid payment system and for quality of care and facility management.

Show MeSH