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RUG Activity Case 1: Assign a resident to a resource utilization group (RUG). To assign the resident to a RUG, use information from the following sources: Case below Figure 1 below Figure 8.6 in textbook Case The resident requires isolation because of an infection (extensive service). The resident received 740 minutes of therapy. These minutes were received when the resident had physical therapy on Monday, Tuesday, Wednesday, Thursday, and Friday and had speech therapy on Monday, Wednesday, and Friday. The resident's ADL score is 9. Figure 1 + 2 RUGS 2 RUGS Patients require extensive services Rehabilitation + extensive services Llimo high + extensive fover 720 minutes Very high + endensive (500-719 minutes High + extensive [325-499 minutes Medium + extensive [150-324 minuts low + extensive (45-149 minutes 2 RUGS 2 RUGS RUG Patients receive at least 45 minutes of therapy por wook Potents do not require extensive services Wilma high (over 720 mm Very high (500-719 mtrutos High (325-490 minukis) Medium (150-324 minutes 3 RUCS 3 RUCS 3 RUGS Rehabilitation patents 3 RUGS low (45-149 minutes 2 RUGS A patients Patents Tequlte skilled or extensive services Extensive services Special care-high Special care-low Clinically complex 3 RUGS 8 RUGS 8 RUGS Pallons do not receive at least 45 minutes of therapy 10 RUGS per week Patents typically do not requtre skilled nursing care Impaired cognition Reduced physical function 4 RUGS 10 RUGS Medicare Payment Advisory Commission [MedPAC]. 2011 October). Payment basics: Skilled nursing facility services payment system. http://www.medpac.gov. Based upon these data, into which RUG is the resident grouped? Is the RUG one of the upper groups? Case 2: Examine the impact of changes in factors of the payment formula over the past three years in the inpatient rehabilitation facility prospective payment system (IRF PPS). Review table 8.13 in the text for calculations. a. Complete the table that follows. i. Obtain the core-based statistical area (CBSA) for your area, the wage index for your CBSA, the standard payment conversion factor, and the labor portion for two years ago, one year ago, and the current year from the appropriate volumes of the Federal Register. ii. Calculate the unadjusted change in the standard payment conversion factor. iii. Calculate the change in the wage index. iv. Calculate the impact of the unadjusted change in the standard conversion factor per case. Calculate the impact of the changes in the wage index, labor portion, and the standard payment conversion factor for 1 year ago and the current year per case. v. vi. Calculate, for an IRF with 370 discharges annually, the impact of the changes in the wage index, labor portion, and the standard payment conversion factor for 1 year ago and the current year. 2 Years Ago 1 Year Ago Current Year Year Core-based Statistical Area (CBSA) of your area Wage Index (Example is CBSA 24780 for Greenville NC) Standard Payment Conversion Factor Labor Portion (estimated varies each year, but approx. 0.75000 per year) Unadjusted Change in Standard Payment Conversion Factor (+ or -) Impact of Unadjusted Change in Standard Payment Conversion Factor (+ or - Per Case Impact of Change in Standard Payment Conversion Factor Multiplied by No. of Discharges Annually(Ex: 370) Change in Wage Index (+ or -) Impact of Change in Wage Index [+ or -), Labor Portion (+ or - and Standard Payment Conversion Factor (+ or -) Per Case Impact of Change in Wage Index [+ or -), Labor Portion (+ or - and Standard Payment Conversion Factor [+ or - Multiplied by No. of Discharges Annually(Ex: 370)