RUG 53 Help Available

Since changes became effective January 1, 2006, BKD Health Care Group has noticed many skilled nursing facilities (SNFs) are underutilizing the nine new RUG classifications, potentially missing opportunities obtain appropriate reimbursement levels.

To help SNFs evaluate their use of the new RUG 53 payment system and to identify areas for improvement, BKD Health Care Group will analyze your facility’s current Part A RUG distribution.

For a complimentary analysis, use this downloadable data form. Complete the highlighted sections then email the form to your BKD advisor or . One of our consultants will analyze your data and call you to discuss opportunities for potential improvement with the new RUG 53 system.

What You Might Be Missing…

Not managing the new RUG 53 payment categories correctly can really add up: Here’s an example of how not properly completing the minimum data set (MDS) can short-change your reimbursement. These rates are based on the 2006 base federal rates for urban SNFs before adjusting for any particular core based statistical area (CBSA).

RMX payment rate	$416
RMC payment rate	$308
Difference in rate	$108	per day
	x 14	days paid under first assessment
	$1,512	potential lost revenue on a single patient
	x 60	(5 admissions per month x 12 months)
	($90,720)	potential lost revenue for 1 year

Guidance for RUG 53 Documentation

Read the article “RUG 53 Update: Accurate Documentation Essential as SNFs Adapt,” in the current edition of BKD Health Care News. The article provides guidance to SNFs for evaluating:

current documentation of activities of daily living (ADL) scoring
extensive services
MDS
special treatments and
assessment reference dates (ARDs).