In a message dated 11/6/2003 1:43:20 PM Eastern Standard Time, [EMAIL PROTECTED]
writes:
> Actually, what I did do, that my software allows me to do is first entered
> in the assessment using day 14 which had IVF in section K, IV med and O2 in
> section P1 and OT 3 days and 105 min., and PT 2 days and 70 minutes (RUG'd
> out as RMC). I then copied this assessment and only changed the therapy
> portion to reflect OT 2 days and 38 minutes and PT 0 days and 18 minutes
> (RUG'd out at SE3). I don't know, I too thought my software pulled the
> higher paying RUG. I believe that as long as I am in the assessment window
> I can use either one that I want and of course I am going
> to take the higher
> paying one. What software do you use?
>
> Tammy Gola BSN, RN, CRNAC
> Wilkes-Barre General Hospital
> Transitional Care Unit
> 575 North River Street
> Wilkes-Barre, PA. 187641-0001
> 570-552-5417
> [EMAIL PROTECTED]
Tammy,
This isnt a software issue, it is a grouper issue and the grouper is issued from CMS.
The grouper was originally designed to place the resident in the highest CMI which
would also appropriately be the highest paying.
However, when they instituted the 20 % add ons to 15 of the RUG categories in 1999
this caused some RUG scores to pay higher even though they had a lower CMI. When CMS
implemented the add-ons they did not change the CMI scores nor the grouper.
This is why in many cases your SE3 will pay higher than some rehabs even though the
Rehab RUGs have a higher CMI. The Grouper ALWAYS picks the RUG score with the Higher
CMI not rate.
Ron
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