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Yes, you will get paid at whatever RUG level
the resident classifies in, whether it be in the Upper 26 or Lower 18.
Resident's can still meet coverage criteria and fall into the lower 18 RUG
categories.
Ron
I am sorry, I guess I wasn't very specific. She
was in a Med A bed, after qualifying hospital stay, for therapy and wound
care. Therapy was d/c'd and wound healed but she was still having
problems with labs PT/INR. Physician did not visit he just made order
changes along with labs. There is adequate documentation for need of
skilled service. My question is at what rate would they pay? I
have a list of RUG's and dollar amounts but her assessment did not RUG out in
the top 26. If Medicare agrees that she still needed skilled service due
to monitoring/assessment, what rate will they pay? The rate that is
assigned to the lower RUG's or what?
Michelle
----- Original Message -----
Sent: Friday, April 16, 2004 11:14
AM
Subject: RE: RUG rate for nursing
coverage
You have multiple order
changes, but do you have M.D. visits? Did this person have a 3 day hospital
stay, are they receiving therapy? Just being started on Coumadin would not
necessarily place them in a "medicare"RUG
ann m schoeny
crnac
sem haven nursing and
rehab
225 cleveland
ave.
milford, ohio
45150
(513)
248-1270
We had a resident who was started on Coumadin and having PT/INR done
every other day with multiple med changes. When the RUG was
calculated it was not in the top 26 RUGs. What rate would medicare
pay in a sitution?
Michelle
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Michelle Witges
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