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RAI Manual Revisions
November, 2005
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CH. |
Sect.
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Pg. |
November 2005 Revision |
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NA |
NA |
Title Page |
Revised date changed |
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NA |
NA |
Acknowledge-ments Page |
Changed website address to read http://cms.hhs.gov/quality/mds20
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NA |
Page V |
Table of Contents – changed RUG-III 44 to 53 |
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CH 6 |
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6-1 to 6-28 |
Replace Chapter 6 in its
entirety, due to numerous changes and changes in pagination.
Throughout chapter replaced
‘44’ with ‘53’, ‘seven’ with ‘eight’, ‘26’ with ‘35’
Added ‘Rehabilitation Plus
Extensive Services’ when indicated |
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B |
1-6 |
RAI Coordinator and Regional Office contacts updated
Changed website address to read http://cms.hhs.gov/quality/mds20
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I |
1-23 |
Replace the previous Section I (pages 1-27)
Change Matrix Version 4.6 (03/15/2005) to 4.7 (08/15/2005)
Change Data Specifications Version: 1.20 to 1.30
Change RUG-III Case Mix Classification, Version 5.12 (or 5.12b)
to 5.20
RP=Resident Assessment Protocols, change MDS Data Specification
Version from 1.01 to 1.30
QM=Quality Measures publicly reported in 11/2004 (15 QMs) |
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EIGHT
MAJOR RUG-III CLASSIFICATION GROUPS |
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MAJOR RUG-III GROUP |
CHARACTERISTICS ASSOCIATED WITH MAJOR RUG-III GROUP |
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Rehabilitation
Plus Extensive Services |
Residents
receiving physical, speech or occupational therapy AND receiving
IV feeding or medications, suctioning, tracheostomy care, or
ventilator/respirator. |
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Rehabilitation |
Residents receiving physical,
speech or occupational therapy. |
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Extensive Services |
Residents receiving complex
clinical care or with complex clinical needs such as IV feeding
or
medications, suctioning,
tracheostomy care, ventilator/respirator and comorbidities that
make the resident eligible for other RUG categories. |
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Special Care |
Residents receiving complex
clinical care or with serious medical conditions such as
multiple sclerosis, quadriplegia, cerebral palsy, respiratory
therapy, ulcers, stage III or IV pressure ulcers, radiation,
surgical wounds or open lesions, tube feeding and aphasia, fever
with dehydration, pneumonia, vomiting, weight loss or tube
feeding. |
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Clinically Complex |
Residents receiving complex
clinical care or with conditions requiring skilled nursing
management and interventions for conditions and treatments such
as burns, coma, septicemia, pneumonia,
foot infections or wounds, internal bleeding,
dehydration, tube feeding, oxygen, transfusions, hemiplegia,
chemotherapy, dialysis, physician visits/order changes. |
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Impaired Cognition |
Residents having cognitive
impairment in decision-making, recall and short-term memory.
(Score on MDS 2.0 cognitive performance scale >=3). |
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Behavior Problems |
Residents displaying behavior
such as wandering, verbally or physically abusive or socially
inappropriate, or who experience hallucinations or delusions |
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Reduced Physical Function |
Residents whose needs are
primarily for activities of daily living and general
supervision. |
Full Text of Revisions from CMS:
November Update 2005
More information about maximizing MDS reimbursement can be found in
the book
The
MDS Coordinator's Handbook
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