Archive for: RUG-IV
Ask Diane: How will the new concurrent therapy ruling impact RUG levels?
Q: How will the judgment to divide concurrent therapy minutes among the residents receiving the service affect facilities from a financial standpoint? It is my understanding that residents can currently receive up to 25% of their therapy as group therapy with those minutes still contributing to the RUG level. Is this correct? How will the concurrent therapy rule impact the RUG level residents qualify for?
Diane: First of all, let me clarify the difference between concurrent therapy and group therapy. Concurrent therapy is the practice of one therapist treating multiple residents at the same time while the residents are performing different activities and have different goals. Group therapy is the practice of one therapist treating multiple residents at the same time while the residents perform the same activities and have the same or similar goals. The rule to change how concurrent therapy minutes are calculated under the MDS 3.0 and RUG-IV does not affect group therapy.
With that being said, let me explain how the change in calculating concurrent therapy minutes will affect SNFs. As I stated in my response to another question about this issue, under the MDS 2.0 and RUG-III, concurrent therapy minutes are counted as one-on-one therapy minutes. This means that if you provide 90 minutes of therapy to a group of three residents who are all doing different exercises, you can capture the entire 90 minutes for each resident on the MDS. The MDS 3.0 and RUG-IV will require therapists to use their professional judgment to divide concurrent therapy minutes among the residents receiving the service.
Ultimately, this will reduce the number of therapy minutes reported on the MDS when therapy is provided concurrently. This will reduce the number of residents qualifying into higher rehab RUG categories which, in turn, with reduce the overall reimbursement for SNFs. However, CMS is planning to implement the MDS 3.0 and RUG-IV in a budget neutral manner and, until more information regarding the payment levels for each RUG is released, it is difficult to determine the actual financial impact of the new case-mix system. We’ll keep you updated as more information is released.
Ask Diane: Will the MDS 3.0 allow us to capture concurrent therapy minutes?
Q: Will the MDS 3.0 allow us to capture concurrent therapy minutes?
Diane: Yes, the MDS 3.0 will allow facilities to capture minutes of concurrent therapy, which is the practice of one therapist treating multiple patients at the same time while the patients are performing different activities. However, concurrent therapy minutes will be calculated differently under the MDS 3.0 and RUG-IV than they are currently.
Under the MDS 2.0 and RUG-III, concurrent therapy minutes are counted as one-on-one therapy minutes. This means that if you provide 90 minutes of therapy to a group of three residents who are all doing different exercises, you can capture the entire 90 minutes for each resident on the MDS.
The MDS 3.0 and RUG-IV will require therapists to use their professional judgment to divide concurrent therapy minutes among the residents receiving the service.
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