Long-Term Care

PPS Q&A

PPS Alert for Long-Term Care, August 1, 2009

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What changes are proposed for activities of daily living (ADL) scoring under Resource Utilization Group, Version Four (RUG-IV)?

Remember that these are proposed changes and we will not know the final RUG-IV specifications until later this year. Highlights of the proposed changes to improve the ADL index scoring methodology include:
Changing the 15-point scale (4–18) to a 17-point scale (0–16) to better capture functional status
The eating ADL no longer considers enteral and IV feeding in the calculation, but will include support codes for staff assistance
The point counts related to specific ADL function have been adjusted based on recent data analysis (e.g., If bed mobility is coded as extensive [G1Aa=3] with assist of one person [G1Ba=2], the score would be 4 of the 15 points under RUG-III, but under RUG-IV, the score would be 2 of the 17 points)
If a late-loss ADL does not occur (G1A or B=8), the score will be 0 points
The ADL levels that subdivide the major hierarchies or categories into payment categories will be standardized, rather than random

This is an excerpt from a member only article. To read the article in its entirety, please login or subscribe to PPS Alert for Long-Term Care.

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