RUG-II (Resource Utilization Group, Version II) impacts on long-term care facilities in New York.
This article observes changes during the first 5 years of Resource Utilization Group, Version II (RUG-II) system utilization by the New York State Department of Health (NYDOH) for Medicaid program reimbursement. Findings include a dramatic increase in the number of residents scoring in the highest intensity resident-care categories, a substantial increase in staffing and expenditures for rehabilitation therapies, and a possible negative impact on the financial performance of New York long-term care (LTC) facilities. RUG-II appears to have been successful in improving access to nursing homes for individuals with heavy-care needs and in encouraging the appropriate utilization of institutionalized skilled nursing care.
Schultz
B M
BM
Integrated Medical Direction, Delray Beach, FL 33444, USA.
Ward
D
D
Knickman
J R
JR
D003361:Cost Allocation; D003953:Diagnosis-Related Groups / Q000145:classification / Q000191:economics; D005376:Financial Management / Q000639:trends; D006302:Health Services Research; D008134:Long-Term Care / Q000145:classification* / Q000191:economics; D008484:Medicaid / Q000706:statistics & numerical data* / Q000639:trends; D009518:New York; D009735:Nursing Homes / Q000191:economics* / Q000706:statistics & numerical data; D010561:Personnel Staffing and Scheduling / Q000639:trends; D012046:Rehabilitation / Q000145:classification / Q000191:economics; D012051:Reimbursement Mechanisms / Q000639:trends*; D013221:State Health Plans / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends; D014481:United States