Assessing the RUG-III resident classification system for skilled nursing facilities.
Resource utilization groups, version III (RUG-III) is used by CMS to classify skilled nursing facility (SNF) residents into Medicare payment groups. Using a sample of 1,304 SNF residents with Medicare-covered stays, we find that RUG-III only explains 10.4 percent of the variance in total per diem costs. RUG-III explains variance in staff-time costs fairly well, but does not explain variance in non-therapy ancillary costs. Receipt of special treatments such as intravenous medications and respiratory therapy is strongly associated with high residual costs (p < 0.01). Modifications to the RUG-III system can increase its variance explanation.
White
Chapin
C
Harvard University, USA. chapin_white@post.harvard.edu
Pizer
Steven D
SD
White
Alan J
AJ
D000368:Aged; D000704:Analysis of Variance; D003361:Cost Allocation; D003953:Diagnosis-Related Groups / Q000145:classification* / Q000191:economics; D017048:Health Care Costs; D006801:Humans; D008484:Medicaid / Q000191:economics; D006278:Medicare / Q000191:economics*; D011445:Prospective Payment System; D012046:Rehabilitation / Q000191:economics; D012866:Skilled Nursing Facilities / Q000191:economics*; D019467:Subacute Care / Q000145:classification* / Q000191:economics; D014481:United States