resource utilization group


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resource utilization group

Health administration Any of a number of groups into which a nursing home resident is categorized, based on functional status and anticipated use of services and resources. See Functional assessment.

Re·source U·ti·li·za·tion Group

(RUG) (rē'sōrs yū'til-ī-zā'shŭn grūp)
One of 44 patient categories, each with a corresponding per diem reimbursement rate as mandated by Medicare.

resource utilization group

Abbreviation: RUG
Any of 44 classifications into which nursing home patients may be assigned according to their activity levels, underlying illnesses, the complexity of care they need, their cognitive status, and other variables affecting their care. The primary use is for insurance reimbursement calculations.
See also: group
References in periodicals archive ?
Case Mix for Nursing Home Payment: Resource Utilization Groups, Version 11.
Case-Mix Classification of Medicare Residents in Skilled Nursing Facilities: Resource Utilization Groups (RUG-T18).
WHEN THE HEALTH CARE FINANCING Administration (HCFA) issued its anxiously anticipated SNF PPS regulation July 31, 2000, many in the SNF community were relieved to learn that HCFA was not proceeding with its proposed plan to increase the number of Resource Utilization Groups (RUGs) to 178 and redistribute payments.
Medicare pays SNFs based on a prospective payment system, which uses a resource classification known as Resource Utilization Groups (RUGs) to help determine a daily payment rate.
Because of this, the Minimum Data Set (MDS) is now used not only to conduct patient assessments, but also to help facilities measure and adjust patient outcomes, and connect payment with the utilization of the required resources via Resource Utilization Groups (RUGs).
The proposed refinement is also important because its implementation will end the 20 percent adjustment to 15 selected resource utilization groups that began April 1 under the Balanced Budget Refinement Act of 1999 (BBRA).

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