SNF management and MDS staff is now pondering how the delay in the RUG-IV classification system until Oct. 1, 2011 will impact case management and utilization of the MDS 3.0?

Following the signing of the Health Care Reform Bill, the original schedule for implementation of the RUGs IV system has been changed to reflect a start date of  Oct 1, 2011. Implementation of MDS 3.0 will still go forward as planned this Oct. 1, 2010 under the Senate bill. Additionally, Oct. 1, 2010, the Department of Health and Human Services will implement the change to concurrent therapy that is a component of RUG-IV. It will also enact on that date changes to the look-back period. Under these look-back changes, only those services furnished after admission to a skilled nursing facility will be factors in determining the Resource Utilization Group classification. IV fluids when provided for nutrition and hydration purposes will be the only extensive service that can be coded when provided during the pre-admission lookback period. Facilities will need to be diligent in obtaining all pre-admission and ER data to investigate for coding IV fluids on an assessment.