New York's resource utilization groups system (RUGs III)

Introduction

Measures resident characteristics & staff care time for various categories of patients.

RUGs based on care needs & utilization, not medical diagnoses or conditions as DRGs.

RUGs III demonstrations project:

• 6 state demonstration project from 1989 through 1998 (New York, Texas, Maine, Mississippi, Kansas, South Dakota)
• 1st 3 years spent of designing classification groups
• payment implemented in 1996
• therapies bundled into PPS payment in 1997
• only 600 volunteer SNFs involved

RUGs III system - 7 major categories - 44 total groups

• rehabilitation - 14 groups
• extensive services - 3 groups
• special care - 3 groups
• clinically complex - 6 groups
• impaired cognition - 4 groups
• behavior only - 4 groups
• reduced physical function - 10 groups

Rugs III group = category + ADL Index + Additional needs

RUGs are in the process of being revised.

Additional terms

• activities of daily living (ADL)
• ADL index
• minimum data set (MDS) for nursing home residents