Re: RUGS Classification

[Guest guest]

1) LOS has become a major issue for us. We now try to pre-screen patients

before admission and not accept any with expected LOS<5 days. Census is

down. If they do transfer, they are usually receiving BID PT and some OT,

so they fit into one of the higher rehab categories. (Yes, we do weekends.)

We have had some " learning experiences. " For example, the patient admitted

on Sunday before Thanksgiving, who had received 520 minutes of therapy by

Thanksgiving. She insisted on going home on Thanksgiving, thus her LOS was

4 days. Since she needs 5 days of rehab for RV level payment, we went to RM

level. Medicare 1, us 0.

2) We have never done restorative care in the TCU. I may be wrong, but that

seems to be a process established to deal with long term patients who no

longer have skilled rehab needs. I don't see those patients as fitting the

profile of patients accepted for TCU care.

Bob @ Asante Health System

> RUGS Classification

>

> For those facilities with hospital based TCU's already on PPS please

> comment

> on the following:

>

> 1. For total hip pt.'s who must stay the geometric mean LOS before

> transfer the TCU, are you able to then keep skilled PT/OT going for at

> least

> 5 days once on the TCU? Our pt.'s usually transfer over on day 3 and stay

> 4

> days as they are typically ready for D/C. (No longer skilled needs - at a

> practice level)

> In this scenario, do you default to rehab low?

>

> 2. Does NS Rehab need to be done by a CNA, or is anyone using a PT aide

> to

> do Restorative Nursing - walking, etc. with pt.'s? In reference to the

> HCFA RAI Manual, the " restorative care " is defined as what our facility

> currently calls routine therapy. (ROM, splint or brace assistance, bed

> mobility, transfer, walking etc.) at a practice level.

>

> appreciate feedback!

>

> Patty @ Muir Health System

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>