rugs iv- 57 - richter healthcare consultants · rugs iii to rugs iv-57 crosswalk rugs iii current...
TRANSCRIPT
RUGS IV- 57
In November 2015, the State of Ohio made a decision to use the RUGS IV 57-Group Model for Medicaid reimbursement reimbursements. This change will affect your Medicaid reimbursement rate calculation beginning July 1, 2016, using calculations data from 4th quarter 2015 and 1st quarter 2016.
The RUGS IV 57-Group Model is the same as the RUGS IV-66-Group Model, except the Rehabilitation and plus Extensive Services groups have been removed.Also, please note “the category precedence for hierarchical classification is the Rehabilitation category (14 groups), the Extensive Services category (3 groups), the Special Care High category (8 groups), the Special Care Low category (8 groups), the Clinically Complex category (10 groups), the Behavioral Symptoms and Cognitive Performance category (4 groups), and the Reduced Physical Functions category (10 groups).”
At Richter Healthcare Consultants, we advise beginning the crosswalk process by recalculating your ADL scores due to the significant changes in scoring process. such as these:• In RUGS III, the maximum ADL score was 18 and the 4 Late Loss ADLs were unequally weighted.• In RUGS IV, the maximum ADL score is 16 and the 4 Late Loss ADLs are equally weighted.
To recalculate your ADLs in RUGS IV, use the information for Section G on your MDS and follow the table below.
RUGS IV Late Loss ADL Table for CalculationBed Mobility, Transfers, Toileting Eating
G0110 (1) G0110 (2) ADL Score G0110 (1) G0110 (2) ADL Score-, 1, 7, or 8 any number 0 -, 0, 1, 2, 7, or 8 -, 0, 1 or 8 0
2 any number 1 -, 0, 1, 2, 7, or 8 2 or 3 23 -, 0, 1, or 2 2 3 or 4 -, 0, or 1 24 -, 0, 1, or 2 3 3 2 or 3 3
3 or 4 3 4 4 2 or 3 4
Resource Reference: https://www.aanac.org/docs/reference-documents/rugiv-grouper-overview-v1.pdf
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RUGSIIItoRUGSIV-57CrosswalkRUGSIIICURRENTSCORE
CROSSWALKINFORMATION RUGSIV57
SCORETHERAPY RUGSIVADLSCORE
DEPRESSION RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA
SE3NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:
• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
Ultra(U)720+minuteswhilearesident
11-16 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUCUltra(U)720+minuteswhilearesident
6-10 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUBUltra(U)720+minuteswhilearesident
0-5 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUAVeryHigh(V)500-719minuteswhilearesident
11-16 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVC
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VeryHigh(V)500-719minuteswhilearesident
6-10 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVB
VeryHigh(V)500-719minuteswhilearesident
0-5 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVA
High(H)325-499minuteswhilearesident
11-16 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHC
High(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHB
High(H)325-499minuteswhilearesident
0-5 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHA
Medium(M)150-324minuteswhilearesident
11-16 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMCMedium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBMedium(M)150-324minuteswhilearesident
0-5 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMALow(L)45-149minuteswhilearesident
11-16 NA NA • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLB
Low(L)45-149minutewhilearesident
0-10 NA NA • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLA
NOTHERAPYREQUIREMENT 15-16 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
HE2
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• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 15-16 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
HD2
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changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes
HC2
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• QuadriplegiawithahigherminimumADLdependencecriterion(ADLscoreof5ormore)
• Chronicobstructivepulmonarydisease(COPD)withshortnessofbreathwhenlyingflat
• Feverwithpneumonia,vomiting,weightloss,ortubefeedingmeetingintakerequirement
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC1
NOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)
HB2
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• Chronicobstructivepulmonarydisease(COPD)withshortnessofbreathwhenlyingflat
• Feverwithpneumonia,vomiting,weightloss,ortubefeedingmeetingintakerequirement
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 2-5 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB1
NOTHERAPYREQUIREMENT 15-16 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE2
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NOTHERAPYREQUIREMENT 15-16 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE1
NOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD2
NOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or
LD1
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1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC1
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NOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB2
NOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE1
NOTHERAPYREQUIREMENT 15-16 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns
CE2
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• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 15-16 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE1
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident
CD1
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• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC2
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
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NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
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NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
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NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
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RUGSIII
SCORETHERAPY RUGSIV
ADLSCORE
DEPRESSION RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
SE2 NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
Ultra(U)720+minuteswhilearesident
11-16 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUCUltra(U)720+minuteswhilearesident
6-10 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUBUltra(U)720+minuteswhilearesident
0-5 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUAVeryHigh(V)500-719minuteswhilearesident
11-16 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVC
VeryHigh(V)500-719minuteswhilearesident
6-10 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVB
VeryHigh(V)500-719minuteswhilearesident
0-5 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVA
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High(H)325-499minuteswhilearesident
11-16 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHC
High(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHB
High(H)325-499minuteswhilearesident
0-5 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHA
Medium(M)150-324minuteswhilearesident
11-16 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMCMedium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBMedium(M)150-324minuteswhilearesident
0-5 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMALow(L)45-149minuteswhilearesident
11-16 NA NA • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLB
Low(L)45-149minutewhilearesident
0-10 NA NA • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLA
NOTHERAPYREQUIREMENT 15-16 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes
HE2
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• QuadriplegiawithahigherminimumADLdependencecriterion(ADLscoreof5ormore)
• Chronicobstructivepulmonarydisease(COPD)withshortnessofbreathwhenlyingflat
• Feverwithpneumonia,vomiting,weightloss,ortubefeedingmeetingintakerequirement
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 15-16 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
HD2
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shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat
HC2
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• Feverwithpneumonia,vomiting,weightloss,ortubefeedingmeetingintakerequirement
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC1
NOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement
HB2
[email protected](866)806-0799Page21
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 2-5 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB1
NOTHERAPYREQUIREMENT 15-16 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE2
NOTHERAPYREQUIREMENT 15-16 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
LE1
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fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD2
NOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
LD1
[email protected](866)806-0799Page23
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
• ANDADLscoreof2ormore
LC1
NOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5 LB2
[email protected](866)806-0799Page24
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE1
NOTHERAPYREQUIREMENT 15-16 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident
CE2
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• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 15-16 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE1
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
[email protected](866)806-0799Page26
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC2
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1 CB1
[email protected](866)806-0799Page27
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND BB1
[email protected](866)806-0799Page28
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
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NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
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RUGSIII
SCORETHERAPY RUGSIV
ADLSCORE
DEPRESSION RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
SE1 NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
Ultra(U)720+minuteswhilearesident
11-16 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUCUltra(U)720+minuteswhilearesident
6-10 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUBUltra(U)720+minuteswhilearesident
0-5 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUAVeryHigh(V)500-719minuteswhilearesident
11-16 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVC
VeryHigh(V)500-719minuteswhilearesident
6-10 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVB
[email protected](866)806-0799Page31
VeryHigh(V)500-719minuteswhilearesident
0-5 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVA
High(H)325-499minuteswhilearesident
11-16 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHC
High(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHB
High(H)325-499minuteswhilearesident
0-5 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHA
Medium(M)150-324minuteswhilearesident
11-16 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMCMedium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBMedium(M)150-324minuteswhilearesident
0-5 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMALow(L)45-149minuteswhilearesident
11-16 NA NA • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLB
Low(L)45-149minutewhilearesident
0-10 NA NA • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLA
NOTHERAPYREQUIREMENT 15-16 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia
HE2
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• Diabeteswithinsulininjectionsandinsulinorderchanges
• QuadriplegiawithahigherminimumADLdependencecriterion(ADLscoreof5ormore)
• Chronicobstructivepulmonarydisease(COPD)withshortnessofbreathwhenlyingflat
• Feverwithpneumonia,vomiting,weightloss,ortubefeedingmeetingintakerequirement
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 15-16 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
HD2
[email protected](866)806-0799Page33
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedical
conditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
HC2
[email protected](866)806-0799Page34
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC1
NOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
HB2
[email protected](866)806-0799Page35
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 2-5 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB1
NOTHERAPYREQUIREMENT 15-16 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE2
[email protected](866)806-0799Page36
NOTHERAPYREQUIREMENT 15-16 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE1
NOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD2
NOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or
LD1
[email protected](866)806-0799Page37
1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC1
[email protected](866)806-0799Page38
NOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB2
NOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB1
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns
CD2
[email protected](866)806-0799Page39
• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC2
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident
CC1
[email protected](866)806-0799Page40
• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,
BB2
[email protected](866)806-0799Page41
rejectionofcare,orwandering.NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.
AND• Havingbehavioralorcognitiveperformancesymptoms,
involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioral
BB2
[email protected](866)806-0799Page42
symptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physical
BA1
[email protected](866)806-0799Page43
behavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
[email protected](866)806-0799Page44
RUGSIII
SCORETHERAPY RUGSIV
ADLSCORE
DEPRESSION RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RUC Ultra(U)720+minuteswhilearesident
11-16 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUCUltra(U)720+minuteswhilearesident
6-10 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUBVeryHigh(V)500-719minuteswhilearesident
11-16 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVC
VeryHigh(V)500-719minuteswhilearesident
6-10 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVB
High(H)325-499minuteswhilearesident
11-16 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHC
High(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHB
Medium(M)150-324minuteswhilearesident
11-16 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMCMedium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBNOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:
• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
[email protected](866)806-0799Page45
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 15-16 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE2
NOTHERAPYREQUIREMENT 15-16 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding
HE1
[email protected](866)806-0799Page46
• Respiratorytherapy
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD2
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
HD1
[email protected](866)806-0799Page47
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 15-16 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE2
NOTHERAPYREQUIREMENT 15-16 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing: LD2
[email protected](866)806-0799Page48
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD1
NOTHERAPYREQUIREMENT 15-16 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5
CE2
[email protected](866)806-0799Page49
• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 15-16 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE1
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns
CD1
[email protected](866)806-0799Page50
• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
[email protected](866)806-0799Page51
RUGSIII
SCORETHERAPY RUGSIV
ADLSCOREDEPRESSI
ONRESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RUBUltra(U)720+minuteswhilearesident
6-10 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUB
Ultra(U)720+minuteswhilearesident
0-5 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUAVeryHigh(V)500-719minuteswhilearesident
6-10 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVB
VeryHigh(V)500-719minuteswhilearesident
0-5 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVA
High(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHB
High(H)325-499minuteswhilearesident
0-5 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHA
Medium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBMedium(M)150-324minuteswhilearesident
0-5 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMANOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:
• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
[email protected](866)806-0799Page52
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD2
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat
HD1
[email protected](866)806-0799Page53
• Feverwithpneumonia,vomiting,weightloss,ortubefeedingmeetingintakerequirement
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
HC2
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement
HC1
[email protected](866)806-0799Page54
• Parenteral/IVfeedingNOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedical
conditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
HB2
Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
HB1
[email protected](866)806-0799Page55
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
ANDADLscoreof2ormore
LD2
NOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD1
[email protected](866)806-0799Page56
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC1
NOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5 LB2
[email protected](866)806-0799Page57
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB1
[email protected](866)806-0799Page58
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC2
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1 CC1
[email protected](866)806-0799Page59
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,
BB2
[email protected](866)806-0799Page60
temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.ANDHavingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
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RUGSIII
SCORETHERAPY RUGSIV
ADLSCOREDEPRESSI
ONRESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RUAUltra(U)720+minuteswhilearesident
6-10 NA NA • RehabilitationRx720minutes/weekminimum• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUB Ultra(U)720+minuteswhilea
resident0-5 NA NA • RehabilitationRx720minutes/weekminimum
• Atleast1rehabilitationdiscipline5days/week• ANDAsecondrehabilitationdiscipline3days/week
RUAVeryHigh(V)500-719minuteswhilearesident
6-10 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVB
VeryHigh(V)500-719minuteswhilearesident
0-5 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVA
High(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHB
High(H)325-499minuteswhilearesident
0-5 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHA
Medium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBMedium(M)150-324minuteswhilearesident
0-5 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMANOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:
• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
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NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC2
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat
HC1
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• Feverwithpneumonia,vomiting,weightloss,ortubefeedingmeetingintakerequirement
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB2
NOTHERAPYREQUIREMENT 2-5 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
HB1
[email protected](866)806-0799Page64
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
LC1
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ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB2
NOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB1
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1 CC2
[email protected](866)806-0799Page66
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
ORCB1
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• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 0-1 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CA2
NOTHERAPYREQUIREMENT 0-1 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CA1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyin
BB2
[email protected](866)806-0799Page68
makingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreonthe
BA1
[email protected](866)806-0799Page69
BriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
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RUGSIII
SCORETHERAPY RUGSIV
ADLSCOREDEPRESSI
ONRESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RVCVeryHigh(V)500-719minuteswhilearesident
11-16 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVC
VeryHigh(V)500-719minuteswhilearesident
6-10 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVB
High(H)325-499minuteswhilearesident
11-16 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHC
High(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHB
Medium(M)150-324minuteswhilearesident
11-16 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMCMedium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBLow(L)45-149minuteswhilearesident
11-16 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLB
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
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NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 15-16 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
Respiratorytherapy
HE2
NOTHERAPYREQUIREMENT 15-16 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding
HE1
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• Respiratorytherapy
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
Respiratorytherapy
HD2
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
[email protected](866)806-0799Page73
NOTHERAPYREQUIREMENT 15-16 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
ANDADLscoreof2ormore
LE2
NOTHERAPYREQUIREMENT 15-16 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE1
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NOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD2
NOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD1
NOTHERAPYREQUIREMENT 15-16 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1 CE2
[email protected](866)806-0799Page75
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 15-16 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE1
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
ORCD1
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• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
[email protected](866)806-0799Page77
RUGSIII
SCORETHERAPY RUGSIV
ADLSCOREDEPRESSI
ONRESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RVBVeryHigh(V)500-719minuteswhilearesident
11-16 NA NA • RehabilitationRx500minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RVC
VeryHigh(V)500-719minuteswhilearesident
6-10 NA NA • RehabilitationRx500minutes/weekminimumANDAtleast1rehabilitationdiscipline5days/week RVB
VeryHigh(V)500-719minuteswhilearesident
0-5 NA NA • RehabilitationRx500minutes/weekminimumANDAtleast1rehabilitationdiscipline5days/week RVA
High(H)325-499minuteswhilearesident
11-16 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHC
High(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHB
High(H)325-499minuteswhilearesident
0-5 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHA
Medium(M)150-324minuteswhilearesident
11-16 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMCMedium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBMedium(M)150-324minuteswhilearesident
0-5 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMALow(L)45-149minuteswhilearesident
11-16 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLB
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Low(L)45-149minuteswhilearesident
0-10 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLA
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
HD2
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feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement
HC2
[email protected](866)806-0799Page80
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC1
NOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
HB2
[email protected](866)806-0799Page81
• RespiratorytherapyNOTHERAPYREQUIREMENT 2-5 NO NA Receivingcomplexclinicalcareorhaveseriousmedical
conditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB1
NOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD2
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NOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD1
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5 LC1
[email protected](866)806-0799Page83
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB2
NOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
LB1
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fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCare
LowqualifierandADLscoreof0or1OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC2
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
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NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
[email protected](866)806-0799Page86
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,
BA1
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rejectionofcare,orwandering. NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwith
activitiesofdailylivingandgeneralsupervision. PC2NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwith
activitiesofdailylivingandgeneralsupervision. PC1NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwith
activitiesofdailylivingandgeneralsupervision. PB2NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwith
activitiesofdailylivingandgeneralsupervision. PB1
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RUGSIII
SCORETHERAPY RUGSIV
ADLSCOREDEPRESSI
ONRESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RVAVeryHigh(V)500-719minuteswhilearesident
0-5 NA NA • RehabilitationRx500minutes/weekminimumANDAtleast1rehabilitationdiscipline5days/week RVA
VeryHigh(V)500-719minuteswhilearesident
0-5 NA NA • RehabilitationRx500minutes/weekminimumANDAtleast1rehabilitationdiscipline5days/week RVB
Low(L)45-149minuteswhilearesident
11-16 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;ANDRestorativenursing6days/week,2services(seeReducedPhysicalFunctionforrestorativenursingservices)
RLB
Low(L)45-149minuteswhilearesident
0-10 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;ANDRestorativenursing6days/week,2services(seeReducedPhysicalFunctionforrestorativenursingservices)
RLA
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
[email protected](866)806-0799Page89
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC2
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC1
[email protected](866)806-0799Page90
NOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB2
NOTHERAPYREQUIREMENT 2-5 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB1
[email protected](866)806-0799Page91
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC1
NOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5 LB2
[email protected](866)806-0799Page92
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB1
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
ORCC2
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• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• 2-5Transfusionswhilearesident
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment
CB1
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• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 0-1 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CA2
NOTHERAPYREQUIREMENT 0-1 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CA1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BB2
[email protected](866)806-0799Page95
Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,or
BA1
[email protected](866)806-0799Page96
decisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PAI
[email protected](866)806-0799Page97
RUGSIII
SCORETHERAPY RUGSIV
ADLSCOREDEPRESSI
ONRESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RHCHigh(H)325-499minuteswhilearesident
11-16 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHC
High(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimum• ANDAtleast1rehabilitationdiscipline5days/week RHB
Medium(M)150-324minuteswhilearesident
11-16 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMCMedium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBLow(L)45-149minuteswhilearesident
11-16 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;ANDRestorativenursing6days/week,2services(seeReducedPhysicalFunctionforrestorativenursingservices)
RLB
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
[email protected](866)806-0799Page98
NOTHERAPYREQUIREMENT 15-16 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
Respiratorytherapy
HE2
NOTHERAPYREQUIREMENT 15-16 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose
HD2
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• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
RespiratorytherapyNOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedical
conditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
NOTHERAPYREQUIREMENT 15-16 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or
LE2
[email protected](866)806-0799Page100
1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 15-16 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE1
NOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
LD2
[email protected](866)806-0799Page101
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD1
NOTHERAPYREQUIREMENT 15-16 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE2
NOTHERAPYREQUIREMENT 15-16 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1 CE1
[email protected](866)806-0799Page102
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
ORCC2
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• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
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RUGSIII
SCORETHERAPY RUGSIV
ADLSCOREDEPRESSI
ONRESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RHBHigh(H)325-499minuteswhilearesident
11-16 NA NA • RehabilitationRx325minutes/weekminimumANDAtleast1rehabilitationdiscipline5days/week RHC
High(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimumANDAtleast1rehabilitationdiscipline5days/week RHB
High(H)325-499minuteswhilearesident
0-5 NA NA • RehabilitationRx325minutes/weekminimumANDAtleast1rehabilitationdiscipline5days/week RHA
Medium(M)150-324minuteswhilearesident
11-16 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMCMedium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBMedium(M)150-324minuteswhilearesident
0-5 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMALow(L)45-149minuteswhilearesident
11-16 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;ANDRestorativenursing6days/week,2services(seeReducedPhysicalFunctionforrestorativenursingservices)
RLB
Low(L)45-149minuteswhilearesident
0-10 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;ANDRestorativenursing6days/week,2services(seeReducedPhysicalFunctionforrestorativenursingservices)
RLA
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:
ES3
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• Tracheostomycareandventilator/respiratorNOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:
• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD2
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)
HD1
[email protected](866)806-0799Page106
• Chronicobstructivepulmonarydisease(COPD)withshortnessofbreathwhenlyingflat
• Feverwithpneumonia,vomiting,weightloss,ortubefeedingmeetingintakerequirement
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC2
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement
HC1
[email protected](866)806-0799Page107
• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
HB2
NOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
HB1
[email protected](866)806-0799Page108
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD2
NOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD1
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease LC2
[email protected](866)806-0799Page109
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC1
NOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident
LB2
[email protected](866)806-0799Page110
• feedingtube(calories>=51%orcalories=26-50%andfluid>=501cc)
• ulcers(2ormorestageIIor1ormorestageIIIorIVpressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB1
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment
CD2
[email protected](866)806-0799Page111
• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC2
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident
CC1
[email protected](866)806-0799Page112
• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioral
BB2
[email protected](866)806-0799Page113
symptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
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RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RHAHigh(H)325-499minuteswhilearesident
6-10 NA NA • RehabilitationRx325minutes/weekminimumANDAtleast1rehabilitationdiscipline5days/week RHB
High(H)325-499minuteswhilearesident
0-5 NA NA • RehabilitationRx325minutes/weekminimumANDAtleast1rehabilitationdiscipline5days/week RHA
Medium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMBMedium(M)150-324minuteswhilearesident
0-5 NA NA • RehabilitationRx150minutes/weekminimum• AND5daysanycombinationof3rehabilitation
disciplines
RMALow(L)45-149minuteswhilearesident
11-16 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;ANDRestorativenursing6days/week,2services(seeReducedPhysicalFunctionforrestorativenursingservices)
RLB
Low(L)45-149minuteswhilearesident
0-10 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLA
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:
ES2
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• Tracheostomycareorventilator/respirator NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:
• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC2
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding
HC1
[email protected](866)806-0799Page116
• Respiratorytherapy
NOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB2
NOTHERAPYREQUIREMENT 2-5 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB1
[email protected](866)806-0799Page117
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC1
NOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease LB2
[email protected](866)806-0799Page118
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB1
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
ORCC2
[email protected](866)806-0799Page119
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment
CB1
[email protected](866)806-0799Page120
• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 0-1 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CA2
NOTHERAPYREQUIREMENT 0-1 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CA1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,or
BB2
[email protected](866)806-0799Page121
decisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyin
BA1
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makingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
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RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RMCMedium(M)150-324minuteswhilearesident
11-16 NA NA • RehabilitationRx150minutes/weekminimumAND5daysanycombinationof3rehabilitationdisciplines
RMCMedium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimumAND5daysanycombinationof3rehabilitationdisciplines
RMBLow(L)45-149minuteswhilearesident
11-16 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;ANDRestorativenursing6days/week,2services(seeReducedPhysicalFunctionforrestorativenursingservices)
RLB
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 15-16 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose
HE2
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• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 15-16 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
HD2
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criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
NOTHERAPYREQUIREMENT 15-16 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffoot
LE2
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withtreatment• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 15-16 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE1
NOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
LD2
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• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD1
NOTHERAPYREQUIREMENT 15-16 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE2
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NOTHERAPYREQUIREMENT 15-16 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE1
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1 CC2
[email protected](866)806-0799Page129
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT
6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,
BB1
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involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
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NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
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RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RMAMedium(M)150-324minuteswhilearesident
6-10 NA NA • RehabilitationRx150minutes/weekminimumAND5daysanycombinationof3rehabilitationdisciplines
RMBMedium(M)150-324minuteswhilearesident
0-5 NA NA • RehabilitationRx150minutes/weekminimumAND5daysanycombinationof3rehabilitationdisciplines
RMALow(L)45-149minuteswhilearesident
0-10 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;• ANDRestorativenursing6days/week,2services(see
ReducedPhysicalFunctionforrestorativenursingservices)
RLA
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator•
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
HC2
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• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC1
NOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes
HB2
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• QuadriplegiawithahigherminimumADLdependencecriterion(ADLscoreof5ormore)
• Chronicobstructivepulmonarydisease(COPD)withshortnessofbreathwhenlyingflat
• Feverwithpneumonia,vomiting,weightloss,ortubefeedingmeetingintakerequirement
• Parenteral/IVfeeding• Respiratorytherapy
[email protected](866)806-0799Page135
NOTHERAPYREQUIREMENT 2-5 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB1
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident
LC1
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• feedingtube(calories>=51%orcalories=26-50%andfluid>=501cc)
• ulcers(2ormorestageIIor1ormorestageIIIorIVpressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB2
NOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)
LB1
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• ulcers(2ormorestageIIor1ormorestageIIIorIVpressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCare
LowqualifierandADLscoreof0or1OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC2
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1 CB2
[email protected](866)806-0799Page138
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB1
NOTHERAPYREQUIREMENT 0-1 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CA2
NOTHERAPYREQUIREMENT 0-1 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
ORCA1
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• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeating
BA2
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words,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
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RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RLBLow(L)45-149minuteswhilearesident
11-16 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;ANDRestorativenursing6days/week,2services(seeReducedPhysicalFunctionforrestorativenursingservices)
RLB
Low(L)45-149minuteswhilearesident
0-10 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;ANDRestorativenursing6days/week,2services(seeReducedPhysicalFunctionforrestorativenursingservices)
RLA
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 15-16 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose
HE2
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• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 15-16 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
HD2
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criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
HC2
[email protected](866)806-0799Page144
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC1
NOTHERAPYREQUIREMENT 15-16 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE2
NOTHERAPYREQUIREMENT 15-16 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5 LE1
[email protected](866)806-0799Page145
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD2
NOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
LD1
[email protected](866)806-0799Page146
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC1
NOTHERAPYREQUIREMENT 15-16 YES NA • ExtensiveServices,SpecialCareHighorSpecialCare CE2
[email protected](866)806-0799Page147
LowqualifierandADLscoreof0or1OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 15-16 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE1
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5
CD1
[email protected](866)806-0799Page148
• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC2
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,or
BB2
[email protected](866)806-0799Page149
decisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyin
BA1
[email protected](866)806-0799Page150
makingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
[email protected](866)806-0799Page151
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
RLA Low(L)45-149minuteswhilearesident
0-10 NA YES • RehabilitationRx45minutes/weekminimum• AND3daysanycombinationof3rehabilitation
disciplines;ANDRestorativenursing6days/week,2services(seeReducedPhysicalFunctionforrestorativenursingservices)
RLA
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareandventilator/respirator•
ES3
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Tracheostomycareorventilator/respirator
ES2
NOTHERAPYREQUIREMENT 2-16 NA NA Residentssatisfyingthefollowingtwoconditions:• HavingaminimumADLdependencyscoreof2ormore.• Whilearesident,receivingcomplexclinicalcareand
haveneedsinvolving:• Isolationforactiveinfectiousdisease
ES1
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)
HD2
[email protected](866)806-0799Page152
• Chronicobstructivepulmonarydisease(COPD)withshortnessofbreathwhenlyingflat
• Feverwithpneumonia,vomiting,weightloss,ortubefeedingmeetingintakerequirement
• Parenteral/IVfeedingRespiratorytherapy
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
Respiratorytherapy
HD1
NOTHERAPYREQUIREMENT 6-10 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding
HC2
[email protected](866)806-0799Page153
• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
Respiratorytherapy
HC1
NOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB2
[email protected](866)806-0799Page154
NOTHERAPYREQUIREMENT 2-5 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
Respiratorytherapy
HB1
NOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD2
NOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or
LD1
[email protected](866)806-0799Page155
1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
LC1
[email protected](866)806-0799Page156
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB2
NOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreonthe
BB2
[email protected](866)806-0799Page157
BriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeating
BA1
[email protected](866)806-0799Page158
words,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
[email protected](866)806-0799Page159
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
SSC NOTHERAPYREQUIREMENT 15-16 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE2
NOTHERAPYREQUIREMENT 15-16 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE1
[email protected](866)806-0799Page160
NOTHERAPYREQUIREMENT 11-14 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding
Respiratorytherapy
HD2
NOTHERAPYREQUIREMENT 11-14 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
LC2
[email protected](866)806-0799Page161
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC1
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
LC2
[email protected](866)806-0799Page162
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC1
NOTHERAPYREQUIREMENT 15-16 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE2
NOTHERAPYREQUIREMENT 15-16 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns
CE1
[email protected](866)806-0799Page163
• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 11-14 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physical
BB2
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behavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BA1
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Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
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RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
SSB NOTHERAPYREQUIREMENT 15-16 YES YES Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE2
NOTHERAPYREQUIREMENT 15-16 NO NO Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HE1
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NOTHERAPYREQUIREMENT 11-14 YES YES Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD2
NOTHERAPYREQUIREMENT 11-14 NO NO Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
NOTHERAPYREQUIREMENT 6-10 YES YES Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose
HC2
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• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 6-10 NO NO Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC1
NOTHERAPYREQUIREMENT 15-16 YES YES • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)
LE2
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with2ormoreskincaretreatments• footinfection/diabeticfootulcer/openlesionsoffoot
withtreatment• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 15-16 NO NO • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LE1
NOTHERAPYREQUIREMENT 11-14 YES YES • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD2
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NOTHERAPYREQUIREMENT 11-14 NO NO • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD1
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or
LC1
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1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 15-16 YES YES • ExtensiveServices,SpecialCareHighorSpecialCare
LowqualifierandADLscoreof0or1OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE2
NOTHERAPYREQUIREMENT 15-16 NO NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE1
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment
CD2
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• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC2
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident
CC1
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• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BA2
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Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
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RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
SSA NOTHERAPYREQUIREMENT 6-10 YES YES Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeedin• Respiratorytherapy
HD2
NOTHERAPYREQUIREMENT 6-10 NO NO Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HD1
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NOTHERAPYREQUIREMENT 6-10 YES YES Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC2
NOTHERAPYREQUIREMENT 6-10 NO NO Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADL
dependencecriterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)
withshortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,or
tubefeedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HC1
NOTHERAPYREQUIREMENT 2-5 YES NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose
HB2
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• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
NOTHERAPYREQUIREMENT 2-5 NO NA Receivingcomplexclinicalcareorhaveseriousmedicalconditionsinvolvinganyoneofthefollowing:
• Comatose• Septicemia• Diabeteswithinsulininjectionsandinsulinorder
changes• QuadriplegiawithahigherminimumADLdependence
criterion(ADLscoreof5ormore)• Chronicobstructivepulmonarydisease(COPD)with
shortnessofbreathwhenlyingflat• Feverwithpneumonia,vomiting,weightloss,ortube
feedingmeetingintakerequirement• Parenteral/IVfeeding• Respiratorytherapy
HB1
NOTHERAPYREQUIREMENT 11-14 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
LD2
[email protected](866)806-0799Page178
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 11-14 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LD1
NOTHERAPYREQUIREMENT 6-10 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LC2
NOTHERAPYREQUIREMENT 6-10 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease LC1
[email protected](866)806-0799Page179
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 2-5 YES NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdisease
withADLscore>=5• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)with2ormoreskincaretreatments
• footinfection/diabeticfootulcer/openlesionsoffootwithtreatment
• radiationtherapywhilearesident• dialysiswhilearesident
ANDADLscoreof2ormore
LB2
NOTHERAPYREQUIREMENT 2-5 NO NA • Cerebralpalsy,multiplesclerosis,orParkinson’sdiseasewithADLscore>=5
• respiratoryfailureandoxygentherapywhilearesident• feedingtube(calories>=51%orcalories=26-50%and
fluid>=501cc)• ulcers(2ormorestageIIor1ormorestageIIIorIV
pressureulcers;or2ormorevenous/arterialulcers;or1stageIIpressureulcerand1venous/arterialulcer)
LB1
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with2ormoreskincaretreatments• footinfection/diabeticfootulcer/openlesionsoffoot
withtreatment• radiationtherapywhilearesident• dialysiswhilearesident
• ANDADLscoreof2ormoreNOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCare
LowqualifierandADLscoreof0or12-5OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 6-10 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
2-5OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment
CC2
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• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 6-10 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 YES NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident
CB1
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• Oxygentherapywhilearesident• IVmedicationswhilearesident
• TransfusionswhilearesidentNOTHERAPYREQUIREMENT 0-1 YES NA • ExtensiveServices,SpecialCareHighorSpecialCare
LowqualifierandADLscoreof0or1OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident
• Transfusionswhilearesident
CA2
NOTHERAPYREQUIREMENT 0-1 NO NA • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CA1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BB2
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Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,or
BA1
[email protected](866)806-0799Page184
decisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
[email protected](866)806-0799Page185
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
CC2 NOTHERAPYREQUIREMENT 15-16 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE2
NOTHERAPYREQUIREMENT 15-16 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE1
NOTHERAPYREQUIREMENT 11-14 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident
CD2
[email protected](866)806-0799Page186
• TransfusionswhilearesidentNOTHERAPYREQUIREMENT
11-14 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
[email protected](866)806-0799Page187
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
CC1 NOTHERAPYREQUIREMENT 15-16 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE2
NOTHERAPYREQUIREMENT 15-16 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CE1
NOTHERAPYREQUIREMENT 11-14 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident
CD2
[email protected](866)806-0799Page188
• TransfusionswhilearesidentNOTHERAPYREQUIREMENT 11-14 NA NO • ExtensiveServices,SpecialCareHighorSpecialCare
LowqualifierandADLscoreof0or1OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
[email protected](866)806-0799Page189
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
CB2 NOTHERAPYREQUIREMENT 11-14 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 6-10 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident
CC2
[email protected](866)806-0799Page190
• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 6-10 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB1
[email protected](866)806-0799Page191
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,
BA2
[email protected](866)806-0799Page192
rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
[email protected](866)806-0799Page193
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
CB1 NOTHERAPYREQUIREMENT 11-14 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD2
NOTHERAPYREQUIREMENT 11-14 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CD1
NOTHERAPYREQUIREMENT 6-10 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident
CC2
[email protected](866)806-0799Page194
• Transfusionswhilearesident
NOTHERAPYREQUIREMENT 6-10 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
NOTHERAPYREQUIREMENT 2-5 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB1
[email protected](866)806-0799Page195
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,
BA2
[email protected](866)806-0799Page196
rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
[email protected](866)806-0799Page197
CA2 NOTHERAPYREQUIREMENT 6-10 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC2
NOTHERAPYREQUIREMENT 6-10 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CC1
NOTHERAPYREQUIREMENT 2-5 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB2
[email protected](866)806-0799Page198
NOTHERAPYREQUIREMENT 2-5 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CB1
NOTHERAPYREQUIREMENT 2-5 NA YES • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CA2
NOTHERAPYREQUIREMENT 2-5 NA NO • ExtensiveServices,SpecialCareHighorSpecialCareLowqualifierandADLscoreof0or1
OR
• Pneumonia;hemiplegiawithADLscore>=5• Surgicalwoundsoropenlesionswithtreatment• Burns• Chemotherapywhilearesident• Oxygentherapywhilearesident• IVmedicationswhilearesident• Transfusionswhilearesident
CA1
NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND BB2
[email protected](866)806-0799Page199
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA2
[email protected](866)806-0799Page200
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
[email protected](866)806-0799Page201
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
IB2 NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BA2
[email protected](866)806-0799Page202
Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
[email protected](866)806-0799Page203
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
IB1 NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BA2
[email protected](866)806-0799Page204
Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
[email protected](866)806-0799Page205
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
IA2 NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BA2
[email protected](866)806-0799Page206
Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
[email protected](866)806-0799Page207
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
IA1 NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BA2
[email protected](866)806-0799Page208
Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
[email protected](866)806-0799Page209
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
BB2 NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BA2
[email protected](866)806-0799Page210
Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
[email protected](866)806-0799Page211
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
BB1 NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BA2
[email protected](866)806-0799Page212
Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
[email protected](866)806-0799Page213
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
BA2 NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BA2
[email protected](866)806-0799Page214
Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
[email protected](866)806-0799Page215
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
BA2 NOTHERAPYREQUIREMENT 2-5 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB2
NOTHERAPYREQUIREMENT 2-5 NA NO • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BB1
NOTHERAPYREQUIREMENT 0-1 NA YES • HavingamaximumADLdependencyscoreof5orless.AND
• Havingbehavioralorcognitiveperformancesymptoms,involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformance
BA2
[email protected](866)806-0799Page216
Scale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
• NOTHERAPYREQUIREMENT 0-1 NA NO • HavingamaximumADLdependencyscoreof5orless.
AND• Havingbehavioralorcognitiveperformancesymptoms,
involvinganyofthefollowing:difficultyinrepeatingwords,temporalorientation,orrecall(scoreontheBriefInterviewforMentalStatus<=9),difficultyinmakingselfunderstood,shorttermmemory,ordecisionmaking(scoreontheCognitivePerformanceScale>=3),hallucinations,delusions,physicalbehavioralsymptomstowardothers,verbalbehavioralsymptomstowardothers,otherbehavioralsymptoms,rejectionofcare,orwandering.
BA1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
[email protected](866)806-0799Page217
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
PE2 NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
PE1 NOTHERAPYREQUIREMENT 15-16 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE2
NOTHERAPYREQUIREMENT 15-16 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PE1
NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
[email protected](866)806-0799Page218
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
PD2 NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
PD1 NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
[email protected](866)806-0799Page219
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
PC2 NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
PC1 NOTHERAPYREQUIREMENT 11-14 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD2
NOTHERAPYREQUIREMENT 11-14 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PD1
NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
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RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
PB2 NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
PB1 NOTHERAPYREQUIREMENT 6-10 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC2
NOTHERAPYREQUIREMENT 6-10 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PC1
NOTHERAPYREQUIREMENT 2-5 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB2
NOTHERAPYREQUIREMENT 2-5 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PB1
NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
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RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
PA2 NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1
RUGSIIISCORE
THERAPY RUGSIVADLSCORE
DEPRESSION
RESTORATIVENURSING
PROGRAMS
ADDITIONALCRITERIA RUGSIVSCORE
PA1 NOTHERAPYREQUIREMENT 0-1 NA YES • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA2
NOTHERAPYREQUIREMENT 0-1 NA NO • Residentswhoseneedsareprimarilyforsupportwithactivitiesofdailylivingandgeneralsupervision. PA1