AQUIPWhat You Need to Know!

– Glenda McLamb, Senior Associate, CAP Support– Deanna Britt, CAP/DA Review Associate– Steve Bailey, Programmer II

What is a RUG?

A Resource Utilization Group is referred to as a RUG. RUGs are used to classify nursing facility residents into groups. Classification is based on a person’s

physical functioning, disease diagnoses, health conditions and treatments received.

Variables used in the RUG calculation can be found in the “Downloads” section

of the AQUIP website.

https://www2.mrnc.org/AQUIP

How Did RUGs Originate?

Nursing Reform Law of the Omnibus Budget Reconciliation

Act

How do I know my client’s RUG score is correct?

Accurate data entry

Section C, Cognitive Status

Comatose

Short Term Memory

Cognitive Skills for Daily Decision Making

Time Awake

Section D, Mood & Behavior Patterns

Indicators of Depression, Anxiety, Sad Mood

Behavioral Symptoms

Section E, Communication/Hearing

Patterns

Making Self Understood

Section G, Disease Diagnoses

Aphasia

Cerebral Palsy

Diabetes Mellitus

Hemiplegia/hemiparesis

Multiple Sclerosis

Quadriplegia

Section G, Infections

Pneumonia

Septicemia

Section H, Health Conditions

Dehydrated

Delusions

Fever

Hallucinations

Internal Bleeding

Vomiting

Section I, Medications

Injections

Section J, Oral/Nutritional Status

Weight Loss

Parenteral/IV

Feeding Tube

Parenteral or Enteral Caloric/Fluid Intake

Section K, Continence

Appliances and Programs

Any Scheduled Toileting Plan

Bladder Retraining Program

Section L, Skin Conditions

Ulcers

Type of Ulcer (pressure)

Section L, Skin Condition

Other Skin Problems or Lesions

Burns

Open lesions/sores

Surgical wounds

Section L, Skin Condition

Pressure relieving device for chair/bed

Turning/repositioning program

Nutrition or hydration intervention to manage skin problems

Ulcer care

Surgical wound care

Section L, Skin Condition

Application of dressings with or without topical meds (other than to feet)

Application of ointments/medications

(other than to feet)

Section L, Skin ConditionFoot Problems and Care

Open lesions of the foot

Infection of the foot

Application of dressings with or without topical medications

Section M, Special Treatments and Procedures

TherapiesOccupational Therapy

Physical Therapy

Respiratory Therapy

Speech-language pathology and audiology services

Section M, Special Treatments and Procedures

Special CareChemotherapy, Dialysis, IV Medication,

Oxygen Therapy, Radiation, Suctioning, Tracheostomy care, Transfusions, and

Ventilator or respirator

Section M, Special Treatments and Procedures

Nursing Rehabilitation/Restorative Care

Physician Visits

Physician Orders

Section M, Nursing Rehabilitation and Restorative

• Measurable goals/objectives and interventions

• Evidence of periodic evaluation by a licensed nurse

• Nurse Aides/In Home Aides/ trained in the techniques

Rehab/Restorative Example• Client Centered – Yes, decreased mobility

• Intervention – PROM 5 x wk for 15 min x 4 wk

• Goal/objectives – Amb indep through out house

• Timeline – 4 wks

• Evaluation end of 4 wks

• Documented in client record

Section M, Nursing Rehabilitation and Restorative

• Client Centered

• Interventions

• Measurable goals/objectives

• Timeline

• Periodic evaluation by Licensed Nurse

• Documentation

Section N, Physical Functioning/Structural

Problems

Bed Mobility

Eating

Toilet use

Transfer

Plan of Care Cost Summary

Data Entry Accuracy

Enteral Formula

• 5 cases (24 cans) per month

• 5 x 24 = 120 cans (237 cal/can)

• 237 by 100 cal = 2.37 units/can

• 120 cans x 2.37U = 284.4 U/M

• 284.4 U x .63 = 179.17

Insulin Syringes

• 1 box (100) Insulin syringes q 2 M

• 1 U = $31.47

• 1 U divided by 2 M = .5 U/M

• .5 U/M x $31.47 = $15.74