Rehab RUG Determinations

Q:  If a Med A patient stays long enough for only 4 days of therapy, how can a Rehab RUG level be obtained since Section T projections have been eliminated from MDS 3.0?

A:  The Medicare Short Stay Assessment Indicator of a Start of Therapy (SOT) OMRA will average the provided therapy minutes to potentially determine a Rehab RUG level.   Six criteria must be met: 

1. SOT OMRA combined with any OBRA, PPS, SBCAA or discharge assessment
2. PPS 5-day or Readmission/Return has been completed/combined with SOT OMRA
3. ARD must be on or before Day 8
4. ARD must be on the last day of the Medicare Covered Stay
5. Rehab started (evaluation) within the last 4 days of the stay
6. At least one therapy discipline continued through the last covered day

If this criteria is met then the minutes of therapy provided is divided by the number of days from the therapy eval to the last covered day to obtain an average. Rehab RUG categories are assigned base on this average. Achieving varying RUG levels would require the following number of minutes per category:

• Ultra High= 144 minutes or above
• Very High= 100 to 143 minutes
• High= 65 to 99 minutes
• Med= 30 to 64 minutes
• Low= 15 to 29 minutes