Pennsylvania Code (Last Updated: April 5, 2016) |
Title 55. PUBLIC WELFARE |
PART III. Medical Assistance Manual |
Chapter 1187. Nursing Facility Services |
SubChapter L. NURSING FACILITY PARTICIPATION REQUIREMENTS AND REVIEW PROCESS…1187.161 |
Appendix A.
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Resource Utilization Group Index Scores for Case-Mix Adjustment Nursing Facility Reimbursement System The following chart is a listing by group of the RUG-III index scores that the Department will use to set each nursing facilitys 5.01 resident care rate for the quarter beginning July 1, 2010, and ending September 30, 2010, as set forth in § 1187.96 (relating to price- and rate-setting computations). The table has one column that is the RUG-III nursing CMI scores and a second column that is the RUG-III PA normalized index scores.
RUG-III VERSION 5.01 INDEX SCORES
RUG-III Group RUG-III
Nursing CMIRUG-III PA Normalized Index RLA 1.14 1.13 RLB 1.36 1.35 RMA 1.25 1.24 RMB 1.38 1.37 RMC 2.09 2.07 RHA 1.06 1.05 RHB 1.31 1.30 RHC 1.50 1.49 RHD 1.93 1.91 RVA 0.82 0.81 RVB 1.18 1.17 RVC 1.79 1.77 SE1 1.78 1.76 SE2 2.65 2.62 SE3 3.97 3.93 SSA 1.28 1.27 SSB 1.47 1.46 SSC 1.61 1.59 CA1 0.67 0.66 CA2 0.76 0.75 CB1 0.94 0.93 CB2 1.08 1.07 CC1 1.16 1.15 CC2 1.19 1.18 CD1 1.37 1.36 CD2 1.46 1.45 IA1 0.49 0.49 IA2 0.60 0.59 IB1 0.80 0.79 IB2 0.88 0.87 BA1 0.41 0.41 BA2 0.58 0.57 BB1 0.78 0.77 BB2 0.87 0.86 PA1 0.39 0.39 PA2 0.52 0.51 PB1 0.66 0.65 PB2 0.68 0.67 PC1 0.77 0.76 PC2 0.86 0.85 PD1 1.00 0.99 PD2 1.01 1.00 PE1 1.13 1.12 PE2 1.19 1.18 The following chart is a listing by group of the RUG-III index scores that the Department will use to set each nursing facilitys 5.12 resident care rate for rate years 2010-2011, 2011-2012 and 2012-2013 and each nursing facilitys resident care rate beginning with rate year 2013-2014, and thereafter, as set forth in § 1187.96. The table has one column that is the RUG-III nursing CMI scores and a second column that is the RUG-III PA normalized index scores.
RUG-III VERSION 5.12 INDEX SCORES
RUG-III 44 Grouper RUG-III
Nursing Only
CMIsRUG-III PA Normalized
IndexRLA 0.87 0.82 RLB 1.22 1.15 RMA 1.06 1.00 RMB 1.20 1.13 RMC 1.48 1.39 RHA 0.96 0.90 RHB 1.16 1.09 RHC 1.30 1.22 RVA 0.89 0.84 RVB 1.14 1.07 RVC 1.24 1.16 RUA 0.85 0.80 RUB 1.05 0.99 RUC 1.43 1.34 SE1 1.28 1.20 SE2 1.52 1.43 SE3 1.86 1.75 SSA 1.11 1.04 SSB 1.15 1.08 SSC 1.24 1.16 CA1 0.82 0.77 CA2 0.91 0.85 CB1 0.92 0.86 CB2 1.00 0.94 CC1 1.08 1.01 CC2 1.23 1.15 IA1 0.58 0.54 IA2 0.63 0.59 IB1 0.73 0.69 IB2 0.76 0.71 BA1 0.52 0.49 BA2 0.61 0.57 BB1 0.71 0.67 BB2 0.75 0.70 PA1 0.51 0.48 PA2 0.53 0.50 PB1 0.55 0.52 PB2 0.56 0.53 PC1 0.70 0.66 PC2 0.72 0.68 PD1 0.73 0.69 PD2 0.78 0.73 PE1 0.84 0.79 PE2 0.86 0.81
Source The provisions of this Appendix A amended August 26, 2011, effective retroactive to July 1, 2010, 41 Pa.B. 4630. Immediately preceding text appears at serial pages (287078) and (332499).