Pennsylvania Code
Title 55 - HUMAN SERVICES
Part III - MEDICAL ASSISTANCE MANUAL
Chapter 1187 - NURSING FACILITY SERVICES
Subchapter L - NURSING FACILITY PARTICIPATION REQUIREMENTS AND REVIEW PROCESS
BED REQUESTS
Appendix A - 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 facility's 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 CMI | RUG-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 facility's 5.12 resident care rate for rate years 2010-2011, 2011-2012 and 2012-2013 and each nursing facility's 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 CMIs | RUG-III PA Normalized Index |
RLA | 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 |