VA250-17-Q-0956-007.doc

Resource Utilization Group (RUG) Crosswalk

RUG CROSSWALK*

*COs should contact the VA Geriatric and Extended Care department for maximum add-on percentages that can be negotiated for each Medicaid category below. CNH program personnel will be able to assist COs with obtaining the percentages. The Crosswalk is not for inclusion in the Indefinite Delivery Contract (IDC), but is for reference only.

RUG II

RUG III

RUG IV

Rehab + Ext Svs – RUX, RUL, RVX, RVL, Ultra-high Rehab + Ext Svs – RUX, RUL

RHX, RHL, RMX, RML,

Very-high Rehab + Ext Svs – RVX, RVL

RLX

High Rehab + Ext Svs – RHX, RHL

Medium Rehab + Ext Svs – RMX, RML

Low Rehab + Ext Svs – RLX

Rehabilitation Therapy

Rehabilitation – RUA, RUB, RUC, RVA, Ultra-high Rehab – RUC, RUB, RUA

RVB, RVC, RHA, RHB,

Very-high Rehab – RVC, RVB, RVA

RHC, RMA, RMB, RMC,

High Rehab – RHC, RHB, RHA

RLA, RLB

Medium Rehab – RMC, RHB, RHA

Low Rehab – RLB, RLA

Extensive Svs – SE1, SE2, SE3

Extensive Svs – ES3, ES2, ES1

Special Care

Special Care – SSA, SSB, SSC

Special Care High – HE2, HE1, HD2, HD1, HC2, HC1, HB2, HB1

Special Care Low – LE2, LE1, LD2, LD1, LC2, LC1, LB2, LB1

Clinically Complex

Clinically Complex – CA1, CA2, CB1, Clinically Complex – CE2, CE1, CD1, CC2, CB2, CCA, CC2

CC1, CB2, CB1, CA2,

CA1

Basic Care

Impaired Cognition – IA1, IA2, IB2 Behavioral Symptoms & – BB2, BB1, Cognitive Performance

BA2, BA1

Behavior Problems – BA1, BA2, BB1, BB2

Reduced Phy Function

Reduced Phy Function – PA1, PA2, PB1 Reduced Phy Function – PE2, PE1, PD2, PB2, PC1, PC2

PD1, PC2, PC1,

PD1, PD2, PE1

PB2, PB1, PA2,

PE2

PA1

Community Nursing Home SOP

Original Date: 05/02/2016