MDS Alert

Published on Fri Jan 01, 2010 PDF

RUG-IV's rollout date is still somewhat up in the air due to legislative efforts in play to delay it.

At press time in late January, the Senate version of the healthcare reform bill included a measure that would push back the revamped payment system for a year -- and that's not all. As written, it would change RUG-III to include the RUG-IV changes to concurrent therapy and "changes to the lookback period to ensure that only those services furnished after admission to a skilled nursing facility are used as factors in determining a case mix classification" under the SNF PPS. Under the proposed measure, MDS 3.0 is still a go for Oct. 1, 2010 (http://democrats.senate.gov/reform/managersamendment.pdf, pages 212 to 213).

The bottom line: "Even though the provision postpones RUG-IV, it still modifies the RUG-III ... so we'd end up with a modified version of the current RUG-III," says Ronald Orth, RN, NHA, CPC, RAC-MT, president of Clinical Reimbursement Solutions in Milwaukee, Wis. "So either way, vendors have to update the software."

Orth notes that although healthcare reform may not pass, the measure to delay RUG-IV and morph RUG-III could still be included in another bill. What are the odds of thelatter happening? "Anything's possible," Barbara Manard, a VP of the American Association of Homes & Services for the Aging, tells Eli. But Manard notes she hasn't heard anyone saying they plan to put the provision in another piece of legislation.

CMS weighs in: In responding to a caller at the January SNF/LTC Open Door Forum who asked about the Senate bill provision delaying RUGIV, a CMS representative said that if legislation passes, CMS will review it and determine what's stated. But "until then we are moving forward" with RUG-IV implementation on Oct. 1, 2010, she said.

Recent research at Massachusetts Institute of Technology (MIT) indicates hat could be the case.

Researchers found that a combination of DHA (a type of omega-3 fatty acid), choline, and uridine helped generate brain synapses in rodents. The rodents that received the nutritional mixture performed better on cognitive tests -- "specifically, the ability to navigate a water maze," according to an MIT release on the research.

Omega-3 fatty acids exist in a number of foods, including "fish, eggs, flaxseed and meat from grassfed animals," according to the release. "Choline can be synthesized in the body and obtained through the diet; it is found in meats, nuts and eggs." You can't obtain uridine from food, although it is found in human breast milk. And the body can produce it, the release notes.

Clinical studies are now testing the brain-boosting brew on people with Alzheimer's disease, a strategy that could hold promise for other brain diseases and injuries, according to the MIT news statement.

Editor's note: Read the news item at http://web.mit.edu/newsoffice/2007/alzheimers-1126.html