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S 3.0 Therapy Minutes G

uideMedicare MDS Assessment Type ARD Window

Case Days ARD Grace Days Payment Days

5 day 1-5 6-8 1 through 14

14 day 13-14 15-18 15 through 30

30 day 27-29 30-33 31 through 60

60 day 57-59 60-63 61 through 90

90 day 87-89 90-93 91 through 100

Start of Therapy (SOT) OMRA (optional)

Day 5-7 from first eval N/A Until next MDS assessment

Short Stay (optional) See criteria below

DC date N/A Through last covered Med A day

End of Therapy (EOT) OMRA (required if continuing Part A after Therapy D/C or 5 day break)

Day 1-3 after therapy last treated

N/A Day after therapy last treated until next MDS Assessment is paid at the nursing RUG

EOT-Resumption (EOT-R) OMRA (modified EOT)

Same as EOT, except adding expectation that therapy will resume and date therapy resumed

Therapy must resume by day 5 after therapy last treated and at the same Rehab RUG level as before the break in therapy

Payment for therapy resumes the day therapy starts treating again

Change of Therapy (COT) OMRA (successive 7 day observation periods that start after last MDS Assessment ARD or after last COT observation period)

Day 7 of the COT observation period

N/A If therapy is provided at a greater or lesser RUG level, the payment for the new RUG begins day 1 of the COT lookback.

Short Stay Criteria:SOT OMRA combined w. or after 5-dayARD is last day & on or before day 8Rehab started within the last 4 daysTherapy still in at time of DC

Add total tx minutesprovided from SOT throughlast day. Divide totalminutes by the # of daysfrom the SOT through the ARD

Short Stay Avg Mins GuideRU 144+RV 100-143RH 65-99RM 30-64RL 15-29

Individual: 1:1 reported fully on the MDSConcurrent: 1:2, as of 10-1-2010 report fully on the MDS. Grouper divides by 2 to allocate minutestoward the Rehab RUG.Group: as of 10-1-2011, will report fully on the MDS and the grouper will divide by 4 to allocate minutes toward the Rehab RUG. 25% of total therapy time per discipline maximum counts toward the RUG.Rehab RUG Level Minutes Guide

REHAB RUG Criteria 5x/week daily avg 6x/week daily avg 7x/week daily avg

RU* 720 minutes per 7 day look back, 2-3 discipline

2 disc. 72/day 3 disc 48/day

2 disc 60/day 3 disc 40/day

2 disc 52/day 3 disc 35/day

RV* 500 minutes per 7 day lookback, At least one discipline

1 disc 100/day 2 disc 50/day 3 disc 35/day

1 disc 84/day 2 disc 42/day 3 disc 28/day

1 disc 72/day 2 disc 36/day 3 disc 24/day

RH* 325 minutes per 7 day look back, At least one discipline

1 disc 65/day 2 disc 33/day

1 disc 55/day 2 disc 28/day

1 disc 46/day 2 disc 23/day

RM* 150 minutes per 7 day look back, any combination of disciplines

30/day

25/day 22/day

RL 45 minutes per 7 day look back, any combination of disc

15/day- 3 days N/A N/A

* A t least 5 days in a 7 day look back must have ponturi pariuri therapy by a single discipline having 5 days of treatment.Exception is Rehab Medium which may be a combination of disciplines but still requires 5 days combined.

Medicare MDS Assessment Type ARD WindowCase Days

ARD Grace Days Payment Days

5 day 1-5 6-8 1 through 14

14 day 13-14 15-18 15 through 30

30 day 27-29 30-33 31 through 60

60 day 57-59 60-63 61 through 90

90 day 87-89 90-93 91 through 100

Start of Therapy (SOT) OMRA(optional)

Day 5-7 from first eval N/A Until next MDS assessment

Short Stay (optional)See criteria below

DC date N/A Through last covered Med A day

End of Therapy (EOT) OMRA(required if continuing Part A after Therapy D/C or 5 day break)

Day 1-3 after therapylast treated

N/A Day after therapy last treated until next MDS Assessment is paid atthe nursing RUG

EOT-Resumption (EOT-R) OMRA(modified EOT)

Same as EOT, exceptadding expectation thattherapy will resumeand date therapyresumed

Therapy must resume byday 5 after therapy lasttreated and at the sameRehab RUG level asbefore the break intherapy

Payment for therapy resumes theday therapy starts treating again

Change of Therapy (COT) OMRA(successive 7 day observationperiods that start after last MDSAssessment ARD or after last COTobservation period)

Day 7 of the COTobservation period

N/A If therapy is provided at a greater or lesser RUG level, the paymentfor the new RUG begins day 1 ofthe COT lookback.

Short Stay Criteria: SOT OMRA combined w. or after 5-day ARD is last day & on or before day 8 Rehab started within the last 4 days Therapy still in at time of DC

Add total tx minutes provided from SOT through last day. Divide total minutes by the # of days from the SOT through the ARD

Short Stay Avg Mins Guide RU 144+ RV 100-143 RH 65-99 RM 30-64 RL 15-29

Individual: 1:1 reported fully on the MDSConcurrent: 1:2, as of 10-1-2010 report fully on the MDS. Grouper divides by 2 to allocate minutestoward the Rehab RUG.Group: as of 10-1-2011, will report fully on the MDS and the grouper will divide by 4 to allocate minutes toward the Rehab RUG. 25% of total therapy time per discipline maximum counts toward the RUG.

Medicare MDS Assessment Type ARD WindowCase Days

ARD Grace Days Payment Days

5 day 1-5 6-8 1 through 14

14 day 13-14 15-18 15 through 30

30 day 27-29 30-33 31 through 60

60 day 57-59 60-63 61 through 90

90 day 87-89 90-93 91 through 100

Start of Therapy (SOT) OMRA(optional)

Day 5-7 from first eval N/A Until next MDS assessment

Short Stay (optional)See criteria below

DC date N/A Through last covered Med A day

End of Therapy (EOT) OMRA(required if continuing Part A after Therapy D/C or 5 day break)

Day 1-3 after therapylast treated

N/A Day after therapy last treated until next MDS Assessment is paid atthe nursing RUG

EOT-Resumption (EOT-R) OMRA(modified EOT)

Same as EOT, exceptadding expectation thattherapy will resumeand date therapyresumed

Therapy must resume byday 5 after therapy lasttreated and at the sameRehab RUG level asbefore the break intherapy

Payment for therapy resumes theday therapy starts treating again

Change of Therapy (COT) OMRA(successive 7 day observationperiods that start after last MDSAssessment ARD or after last COTobservation period)

Day 7 of the COTobservation period

N/A If therapy is provided at a greater or lesser RUG level, the paymentfor the new RUG begins day 1 ofthe COT lookback.

Short Stay Criteria:SOT OMRA combined w. or after 5-dayARD is last day & on or before day 8Rehab started within the last 4 daysTherapy still in at time of DC

Add total tx minutesprovided from SOT throughlast day. Divide totalminutes by the # of daysfrom the SOT through the ARD

Short Stay Avg Mins GuideRU 144+RV 100-143RH 65-99RM 30-64RL 15-29

Individual: 1:1 reported fully on the MDS Concurrent: 1:2, as of 10-1-2010 report fully on the MDS. Grouper divides by 2 to allocate minutes toward the Rehab RUG. Group: as of 10-1-2011, will report fully on the MDS and the grouper will divide by 4 to allocate minutes toward the Rehab RUG. 25% of total therapy time per discipline maximum counts toward the RUG. Rehab RUG Level Minutes Guide

REHAB RUG Criteria 5x/week daily avg 6x/week daily avg 7x/week daily avg

RU* 720 minutes per 7 day lookback, 2-3 discipline

2 disc. 72/day3 disc 48/day

2 disc 60/day3 disc 40/day

2 disc 52/day3 disc 35/day

RV* 500 minutes per 7 day lookback, At least one discipline

1 disc 100/day2 disc 50/day3 disc 35/day

1 disc 84/day2 disc 42/day3 disc 28/day

1 disc 72/day2 disc 36/day3 disc 24/day

RH* 325 minutes per 7 day lookback, At least one discipline

1 disc 65/day2 disc 33/day

1 disc 55/day2 disc 28/day

1 disc 46/day2 disc 23/day

RM* 150 minutes per 7 day lookback, any combination ofdisciplines

30/day 25/day 22/day

RL 45 minutes per 7 day look back, any combination of disc

15/day- 3 days N/A N/A

*At least 5 days in a 7 day look back must have therapy by a single discipline having 5 days of treatment.Exception is Rehab Medium which may be a combination of disciplines but still requires 5 days combined.

Rehab RUG Level Minutes Guide

Medicare MDS Assessment Type ARD WindowCase Days

ARD Grace Days Payment Days

5 day 1-5 6-8 1 through 14

14 day 13-14 15-18 15 through 30

30 day 27-29 30-33 31 through 60

60 day 57-59 60-63 61 through 90

90 day 87-89 90-93 91 through 100

Start of Therapy (SOT) OMRA(optional)

Day 5-7 from first eval N/A Until next MDS assessment

Short Stay (optional)See criteria below

DC date N/A Through last covered Med A day

End of Therapy (EOT) OMRA(required if continuing Part A after Therapy D/C or 5 day break)

Day 1-3 after therapylast treated

N/A Day after therapy last treated until next MDS Assessment is paid atthe nursing RUG

EOT-Resumption (EOT-R) OMRA(modified EOT)

Same as EOT, exceptadding expectation thattherapy will resumeand date therapyresumed

Therapy must resume byday 5 after therapy lasttreated and at the sameRehab RUG level asbefore the break intherapy

Payment for therapy resumes theday therapy starts treating again

Change of Therapy (COT) OMRA(successive 7 day observationperiods that start after last MDSAssessment ARD or after last COTobservation period)

Day 7 of the COTobservation period

N/A If therapy is provided at a greater or lesser RUG level, the paymentfor the new RUG begins day 1 ofthe COT lookback.

Short Stay Criteria:SOT OMRA combined w. or after 5-dayARD is last day & on or before day 8Rehab started within the last 4 daysTherapy still in at time of DC

Add total tx minutesprovided from SOT throughlast day. Divide totalminutes by the # of daysfrom the SOT through the ARD

Short Stay Avg Mins GuideRU 144+RV 100-143RH 65-99RM 30-64RL 15-29

Individual: 1:1 reported fully on the MDSConcurrent: 1:2, as of 10-1-2010 report fully on the MDS. Grouper divides by 2 to allocate minutestoward the Rehab RUG.Group: as of 10-1-2011, will report fully on the MDS and the grouper will divide by 4 to allocate minutes toward the Rehab RUG. 25% of total therapy time per discipline maximum counts toward the RUG.

Medicare MDS Assessment Type ARD WindowCase Days

ARD Grace Days Payment Days

5 day 1-5 6-8 1 through 14

14 day 13-14 15-18 15 through 30

30 day 27-29 30-33 31 through 60

60 day 57-59 60-63 61 through 90

90 day 87-89 90-93 91 through 100

Start of Therapy (SOT) OMRA(optional)

Day 5-7 from first eval N/A Until next MDS assessment

Short Stay (optional)See criteria below

DC date N/A Through last covered Med A day

End of Therapy (EOT) OMRA(required if continuing Part A after Therapy D/C or 5 day break)

Day 1-3 after therapylast treated

N/A Day after therapy last treated until next MDS Assessment is paid atthe nursing RUG

EOT-Resumption (EOT-R) OMRA(modified EOT)

Same as EOT, exceptadding expectation thattherapy will resumeand date therapyresumed

Therapy must resume byday 5 after therapy lasttreated and at the sameRehab RUG level asbefore the break intherapy

Payment for therapy resumes theday therapy starts treating again

Change of Therapy (COT) OMRA(successive 7 day observationperiods that start after last MDSAssessment ARD or after last COTobservation period)

Day 7 of the COTobservation period

N/A If therapy is provided at a greater or lesser RUG level, the paymentfor the new RUG begins day 1 ofthe COT lookback.

Short Stay Criteria:SOT OMRA combined w. or after 5-dayARD is last day & on or before day 8Rehab started within the last 4 daysTherapy still in at time of DC

Add total tx minutesprovided from SOT throughlast day. Divide totalminutes by the # of daysfrom the SOT through the ARD

Short Stay Avg Mins GuideRU 144+RV 100-143RH 65-99RM 30-64RL 15-29

Individual: 1:1 reported fully on the MDSConcurrent: 1:2, as of 10-1-2010 report fully on the MDS. Grouper divides by 2 to allocate minutestoward the Rehab RUG.Group: as of 10-1-2011, will report fully on the MDS and the grouper will divide by 4 to allocate minutes toward the Rehab RUG. 25% of total therapy time per discipline maximum counts toward the RUG.

Medicare MDS Assessment Type ARD WindowCase Days

ARD Grace Days Payment Days

5 day 1-5 6-8 1 through 14

14 day 13-14 15-18 15 through 30

30 day 27-29 30-33 31 through 60

60 day 57-59 60-63 61 through 90

90 day 87-89 90-93 91 through 100

Start of Therapy (SOT) OMRA(optional)

Day 5-7 from first eval N/A Until next MDS assessment

Short Stay (optional)See criteria below

DC date N/A Through last covered Med A day

End of Therapy (EOT) OMRA(required if continuing Part A after Therapy D/C or 5 day break)

Day 1-3 after therapylast treated

N/A Day after therapy last treated until next MDS Assessment is paid atthe nursing RUG

EOT-Resumption (EOT-R) OMRA(modified EOT)

Same as EOT, exceptadding expectation thattherapy will resumeand date therapyresumed

Therapy must resume byday 5 after therapy lasttreated and at the sameRehab RUG level asbefore the break intherapy

Payment for therapy resumes theday therapy starts treating again

Change of Therapy (COT) OMRA(successive 7 day observationperiods that start after last MDSAssessment ARD or after last COTobservation period)

Day 7 of the COTobservation period

N/A If therapy is provided at a greater or lesser RUG level, the paymentfor the new RUG begins day 1 ofthe COT lookback.

Short Stay Criteria:SOT OMRA combined w. or after 5-dayARD is last day & on or before day 8Rehab started within the last 4 daysTherapy still in at time of DC

Add total tx minutesprovided from SOT throughlast day. Divide totalminutes by the # of daysfrom the SOT through the ARD

Short Stay Avg Mins GuideRU 144+RV 100-143RH 65-99RM 30-64RL 15-29

Individual: 1:1 reported fully on the MDSConcurrent: 1:2, as of 10-1-2010 report fully on the MDS. Grouper divides by 2 to allocate minutestoward the Rehab RUG.Group: as of 10-1-2011, will report fully on the MDS and the grouper will divide by 4 to allocate minutes toward the Rehab RUG. 25% of total therapy time per discipline maximum counts toward the RUG.