Resource utilization groups (RUGs) use which reimbursement methodology by skilled nursing facilities?

Resource Utilization Groups (RUGs) employ a cost-based reimbursement methodology for skilled nursing facilities. This system categorizes patients based on their care needs and the resources required to provide that care, effectively aligning reimbursement with the anticipated costs of care.

Using RUGs, skilled nursing facilities receive payments determined by the level of care patients require, which is assessed through their clinical profiles and service needs. This approach allows for a more accurate reflection of the resources utilized in patient care, ensuring that facilities are reimbursed according to the complexity and intensity of services provided.

The cost-based methodology is designed to cover the expenses incurred by the facilities, ensuring they can maintain quality care. Each RUG classification corresponds to a specific payment rate, allowing skilled nursing facilities to manage their operational costs effectively while delivering the necessary level of care for patients.