News, Skilled Nursing Facility

RCS-1 draft model calculation worksheet

SNF providers are on the edge of their seats as they anticipate CMS’ consideration of a replacement for the Resource Utilization Group (RUG) system, which will change the way facilities are reimbursed for SNF Medicare Part A residents beginning as early as FY2019. The Resident Classification System, Version 1 (RCS-1) will be the most significant change in the current reimbursement model, which has been in place for nearly two decades.

While providers wait for an official implementation date, CMS has laid a lot of groundwork and published several documents regarding RCS-1 in draft format this past July, including a calculation worksheet for SNFs.

CMS explains that the purpose of this worksheet is to provide a step-by-step walk-through to manually determine a resident’s RCS-I classification based on the data from an MDS assessment. To download this draft document, click here.

For more guidance on how this new payment system will affect reimbursement in your facility, including how to use the new proposed case mix methodology and new ADL scoring, tune in to Goodbye RUG-IV, Hello RCS-1: How to Achieve Quality Outcomes Under a New Payment System led by industry expert Maureen McCarthy, BS, RN, RAC-MT, QCP-MT.