Time Study Project Data Collection and Analysis

This contract was awarded to assure that payments to skilled nursing facilities (SNFs) remain accurate by reflecting current patient care practices, such as allocation of nursing home staff time to residents. Medicare reimburses Part A skilled nursing services on a prospective payment system (PPS), which used the Resource Utilization Group, version three (RUG-III), case mix classification system to determine payments based on resident data. Introduced in 1998, the SNF PPS was constructed on the basis of staff time measurement studies conducted over a decade ago (in 1990, 1995, and 1997). Staff Time and Resource Intensity Verification (STRIVE) analysis suggested industry practices changed over the last decade, and CMS introduced RUG-IV through regulation to be effective October 2010. This will update SNF nursing rates, provide the means for states to update payment rates for their Medicaid nursing homes, and make available national data resulting from STRIVE analysis to State Medicaid agencies to evaluate their payment structures. The introduction of CMS's latest version of the assessment instrument, MDS 3.0, which STRIVE has analyzed to the extent its items collect resident characteristics necessary to case-mix classification under the RUG model, will be in October, 2010. This contract will continue to provide pre and post-implementation monitoring, evaluation and analysis of RUG-IV, provide technical support on RUG-IV specifications by responding to questions submitted by State agencies, and develop RUG-34, 44, and 53 Medicaid Groupers for RUG-IV.