Volume XXX, Number 5
Distribution of Resident Days by RUG Level Report No Longer Available
For the past several years THCA has included in each month’s issue of THCA Notes a distribution of nursing facility resident days by RUG level, reflective of the claims submission activity of the prior twelve months. THCA previously obtained this information from the Department of Aging and Disability Services (DADS), based upon the number of Medicaid days billed to the agency by nursing facilities. With the implementation of Medicaid Managed Care, however, almost all claims are now submitted to the various Managed Care Organizations (MCOs) participating in the Star+Plus program. Subsequently, there is currently no reporting mechanism with which to obtain comparable data.
In its meetings with the Health and Human Services Commission (HHSC), THCA has communicated that it would like to continue to obtain this information as we move forward with managed care, and the agency has indicated that this information should once again be available in the future. We will continue to share that and other pertinent information with you as it becomes available. If you have any questions regarding the information, contact Tom Plowman at the THCA office.
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