Sample Reports
All of these sample reports are based on data provided by CMS to MDS software vendors to test their software. The particular submission file I'm using consists of 11 Medicare 5-day assessments, one quarterly, one admission assessment, an inactivation request and a discharge tracking form, for a total of 15 records. At the default settings, two reports are generated, a Medicaid 5.12-34 Grouper Report and a Medicare/PPS Report. I'm using RUG-III Analyzer in my Georgia facility for both Medicaid reimbursement and Medicare reimbursement? What settings do you recommend? The first thing to do when you launch the program is to hit the button labelled "5.12 34-Group Medicaid Grouper Options". For the calculation algorithm, choose "Georgia" from the pull-down menu. I've adjusted some of the other settings to my preference. Click here to see what the form should now look like. If you suspect that your facility is undercoding significantly the ADL items, you may want to increase this value to 3 or 4. The second thing to do from the main form is to click on the button labelled "5.12 34-Group Medicaid Report Options". Because Georgia reimbursement increases for residents with a CPS score of 4 or more, check "Print CPS Score and Text for Each Assessment." Make sure that the last option, "Print 5.12-34 Group Medicaid Report" is checked. My favorite sort option is "Potential CMI Increase". For most purposes, I'd uncheck "Include Discharge, Reentries and Inactivations", but I've kept it here for the sample report. Click here to see what the Medicaid Report Options forms looks like. Next, from the main form, click on "Medicare PPS Grouper Options". Let's assume your facility is Urban, and it's prior to January 1, 2006. So your Medicare Grouper Options form might look like this. Finally, from the main form, click on "PPS Report Options". This time, let's sort by RUG-III Category. Let's not include the non-Medicare assessments, and let's not include the Discharges, Reentries and Inactivations. We'll also not need the ADL calculation grid at the end of the report. So your Medicare Report Options screen will look like this. Based on these options, these are your reports: Last updated September 15, 2005.
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