Visual RUG-II Patient Review Instrument (PRI)

1 RELIABLE HEALTH SYSTEMS, LLC 2610 Nostrand Avenue Brooklyn, New York 11210 Tel. (718) 338-2400 Fax: (718) 338-2741 www. SheetVisual RUG-IIPatient Review Instrument (PRI) PRIs in a Nursing HomeBiannual Full House. NursingHomes facilities are required tocomplete Patient ReviewInstruments (PRIs) twice a year forall residents in their facility. The PRIinstrument collects informationrelating to administrative data ,medical events, activities of dailyliving, behavior, specializedservices, diagnosis and utilizationreview. Quarterly Admissions andDischarges. On alternate quartersNursing Homes are required tocomplete a PRI for each admissionthat took lace during that these alternate quarters facilitiesare additionally required tocomplete a discharge form for alldischarges that occurred during Utilization Group II( RUG-II ).

2 Each PRI that iscompleted must be assigned one of16 RUG-II groupings using asophisticated formula that is basedon the responses in the PRI RUG-II groupings are dividedinto five main groupings including:Rehabilitation, Special Care,Clinically Complex, Behavioral, andPhysical functioning. Each group isthen further subdivided into sub-groups based on the ADL to NYS. After the PRIsare completed they are sent to thestate. The RUG II groupings arethen used by the state to calculatethe amount of Medicaidreimbursement the facility willreceive for direct Patient care. The Visual PRI SolutionImportance of the PRI. RHSrecognizes that the PRI instrumentplays the main role in determiningMedicaid reimbursement for directpatient care. Furthermore, if the PRIis completed incorrectly the facilitymay be subject to ever stricteraudits and loss of revenue. ReliableHealth Systems, LLC, has thereforedeveloped the Visual PatientReview Instrument Software tosimplify the completion process,decrease the number of errors, andhelp the facility monitor At the beginning of theyear the facility sets up a scheduleof when the PRI are due - asprovided to the facility by the on this schedule the facilityis prompted to complete theappropriate PRI Instrument for eachresident.

3 Missing and incompletePRIs are then Input Modes. The userhas the choice of using one of threeinput modes for completing the PRIinstrument. The user may use aninput form that is identical to thestate form or a condensed form thatsummarizes all questions on asingle sheet . In addition, theinformation may be entered into agrid that displays all clinical fieldsfor all residents in a nursing RUG-II scores are calculated by thesoftware and are automaticallystored in the residents records asthe PRI is and Worksheets. Avariety of reports and worksheetsare available to make the collection,auditing and submission process asaccurate and efficient as are, one- sheet PRIlistings, RUG-II analysis reports,quality indicators, PRI listings,facility analysis and to the State. Uponcompletion and Review the systemallows the user to automaticallycreate a submission file that is sentto the state.

4 A history of all sub-missions is stored on the systemand can be viewed at any Query. Integrated with thePatient Review Instrument softwareis a report query system that allowsthe facility to extract and report onany field within the Patient ReviewInstrument. These reports can bestored and can be run at any timebased on historic or current and PlatformThe Visual Care Planning module isa Web-based solution operatingwithin Microsoft Internet Server Pages combiningHTML, reusable Active-Xcomponents, Java and Visual Basicscripting provide a graphical point-and-click user data base is Microsoft s SQLS erver and printing of reports isaccomplished with the user-friendlyCrystal Reporting. RELIABLE HEALTH SYSTEMS, LLC 2610 Nostrand Avenue Brooklyn, New York 11210 Tel.

5 (718) 338-2400 Fax: (718) 338-2741 www. UnitSchedulePRI InputCondensedInformationTo obtain more information pleasecontact our marketing division orvisit our web page Health Systems, LLC2610 Nostrand AvenueBrooklyn, NY 11210 Tel: 718 - 338 - 2400 Fax: 718 - 338 - 2741