Version

Models supported: 44 group hierarchical (model

suffix code = "A").

This was the initial version of the processor. It was limited to hierarchical classification. When an MDS+ database file (DBF file) was updated by the processor, the RUG3 class was always placed in a field labeled HCFA_GP in the MDS+ database.

Models supported: 44 group hierarchical and index

maximizing (model suffix code = "B").

This version allowed Medicaid Payment and Medicare Payment classifications in addition to Clinical Hierarchy classifications. The Medicaid Payment classification maximizes the Medicaid Case Mix Index (CMI) for a resident. The Medicare Payment classification maximizes the Medicare Case Mix Index (CMI) for a resident.

When an MDS+ database file (DBF file) is updated by the processor, the RUG3 class for Clinical Hierarchy classification is always placed in fields labeled MCDGP and MCRGP in the MDS+ database; the class for Medicaid payment is placed in the ST_GP field; and the class for Medicare payment is placed in the HCFA_GP field.

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Version

continued

· The new Very High Intensity Multidisciplinary Rehabilitation groups have been added. Qualification for these groups requires (1) 450 minutes or more of rehabilitation therapy per week, and (2) at least 5 days per week of one type of therapy, and (3) at least two of the three therapies provided.

· The High Intensity Rehabilitation groups no longer required two or more different types of therapy. The requirements now are (1) 300 minutes or more of rehabilitation therapy per week, and (2) at least 5 days per week of one type of therapy.

· The comatose criterion for Special Care has been further qualified. The comatose criterion must now also include maximum dependence (value 4) or indeterminant dependence (value 8) on each of the self performance ADL items for Bed Mobility, Eating, Transfer, and Toilet Use.

· Foot soaks (MDS+ item J7B) have been deleted from the set of criteria for Clinically Complex.

· Item B3E ("None of the Above" for short term memory) has been deleted from the set of criteria for Cognitive Impairment.

Version

Models supported: 44 group hierarchical and index

maximizing (model suffix code = "B").

This version is exactly the same as version 2.01 except for changes made to the pseudocode. The following information was added to the pseudocode:

· Which MDS items correspond to MDS+ items required for classification; any coding differences between these MDS items and corresponding MDS+ items.

· Which items required for classification are missing on the MDS.

· Several suggestions for developing classification logic to use with the MDS.

Models supported: 44 group hierarchical and index

maximizing (model suffix code = "C"); 35 group

hierarchical and index maximizing (model suffix

code = "D").

There were two minor changes to the dbf structure for MDS+ files to be used with the processor. These changes involved 2 field names. The field previously named MCRGP was renamed P3MED, and the field previously named MCDGP was renamed P3STATE. Note that the position, length, format, and contents for these fields did not change--only the field names in the dbf structure changed.

This version allowed classifications (whether Clinical Hierarchical or Index Maximizing) to be made for all 44 RUG3 groups or for a new RUG3 model which involves only 35 groups. The 35 group model involves collapsing several of the Rehabilitation groups from the 44 group model.

Version

continued

The Multistate Project CMI set provided with the processor included corrections from that in previous versions.

Models supported: 44 group hierarchical and index

maximizing (model suffix code = "C"); 35 group

hierarchical and index maximizing (model suffix

code = "D").

This version is exactly the same as version 3.0 except for two very minor corrections in the pseudocode. Both corrections are in the table giving MDS+ item, corresponding MDS item, permissible values, and description. The description for MDS+ item b4 was corrected to read "Cognitive skills." The MDS item corresponding to the n1bea MDS+ item was corrected to p1o.

Models supported: 44 group hierarchical and index

maximizing (model suffix code = "C"); 35 group

hierarchical and index maximizing (model suffix

code = "D").

The major change with this version was to produce executable code that would run under DOS 6.

Some minor changes were made to recoding prior to application of the classification logic. These included: (1) blanks or dashes for items b3a through b3d and g1a through g1c were recoded to 1 rather than 0 and (2) blanks or dashes for all other classification items were recoded to 0.

Version

continued

All fields in the test data (m3test31.dbf and m3test31.asc) have been filled with valid values. In prior versions, most fields which were not used for classification had been left blank.

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "C");

35 group hierarchical and index maximizing (model

suffix code = "D").

The major changes to this version were to accommodate Medicare classification for the Multistate Case Mix Demonstration. Documentation for performing Medicare classification was added. New test data for Medicare classification was also added. Acknowledgement of HCFA support and a copyright notice were added. Finally, sets of appropriate Medicare indices (CMIs) were added to the program for 2 states (Kansas and Texas) in the Multistate Medicare Case Mix Demonstration Project.

Version

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "G").

This version implements a new RUG-III classification model called RUG-III 1997 Update. This new model is based upon a staff time measurement study conducted in several states in 1995. The RUG-III 1997 Update incorporates new Ultra High Rehabilitation classes, new scales for depression and cognitive impairment, and updated qualifiers for most of the RUG-III clinical categories. M3PI Version 3.20 supports 44 group classification using Hierarchical, Index Maximizing, and Medicare calculation types.

Version

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "G").

This version is exactly the same as version 3.20 with 2 changes:

1. CMI sets appropriate to South Dakota were added (these had inadvertently been omitted from version 3.20).

2. A new RUG-III result using the Medicare calculation type and South Dakota Medicare CMIs was added to the test databases.

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "G").

This version is similar to version 3.20 with the following changes:

1. This version is only appropriate for use in New York.

2. The allowable data formats for MDS+ items j2a,j2b,j2c,j2d,n1bab,n1bbb,n1bcb, and n5 were changed to allow leading and trailing spaces in these data fields.

3. The valid range for O3 items was changed to allow for a blank value.

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "G").

This version is similar to version 3.20S with the following change:

1. The valid range for O3 items was changed to allow for a blank value.

Version

Models supported: 44 group hierarchical and index

maximizing (model suffix code = "E"); 35 group

hierarchical and index maximizing (model suffix

code = "F").

This version has similar capabilities to version 3.1 but applies to the 12/92 version of the MDS+.

There are some classification logic changes with Version 4.0, including:

· Cerebral palsy is identified if item I12b on the "Background Information at Intake or Admission" is checked or if Section K item K1ff is checked.

· In determining depression symptoms for classification, a depression symptom was formerly counted if E1c or E1h were checked. In Version 4.0 a depression symptom is counted if E1c, E1g, E1h, or E1i is checked.

· In versions for the 12/90B MDS+, one could qualify for Clinically Complex if there was a surgical wound (J4d) and item J5d was checked (indicated care for surgical wound or pressure ulcer). In version 4.0 for the 12/92 MDS+, such qualification is indicated by item J4d and J5f (surgical wound care).

· In prior versions, classification in a Rehabilitation group was always based on therapies actually received (Section N1b). In version 4.0, a new classification type ("Medicare" classification) is allowed which uses ordered therapies (Section N1c) rather than received therapies, but only if the reason for assessment is "preliminary" (item A6a). For all other reasons for assessment, Medicare classification still uses therapies actually received (Section N1b).

Version

Models supported: 44 group hierarchical and index

maximizing (model suffix code = "E"); 35 group

hierarchical and index maximizing (model suffix

code = "F").

This version is exactly the same as version 4.0 with 2 minor exceptions. Acknowledgement of HCFA support and a copyright notice were added.

Models supported: 44 group hierarchical and index

maximizing (model suffix code = "E"); 35 group

hierarchical and index maximizing (model suffix

code = "F").

The major changes to this version were to accommodate Medicare classification for the Multistate Case Mix Demonstration.

· Documentation for performing Medicare classification was added.

· New test data for Medicare classification was added.

· Finally, the classification logic was changed for Medicare classification. In prior versions (4.0 and 4.01), Medicare classification involved the 44 group model and hierarchical calculation. In this version, Medicare classification was modified to use the 44 group model but index maximizing calculation. Also, sets of appropriate Medicare indices (CMIs) were added to the program for four states (Maine, Mississippi, New York, and South Dakota) in the Multistate Medicare Case Mix Demonstration Project. These are the CMI sets to be used with the index maximizing calculations for Medicare residents.

Version

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "G");

35 group hierarchical and index maximizing (model

suffix code = "H").

There are 3 changes with this version:

1. This version supports several changes to the 12/92 MDS+ record layout. The 12/92 MDS+ record layout supported is that presented in the system control file MDSSTRU1.DBF. The specific changes made to this layout (versus that for version 4.02) are as follows:

· The field length for the social security number fields--I3, III3, and A2--have length increased to 12 characters.

· The field previous named SS (corresponding to A2) has been renamed as A2 in the layout.

· The fields comprising the last 57 characters of the record layout have been completely redefined.

2. When a DBASE file is processed to calculate and update RUG-III values in that file, a text file named RUGLIST.TXT is now automatically produced. This text file reports the RUG-III values calculated for each record in the DBASE file.

3. For Medicare classification in previous versions, Rehabilitation group membership was based on ordered therapies for preliminary assessments (A6a = 1) but on therapies received for other assessment types. In Version 4.03, Rehabilitation group membership is based on ordered therapies for both preliminary (A6a = 1) and readmission (A6a = 3) assessments, with ordered therapies used for other assessment types.

Version

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "G");

35 group hierarchical and index maximizing (model

suffix code = "H").

Changes with this version:

1. An error in Medicare Very High Rehabilitation classification in Version 4.03 was corrected. This error only occurred when the Calculation Type was Medicare and the assessment was a preliminary assessment (a6a = 1) or readmission assessment (a6a = 3). To be classified as Very High Rehab on these types of assessments, a resident must have orders for 2 or more therapies. A therapy is ordered if the number of days the therapy is scheduled (n1caa, n1cba, or n1cca) is one or more. Version 4.03 erroneously counted a therapy as ordered only if the number of days scheduled was between 1 and 7. If 8 or more days were scheduled, the therapy was omitted when counting the number of therapies with orders, and the resident could have been incorrectly classified as High Rehab rather than Very High Rehab. This error did not affect classification into any other group for any assessment type. Version 4.04 corrects this error.

Version

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "I").

This version implements a new RUG-III classification model called RUG-III 1997 Update. This new model is based upon a staff time measurement study conducted in several states in 1995. The RUG-III 1997 Update incorporates new Ultra High Rehabilitation classes, new scales for depression and cognitive impairment, and updated qualifiers for most of the RUG-III clinical categories. M3PI Version 4.10 supports 44 group classification using Hierarchical, Index Maximizing, and Special Medicare calculation types.

Version

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "01").

This is the first version to accommodate MDS 2.0. This version is an interim version which supports 44 group classification but NOT 35 group classification. All other features are available.

The classification algorithm used in this version is a crosswalk from that for version 4.03 with some changes to Medicare type classification. Medicare type changes were necessitated because ordered therapy items were changed with the MDS 2.0.

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "01").

This version is exactly the same as version 5.00 with 1 change. In version 5.00 a blank was not included in the permissible range for item T1b (Ordered Therapies) and a blank in this field led to a default BC1 classification when the M3PI processor was used to update an assessment file. There was no similar problem for the M3PI manual calculator for version 5.00.

A value of blank on T1b is actually a permissible value. In version 5.01, a value of blank is included in the valid range for item T1b "Ordered Therapies" and valid classifications will now be calculated when this item is blank.

Version

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "03").

This version implements a new RUG-III classification model called RUG-III 1997 Update. This new model is based upon a staff time measurement study conducted in several states in 1995. The RUG-III 1997 Update incorporates new Ultra High Rehabilitation classes, new scales for depression and cognitive impairment, and updated qualifiers for most of the RUG-III clinical categories. M3PI Version 5.10 supports 44 group classification using Hierarchical, Index Maximizing, and Special Medicare calculation types.

Models supported: 44 group Medicare, hierarchical,

and index maximizing (model suffix code = "05");

34 group hierarchical and index maximizing (model

suffix code = "06").

This version classifies using the RUG-III 1997 Update logic. There is one major change from version 5.10:

Classification has been added for a 34 group model which is better suited to Medicaid classification than the 44 group model.

There were 2 minor additional changes with this version:

1. The file processing procedure skips Discharge and Reentry records and does not attempt to calculate a classification for these records.

2. The file processing procedure detects some unusual out-of-range values that were not correctly detected in version 5.10. Examples of such values are "1a11" where the range is from "0000" to "9999".