Department of Health and Human Services 

OFFICE OF 

INSPECTOR GENERAL 

JULY 2001 

OEI-02-01-00280 

Trends in the Assignment of 

Resource Utilization Groups by 

Skilled Nursing Facilities 
OFFICE OF INSPECTOR GENERAL 

The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, is to 

protect the integrity of the Department of Health and Human Services programs as well as the 

health and welfare of beneficiaries served by them. This statutory mission is carried out through 

a nationwide program of audits, investigations, inspections, sanctions, and fraud alerts. The 

Inspector General informs the Secretary of program and management problems and recommends 

legislative, regulatory, and operational approaches to correct them. 

Office of Evaluation and Inspections 

The Office of Evaluation and Inspections (OEI) is one of several components of the Office of 

Inspector General. It conducts short-term management and program evaluations (called 

inspections) that focus on issues of concern to the Department, the Congress, and the public. 

The inspection reports provide findings and recommendations on the efficiency, vulnerability, 

and effectiveness of departmental programs. 

OEI's New York regional office prepared this report under the direction of John I. Molnar, 

Regional Inspector General, and Renee C. Dunn, Deputy Regional Inspector General. Principal 

OEI staff included: 

REGION HEADQUARTERS

Jodi Nudelman, Project Leader Tricia Davis, Program Specialist

Danielle Fletcher, Lead Analyst Brian Richie, Director, Technical Support Staff

To obtain copies of this report, please call the New York Regional Office at (212) 264-2000. 

Reports are also available on the World Wide Web at our home page address: 

http://www.hhs.gov/oig/oei 
EXECUTIVE SUMMARY 

PURPOSE 

To examine changes in the proportion of Medicare beneficiaries assigned to each 

Resource Utilization Group in light of recent legislative changes to the prospective 

payment system for skilled nursing facilities. 

BACKGROUND 

Congress mandated in Section 314 of the Benefits Improvement and Protection Act that 

the Office of Inspector General review the Medicare payment structure for services 

classified within the rehabilitation Resource Utilization Groups (RUGs) no later than 

October 1, 2001. In response, this inspection examines the trends in the proportion of 

Medicare residents assigned to each RUG to assess whether recent changes to the 

payment rates have created incentives for nursing facilities to admit certain patients. 

The Balanced Budget Act of 1997 changed reimbursement for skilled nursing facilities 

from a cost-based to a prospective payment system (PPS). Under the prospective 

payment system, skilled nursing facilities are required to assign residents to 1 of 44 

RUGs. In the Fall of 1999, Congress enacted the Balanced Budget Refinement Act 

(BBRA), which included a 4 percent across-the-board increase in payments to skilled 

nursing facilities for Fiscal Years 2001 and 2002 and a temporary 20 percent increase to 

15 RUGs for patient conditions considered medically complex. The changes went into 

effect on October 1, 2000. In 2000, Congress further adjusted the payment rates under 

the Benefits Improvement and Protection Act, which became effective on April 1, 2001. 

This inspection is based on an analysis of the Centers for Medicare and Medicaid 

Services’ National Claims History File. We analyzed the admission RUG code for all 

residents by quarter from January 1999 to January 2001. 

FINDINGS 

No major changes in RUG assignment since the implementation 

of PPS 

Virtually no change in the proportion of residents assigned to the 

rehabilitation RUGs There are seven RUG categories: special rehabilitation, 

extensive care, special care, clinically complex, cognitively impaired, behavior problems, 

and reduced physical functions. The proportion of Medicare residents assigned to the 

RUGs in the rehabilitation category has remained about the same since the 

implementation of PPS in January 1999. There have also been no large changes in the 

Trends in RUGs for SNFS i OEI-02-01-00280 
proportion of Medicare residents assigned to any of the other categories during this time 

period. In the first quarter of 2001, about 78 percent of all Medicare residents were 

assigned to one of the rehabilitation RUGs at admission. 

Small shifts within the rehabilitation RUGs Shifts have occurred in the proportion 

of residents assigned to the RUGs within the rehabilitation category since the 

implementation of PPS in January 1999. Medicare residents who require therapy are 

coded into one of five sub-categories depending upon the amount of therapy they need. 

These sub-categories are: ultra high, very high, high, medium, and low. The proportion 

of Medicare residents assigned to the high and medium therapy sub-categories increased 

slightly, while those assigned to the ultra high, very high, and low therapy sub-categories 

decreased slightly since the implementation of PPS. 

The BBRA increased payment rates for three RUGs within the high and medium therapy 

sub-categories. The proportion of Medicare residents assigned to two of these RUGs 

increased slightly, while those assigned to the third RUG remained about the same since 

the implementation of PPS. At the same time, the proportion of residents in all of the 

RUGs in the ultra-high, very high, and low therapy sub-categories steadily decreased 

over the last 2 years. It is important to note that the trends in the proportion of residents 

assigned to all of these RUGs have not changed since the BBRA became effective. 

No changes in the other RUGs The BBRA increased payment for all RUGs in the 

extensive care, special care, and clinically complex categories by 20 percent. Our 

analysis shows minimal changes in the proportion of residents coded in each of the RUGs 

in these categories since the implementation of PPS. 

Beneficiary characteristics remain the same We found no substantial changes in 

the characteristics of Medicare beneficiaries who were admitted to SNFs since the 

implementation of PPS. Specifically, beneficiaries’ age, sex, race, and reason for 

Medicare eligibility are the same in every quarter since January 1999. 

CONCLUSION 

While we identified small changes in the affected rehabilitation RUGs, it appears that 

these trends began prior to the BBRA. We will continue to monitor the trends in the 

proportion of Medicare residents assigned to each of the RUGs as new data become 

available. 

Trends in RUGs for SNFS ii OEI-02-01-00280 
TABLE OF CONTENTS 

PAGE

EXECUTIVE SUMMARY ...................................................... i

INTRODUCTION ............................................................. 1

FINDINGS 

No major changes in RUGs since PPS ....................................... 5

CONCLUSION ............................................................... 8

APPENDICES 

A: List of RUGs ......................................................... 9

B: RUG Payment Rates .................................................. 10

C: Proportion of Medicare Residents in RUG Categories ........................ 11

D: Proportion of Medicare Residents in each RUG ............................ 12

Trends in RUGs for SNFS iii OEI-02-01-00280 
INTRODUCTION 

PURPOSE 

To examine changes in the proportion of Medicare beneficiaries assigned to each 

Resource Utilization Group in light of recent legislative changes to the prospective 

payment system for skilled nursing facilities. 

BACKGROUND 

Congress mandated in Section 314 of the Benefits Improvement and Protection Act 

(BIPA) that the Office of Inspector General (OIG) review the Medicare payment 

structure for services classified within the rehabilitation Resource Utilization Groups 

(RUGs) no later than October 1, 2001. In response, this inspection examines the trends 

in the proportion of residents assigned to each RUG to assess whether recent changes to 

the payment rates have created incentives for facilities to admit certain patients. This 

inspection is related to the OIG study entitled, Medicare Beneficiary Access to Skilled 

Nursing Facilities 2001, OEI-02-01-00160, which evaluates access to SNFs for Medicare 

beneficiaries based on interviews with hospital discharge planners and an analysis of 

Medicare data. 

Medicare Payments to SNFs 

Medicare Part A helps to pay for SNF care when a beneficiary meets certain conditions. 

These conditions include a requirement of daily skilled nursing or rehabilitation services, 

a prior three consecutive day stay in a hospital, admission to a SNF within a short period 

of time after leaving the hospital, treatment for the same condition that was treated in the 

hospital, and a medical professional certifying the need for daily skilled nursing or 

rehabilitative care. The number of SNF days provided under Medicare is limited to 100 

days per benefit period, with a co-payment required for days 21 through 100. After the 

Medicare 100 day SNF Part A benefit runs out, the Medicare Part B benefit continues to 

pay for physician services and other Part B covered services. 

In order to control escalating nursing home costs, the Balanced Budget Act of 1997 

changed SNF reimbursement from a cost-based to a prospective payment system. 

Beginning with the first cost reporting period after July 1, 1998, SNFs are paid through 

prospective, case-mix adjusted per diem payments that cover routine, ancillary, and 

capital-related costs, including most items and services for which payment was 

previously made under Medicare Part B. The per diem payment is based on Fiscal Year 

1995 Part A & B costs adjusted using the SNF market basket index, the case-mix from 

resident assessments, and geographical wage variations. The market basket index 

Trends in RUGs for SNFS 1 OEI-02-01-00280 
represents an inflation factor. The case-mix index takes into account that SNF residents 

require different levels of care. 

To determine the case-mix, SNFs are required to classify residents into 1 of 44 Resource 

Utilization Groups (RUGs). (See Appendix A for a complete listing of the RUGs.) To 

do this, SNFs must fill out the Minimum Data Set 2.0 (MDS) assessment, a standardized 

set of clinical and functioning status measures. An interdisciplinary team from the 

nursing home completes the MDS for every resident by the 5th, 14th, 30th, 60th, and the 90th 

days of their stay. Prior to PPS, the MDS had been used exclusively for care planning. 

The RUGs are divided into seven major categories: special rehabilitation, extensive 

services, special care, clinically complex, impaired cognition, behavior problems, and 

reduced physical function. Each of the RUGs is associated with a payment rate that is 

based on a number of factors such as the need for therapy and the level of functioning 

measured in terms of the activities of daily living (ADL). Medicare typically reimburses 

SNFs for residents coded only in the first four categories. 

Residents requiring physical or occupational therapy are assigned to a RUG in the special 

rehabilitation category. There are five special rehabilitation sub-categories: ultra-high, 

very high, high, medium and low. Each resident is classified in a sub-category depending 

on the number of therapy minutes required as indicated on the MDS in the last seven 

days. Each resident is then assigned to a specific RUG within these sub-categories 

depending on the level of self-performance and support needed with four ADLs: eating, 

bed mobility, toileting, and transfers. The score on the MDS for these four ADLs places 

the resident into a specific RUG. For example, a resident who requires 500 minutes of 

therapy and scores a 12 on the MDS for the ADLs would be assigned to RVB. (See 

Table 1.) 

Trends in RUGs for SNFS 2 OEI-02-01-00280 
Table 1 

Special Rehabilitation Category 

Sub-Category Therapy Minutes 

Required in the Last 

7 Days 

Score on the MDS 

of Four ADLs for 

each RUG 

Ultra-High 720 minutes RUC= 16 to 18 

RUB= 9 to 15 

RUA= 4 to 8 

Very-High 500 minutes or more RVC= 16 to 18 

RVB= 9 to 15 

RVA= 4 to 8 

High 325 minutes or more RHC= 16 to 18 

RHB= 9 to 15 

RHA= 4 to 8 

Medium 150 minutes or more RMC= 16 to 18 

RMB= 9 to 15 

RMA= 4 to 8 

Low 45 minutes or more RLB= 14 to 18 

RLA= 4 to 13 

Recent Legislation 

Since the passage of the BBA 1997, Congress has made several changes to PPS. In the 

Fall of 1999, Congress enacted the Balanced Budget Refinement Act (BBRA) in 

response to providers’ concerns that reductions in payments were too severe. The BBRA 

included a 4 percent across-the-board increase in payments to SNFs for Fiscal Years 

2001 and 2002 and a temporary 20 percent increase to 15 RUGs for patient conditions 

considered medically complex. These include all the RUGs in the clinically complex, 

special care, and extensive care categories as well as three RUGs in the special 

rehabilitation category (RMB, RHC, and RMC). In addition, several costly non-therapy 

ancillary services, including certain ambulance services, prostheses, and chemotherapy 

drugs, are excluded from the prospective payment system and paid for separately. The 

BBRA changes went into effect on October 1, 2000. (See Appendix B for an example of 

the changes in the payment rates under BBRA.) 

In 2000, Congress further adjusted the payment rates under the Benefits Improvement 

and Protection Act (BIPA). The BIPA increased the inflation update to the full market 

basket in Fiscal Year 2001 and raised the nursing component of the RUGs by 16.6 

Trends in RUGs for SNFS 3 OEI-02-01-00280 
percent in an effort to improve PPS nursing staff ratios. Additionally, the BBRA 20 

percent increase to the three rehabilitation RUGs was spread across all 14 special 

rehabilitation RUGs as a 6.7 percent increase. The other RUGs affected in the BBRA 

maintained the 20 percent increase. These changes went into effect on April 1, 2001. 

METHODOLOGY 

Using the Centers for Medicare and Medicaid Services’ (CMS) National Claims History 

File, we examined data for Medicare beneficiaries who were admitted to SNFs between 

January 1, 1999 and March 31, 2001. We reviewed the RUG code generated from the 

MDS assessment conducted at admission that is on the UB92 claim. We analyzed the 

proportion of Medicare beneficiaries in each of the 44 RUG codes and in each of the 7 

RUG categories by quarter beginning in January 1999. We specifically focused on 

changes in the special rehabilitation RUGs that may result from the BBRA legislation. 

Second, we examined select characteristics of the Medicare beneficiaries in our analysis. 

Specifically, we analyzed the CMS enrollment data including beneficiaries’ age, race, 

sex, and the reason for eligibility to assess whether changes in these characteristics are 

associated with trends in the RUGs. Note that another OIG inspection, Medicare 

Beneficiary Access to Skilled Nursing Facilities 2001, OEI-02-01-00160, addresses the 

clinical characteristics of beneficiaries admitted to SNFs. Included in that analysis is the 

proportion of Medicare beneficiaries discharged to SNFs and the length of hospital stays 

for these patients by key diagnosis related groups (DRGs). 

Limitations 

The changes to the payment rates legislated in the BIPA will not be implemented until 

April 1, 2001. This analysis is therefore limited to the changes SNFs make as they 

anticipate the reforms made in the BIPA legislation. 

The data in the most recent quarter, January to March 2001, are not as complete as the 

other data used in our analysis. These data may change based on additional and adjusted 

claims submitted over the next year. 

This inspection was conducted in accordance with the Quality Standards for 

Inspections issued by the President’s Council on Integrity an Efficiency. 

Trends in RUGs for SNFS 4 OEI-02-01-00280 
Trends in RUGs for SNFS 5 OEI-02-01-00280

FINDINGS

No major changes in RUG assignment since the implementation of

PPS 

Virtually no change in the proportion of residents assigned to the rehabilitation

RUGs

The proportion of Medicare residents assigned to RUGs in the rehabilitation category has

remained about the same since the implementation of PPS in January 1999. 

have been no large changes in the proportion of Medicare residents assigned to any of the

other RUG categories during this time period. 

special care, clinically complex, cognitively impaired, behavior problems, and reduced

physical functions. 

In the first quarter of 2001, about 78 percent of all Medicare residents were assigned to

one of the rehabilitation RUGs at admission. 

in the extensive care category and 5 percent were in the special care category. 

Figure 1.)

Figure 1

Source: National Claims History File

There also

These categories include: extensive care,

(See Appendix C.)

Another 13 percent were assigned to RUGs

(See
Trends in RUGs for SNFS 6 OEI-02-01-00280

Small shifts within the rehabilitation RUGs

Shifts have occurred in the proportion of residents assigned to the RUGs within the

rehabilitation category since the implementation of PPS in January 1999. 

residents who require therapy are coded in one of five sub-categories in the rehabilitation

category depending upon the amount of therapy they need. 

ultra high, very high, high, medium, and low. 

The proportion of Medicare residents coded in the high and medium therapy subcategories increased slightly in every quarter since the implementation of PPS. 

same time, the proportion of Medicare residents in the ultra high, very high, and low subcategories decreased in almost every quarter since the implementation of PPS. 

in Figure 2, the high and medium sub-categories increased from 53 percent to 61 percent

over the last 2 years, whereas the other three therapy sub-categories decreased from 23

percent to 17 percent during this time period.

Figure 2

Proportion of Medicare Residents in RUGs

Source: National Claims History File

Medicare

These sub-categories are:

At the

As shown
The Balanced Budget Refinement Act (BBRA) raised the payment rates for three RUGs 

within the high and medium therapy sub-categories: RHC, RMC, RMB. These changes 

may have created incentives for SNFs to put residents into these RUGs as opposed to 

other rehabilitation RUGs. 

Our analysis shows that the proportion of Medicare residents assigned in the three RUGs 

affected by the BBRA increased or remained about the same since the implementation of 

PPS in January 1999. Specifically, the proportion of residents coded in RHC increased 

from 15 to 19 percent, those coded in RMB rose from 8 to 9 percent, and those coded in 

RMC remained about the same at 5 percent from 1999 to 2001. The proportion of 

residents in the other RUGs in the high and medium therapy sub-categories that were not 

affected by the BBRA followed similar patterns in that they increased or remained stable. 

At the same time, the proportion of residents assigned to all the remaining RUGs in the 

ultra-high, very high, and low therapy sub-categories steadily decreased over the last 2 

years. It is important to note that the trends in the proportion of residents assigned to all 

of these RUGs have not changed since the BBRA became effective in October 2000. 

(See Appendix D.) 

No changes in the other RUGs 

The BBRA increased payment for each of the RUGs in the extensive care, special care, 

and clinically complex categories equally by 20 percent. In doing so, the law did not 

create incentives for SNFs to assign residents to one RUG as opposed to another. Our 

analysis shows minimal changes in the proportion of residents coded in each of the RUGs 

in these categories since the implementation of PPS. Specifically, the proportion of 

residents in each of these RUGs fluctuated by less than one percentage point in every 

quarter in the last 2 years. 

Beneficiary characteristics remain the same 

We found no substantial changes in the characteristics of Medicare beneficiaries who 

were admitted to SNFs since the implementation of PPS. Specifically, beneficiaries’ age, 

sex, race, and reason for Medicare eligibility are the same in every quarter since January 

1999. In the first quarter of 2001, the average age of SNF Medicare beneficiaries at 

admission was 80 years. About 66 percent of Medicare beneficiaries were female. 

Eighty-eight percent were white and nine percent were black. About 94 percent of 

beneficiaries were eligible for Medicare because of age without end stage renal disease. 

Trends in RUGs for SNFS 7 OEI-02-01-00280 
CONCLUSION 

While we identified small changes in the affected rehabilitation RUGs, it appears that 

these trends began prior to the BBRA. We will continue to monitor the trends in the 

proportion of Medicare residents assigned to each of the RUGs as new data become 

available. 

Trends in RUGs for SNFS 8 OEI-02-01-00280 
APPENDIX A 

Trends in RUGs for SNFS 9 OEI-02-01-00280 
APPENDIX B 

Comparison of RUG Rates for Urban Skilled Nursing Facilities 

RUG Original BBRA 

Payment* Payment** 

Revised 

RUC $384.21 $400.93 

RUB $345.90 $360.90 

RUA $327.28 $341.46 

RVC $296.15 $309.12 

RVB $286.30 $298.83 

RVA $261.12 $272.52 

RHC $271.53 $340.19 

RHB $249.64 $260.61 

RHA $228.84 $238.88

RMC $267.34 $334.96 

RMB $238.87 $299.27 

RMA $224.64 $234.52 

RLB $212.95 $222.39

RLA $179.01 $186.93

SE3 $252.91 $317.02 

SE2 $218.97 $274.46 

SE1 $194.88 $244.26 

SSC $190.50 $238.78 

SSB $181.74 $227.80 

SSA $177.36 $222.30 

CC2 $189.41 $237.41 

CC1 $175.18 $219.56 

CB2 $166.42 $208.58 

CB1 $158.75 $198.97 

CA2 $157.66 $197.60 

CA1 $148.90 $186.62 

*Published in the May 12, 1998 Federal Register 

** Calculated from the revised SNF payment rates released by the CMS on April 1, 2001 

http://www.hcfa.gov/medicare/snfppsuprate.htm 

***Highlighting indicates RUGs that were increased by the Balanced Budget Refinement Act 

Trends in RUGs for SNFS 10 OEI-02-01-00280 
The Proportion of Medicare Residents in Each

RUG Category at Admission by Quarter 

RUG 

CY 1999 CY2000 C

QTR 1 QTR 2 QTR 3 QTR 4 QTR 1 QTR 2 QTR 3 QTR 4 

Rehabilitation 76.5 77.0 77.0 76.3 76.2 76.4 76.6 77.3 Extensive 12.6 12.6 12.7 13.3 13.5 13.1 13.1 12.9 Care Special Care 5.6 5.4 5.4 5.3 5.2 5.3 5.2 4.9 ClinicallyComplex 

3.8 3.5 3.4 3.4 3.4 3.4 3.3 3.1 

CognitivelyImpaired 

.3 .3 .3 .4 .4 .4 .4 .4 

Behavior .04 .04 .1 .1 .1 .1 .1 .1 Problems Reduced 1.1 1.1 1.2 1.2 1.1 1.3 1.3 1.2 PhysicalFunctions Total 421,912 412,927 406,346 421,990 476,749 430,072 416,336 392,319 

Trends in RUGs for SNFs 11 
The Proportion of Medicare Residents in Each

RUG at Admission by Quarter 

CY 1999 CY 2000 C

RUG QTR 1 QTR 2 QTR 3 QTR 4 QTR 1 QTR 2 QTR 3 QTR 4 

RUA 1.2 1.0 0.9 0.7 0.7 0.7 0.6 0.6 

RUB 4.3 3.8 3.4 2.9 2.7 2.6 2.5 2.3 

RUC 1.1 0.9 0.8 0.7 0.7 0.7 0.6 0.6 

RVA 3.9 3.7 3.6 3.3 3.3 3.2 3.1 2.9 

RVB 10.1 10.0 9.9 9.4 9.2 8.7 8.7 8.3 

RVC 2.0 2.0 1.9 1.8 1.7 1.6 1.6 1.4 

RHA 6.1 6.1 6.1 6.0 6.2 6.2 6.1 6.2 

RHB 15.8 16.6 16.9 17.3 17.3 17.3 17.4 17.8 

RHC 15.0 15.7 16.3 16.9 16.9 17.5 17.9 18.9 

RMA 3.4 3.3 3.4 3.3 3.4 3.5 3.4 3.4 

RMB 8.2 8.3 8.3 8.4 8.5 8.9 9.1 9.4 

RMC 4.9 5.0 5.1 5.1 5.3 5.2 5.2 5.3 

RLA 0.3 0.3 0.2 0.2 0.2 0.2 0.2 0.2 

RLB 0.2 0.2 0.1 0.1 0.1 0.1 0.1 0.1 

*Highlighting indicates RUGs that were increased by the Balanced Budget Refinement Act 

Cont’d 

Trends in RUGs for SNFs 12 
 CY 1999 CY 2000 

RUG QTR 1 QTR 2 QTR 3 QTR 4 QTR 1 QTR 2 QTR 3 QTR 4 

SE1 0.4 0.4 0.4 0.5 0.4 0.5 0.4 0.4 

SE2 6.7 6.7 6.8 7.1 7.2 7.0 7.0 6.9 

SE3 5.5 5.5 5.4 5.8 5.9 5.6 5.7 5.5 

SSA 3.6 3.6 3.6 3.6 3.5 3.7 3.6 3.4 

SSB 1.2 1.1 1.1 1.1 1.1 1.0 1.0 0.9 

SSC 0.8 0.7 0.7 0.7 0.7 0.6 0.7 0.6 

CA1 1.7 1.5 1.5 1.5 1.5 1.5 1.4 1.4 

CB1 1.1 1.0 1.0 1.0 1.0 1.0 1.0 0.9 

CC1 0.4 0.3 0.3 0.3 0.3 0.3 0.3 0.3 

CA2 0.3 0.3 0.3 0.3 0.3 0.3 0.3 0.3 

CB2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 

IA1 0.1 0.1 0.1 0.1 0.2 0.2 0.2 0.2 

BA1 0.0 0.0 0.0 IB1 0.2 0.2 0.2 0.2 0.2 0.2 0.2 0.2 IA2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 IB2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

0.0 0.0 0.0 0.0 0.0 

*Highlighting indicates RUGs that were increased by the Balanced Budget Refinement Act 

Cont’d 

Trends in RUGs for SNFs 13 
 CY 1999 CY 2000 

RUG QTR 1 QTR 2 QTR 3 QTR 4 QTR 1 QTR 2 QTR 3 QTR 4 

BB1 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

BA2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

BB2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

PA1 0.4 0.3 0.4 0.4 0.3 0.4 0.4 0.4 

PB1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 

PC1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 

PD1 0.3 0.3 0.4 0.4 0.4 0.4 0.4 0.4 

PE1 0.1 0.1 0.2 0.2 0.2 0.2 0.2 0.2 

PA2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

PB2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

PC2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

PD2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

PE2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 

Other 0.1 0.1 0.1 0.1 0.1 0.1 0.1 0.1 

Total 421,912 412,927 406,346 421,990 476,749 430,072 416,336 392,319 

Trends in RUGs for SNFs 14