The facility receives a specific payment for each day a resident is at a RUG-III determined level of care. How the money is spent is up to the facility, as long as the resident receives all needed care. The PPS system was designed to be self-balancing with care, quality, and payment based on the same tool. Any such pressure must be rejected. Nurses must understand the process of both resident assessment and prospective payment to insure appropriate care, appropriate payment, and to avoid potential pitfalls.
Professional practice is the only winning strategy.