What determines the daily rate that a Skilled Nursing Facility will be paid?

• A. Resource Utilization Groups.
• B. Patient age.
• C. Facility location.
• D. Type of primary diagnosis.

Answer: (A)

The daily rate paid to a Skilled Nursing Facility is driven by Resource Utilization Groups. RUGs classify residents based on how much care they actually need, using data from the MDS assessment such as activities of daily living, nursing hours, and therapy minutes. The more intensive the resource needs, the higher the RUG category and the higher the per‑diem rate. Age, facility location, or the specific primary diagnosis do not by themselves determine the daily rate; they may influence care plans, but the payment is tied to resource intensity captured by the RUG classification. For example, a resident needing extensive rehab and substantial nursing care will be in a higher-RUG category with a higher daily rate than someone needing only minimal services.