The RUG-III case mix classification system for long-term care nursing facilities: is it adequate for nurse staffing?

The purpose of this study was to explore the validity of the nursing time associated with the Resource Utilization Group Version III (RUG-III) case mix classification system by determining its potential usefulness for making nurse staffing decisions in long-term care (LTC) facilities. Experts in LTC nursing administration were asked to determine the amount of nursing time required by nursing home residents. The estimates were significantly higher than the RUG-III nursing time for all case mix groups. This finding suggests that the nursing time associated with the RUG-III system may not meet the needs of nursing home residents if used as a basis for nurse staffing. Further analysis questions the wisdom of mandating minimum staffing standards for LTC facilities without taking into account the individual needs of residents.