Resource Utilization Group (RUG) Training

NF - Medicaid Fraud for Nursing Facilities Training

Per 1 Texas Administrative Code §371.214, a nursing facility registered nurse (RN) assessment coordinator who signs the Long-Term Care Medicaid Information (LTCMI) or successor form or certifies the completeness of a Minimum Data Set (MDS) assessment for Medicaid reimbursement must, at the time of signing, be current on his or her HHSC-approved RUG, or other HHSC-required, training. 

 Waivers - Medical Necessity & Level of Care Assessment for Community Services 

The STAR+PLUS contract requires Service Coordinators who conduct the Medical Necessity/Level of Care Assessment for STAR+PLUS HCBS eligibility to be RUG-Certified. The STAR Health and STAR Kids contracts require all MCO staff or MCO-contracted staff administering the MDCP portion of the SAI to be RUG-certified. 

The current process of accessing the trainings and receiving a 2-year certification through Texas State University (TXST) will be changing. 

No later than September 1, 2025, and to align with the implementation of the new PDPM LTC methodology, OIG and HHSC will host the trainings (exact location to be determined). The updated trainings hosted by OIG will be available to participants at no cost. Information and links for the trainings will be sent out at a later date.

June 16, 2025 – Access to the TXST RUG training ends.

• After June 16, 2025, nurse assessors attempting to register for the training will be directed to complete a form and will be asked to provide OIG with information such as: First name, Last name, license #, license state, email address and course selection, Community Services-Waivers or Nursing Facility. 
• Certifications will not lapse during this changeover period. If participants have a certification that expires June 16, 2025 – August 31, 2025, they will be directed to complete the form and will be granted an extension of 90 days beyond September 1, 2025.
• If new nurse assessors need to take the training for the first time between June 16, 2025 – August 31, 2025, the individual will fill out the form on the TXST website and will be added to the certification file so they may submit assessments during the transition. 
• You will need to confirm that you are currently in a role that requires you to be certified in accordance with 1 TAC §371.214, as the extensions apply to those who are required to be certified to submit the LTCMI or certify completeness of an MDS assessment.

Beginning September 1, 2025:

• PDPM training will be available through OIG.
• The interim process for completing a form described in the section above will end.
• Nurse assessors and MCO service coordinators will access and complete PDPM LTC trainings through OIG as their current RUG certification period ends.
• The training materials will be available at no cost for participants to review.
• Certificates will not be issued from the training.
• New nurse assessors and MCO service coordinators who were added to the certification file between June 16, 2025 – August 31, 2025, are expected to complete the new training within 90 days after September 1, 2025.
• Individuals with a certification that expires September 2025 – November 2025 are expected to complete the new training within 90 days after September 1, 2025.

For all questions or concerns as relates to Medicaid Fraud for Nursing Facilities PDPM LTC training please reach out to OIG_UR@hhs.texas.gov.

For questions about the PDPM LTC training for STAR+PLUS HCBS and MDCP email Managed_Care_Initiatives@hhs.texas.gov. 

TXST RUG is open Monday through Friday, 9 am to 4 pm CST. 

• No emails, registrations, certificates or TMHP updates are done outside of these hours
• Anything received outside of normal business hours will be answered the next business day
• TXST RUG follows the Texas State University Holiday Schedule
  • Closed for Winter and Spring Break, and all national holidays
• Questions: txstrug@txstate.edu