Current through Register Vol. 56, No. 24, December 18, 2024
(a)
Rehabilitative services include physical therapy, occupational therapy and
speech-language pathology services provided by a qualified therapist for the
purpose of attaining maximum reduction of physical or mental disability and
restoration of the resident to his or her best functional level. Rehabilitative
services shall be made available to Medicaid beneficiaries as an integral part
of an interdisciplinary program. Rehabilitative services shall not include
physical medicine procedures administered directly by a physician, or physical
therapy, which is purely palliative, such as the application of heat per se, in
any form; massage; routine calisthenics or group exercises; assistance in any
activity; use of a simple mechanical device; or other services not requiring
the special skill of a qualified therapist.
1. If the attending physician orders an
evaluation for physical, speech-language pathology services or occupational
therapy, an appropriately qualified therapist shall perform an assessment to
determine the need for services. The therapist shall complete a written report
of therapy recommendations within 14 days of the physician's order and shall
include the report in the clinical record, for review by the attending
physician.
2. Rehabilitative
treatment shall be provided under the direct supervision and in the presence of
a qualified therapist or physiatrist, only upon the written signed order of the
physician who shall indicate modality and frequency and duration of treatments.
The attending physician shall evaluate each resident's response to therapeutic
services on a monthly basis. Continuance of said services shall be based on
documentation of a potential for significant functional improvement within a
reasonable time frame.
i. Rehabilitation
therapy services shall be integrated with medical, nursing, recreational and
social services to promote development or restoration of the resident to
his/her maximum potential and reviewed in conjunction with other periodic
reviews of the interdisciplinary care plan.
3. Rehabilitative services shall be provided
by qualified therapists employed by or under contract to:
i. An approved home health agency;
ii. A licensed or accredited general or
special hospital;
iii. An approved
independent outpatient health facility; or
iv. An NF.
