Specialized Rehabilitative Services ( 483.65) Presenter: Brandy Shumaker
Summary Current regulations at 483.45 set forth the services that a facility must provide if a resident needs specialized rehabilitative services. Following the reorganization, these existing provisions were relocated to 483.65 with minor revisions.
Summary CMS added respiratory therapy to the list of specialized rehabilitative services so that the needs of the resident are met and. Support the resident in attaining or maintaining their highest practicable physical, mental, and psychosocial well-being. The regulation requires that these services be provided in accordance with the resident s comprehensive assessment and plan of care.
Summary CMS urges facilities to use the facility-wide assessment that as a tool for appropriately assessing the resources necessary for providing care to its residents. Facilities should use this assessment to make decisions about their direct care staff needs as well as their capabilities to provide services to the residents in their facility.
Requirements F406 - Specialized Rehabilitative Services Provision of services. If specialized rehabilitative services such as but not limited to; Physical therapy Speech-language pathology Occupational therapy Respiratory therapy and Rehabilitative services
Requirements F406 - Specialized Rehabilitative Services Provision of services For mental illness and intellectual disability or services of a lesser intensity as set for at 483.120(c) (regarding expectations associated with PASSAR) are required in the resident s comprehensive plan of care, the facility must..
Requirements F406 - Specialized Rehabilitative Services Provide the required services; or In accordance with Administrative requirements at 487.30(g), obtain the required services from an outside resource that is a provider of specialized rehabilitative services and is not excluded from participating in any federal or state health care programs pursuant to section 1128 and 1156 of the Act.
Requirements F407 - Specialized Rehabilitative Services Qualifications Specialized rehabilitative services must be provided under the written order of a physician qualified personnel.
Implementation Deadlines Specialized Rehabilitative Services Phase 1: November 28, 2016
Market Analytics Hospital VBP Hospital readmission penalty by pulmonary DRG
Market Analytics Pulmonary DC s by DRG
Work group probes Review scope of practice for licensed nurses and respiratory therapists to determine which respiratory needs can be met safely and within scope of nursing Obtain respiratory therapy services either internally or externally May be full-time, part-time, or contract basis depending on facility/ resident need May need to develop or obtain a job description for respiratory therapist
Work group probes Assess internal or external (contractor) capabilities of providing respiratory therapy services within their community What are necessary steps to secure such services needed? Marketing opportunities/market analytics for pulmonary program Meeting with upstream partners to determine need of bigger program
Questions?
Resources https://www.advisory.com/ https://vantagecps.avalere.com/vantagecps2/rdpage.aspx?rdreport =Analytics.PatientMovement https://vantagecps.avalere.com/vantagecps2/rdpage.aspx?rdreport =Analytics.PatientMovement https://www.federalregister.gov/documents/2016/10/04/2016-23503/medicare-and-medicaid-programs-reform-of-requirementsfor-long-term-care-facilities#h-136