[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR412.29]



[Page 475]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 412_PROSPECTIVE PAYMENT SYSTEMS FOR INPATIENT HOSPITAL SERVICES

--Table of Contents

 

Subpart B_Hospital Services Subject to and Excluded From the Prospective 

  Payment Systems for Inpatient Operating Costs and Inpatient Capital-

                              Related Costs

 

Sec. 412.29  Excluded rehabilitation units: Additional requirements.



    In order to be excluded from the prospective payment systems 

described in Sec. 412.1(a)(1) and to be paid under the prospective 

payment system specified in Sec. 412.1(a)(3), a rehabilitation unit 

must meet the following requirements:

    (a) Have met either the requirements for--

    (1) New units under Sec. 412.30(a); or

    (2) Converted units under Sec. 412.30(c).

    (b) Have in effect a preadmission screening procedure under which 

each prospective patient's condition and medical history are reviewed to 

determine whether the patient is likely to benefit significantly from an 

intensive inpatient program or assessment.

    (c) Ensure that the patients receive close medical supervision and 

furnish, through the use of qualified personnel, rehabilitation nursing, 

physical therapy, and occupational therapy, plus, as needed, speech 

therapy, social services or psychological services, and orthotic and 

prosthetic services.

    (d) Have a plan of treatment for each inpatient that is established, 

reviewed, and revised as needed by a physician in consultation with 

other professional personnel who provide services to the patient.

    (e) Use a coordinated multidisciplinary team approach in the 

rehabilitation of each inpatient, as documented by periodic clinical 

entries made in the patient's medical record to note the patient's 

status in relationship to goal attainment, and that team conferences are 

held at least every two weeks to determine the appropriateness of 

treatment.

    (f) Have a director of rehabilitation who--

    (1) Provides services to the unit and to its inpatients for at least 

20 hours per week;

    (2) Is a doctor of medicine or osteopathy;

    (3) Is licensed under State law to practice medicine or surgery; and

    (4) Has had, after completing a one-year hospital internship, at 

least two years of training or experience in the medical management of 

inpatients requiring rehabilitation services.



[50 FR 12741, Mar. 29, 1985, as amended at 57 FR 39821, Sept. 1, 1992; 

59 FR 45397, 45400, Sept. 1, 1994; 60 FR 45847, Sept. 1, 1995; 66 FR 

41387, Aug. 7, 2001; 68 FR 45699, Aug. 1, 2003; 69 FR 66976, Nov. 15, 

2004]