[Code of Federal Regulations]

[Title 42, Volume 4]

[Revised as of October 1, 2006]

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

[CITE: 42CFR485.711]



[Page 632]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 485_CONDITIONS OF PARTICIPATION: SPECIALIZED PROVIDERS--Table of 

 

   Subpart H_Conditions of Participation for Clinics, Rehabilitation 

Agencies, and Public Health Agencies as Providers of Outpatient Physical 

             Therapy and Speech-Language Pathology Services

 

Sec.  485.711  Condition of participation: Plan of care and physician 



involvement.



    For each patient in need of outpatient physical therapy or speech 

pathology services there is a written plan of care established and 

periodically reviewed by a physician, or by a physical therapist or 

speech pathologist respectively. The organization has a physician 

available to furnish necessary medical care in case of emergency.

    (a) Standard: Medical history and prior treatment. The following are 

obtained by the organization before or at the time of initiation of 

treatment:

    (1) The patient's significant past history.

    (2) Current medical findings, if any.

    (3) Diagnosis(es), if established.

    (4) Physician's orders, if any.

    (5) Rehabilitation goals, if determined.

    (6) Contraindications, if any.

    (7) The extent to which the patient is aware of the diagnosis(es) 

and prognosis.

    (8) If appropriate, the summary of treatment furnished and results 

achieved during previous periods of rehabilitation services or 

institutionalization.

    (b) Standard: Plan of care. (1) For each patient there is a written 

plan of care established by the physician or by the physical therapist 

or speech-language pathologist who furnishes the services.

    (2) The plan of care for physical therapy or speech pathology 

services indicates anticipated goals and specifies for those services 

the--

    (i) Type;

    (ii) Amount;

    (iii) Frequency; and

    (iv) Duration.

    (3) The plan of care and results of treatment are reviewed by the 

physician or by the individual who established the plan at least as 

often as the patient's condition requires, and the indicated action is 

taken. (For Medicare patients, the plan must be reviewed by a physician, 

nurse practitioner, clinical nurse specialist, or physician assistant at 

least every 30 days, in accordance with Sec.  410.61(e) of this 

chapter.)

    (4) Changes in the plan of care are noted in the clinical record. If 

the patient has an attending physician, the therapist or speech-language 

pathologist who furnishes the services promptly notifies him or her of 

any change in the patient's condition or in the plan of care.

    (c) Standard: Emergency care. The organization provides for one or 

more doctors of medicine or osteopathy to be available on call to 

furnish necessary medical care in case of emergency. The established 

procedures to be followed by personnel in an emergency cover immediate 

care of the patient, persons to be notified, and reports to be prepared.



[54 FR 38679, Sept. 20, 1989. Redesignated and amended at 60 FR 2326, 

2327, Jan. 9, 1995; 63 FR 58913, Nov. 2, 1998]



[[Page 633]]