[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: 42CFR485.729]



[Page 636-637]

 

                         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.  485.729  Condition of participation: Program evaluation.



    The organization has procedures that provide for a systematic 

evaluation of its total program to ensure appropriate



[[Page 637]]



utilization of services and to determine whether the organization's 

policies are followed in providing services to patients through 

employees or under arrangements with others.

    (a) Standard: Clinical-record review. A sample of active and closed 

clinical records is reviewed quarterly by the appropriate health 

professionals to ensure that established policies are followed in 

providing services.

    (b) Standard: Annual statistical evaluation. An evaluation is 

conducted annually of statistical data such as number of different 

patients treated, number of patient visits, condition on admission and 

discharge, number of new patients, number of patients by diagnosis(es), 

sources of referral, number and cost of units of service by treatment 

given, and total staff days or work hours by discipline.



[41 FR 20865, May 21, 1976. Redesignated at 42 FR 52826, Sept. 30, 1977. 

Further redesignated and amended at 60 FR 2326-2327, 2329, Jan. 9, 1995]