Nursing homes and other healthcare facilities must now ensure that specialized rehabilitative services, such as physical, occupational, speech, and respiratory therapy, are provided under the written order of a physician or therapist, as delegated by the physician, and are provided by qualified personnel. Qualified personnel include physical therapists, occupational therapists, respiratory therapists, speech-language pathologists, physicians, nurse practitioners, clinical nurse specialists, or physician’s assistants, as well as physical therapist assistants and occupational therapy assistants when providing services under the supervision of a qualified therapist. These personnel must have the training and competencies necessary to care for residents as identified through resident assessments and described in the plan of care. Facilities must also ensure that personnel providing these services meet the specific competency requirements of their license and certification, and any other requirements established by state law or regulations. Facilities must also ensure that personnel providing services under Medicare Part B have a physician or recognized non-physician practitioner sign and date the plan of care. In addition, if there are differences between federal and state supervision requirements, the requirement with the greater level of supervision will apply. Nursing homes and other healthcare facilities must now ensure they are compliant with these new requirements or face potential citations.

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