Ask Diane: Can rehab and restorative nursing provide duplicative services?
Q: A resident covered by Medicare Part B is picked up by rehab. However, the resident is also on restorative nursing programs that duplicate the services being provided by rehab. Do the restorative nursing programs need to be held until the resident is discontinued from therapy?
Diane: The restorative nursing and rehab teams need to determine, through assessment, if there are different goals the restorative nursing team can work on that would benefit the resident. If not, then they should wait until the Part B rehab is completed and then pick up the resident on restorative nursing programs, if it is warranted.
In some situations, it can be appropriate for both restorative and rehab to be treating the resident, but they must be working on different aspects and have different goals that are compatible rather than duplicative.
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Diane Brown
Diane Brown is a long-term care regulatory specialist and lead educator for HCPro's MDS 3.0 Boot Camp and Medicare Boot Camp-Long-Term Care Version. She is also a long-term care consultant with over 25 years of operational experience in healthcare. For Diane's complete bio, visit the About page.
Diane has written 240 posts.
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I am currently studying for the NLN CNE certificaion exam, this blog contents was recommended as a resource and it has been very helpful in preparation for the exam. It is not only an excellent resource for the exam, but also an excellent resource for the novice nurse educator. For those of us in nursing education for a number of years, this blog is excellent at refreshing us and providing new ideas and innovations in nursing
If indeed, as written, both restorative and rehab were working on the same issues, lets say ambulation skills, then Rehab should not be involved as it would not meet Medical Necessity criteria, in that only a Professional nurse or therapist could provide the service. If the services can be provided by restorative aides safely, then the professsional skills of the therapist would not be needed.
Is nursing restorative required in a nursing home setting? I currently run a restorative program at a 462 bed facility with 5 aides. I was wondering if it is required or just an “added bonus” to the facility.
Hi Ron,
There are two issues to discuss related to your question. From the MDS Manual in Section P3: Rehabilitative and restorative care refers to nursing interventions that promote the resident’s ability to adapt and adjust to living as independently as possible. This concept actively focuses on achieving and maintaining optimal physical, mental, and psychosocial functioning. There is a direct relationship between the MDS manual intent and the quality of care survey tags F309 and F310. Therefore, when necessary and appropriate restorative nursing must be provided.
The second issue relates to the MDS coding of P3. Even if restorative nursing interventions are provided, in order to code them, you must follow the instructions in the manual.
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