Ask Proactive – Can a resident be on both restorative and therapy at the same time?

Can a resident be on both restorative and therapy at the same time?

A:

Yes. Facilities may elect to have licensed rehabilitation professionals perform skilled therapeutic interventions that constitute a high level of complexity, or train aides in individualized programming for restorative / maintenance services.  For example, the PT may address higher level balance challenges and navigating stairs management, while lesser skilled interventions such as AROM exercises and ambulation are transitioned to a restorative nursing program.   In situations where such services do not actually require the involvement of a qualified therapist, the services may not be coded as therapy in item O0400, Therapies or O0425, Part A Therapies, because the specific interventions are considered restorative nursing services. Although therapists may participate, members of the nursing staff are still responsible for overall coordination and supervision of restorative nursing programs. Keep in mind, the two disciplines should be working towards/on different goals. The clinical judgement of the therapists and the Restorative Nursing Manger will be critical to avoid unapproved overlaps in the delivery of service and to provide substantive documentation to demonstrate the need for RNPs concurrently with therapy services.