Page 18 - Rehab Orientation Manual 4 04 19-updated_Neat

and periodic reassessment of the patient’s needs, and consistent with the
patient’s capacity and tolerance.
For example, a patient diagnosed with Parkinson’s disease who has not
been under a rehabilitation regimen may require the services of a
qualified therapist to determine what type of exercises will contribute the
most to the maintenance of his present level of functioning.”
iv. Maintenance therapy is
a. Designing and setting up a maintenance program
b. Instructing patient, family and Home Health Aides in the
program (not Home Health Aide only)
c. Infrequently re-evaluating the program and/or the patient
d. REQUIRES the specialized knowledge, skill and judgment of
the therapist (PT, OT, SLP)
v. Creating a therapy program to:
a. Maintain current functional level
b. Decrease amount of assistance needed from caregivers at
current functional level
c. Increase safety at current functional level
d. Identify needed assistive devices/aids to maintain current
functional level
e. Instruct caregivers in proper participation with current
functioning
vi. Maintenance therapy would:
a. Be determined with the MD – both therapist and MD need
to agree that there is no expectation of improvement in
condition (no restorative therapy needs) and that agreement
should be documented in a COC note.
b. Documentation would show skilled maintenance and use the
Maintenance purpose of visit code.

VNSNY CRITERIA FOR ADMISSION

1. Patient resides within the service area: 5 boroughs of NYC, Nassau, Suffolk, and
Westchester counties.
2. Patient is under the care of a physician overseeing the plan of care
3. Patient is able and willing to participate and cooperate in carrying out the plan of care; if the
patient is unable, a mutual care agreement is needed – a form signed by a family member or
caregiver assuming responsibility for participation in the plan of care and ensuring the
patient’s safety in the home in the absence of VNSNY personnel.
4. Patient with Medicare must be home bound:
a. Patient leaves the home infrequently with “considerable and taxing” effort.
b. Patient may leave home for religious services.
c. Patient may leave home for adult day care program.
d. Patient may leave home for medical care.
e. Patient may leave home for beautician and appointments.
5. Presence of a physical or cognitive problem.

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